Digital cognitive interventions (DCIs) have emerged as scalable approaches for treating cognitive dysfunction across psychiatric, neurological, and aging populations. Despite growing evidence of efficacy, little is known about which intervention components drive therapeutic effects or through which neurocognitive mechanisms they operate. As a result, null findings are often difficult to interpret, making it unclear whether interventions failed to engage their intended targets, or whether the targets themselves are not causally related to meaningful outcomes. This limits intervention refinement, comparative evaluation, and precision personalization. Here, we argue that DCI research should shift from broad efficacy testing toward mechanistic trials designed to identify active ingredients—the intervention components responsible for engaging prespecified neurocognitive targets and producing clinically meaningful benefits. We propose adapting dismantling design methodology from psychotherapy research in order to integrate Research Domain Criteria constructs, mechanistic neuroscience, and high-resolution digital behavioral data to identify factors driving cognitive and functional outcomes. This approach aligns with the National Institute of Mental Health experimental therapeutics framework by explicitly linking target specification and target engagement with downstream clinical and functional outcomes. Mechanistic dismantling trials can determine whether specific DCI features, including adaptive difficulty, reward schedules, feedback contingencies, task variability, cognitive targets, and human support, are necessary, sufficient, or synergistic for engaging neural circuitry and producing durable and clinically meaningful transfer. Beyond optimizing intervention design, such studies may transform null or negative trials into mechanistically interpretable findings, while clarifying disease mechanisms and supporting the development of personalized, optimized, and usable DCIs.
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A hybrid implementation-effectiveness study of a school-based intervention for promoting health and well-being in low-resource settings: the ISOBAR study protocol
IntroductionSchool-based interventions can improve adolescent health outcomes and tackle the growing burden of non-communicable diseases (NCDs) in low-and-middle-income countries (LMICs). Results to date are variable, partly due to lack of cultural adaptation of Westernised models and limited focus on implementation processes. The aim of the ISOBAR project is to develop, implement, and test a school-based intervention to address the emergence of mental and physical (i.e., nutritional, physical inactivity) health problems in LMICs. The three-stage intervention comprises (1) assessment for mental and physical health problems, (2) universal health literacy, and (3) indicated counselling.Methods and analysisThe ISOBAR multi-site project comprises three phases: (1) pre-intervention (co-development and cultural adaptation of the intervention); (2) implementation of the intervention; and (3) post-intervention evaluation. The intervention will be delivered using a staggered roll-out design to introduce the intervention sequentially to three schools per site (nine in total) in Chennai, Gujarat (India), and Ibadan (Nigeria). Each school will receive the intervention by the end of the study period. Local teams will recruit 200 adolescents per school (Total n=1, 800). All adolescents (in intervention and control conditions) will be assessed for mental health/behavioural problems and nutritional/weight problems at baseline. Adolescents in the intervention school will receive the universal health literacy intervention (main cohort), and those adolescents reaching pre-determined thresholds on mental health and/or nutritional indices (sub-cohort) will be referred to school-based counselling support. A suite of assessments will be conducted throughout the study period including: (1) intervention effectiveness (e.g., impact on help-seeking, weight, and mental health and behavioural outcomes); (2) implementation processes (e.g., facilitators and barriers) and outcomes (e.g., acceptability, appropriateness, sustainability); and (3) cost-effectiveness.Ethics and disseminationThe study was approved by the University of Warwick’s Biomedical and Scientific Research Ethics Committee (BSREC 36/23-24) and the institutional ethics committees of all participating sites. Research findings will be disseminated through peer reviewed scientific publications, public announcements in local communities, policy briefings, print and online media, and institutional and professional social media accounts and websites.
