Jaime Delgadillo

Jaime Delgadillo
The University of Sheffield | Sheffield · Department of Psychology (Faculty of Science)

PhD

About

97
Publications
46,402
Reads
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2,113
Citations
Citations since 2016
82 Research Items
2027 Citations
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20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
Introduction
My work focuses on the treatment of depression, anxiety and addiction problems. I am particularly interested in understanding individual differences in treatment response, in order to personalize mental health care.
Additional affiliations
April 2018 - present
Rotherham Doncaster and South Humber NHS Foundation Trust
Position
  • Director of Psychological Therapies Research

Publications

Publications (97)
Article
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Background: Previous research suggests that using outcome feedback technology can enable psychological therapists to identify and resolve obstacles to clinical improvement. This study aimed to evaluate the effectiveness of an outcome feedback quality assurance system applied in stepped care psychological services. Methods: This multi-site cluster r...
Article
Risk and prognosis are central concepts in precision medicine, referring to the probability of future outcomes in people with a particular health condition. Prognosis research has a long history in epidemiology, medicine, and public health. According to the PROGnosis RESearch Strategy (PROGRESS) framework,¹ there are 4 broad types of prognostic res...
Article
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IMPORTANCE: Depression is a major cause of disability worldwide. Although empirically supported treatments are available, there is scarce evidence on how to effectively personalize psychological treatment selection. OBJECTIVE: To compare the clinical effectiveness and cost-effectiveness of 2 treatment selection strategies: stepped care and stratifi...
Article
Background: Occupational burnout is highly prevalent in the mental healthcare workforce and associated with poorer job satisfaction, performance and outcomes. Aims: To evaluate the effects of the Mind Management Skills for Life Programme on burnout and wellbeing. Methods: N=173 mental health nurses were recruited from the English National Health...
Article
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Background: Approximately 1.5 million referrals are made to Improving Access to Psychological Therapy (IAPT) services annually. However, treatment is received in less than half of cases due to ineligibility or non-attendance. The aim was to explore risk factors for non-attendance at the initial two IAPT appointments following referral. Methods: An...
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The Dysfunctional Attitude Scale (DAS; Weissman, 1979) measures depression related enduring beliefs and is one of the core measures of cognitive behavioral (CBT) research and theory. It has been the central marker of etiological claims of CBT, and so any change to the understanding of the composition of the DAS would have potentially far-reaching i...
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Purpose: This review presents a comprehensive evaluation of the effectiveness of routinely delivered psychological therapies across inpatient, outpatient and University-based clinics. Methods: This was a pre-registered systematic-review of studies meeting pre-specified inclusion criteria (CRD42020175235). Eligible studies were searched in three dat...
Article
Background: Early dropout hinders the effective adoption of brief psychological interventions and is associated with poor treatment outcomes. This study examined if attendance and depression treatment outcomes could be improved by matching patients to either face-to-face or computerized low-intensity psychological interventions. Methods: Archival...
Article
Currently, no reports exist on the phenomenon of early response in humanistic-experiential therapies. This study investigated the prognostic value of early response on posttreatment outcomes in person-centered experiential therapy (PCET) for depression within the English Improving Access to Psychological Therapies program. The design of the study w...
Chapter
Computers are capable of learning how to solve complex problems. The emergence of machine learning (ML) represents a major advance for the field of mental health. ML algorithms can be trained to recognize subgroups of people with similar symptoms (diagnosis), to estimate the probability of recovery from these symptoms (prognosis), to make a judgeme...
Article
Objective: Some psychotherapists are more effective than others, which means that patients' treatment outcomes partly depend on therapist effects (TEs). This study investigated whether the use of progress feedback influences TE. Method: Data from N = 4,549 participants and 131 therapists across six clinical trials of progress feedback were analy...
Article
Outcome measurement in the field of psychotherapy has developed considerably in the last decade. This review discusses key issues related to outcome measurement, modeling, and implementation of data-informed and measurement-based psychological therapy. First, an overview is provided, covering the rationale of outcome measurement by acknowledging so...
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Dropout during psychological intervention is a significant problem. Previous evidence for associations with socioeconomic deprivation is mixed. This study aimed to review the evidence for associations between deprivation and dropout from contemporary adult psychological interventions for common mental disorders (CMDs). Systematic review, narrative...
Article
Objective: To provide a comprehensive assessment of the association between psychological treatment adherence/competence/integrity (ACI) and clinical outcomes. Method: The review protocol was preregistered (CRD42020193889). Studies that assessed ACI-outcome relationships for adult psychotherapy were searched across three databases (Scopus, PsycI...
