A model for streamlining psychotherapy in the RDoC era: the example of 'Engage'.

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Streamlining psychotherapy is crucial for community clinician adoption.
• Neurobiological insights, particularly from the Research Domain Criteria (RDoC) project, offer targets for simplified treatments.
• The RDoC framework signifies the field's readiness to integrate neurobiology into treatment development.

Purpose of the Study:

• To present 'Engage,' a streamlined psychotherapy for late-life depression grounded in RDoC constructs.
• To demonstrate how neurobiological knowledge can guide the development of effective, simplified psychotherapies.
• To outline a three-step 'reduction' process for creating simplified, effective therapies.

Main Methods:

• 'Engage' targets behavioral domains of late-life depression based on RDoC constructs.
• The therapy utilizes 'reward exposure' and addresses barriers like 'negativity bias,' 'apathy,' and 'emotional dysregulation.'
• A structured, stepped approach integrates neurobiological targets and personalization strategies.

Main Results:

• 'Engage' offers a structured, stepped approach to psychotherapy.
• The therapy uses neurobiological constructs as targets and guides personalization.
• The proposed 'reduction' process involves identifying RDoC constructs, creating targeted interventions, and examining efficacy mediation.

Conclusions:

• Simplified psychotherapies can be developed using neurobiological targets and the RDoC framework.
• The 'Engage' therapy exemplifies a structured, personalized approach for late-life depression.
• A three-step process can facilitate the creation of effective, streamlined psychotherapies guided by neurobiology.