Patricia Arean

• Professor
• University of Washington

Introduction Digital mental health treatments (DMHTs) have begun to be implemented in some healthcare systems across the United States. These implementations are conducted as business arrangements. Thus, information on successful or unsuccessful implementations is not published or disseminated. This slows progress, as experiences and learnings are...

The current manuscript is a commentary on “Mobile phone–based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials”. Although embedded within a nuanced discussion, one of the primary conclusions readers have taken from the meta-analysis was “we failed to find convincing evidence in support of...

Most people with mental health disorders cannot receive timely and evidence-based care despite billions of dollars spent by healthcare systems. Researchers have been exploring using digital health technologies to measure behavior in real-world settings with mixed results. There is a need to create accessible and computable digital mental health dat...

Background: Smartphones are increasingly used in health research. They provide a continuous connection between participants and researchers to monitor long-term health trajectories of large populations at a fraction of the cost of traditional research studies. However, despite the potential of using smartphones in remote research, there is an urge...

BACKGROUND Smartphones are increasingly used in health research to reach, recruit and assess the health of large and diverse populations. These devices provide a continuous connection between participants and researchers to monitor long-term health and behavior trajectories using multimodal data streams, ranging from health surveys to sensor data a...

Background: People often prefer evidence-based psychosocial interventions (EBPIs) for mental health care; however, these interventions frequently remain unavailable to people in nonspecialty or integrated settings, such as primary care and schools. Previous research has suggested that usability, a concept from human-centered design, could support...

Introduction: Digital mental health tools have become popular alternatives to traditional psychotherapy. One emerging form of digital mental health is message-based care, the use of text messages or asynchronous voice or video messaging to provide psychotherapy. There has been no research into whether this is an effective method of psychotherapy a...

Background Targeting social connection to prevent suicide in later life shows promise but requires additional study to identify the most effective and acceptable interventions. This study examines acceptability, feasibility, and efficacy of Engage Psychotherapy to improve subjective disconnection (target mechanisms: low belonging and perceived burd...

BACKGROUND Although effective mental health treatments exist, the ability to match individuals to optimal treatment options is poor and timely assessment of response is difficult. One reason for these challenges is the lack of objective measurement of psychiatric symptoms and behaviors of daily function. Sensors and active tasks enabled by smartpho...

Background Although effective mental health treatments exist, the ability to match individuals to optimal treatments is poor, and timely assessment of response is difficult. One reason for these challenges is the lack of objective measurement of psychiatric symptoms. Sensors and active tasks recorded by smartphones provide a low-burden, low-cost, a...

BACKGROUND COVID-19 has created serious mental health consequences for people who are designated as essential workers or have become unemployed as a result of the pandemic. OBJECTIVE The purpose of this study was to determine the extent of psychiatric distress in these two sectors of the community and understand how digital mental health tools (DM...

BackgroundCOVID-19 has created serious mental health consequences for essential workers or people who have become unemployed as a result of the pandemic. Digital mental health tools have the potential to address this problem in a timely and efficient manner. Objective The purpose of this study was to document the extent of digital mental health too...

Most human subjects, research requires data collection by contacting local participants who visit a research site. This is costly, time-consuming, and decreases subject retention with each required visit. Additionally, studies require increasingly large troves of data collected continuously during their typical daily lives using sensors (e.g., fitn...

BACKGROUND Anxiety is an extremely prevalent condition, but has received notably less attention than depression and other mental health conditions from a research, clinical, and public health perspective. Growing concerns about the burden of anxiety have only been exacerbated by the Coronavirus (COVID-19) pandemic due to the confluence of physical...

Background Anxiety is an extremely prevalent condition, and yet, it has received notably less attention than depression and other mental health conditions from a research, clinical, and public health perspective. The COVID-19 pandemic has only exacerbated growing concerns about the burden of anxiety due to the confluence of physical health risks, e...

Researchers have increasingly begun to use consumer wearables or wrist-worn smartwatches and fitness monitors for measurement of cardiovascular psychophysiological processes related to mental and physical health outcomes. These devices have strong appeal because they allow for continuous, scalable, unobtrusive, and ecologically valid data collectio...

Researchers have increasingly begun to use consumer wearables or wrist-worn smartwatches and fitness monitors for measurement of cardiovascular psychophysiological processes related to mental and physical health outcomes. These devices have strong appeal because they allow for continuous, scalable, unobtrusive, and ecologically valid data collectio...

Digital technologies such as smartphones are transforming the way scientists conduct biomedical research using real-world data. Several remotely-conducted studies have recruited thousands of participants over a span of a few months. Unfortunately, these studies are hampered by substantial participant attrition, calling into question the representat...

Digital technologies such as smartphones are transforming the way scientists conduct biomedical research using real-world data. Several remotely-conducted studies have recruited thousands of participants over a span of a few months. Unfortunately, these studies are hampered by substantial participant attrition, calling into question the representat...

The proliferation of mobile, online, and remote monitoring technologies in digital geriatric mental health has the potential to lead to the next major breakthrough in mental health treatments. Unlike traditional mental health services, digital geriatric mental health has the benefit of serving a large number of older adults, and in many instances,...

Introduction Late life depression has detrimental effects on older adults’ functioning and well-being. Depressed older adults often experience loneliness and social isolation, which are risk factors for incident depression, increased depression severity, and medical illness. Neurobiological studies suggest that depressed individuals of all ages exh...

Several barriers complicate access to psychotherapy for depression, including time commitment, location of services, and stigma. Digital treatment has the potential to address these barriers, yet long term use of digital psychotherapy is poor. This paper presents data from a mixed-methods, online survey to document concerns patients with depression...

