There have been exciting advancements in mechanisms of change research, but most innovations are rarely applied in community settings. Growing depression rates and clinician shortage call for a significant change in the field. I suggest that mechanisms of change research is a promising path to develop precision psychotherapies for the community. I focus on five key problems and possible solutions to advance psychotherapy through mechanisms research: (1) Depression is heterogeneous and patients' profiles vary. Identifying each patient's unique mechanism can inform precision psychotherapies that target this mechanism; (2) research often relies on self-reports, limiting precision. A multimodal approach with objective measures (e.g., brain, behaviors, voice, language) can improve precise measurement of mechanisms and guide personalization; (3) there is a need for simplified first-line treatments that community therapists can deliver. Simplified psychotherapies and digital interventions can target key mechanisms, enhancing efficacy and cost-effectiveness; (4) methods and technologies are evolving rapidly, no single lab can encompass all necessary expertise. Interdisciplinary collaborations can accelerate mechanisms research; (5) insights from mechanisms research are rarely applied due to academia-clinical practice disconnect. Research-practice networks can develop and tailor targeted psychotherapies for underserved communities. Taken together, discovering key mechanisms of change can improve psychotherapy precision, efficacy and effectiveness in real-world settings.
Nili Solomonov (Mon,) studied this question.