Article
Background One in two patients seeking help for substance use disorders (SUDs) has clinically significant depression symptoms. This co-occurrence impairs treatment outcomes, but limited evaluation of the implementation of evidence-based interventions has taken place. Methods This pilot randomized controlled trial (RCT) assessed the feasibility and...
Article
Objective: The Personalized Advantage Index (PAI) is a method to guide treatment selection by investigating which of two or more treatments is optimal for a given individual. Recently, it was shown that, on average, twice-weekly sessions of psychotherapy for depression lead to better outcomes compared to once-weekly sessions. The present study app...
Article
Background: Prior research indicates that patients’ personality traits are associated with psychotherapy processes and outcomes. However, the potential relevance of the therapist’s personality traits is less understood. Methods: This is a scoping review of studies investigating associations between therapists’ personality traits with treatment pro...
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Objectives: To investigate associations between alcohol use, psychological treatment attendance and clinical outcomes. Methods: We analysed electronic health records for N=7,986 patients accessing psychological treatment for common mental disorders. Data were collected for pre-treatment alcohol use (average units per week) and severity of dependenc...
Article
Background: In theory, depression is thought to be associated with deficits in adaptive and excesses in maladaptive coping strategies. This study aimed to investigate associations between coping strategies and depression treatment outcomes. Method: Participants (N = 126) completed measures of adaptive and maladaptive coping strategies before and af...
Chapter
This chapter addresses fundamental issues of change in psychotherapy: how to measure, monitor, predict change, and provide feedback on treatment outcome. The chapter starts with a historical overview, covering several approaches applied to measure change in psychotherapy research. We proceed with a description of classical concepts to evaluate chan...
Chapter
In the modern history of psychotherapy, understanding the individual patient and how to optimize treatment for each individual has been an important challenge. For the therapist, personalization often has meant deciding which treatments to offer based on clinical assessment and formulation, or deciding moment-to-moment what techniques to employ, gi...
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Background: Depression is a heterogeneous condition, with multiple possible symptom-profiles leading to the same diagnosis. Descriptive depression subtypes based on observation and theory have so far proven to have limited clinical utility. Aim: To identify depression subtypes and to examine their time-course and prognosis using data-driven meth...
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Background: Previous reviews indicate that depressed patients with a comorbid personality disorder (PD) tend to benefit less from psychotherapies for depression and thus personality pathology needs to be the primary focus of treatment. This review specifically focused on Cognitive Behavioural Therapy (CBT) studies examining the influence of comorbi...
Article
For many years, psychiatrists have tried to understand factors involved in response to medications or psychotherapies, in order to personalize their treatment choices. There is now a broad and growing interest in the idea that we can develop models to personalize treatment decisions using new statistical approaches from the field of machine learnin...
Article
Background Feedback-informed treatment (FIT) involves using computerized routine outcome monitoring technology to alert therapists to cases that are not responding well to psychotherapy, prompting them to identify and resolve obstacles to improvement. In this study, we present the first health economic evaluation of FIT, compared to usual care, to...
Article
Early response is a well-established predictor of positive outcomes at the end of psychological treatments for common mental disorders. There is some prior evidence that this conclusion also applies to eating disorders, including three meta-analyses, but no moderators of that relationship have been identified. However, a number of further papers ha...
Article
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Objectives. This review sought to evaluate the effectiveness of the ‘Stress Control’ (SC) large psychoeducational 6-session group programme developed to increase access to treatment for patients with anxiety and depression. Design. Systematic review and meta-analysis (Prospero registration:CRD42020173676). Methods. Pre–post and post-treatment follo...
Article
Background Depression often co-occurs with substance use problems and is associated with poor treatment outcomes. While the efficacy of behavioral activation (BA) has been tested in clinical trials with substance users, outcomes have not yet been quantitatively synthesized. Methods The study team performed a random effects meta-analysis of the ran...
Article
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Background: This was a multi-site evaluation of psycho-educational transdiagnostic seminars (TDS) as a pre-treatment intervention to enhance the effectiveness and utilisation of high intensity cognitive-behavioural therapy (CBT). Aims: To evaluate the effectiveness of TDS combined with high intensity CBT (TDS+CBT) versus a matched sample receiving...
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Video abstract: https://www.youtube.com/watch?v=odRicwO-GsY Background: Common mental disorders can be effectively treated with psychotherapy, but some patients do not respond well and require timely identification to prevent treatment failure. We aimed to develop and validate a dynamic model to predict psychological treatment outcomes, and to com...
Article
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Objectives: To investigate the effectiveness of an 8-session cognitive analytic therapy (CAT) protocol for patients with anxiety and depression in the context of relational problems, personality disorder traits, or histories of adverse childhood experiences and then to compare outcomes with cognitive behavioural therapy (CBT). Methods: The study...