Objective: Loneliness and social isolation are associated with depressive symptoms, cognitive and physical disabilities, and increased risk of mortality among older adults. Socially rewarding activities reduce loneliness, and neurobiological evidence suggests that these activities may activate neural reward systems in older adults to a greater ext...

Background: Smartphones provide a low-cost and efficient means to collect population level data. Several small studies have shown promise in predicting mood variability from smartphone-based sensor and usage data, but have not been generalized to nationally recruited samples. This study used passive smartphone data, demographic characteristics, an...

Background: To inform measurement-based care, practice guidelines suggest routine symptom monitoring, often on a weekly or monthly basis. Increasingly, patient-provider contacts occur remotely (eg, by telephone and Web-based portals), and mobile health tools can now monitor depressed mood daily or more frequently. However, the reliability and util...

Advances in technology have ushered in exciting potential for smartphone sensors to inform mental health care. This commentary addresses the practical challenges of collecting smartphone-based physical activity data. Using data (N = 353) from a large scale, fully remote randomized clinical trial for depression, we discuss findings and limitations a...

Mental Health conditions are now amongst the top five burdensome diseases in the US. Disparities in access to services and health outcomes vary due to several factors including socioeconomic status, shortage of mental health professionals, stigma and the linguistic gap between providers and non-English speaking minority population. This study explo...

Objective Engage grew out of the need for streamlined psychotherapies that can be accurately used by community therapists in late-life depression. Engage was based on the view that dysfunction of reward networks is the principal mechanism mediating depressive symptoms. Accordingly, Engage uses “reward exposure” (exposure to meaningful activities) a...

Mental health research funding priorities in high-income countries must balance longer-term investment in identifying neurobiological mechanisms of disease with shorter-term funding of novel prevention and treatment strategies to alleviate the current burden of mental illness. Prioritizing one area of science over others risks reduced returns on th...

Background/Aims: Effective treatments to depression exist, but treatment response is variable. Persons likely to respond to antidepressants often show early change in emotional processing and attentional bias. Methods to assess these constructs passively and at low burden/cost are now available via smartphone apps, with potential for broad dissemin...

Mental health research funding priorities in high-income countries must balance longer-term investment in identifying neurobiological mechanisms of disease with shorter-term funding of novel prevention and treatment strategies to alleviate the current burden of mental illness. Prioritising one area of science over others risks reduced returns on th...

Assessment and outcome monitoring are critical for the effective detection and treatment of mental illness. Traditional methods of capturing social, functional, and behavioral data are limited to the information that patients report back to their health care provider at selected points in time. As a result, these data are not accurate accounts of d...

Importance Advances in mobile technology have resulted in federal and industry-level initiatives to facilitate large-scale clinical research using smart devices. Although the benefits of technology to expand data collection are obvious, assumptions about the reach of mobile research methods (access), participant willingness to engage in mobile rese...

The goal of this qualitative study was to describe the beliefs and experiences of Vietnamese caregivers caring for a family member with dementia and to elicit their ideas about promising interventions. We recruited 10 caregivers from support groups, the Alzheimer's Association, and local community-based organizations in Northern California. We cond...

The recent increase in the aging population, specifically in the United States, has raised concerns regarding treatment for mental illness among older adults. Late-life depression (LLD) is a complex condition that has become widespread among the aging population. Despite the availability of behavioral interventions and psychotherapies, few depresse...

Both executive dysfunction (ED), measured by performance-based tasks, and dysexecutive behavior (DB), measured by behavioral rating scales, contribute to late-life depression and comorbid disability. There is a modest positive association of ED and DB, but less is known about their relative contributions to core aspects of neuropsychiatric conditio...

Integrated behavioral health care has the potential to reduce barriers to mental health treatment among low-income and minority populations. This study aimed to identify predictors of Latino patients' decision to follow through with referrals to depression treatment in an integrated primary care setting, including type of referral (a "warm handoff"...

To identify cognitive predictors of geriatric depression treatment outcome. Older participants completed baseline measures of memory and executive function, health, and baseline and post-treatment Hamilton Depression Scales (HAM-D) in a 12-week trial comparing psychotherapies (problem-solving vs. supportive; N = 46). We examined cognitive predictor...

Clinical psychology training for research-oriented scientist-practitioners tends to have a gap in research training during the predoctoral internship year. In 1982, the Clinical Psychology Training Program (CPTP) at the University of California, San Francisco (UCSF) began a 2-year clinical and clinical research training program combining an America...

Problem-solving therapy (PST) is a psychological intervention for depression that teaches people a structured method for overcoming problems they feel have either contributed to their depressive state or have become difficult to overcome because of their depression. PST was originally developed by Nezu and colleagues¹ and has since bee...

Depression in older adults can be treated successfully with psychotherapy. This article reviews the latest information on the effectiveness of two types of psychotherapy for late-life depression, cognitive-behavioral therapy and interpersonal therapy. The reader will learn the theory, structure, and adaptations of these therapies for older adult po...

A new focus on these common causes of distress and impairment.

The purpose of this paper is to review theory, research, and applications of Problem-Solving Therapy for depression (PST), a form of cognitive-behavioral therapy that is based on Social Learning Theory. PST is capable of broad application, and is a relatively systematic and brief form of therapy. This paper will present a synthesis of theoretical a...

Resumen En este trabajo se revisa la teoría, la investigación y las aplicaciones de la Terapia de solución de problemas para la depresión (TSP), un tipo de terapia cog-nitivo-conductual basada en la teoría del aprendizaje social. La TSP tiene un ámbito de aplicación muy amplio y es, además, un tipo de terapia breve y relativamente sistemática. En e...