Ara Chackerian Takes on Innovation and Behavioral Health

In some of our more stereotypical images of behavioral health, we envision a “salt and pepper” therapist taking notes from his desk while the identified patient “pontificates” about the good and bad of life from a plush leather couch.

It’s assumed that the provider will eventually find the root of the patient’s trouble and offer both a suitable diagnosis and a beneficial treatment.

There is, of course, a few problems with this iconic image of therapist and patient. For one, many individuals are reluctant to disclose their secrets and concerns to the “stranger” behind the desk. Second, the time involved in working with a therapist is often cumbersome and not necessarily well managed.

Additionally, “talk treatments” do not work well for all patients. This all leads to patient attrition—an almost endemic concern and issue for mental health professionals.

Is there hope for more effective behavioral health diagnoses and treatments? Absolutely. In the ever-changing world of healthcare for individuals confronting acute and chronic behavioral health challenges, technology is continuously deployed to provide patients with the best possible outcomes.

Fueled by the innovations and energy of pioneers like Ara Chackerian, who lauded the promise of magnetic stimulation in mental health management, healthcare providers increasingly turn to technology to complement traditional therapies and medicines.

Behavioral health, for example, continues to benefit from technological innovation and deployment. Once a bastion of medial orthodoxies, including psychotherapy and group conversation, behavioral health now relies on nuanced technologies to enhance patient experience and prognoses.

For instance, try to imagine a virtual exam conducted with a handheld device and instantaneously transmitted to a physician thousands of miles away. Picture software coupled with technology that monitors behavioral health symptoms in “real-time,” offering patients immediate access to holistic treatments that could provide relief until the patient is personally seen by the provider.

Think of how such technology can remedy the continuing dilemma of patient attrition, just one front where deployment of technology is literally at hand—via handheld—in finding a solution.

Tackling Attrition Through Technology

According to the National Center for Biotechnology Information (NCBI), clients continue to disengage from mental health services at a rate comparable to that found more than 50 years ago.

According to the Harvard Medical School, nearly half of those who begin psychotherapy—whether individual, group, or couples—drop out because of dissatisfaction and against the therapist’s recommendation.

For professionals, the need to understand why patients enlisting in treatment end up dropping out of their sessions and treatment regimen is great.

Harvard studies cite the following reasons that patients quit their psychotherapy treatments:

—They are unwilling to be candid or open up about themselves.

—They do not agree with their therapist on what the problem is.

—They believe the therapist is incompatible with them; they just don’t get along, and therefore, they lack confidence or trust in the therapist.

—They feel they are not improving quickly enough.

—They harbor unrealistic expectations.

The medical school warns that those confronting a patient who drops out risk encountering chronic problems. For example, when an individual drops out of group therapy, others in the group might feel abandoned. Group cohesion is therefore damaged.

Moreover, psychotherapists risk indifference and the feeling of being ineffectual. It can negatively influence their treatment with other patients.

The school points to possible solutions in avoiding such drop-out dilemmas, however. Virtually all the following solutions lend themselves to improved communication technologies, such as video therapy sessions and spontaneous messaging via handheld devices.

Better Patient Selection

This is a matching game, which can take a lot of time when using traditional methods and old technology. With more reliable screening, patients at high risk of attrition can be offered a different, more effective treatment regimen or even an orientation process to treatment.

Better Preparation

Before beginning psychotherapy, some patients require more knowledge about the process; they need to be informed. For example, the roles and duties of both patient as well as therapist need to be plainly outlined. The likely roadblocks along the way and a realistic understanding of results must be conveyed—e.g., simulated therapy sessions and videotaped excerpts from actual sessions. This is especially critical when introducing an individual to group therapy sessions.

Short-term Therapy

Treatments of shorter duration tend to lower the dropout rate—in some instances as much as 50 percent in reduction, according to Harvard studies. The fewer hours or days a patient spends in therapy, the fewer chances of premature termination. Also, knowing that a treatment will end over a short period of time will instill a sense of urgency and mission, possibly dissuading the patient from becoming disillusioned about the treatment.

Conduct a Negotiation

Therapist and patient should come to terms on the methods and objectives of therapy in advance. The patient must understand what he or she needs to accomplish and how it is to be achieved. This is especially critical to group therapy, which otherwise risks the notion by an individual that he or she is being neglected or ignored.

Provide Motivation

Occasionally a patient is simply not prepared to adopt the changes and responsibilities requisite to psychotherapy. Motivational enhancement can promote confidence in the patient and nudge him or her to commit to the changes and obligations inherent to therapy. Motivational enhancement proves beneficial for treatment of other disorders, including alcoholism, drug addiction, and excessive eating.

Establishing an Alliance

Research suggests that successful psychotherapy results from strong working relationships between the patient and therapist. Though there is no particular recipe for successful therapy, its underpinnings include empathy, respect, genuine interest, and compassion. This alliance needs to be established very early in the relationship. Otherwise, it may never be established, and therapist-client trust erodes as time passes.

