What works when for whom? Advancing therapy change process research by mining for therapy-related textual features in effective e-mental health interventions
Mental illnesses, like depression and anxiety, are among the leading causes of the global burden of disease. E-mental health (EMH) interventions, i.e., web-based psychotherapy treatments, are increasingly used to improve access to psychotherapy for a wider audience. Whereas different EMH interventions tend to be equally effective, the responsiveness to a specific treatment shows large individual differences. Therefore, the personalization of treatments is seen as the major road for improvement. Because most EMH interventions use language for communication between counselors and clients, assessing language use provides an important avenue for opening the black box of what happens within therapy. Moreover, EMH makes data of the linguistic interactions between client and counselor available on an unprecedented large scale. The objective of the study is to use e-science methods and tools, in particular natural language processing, visualization and multivariate analysis methods, to analyze patterns in therapy-related textual features in e-mail correspondence between counselor and client. By connecting these patterns to therapy outcome, the question What Works When for Whom? can be answered, which will greatly improve the effectiveness of EMH. The core of the project concerns the development of open source software for the Dutch language, using data from six EMH-interventions with a total of 10.000 e-mails. These data are sufficiently large and varied to allow for computer-based modelling, and testing of use cases with varying complexity. At the end of the project, the step toward English language software will be made to increase the impact of the project.
Funding: NWO/Netherlands escience center
Supervisors: Anneke Sools, Gerben Westerhof, Bernard Veldkamp, Sytske Wiegersma
Online Life Story Books
At present, about 260.000 people with dementia live in the Netherlands. This number will double over the coming twenty years. Dementia has a high burden for patients, informal caregivers and society. About two thirds of persons with dementia is estimated to live at home, but this number will increase given changes in long-term care. However, living at home with a good quality of life is not easy to achieve. Dementia is often accompanied by neuropsychiatric symptoms like apathy, agitation, hallucinations, depression, and anxiety. This is also related to the quality of life of the patient. Whereas the cognitive deterioration can hardly be influenced, it is possible to reduce neuropsychiatric symptoms. A good fit with the personal world of the person with dementia is an important condition for interventions. Reminiscence interventions can contribute as the recollection of valuable personal memories can give feelings of pleasure and trust. Memories are part of the autobiographical memory system that remains intact for a relatively long time in dementia. The Online Life Story Book (OLSB) is an intervention that nicely ties in with these changes in care for persons with dementia. The current study therefore wants to assess the effectiveness of this intervention for people with early dementia and their informal caregivers.
Funding: ZonMW Memorabel, Alzheimer Nederland, PGGM
Supervisors: Gerben Westerhof, Miriam Kunz, Sytse Zuidema
Narrative Futuring to enhance well-being in precarious and complex worlds
This project develops theory, research and methodology for studying and enhancing well-being in precarious and complex worlds, based on future stories. It takes as point of departure that optimal human functioning in a sustainable way that simultaneously warrants and enhances flourishing of the environment is of the utmost importance. A narrative futuring approach, based on a future-forming epistemology and a social-constructivist methodology, is proposed as answer to this challenge. The urgency of the issue of flourishing comes from the recognition that flourishing is under pressure all over the world. In Europe, for example, the impact of the socio-economic crisis in the lives of many citizens is very real. Closer to home, the Western-European context of an apparent higher material welfare, does not guarantee optimal human functioning either. Of the manifold constraints to reaching full potential, our capacity to imagine believable and desirable future selves stands out as a historically and psychologically challenging concern. This capacity and its constraints, considered to be an interaction between cognitive capacity and environmental affordances (cultural, social, physical, educational etc.), is subject of investigation in several studies, e.g.:
1) Letters from the Future as decision aid prior to the Greek Referendum in 2015;
2) comparative study of unemployed and employed youth visualizing and reflecting on desired futures;
3) co-creating future stories by professionals and experiential experts envisioning a more humane care/justice system;
4) psychiatric patients in recovery projects imagining desired futures.
Prof. Dr. Maria Borcsa and Egle Narasciute Msc (applied university of Nordhausen, Germany)
Prof. dr Ephrat Huss (Ben Gurion University of the Negev, Israel)
Dr. Sofia Trivilia (University of Crete, Greece)
Dr. Miltos Hadjiosif (University of the West of England, UK)
Olivia Glebbeek (documentary maker)
Mariette van Tuyll (Mediant, mental health organization)
Contact: Anneke Sools
Machine-based mapping of innovation journeys
Commercial innovation is vital for the future of organisations. Especially to large and mature corporations, managing innovation has become a great challenge, involving large numbers of teams inside and outside organisational boundaries, operating in various timeframes. Our current understanding of innovation processes and how they can be managed does not adequately match today’s reality. In this study, we will develop new and more accurate complex innovation process models by exploiting advanced machine learning and data mining techniques, applied to the empirical textual data of a large number of cases over an extended period of time.