AI Agents Are Coming: 5-Stage Taxonomy of Language-Based AI Systems for Psychiatry, Psychotherapy, and Counseling
The rapid evolution of large language models has accelerated the development of agentic artificial intelligence (AI) systems capable of pursuing autonomous goals, creating an urgent need for structural frameworks in psychiatry and psychotherapy. While existing classifications often draw parallels to autonomous driving, this paper argues that the mental health domain requires a distinct, domain-specific theoretical foundation, as the 2 domains differ fundamentally in their semantic, ideographic, and epistemological demands. Furthermore, they differ in their end goals, for which we introduce terms such as agentic guidance capability. To guide clinicians and researchers through these developments, we propose a 5-stage taxonomy for language-based AI systems that differentiates technical functionality from clinical effectiveness. The taxonomy progresses from level 1 (knowledge level), in which systems perform static benchmark tasks, to level 2 (elementary level), characterized by dynamic engagement in specific therapeutic microskills. At level 3 (integration level), systems achieve consistency across and within modules, as well as basic case-level conceptualization suitable for blended therapy under human oversight. Level 4 (saturation level) describes therapist-in-the-loop systems capable of autonomous functioning with minimal supervision, whereas level 5 (mastery level) represents AI systems that are technically capable of performing autonomous therapy. By distinguishing technical functionality from clinical effectiveness, we conclude that level 4 or level 5 performance does not automatically translate into full treatment effectiveness, even if high treatment fidelity can be achieved. We conclude by emphasizing the need to shift benchmarking from static knowledge tests to dynamic evaluations of therapeutic capabilities in order to safely navigate the transition toward autonomous care.
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HALO-TRIAL: High, Medium And LOw Intensity Psychotherapy for Binge Eating Disorder
Conditions: Binge Eating Disorder; Binge Eating Episodes; Binge Eating/Loss of Control Eating; Binge Eating Disorders; Binge Eating; Binge Eating Behaviour; Binge Eating Disorder Associated With Obesity; Eating Disorder Binge; Eating Disorders
Interventions: Behavioral: Cognitive Behavioral Therapy Enhanced – Individual; Behavioral: Cognitive Behavioral Therapy Enhanced – Group; Behavioral: Cognitive Behavioral Therapy – Guided Self Help; Behavioral: Systemic Narrative Therapy – Group
Sponsors: Herlev and Gentofte Hospital; Jascha Fonden; BETA-HEALTH Foundation; Mental Health Centre Ballerup; Region Capital Denmark; University of Copenhagen
Recruiting
Interventions: Behavioral: Cognitive Behavioral Therapy Enhanced – Individual; Behavioral: Cognitive Behavioral Therapy Enhanced – Group; Behavioral: Cognitive Behavioral Therapy – Guided Self Help; Behavioral: Systemic Narrative Therapy – Group
Sponsors: Herlev and Gentofte Hospital; Jascha Fonden; BETA-HEALTH Foundation; Mental Health Centre Ballerup; Region Capital Denmark; University of Copenhagen
Recruiting
Efficacy of digital interventions in social anxiety disorder: a systematic review and Bayesian network meta-analysis
BackgroundSocial anxiety disorder (SAD) is characterized by a significant and persistent fear of social or performance situations. The prevalence of SAD has gradually increased recently, and the unique advantages of digital interventions (DIs) have gained traction in psychiatric disorders. However, there is currently no comprehensive review comparing the effectiveness of diverse DIs for SAD.MethodsRandomized controlled trials (RCTs) evaluating DIs for patients with SAD were identified by searching the PubMed, Cochrane Library, and Embase databases from January 1, 1995, to March 31, 2025. The study protocol for this network meta-analysis was registered in PROSPERO. Data were analyzed via Bayesian framework network meta-analysis.ResultsForty-two RCTs were included. The results showed that DIs exerted better efficacy than non-digital interventions and wait-list controls (WLC). Different forms of internet-based cognitive behavioral therapy (ICBT) demonstrated robust effects across all four outcomes. Internet-based cognitive therapy (ICT) yielded favorable effects in reducing social anxiety and depressive symptoms. VR showed relatively large effect sizes for improving quality of life.ConclusionDIs can be recommended as adjunctive or combined treatments for SAD. Different forms of ICBT show consistent efficacy and can serve as the first-line option among digital interventions. We recommend promoting the application of DIs to expand treatment coverage for SAD and overcome the limitations of traditional psychotherapy.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251077835.