Appointment Reminders

In most medical fields, reminders to patients of their appointments is quite common. However, psychotherapists sometimes try to avoid this habit because they want to encourage patient responsibility. They prefer, instead, to explore the reasons and meanings behind patient cancellations. Still, remembering appointments is vital to any successful psychotherapy.

Encouraging Expression

The psychotherapist must foster an atmosphere with the patient that promotes freedom to express emotions, doubts, questions and feelings in general. Without an environment that promotes an uninhibited rapport, the patient is likely to withdraw and become uneasy. This can result in the patient’s termination of therapy.

The Task at Hand for New Technology

Many findings about mental illness and the use of psychotherapy are still unfolding. Just examining previously unknown triggers for an illness such as depression can result in years of further research. Most of the research in this realm already touches on the inner workings of what is still a greatly unknown universe inside our bodies—the brain.

After all, emotions such as sadness and anxiety rely on impulses that spur chemical reactions in our brains. Of course, depression’s staying power and its complexity call for a deeper understanding of the brain than that demanded by momentary emotions, according to mental health experts.

The Harvard Medical School provides a synopsis of depression and its complexity on its website:

“Depression can leave you feeling continuously burdened and can squash the joy you once got out of pleasurable activities.”

When depression strikes, doctors usually probe what’s going on in the mind and brain first. But it’s also important to check what’s going on in the body, since some medical problems are linked to mood disturbances. In fact, physical illnesses and medication side effects are behind up to 15 percent of all depression cases.”

Depression isn’t a one-size-fits-all illness. Instead, it can take many forms. Everyone’s experience and treatment for depression is different. Effective treatments include talk therapy, medications, and exercise. Even bright light is used to treat a winter-onset depression known as seasonal affective disorder. Treatment can improve mood, strengthen connections with loved ones, and restore satisfaction in interests and hobbies.”

New discoveries are helping improve our understanding of the biology of depression. These advances could pave the way for even more effective treatment with new drugs and devices. Better understanding of the genetics of depression could also usher in an era of personalized treatment.”

In the realm of new discoveries, the accommodations that apps and handhelds offer will continue to play a significant role for treatment of depression. Not only can treatments be personalized, but medicines and dosages can be more customized as well. Therapists will not be tempted to lob a set of symptoms into one of the cookie cutter prescriptions of other patients with similar symptoms. This is because the more spontaneous and continuous monitoring that therapy by handheld affords will allow doctors to notice more subtle differences from one patient who shares the symptoms of another.

Ara Chackerian Provides Strategies For Assessing New Healthcare Startups from Ara Chackerian on Vimeo.

In essence, such communication technology can help identify the differences in triggers, sources, and reactions from one patient to the next. It can fill the cracks in the floor created by assimilation of treatments and medicines. In short, Type A, Type B, and Type C prescriptions can be as specific as attaching only the individual’s name to them rather than a set of drugs—the “one shoe fits all” hazard that the Harvard Medical School cites.

The Work is Still Cut Out for Technology

According to the National Alliance on Mental Health, nearly 20 percent of U.S. teens aged 13-18 suffer from mental disorders every year. About 11 percent suffer mood disorder;10 percent a behavioral or conduct disorder; about 8 percent an anxiety disorder.

Compounding these tragic statistics, suicide remains the third leading cause of death for U.S. teens. The numbers for adults are not much better. The good news? Technological tools like magnetic stimulation can become lifesaving bridges for teens and other constituencies impacted by behavioral health struggles.

Dr. Justin Baker of McLean Hospital joins Ara Chackerian and other innovators in trumpeting the potential benefits of technological integration into behavioral healthcare. Baker admits “that (when) technologies are tailored to real-world patients, such advancements can have a transformational impact in not only improving care but expanding access to care.”

A More Participatory Patient

At McLean, partnerships with technology companies explore the ways smartphone applications can help patients troubleshoot and monitor their own symptoms and treatments. For younger generations that are increasingly wired to the digital landscape, devices and software that offer “ownership” of one’s symptoms and treatments could certainly lead to better understandings and better outcomes.

This patient ownership of the treatment process poses a means for the patient to overcome many of the motivations for dropping out of therapy sessions as listed earlier in this article by the Harvard Medical School—responsibility, commitment, motivation, methodology, preparation, and rapport included.

On the provider side of the technological bridge, “fingertip” access to patient health and treatment information streamlines “paperwork,” lowers costs, and improves the patient/provider experience—again, particularly in relation to the Harvard list of solutions to patient attrition. Everyone benefits.

The Specifics—Mobile Apps

Researchers note a typical 17-year lag between science and implementation for traditional medical interventions. Software, specifically mobile apps, can potentially address the “innovation to implementation” lag time.

Providers look to cutting-edge apps to gain immediate access to clinically proven screening methods and tools, helping to expedite treatment decisions, treatment referrals, and the like.