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Background: Whilst the delivery of low-intensity group psychoeducation is a key feature of the early steps of the Improving Access to Psychological Therapies (IAPT) programme, there is little consensus regarding the skills and competencies demanded. Aims: To identify the competencies involved in facilitating CBT-based group psychoeducation in order...
Article
Objective: Low-intensity cognitive behavioural therapy (LiCBT) can help to alleviate acute symptoms of depression and anxiety, but some patients relapse after completing treatment. Little is known regarding relapse risk factors, limiting our ability to predict its occurrence. Therefore, this study aimed to develop a dynamic prediction tool to ident...
Article
Cognitive behavioural therapy (CBT) is an effective psychological treatment for anxiety-related disorders (anxiety disorders, post-traumatic stress disorder, and obsessive-compulsive disorder). However, relapse of anxiety symptoms is common following completion of treatment. This study aimed to identify predictors of relapse of anxiety after CBT fo...
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This editorial article is a primer on key concepts and considerations for the quality appraisal of studies applying Machine Learning methods in the field of psychotherapy and mental health research.
Article
Background: Managing the alliance is considered to be a core competency and central therapeutic change process during cognitive analytic therapy (CAT). This study examined latent trajectories of change in the alliance and their relationship to depression treatment outcomes. Design: Secondary analysis of a randomised controlled trial. Methods: A sam...
Article
The “Good-Enough Level” (GEL) model proposes that people respond differentially to psychotherapy, and that the typical curvilinear “dose-response” shape of change may be an artefact of aggregation. We conducted a systematic review and meta-analysis of the GEL literature to examine 1) whether different sub-groups of adults accessing psychotherapy re...
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Objective: The Coronavirus Disease (COVID-19) pandemic and related lockdown measures have raised important questions about the impact on mental health. This study evaluated several mental health and well-being indicators in a large sample from the United Kingdom (UK) during the COVID-19 lockdown where the death rate is currently the highest in Euro...
Article
Objective: Many patients relapse within one year of completing effective cognitive behavioural therapy (CBT) for depression and anxiety. Residual symptoms at treatment completion have been demonstrated to predict relapse, and so this study used network analyses to improve specificity regarding which residual anxiety and depression symptoms predict...
Article
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Objectives Improving Access to Psychological Therapies (IAPT) is a national‐level dissemination programme for provision of evidence‐based psychological treatments for anxiety and depression in the United Kingdom. This paper sought to review and meta‐analyse practice‐based evidence arising from the programme. Design A pre‐registered (CRD42018114796...
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(Open access: https://www.karger.com/Article/FullText/507793) Deciding on the number of psychotherapy sessions to satisfactorily treat a patient is a vital clinical as well as economic issue in most mental health systems worldwide. Based on a systematic review, we identified 20 naturalistic samples across 8 countries (published between 2015-2019)....
Article
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Objective: Psychotherapy outcomes vary between therapists, but it is unclear how such information can be used for treatment planning or practice development. This proof-of-concept study aimed to develop a data-driven method to match patients to therapists. Methods: We analyzed data from N=4,849 patients who accessed cognitive behavioral therapy in...
Article
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Within the Routine Outcome Monitoring System “OQ-Analyst”, the questionnaire “Assessment for Signal Cases” (ASC) supports therapists in detecting potential reasons for not-on-track trajectories. Factor analysis and a machine learning algorithm (LASSO with 10-fold cross-validation) were applied and potential predictors of not-on-track classification...
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Background: Cognitive behavioural therapy (CBT) is effective for the treatment of common mental health problems, but the number of sessions required to maximise improvement in routine care remains unclear. Aim: This study aimed to examine the dose-response effect in low (LiCBT) and high (HiCBT) intensity CBT delivered in stepped care services. Me...
Article
Aim: To investigate if therapists’ personality influences their patients’ treatment outcomes. Methods: N = 4,052 patients were treated by 69 therapists, including 36 Psychological Wellbeing Practitioners (PWPs) and 33 Cognitive Behavioural Therapists (CBTs). Therapists completed the NEO-PI-R personality inventory, they reported years of clinical ex...
Article
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Clinical guidelines for the treatment of depression and anxiety recommend psychological interventions organised in a stepped care model, where patients initially access low intensity guided self-help followed by high intensity psychotherapies if their symptoms persist. The Leeds Risk Index (LRI) is a data-driven tool that enables clinicians to prof...
Article
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Objective: Depression is a highly common mental disorder and a major cause of disability worldwide. Several psychological interventions are available, but there is a lack of evidence to decide which treatment works best for whom. This study aimed to identify subgroups of patients who respond differentially to cognitive behavioural therapy (CBT) or...
Article
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Background: Previous studies indicate that early symptomatic improvement, typically observed during the first 4 weeks of psychological therapy, is associated with positive treatment outcomes for a range of mental health problems. However, the replicability, statistical significance, and magnitude of this association remain unclear. Aim: The curr...