Non-Suicidal Self-Injury Digital Psychotherapy Trial
Conditions: Non-suicidal Self-injury (NSSI)
Interventions: Behavioral: digital psychotherapy; Drug: Treatment as Usual (TAU)
Sponsors: The Fourth Affiliated Hospital of Zhejiang University School of Medicine
Not yet recruiting
Interventions: Behavioral: digital psychotherapy; Drug: Treatment as Usual (TAU)
Sponsors: The Fourth Affiliated Hospital of Zhejiang University School of Medicine
Not yet recruiting
Hair cortisol as psychotherapy process parameter – an inpatient pediatric psychosomatic study
IntroductionPediatric-psychosomatic inpatient therapy is an essential part of the German health care system for the treatment of mental disorders in children and adolescents. However, empirical research in this field remains scarce and limited to psychological parameters. This longitudinal naturalistic study aimed to evaluate the efficacy and sustainability of inpatient psychosomatic therapy in children and adolescents by examining both psychological outcomes and biological markers.MethodsA total of 58 patients were assessed at seven time points before, during, and after treatment. Hair cortisol concentration (HCC) was measured as a neuroendocrine parameter of long-term stress regulation. Psychometric data were collected using five validated questionnaires.ResultsFindings indicated significant improvements in perceived stress, depressive and anxiety symptoms, family functioning and internalizing symptoms in the course of inpatient treatment. Overall, these effects remained stable at three- and six-month follow-ups, with only transient increases in depressive symptoms and family problems. HCC showed a significant decrease from admission to discharge and remained stable across follow-ups.DiscussionThese results support the efficacy of inpatient pediatric psychosomatic interventions on both psychological outcomes and neuroendocrine stress regulation and highlight the value of integrating biological markers into psychotherapy research.
Enhancing psychiatry education: effectiveness of a psychodynamic psychotherapy module for borderline personality disorder for psychiatry residents
BackgroundPsychodynamic psychotherapy is the treatment of choice for borderline personality disorder (BPD); however, psychiatric residents frequently report difficulty in applying it, partly due to the lack of structured training models. This study developed and evaluated the effectiveness of psychodynamic psychotherapy learning modules for BPD among Indonesian psychiatry residents.MethodsA quasi-experimental pre-/post-test control group study using mixed methods was conducted across nine psychiatric residency programs in Indonesia. Thirty-four residents were recruited, of whom 33 completed the study. Learning outcomes were assessed using multiple-choice questions and the Psychodynamic Formulation Competency Assessment Scale (PF-CAS) and Practical Competency Assessment Scale (PC-CAS). The module program was evaluated by the participants using the Indonesian version of the Kirkpatrick Level 1 questionnaire.ResultsThe intervention group showed significantly greater improvement in psychodynamic formulation skills (PF-CAS) than the control group (p < 0.001). The multiple-choice scores improved in both groups, with no significant between-group differences. The intervention group showed a numerically greater improvement in Practical Skills (PC-CAS) than the control group, although the difference was not statistically significant. Participants’ feedback was highly positive, emphasizing the usefulness of psychodynamic formulation training, psychotherapy protocols, and supervision.ConclusionImplementation of the psychodynamic psychotherapy for BPD Learning Module enhanced competencies in the cognitive and affective domains and showed promising trends in practical skills. This positive reception highlights its feasibility and potential benefits as part of the residency training curriculum.
Institutional Member Updates: Summer 2026
Institutional Members are clinics and programs in the US and around the globe that offer residential and/or intensive treatment for OCD and related disorders, are specialty outpatient clinics with a large staff dedicated to treating OCD, or provide low-cost treatment options through research studies.
Below are quarterly updates from our Institutional Members organized alphabetically. Click the (+) to open each menu and read updates and find contact information for clinics near you:
Do you work at a residential program, intensive outpatient program (ITP), or specialty outpatient clinic and looking to advertise your services? Learn more about becoming an Institutional Member and having your program updates included below!
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A Pilot Study of Adjunctive Structured Supportive Psychotherapy in Schizophrenia
Conditions: Schizophrenia; Cognitive and Executive Dysfunction; Neuroinflammation
Interventions: Behavioral: Structured supportive psychotherapy; Drug: Risperidone 2 mg; Behavioral: Standard Clinical Care with Active Control; Drug: Risperidone 2 mg
Sponsors: Hasanuddin University
Completed
Interventions: Behavioral: Structured supportive psychotherapy; Drug: Risperidone 2 mg; Behavioral: Standard Clinical Care with Active Control; Drug: Risperidone 2 mg
Sponsors: Hasanuddin University
Completed