Conversely, patients in need of immediate help benefit from apps designed to provide behavioral health triage in acute situations.

For instance, 90 percent of those committing suicide suffer an underlying mental illness—many displaying the classic symptoms that were unnoticed or not recorded: severe mood swings that affect relationships; trying to harm oneself or another; admitting plans to do so; fear that affects normal routines; drug or alcohol dependence; inconsistent sleeping patterns; not eating, and even racing circulatory or respiratory functions.

Such symptoms occur anytime and anywhere. Therefore, immediacy of detection is critical. The asynchronous nature of digital communications offers a means to mitigate potentially damaging emotions in real time.

A suicide prevention app provided by the Substance Abuse and Mental Health Service Administration (SAMHSA) serves as an example of a technology offering immediate care in critical situations.

The SAMHSA app provides those pondering suicide with instant access to educational materials, as well as an immensely successful treatment locator. Other apps help patients maintain appointments, treatment goals, and patient recordkeeping—again, all the ingredients to successful therapy as already noted earlier in this article.

Essentially, the app attempts to virtually babysit a potential victim when the mood swings or other symptoms counter the effort to consult and seek advice. Something only remote digital technology can do.

The Specifics—Virtual Reality

While virtual reality (VR) is deployed in numerous settings, VR affords ample benefit to behavioral health patients eager to confront troublesome symptoms and damaging thought patterns.

Exposure therapy, specifically, proves to be one variety of VR application that affords hope to behavioral health patients. In exposure therapy, patients encounter discomforting simulations in a safe environment.

Because VR technologies can deftly simulate everything from combat situations to phobia scenarios, patients with struggles ranging from mild depression to PTSD, learn how to manage anxious situations, help to alleviate debilitating symptoms and better prepare the identified patient to manage similar situations in the future.

The Specifics—Mental Acuity and Skills Training

A bevy of technologies and software offerings help patients and healthy individuals refine mental acuity and enhance skills training. As Ara Chackerian and other visionaries assert, technologies—existing and under development—demonstrate the potential to target certain areas of the brain to increase performance and lessen troubling symptoms.

Mental acuity exercises, for example, may help an individual with severe mental illness make better decisions in a shorter amount of time. Similarly, technology-based skills training exercises may help those struggling with depression, anxiety, or obsessive-compulsive tendencies to improve their decision-making strategies.

Final Thoughts

While reclining on a leather couch may pose an appropriate therapy for some individuals working through behavioral health issues, technology is not only providing complementary resources to those who want to improve outcomes at an expedited pace, it is also but blazing a trail to new methodologies altogether.

Sometimes the speed of therapy can make a difference between a life and death situation, especially for persons obsessed with thoughts of suicide. In other cases, speed of communication can reinforce patient-therapist relationships, expedite accurate diagnoses, and mitigate harmful scenarios on the patient’s end.

The list of benefits from digital technology can only grow over time. Already, such technology has produced software, instant communication devices, and large imaging technologies to offer struggling patients renewed hope for a better and safer future in a more timely and critical fashion.

The Healthcare Sector Changes the Dynamics of Stock Investment

 

There is nothing sweeter to investors than seeing the return on their investments increase with time. However, many of them never experience this satisfaction because they lack one secret that could make their investment yield skyrocket: reinvesting their dividend. Although this is an unusual habit for many investors, it could significantly increase the success of their investments. Some investors also fall into the trap of choosing to invest in stocks that yield very low investment returns, if any. However, the healthcare sector has shown tremendous performance in the stock market. Below, you’ll find three highly-recommended stocks for any investor to try.

 

  • Welltower

This company is one of the leaders in drug manufacturing, with its drugs in high demand. This has enabled the stock to yield a consistent return of above 5.4% over the past several years. In the long run, the company’s performance is expected to improve even more due to the management’s implementation of a strategic plan. Welltower plans to launch a drug that will attract high demand and consequently impact the performance of its stock.

 

  • Abbvie

This is another drug manufacturer that has dominated the international market for decades. One of its drugs, Humira, is the top-selling drug internationally. For this reason, Abbvie has maintained a constant dividend of more than 4% annually, which it returns to its shareholders. Experts predict that Humira will remain at the top in worldwide sales for the next six years, which is enough time for the company to release other drugs into the market and boost its sales even more.

 

  • Pfizer

This company has been a trailblazer in the real estate investment trust, and has focused specifically on the healthcare sector. The organization owns many high-end properties in urban markets. Amid this success, the stock has performed perfectly since 1938.

Ara Chackerian

A graduate of Florida State University, Ara Chackerian wears multiple hats: healthcare executive, innovator, and generous philanthropist. Called to publicly reflect on many healthcare initiatives and technologies, Chackerian is viewed as a pioneer of technology’s interface with behavioral health diagnoses and treatment.

Committed to ensuring a sustainable future for his neighbors in the developing world, Chackerian leverages his leadership acumen to help with the enrichment of communities overlooked by the progression of time and technology.

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