Funding: Tech4People, University of Twente
Supervisors: Anneke Sools, Matthias Visser (TMS) , Gwenn Englebienne (HMI), Klaasjan Visscher (STePS)
Contact: Shengfa Miao
Life stories and personality disorder: An explorative study with implications for narrative interventions
In this research project several aspects of the relationship between life stories and personality disorders are being studied. In the first study, the clinicians view was used to develop a systematic evaluation method of life stories to support clinical decision-making on treatment assignment. In the second study, the patient perspective is studied in life stories, being personal narratives of patients that suffer from enduring dysfunctional patterns of behavior, cognition, and inner feelings they experience across many contexts. We value the patient perspective to learn more about this severe and often invaliding condition. Our interest lays especially in the meanings that are present in life stories of patients that seek help. In the third study, we conduct a study on relevant themes in life stories, and their change after intensive (day)clinical psychotherapeutic treatment. And in the fourth study, the implications are discussed of the last two studies for developing narrative interventions supporting patients in creating a healthy narrative that allows for personal growth.
Supervisors: Ernst Bohlmeijer, Anneke Sools, Gerben Westerhof
Contact: Silvia Pol
Wonderful life: a novel, appreciative intervention to elicit meaning in life
Experiencing meaning in life is crucial to well-being. In this study, we focus on those extraordinary moments in life when meaning manifests itself spontaneously: when we suddenly feel a powerful, affirmative connection to existence. Narratives of these wonderful moments in life are collected by using a question derived from the Japanese movie ‘After Life’: ‘What if there is an afterlife. There, all your memories will be erased, except for one. Which memory do you choose to take with you to eternity?’. Insights from these narratives are used to develop an intervention that helps to establish our connection to meaning in daily life.
Supervisors: Gerben Westerhof, Anneke Sools, Ernst Bohlmeijer
Contact: Jacky van de Goor
Developing a professional identity through autobiographical reflection with the use of persuasive technology
The profession of social worker is quickly changing now hat it entails less the solution of clients but the support of autonomy, strengths and social contacts of clients. Reflection on core aspects of their first professional experiences helps students in social work to develop a professional identity. This project assesses whether adding autobiographical reflection in the sense of a review of one’s personal life strengthens the development of a professional identity. Furthermore, the study assesses whether a blended e-learning using persuasive technology supports the process.
Supervisors: Gerben Westerhof, Saskia Kelders, Kariene Woudt
Contact: Monique Engelbertink
Images of recovery: A visual-narrative study exploring the concept of personal recovery in mental health
Recovery oriented care has become a guiding principle within mental health. This qualitative research project focusses on the exploration of personal recovery on both people with lived experiences of mental illness and mental health professionals. The first group is often unheard and marginalized in society. A visual-narrative approach via PhotoVoice methodology is applied to empower their voice and make recovery tangible. Views on recovery by a second group of professionals are then compared to gain insight if both groups are speaking the same language when it comes to personal recovery and how this influences a recovery oriented mental health.
Funding: Brothers of Charity
Supervisors: Gerben Westerhof, Manuel Morrens
Contact: Tom Vansteenkiste
Resistance to crime: an exploration on ‘not doing crime’ based on lifestories of resisters
Narrative criminological research is primarily focused on people with a criminal career or those who desist from it. Research on people who do not have a criminal career is largely neglected. This exploratory qualitative research focuses on so-called ‘resisters’; people who are subjected to and/or grew up in a dominantly criminal environment, but did not develop a criminal career. Lifestories of resisters are analysed, based on a narrative approach in order to gain meaningful insights into resistance to crime.
Contact: Sheila Adjiembaks
Who am I? A life story intervention for persons with intellectual disabilities and psychiatric problems
“Who am I?” is a life story intervention that was is developed for persons with intellectual disabilities and psychiatric problems. The intervention builds on insights from narrative therapy and life review therapy. A first evaluation has shown that the intervention is well accepted by clients and that their complaints reduce during the intervention. Further research will contribute to the theoretical foundation of the intervention and effects on positive functioning besides effects on psychiatric problems. Furthermore, qualitative analyses of course books as well as several n=1 studies are planned.
Contact: Janny Beernink