Article
Aim: Socioeconomic deprivation is known to be associated with depression and anxiety symptoms. This study aimed to investigate the influence of several domains of neighbourhood deprivation on psychological treatment outcomes. Method: Healthcare records from 44805 patients who accessed psychological treatment were analysed. Patient-level depression...
Article
Aim: The study aimed to investigate the impact of socio-demographic similarity on the probability of attending an adequate dose of a psychoeducational group intervention (≥4 of 6 sessions). Method: The sample comprised 2071 patients (63% female, 93% White, 15% unemployed, mean age 43) who received the Stress Control intervention in the UK’s nation...
Article
The dose-response effect refers to the relationship between the dose (e.g., length, frequency) of treatment and the subsequent probability of improvement. This systematic review aimed to synthesise the literature on the dose-response effect in routine psychological therapies delivered to adult patients with mental health problems. Twenty-six studi...
Article
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Background Cognitive behavioural therapy (CBT) is an effective psychological treatment for major depressive disorder, although some patients experience a return of symptoms after finishing therapy. The ability to predict which individuals are more vulnerable to deterioration would allow for targeted interventions to prevent short-term relapse and l...
Article
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Variability is intrinsic to all human activities and psychotherapy is no exception. However, trials methodology is not suited to investigating and building our knowledge about variability. By contrast, the paradigm of practice-based evidence, which focuses on routine practice, is a better way of researching the phenomenon of variability. We outline...
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Background: Narrative reformulation (NR) is a component of cognitive analytic therapy (CAT) that is assumed to increase client engagement and improve clinical outcomes. This study set out to test these claims. Methods: A single-blind randomized and controlled dismantling trial investigated treatment outcomes for moderate to severely depressed pa...
Article
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Background: Occupational burnout is common in mental health professionals, but its impact on patient outcomes is as yet uncertain. This study aimed to investigate associations between therapist-level burnout and patient-level treatment outcomes after psychological therapy. Methods: We applied multilevel modelling using depression (PHQ-9) and anxiet...
Article
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Background: Socioeconomic deprivation is associated with higher prevalence of mental health problems; however, the influence of socioeconomic status (SES) on psychological therapy outcomes is as yet unclear. Aim: To review published evidence on the association between indicators of SES (income, education, employment, neighbourhood deprivation, soci...
Article
Background: Trauma focused cognitive behavioral therapy (Tf-CBT) and eye movement desensitization and reprocessing (EMDR) are two highly effective treatment options for post-traumatic stress disorder (PTSD). Yet, on an individual level, PTSD patients vary substantially in treatment response. The aim of the paper is to test the application of a trea...
Article
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Background: It is recognized that a significant proportion of people with depression are prone to relapse, even after successful treatment, and that self-management interventions should be developed and provided. There is evidence that implementation intentions (IMPS) can be successfully applied to health-related behaviours but their application to...
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This editorial summarises key findings from contemporary research on social inequalities and psychological care. In particular, socioeconomic factors such as unemployment, low income and social-class disparities raise important challenges for the delivery of equitable and effective psychological therapy. Implications for theory, research and practi...
Article
Background: Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also someti...
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Background: This study aimed to evaluate eye-movement desensitisation and reprocessing (EMDR) as a treatment for obsessive-compulsive disorder (OCD), by comparison to cognitive behavioural therapy (CBT) based on exposure and response prevention. Method: This was a pragmatic, feasibility randomised controlled trial in which 55 participants with OCD...
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Aims: To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
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Introduction: Socioeconomic deprivation is associated with higher prevalence of mental disorders but poor access to care. We conducted a national workforce survey to examine the demand, supply and utilisation of primary care psychological services. Aim: To understand the variability in the rates of access to psychological care in different geograp...
Article
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Introduction: Obsessive-compulsive disorder (OCD) is usually treated with Cognitive Behavioural Therapy (CBT) based on exposure and response prevention principles; although Eye Movement Desensitisation and Reprocessing (EMDR) has also been proposed as a potentially helpful treatment. Aim: To investigate patients’ experiences of the process and outc...
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Cognitive behavioural therapy (CBT) has been shown to reduce the longer-term risk of relapse and recurrence of depression, particularly compared to discontinued pharmacotherapy. Briefer ‘low intensity’ forms of CBT (LiCBT) are also effective treatments for acute symptoms of depression and anxiety; however, the long-term durability of these effects...
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Practice research networks (PRNs) can support the implementation of evidence based practice in routine services and generate practice based evidence. This paper describes the structure, processes and learning from a new PRN in the Improving Access to Psychological Therapies programme in England, in relation to an implementation framework and using...