Annual Research Review: Building a science of personalized intervention for youth mental health

摘要: Background Within the past decade, health care service and research priorities have shifted from evidence-based medicine to personalized medicine. In mental care, a similar shift intervention may boost effectiveness clinical utility of empirically supported therapies (ESTs). The emerging science will need encompass methods for determining which problems target in order, selecting treatments deciding whether how combine them, informing ongoing decision-making through monitoring treatment response throughout episodes care. We review efforts develop these methods, drawing primarily psychotherapy with youths. Then we propose strategies building youth health. Findings The growing evidence base personalizing interventions includes on adapted specific subgroups; targeting youths’ environments; modular therapies; sequential, multiple assignment, randomized trials; measurement feedback systems; meta-analyses comparing patient characteristics; data-mining decision trees; individualized metrics. Conclusion The presents questions that can be addressed several ways. First, evaluate organize interventions, modifying system used ESTs. Second, help keep pace practice needs, exploiting existing trial data inform approaches, prioritizing approaches likely greatest impact, conducting more idiographic research, studying tailoring usual Third, encourage clinicians’ use their practice, expanding outlets summaries case studies, developing heuristic frameworks incorporate into integrating delivery systems. Finally, build richer understanding why work particular individuals, accelerating identify mediators within across RCTs, isolate mechanisms change, diagnoses psychopathological processes. This ambitious agenda science, although challenging, could markedly alter nature benefit provided youths families.