Psychology Training Falls Short on Policy Skills, New Research Shows
Psychology Training Falls Short on Policy Skills, New Research Shows
A recent study reveals a significant gap in how psychologists are prepared to engage with public policy during their graduate training, potentially limiting their ability to create broader social change.
Researchers interviewed 18 school and counseling psychologists from the United States and United Kingdom who have experience working on policy issues affecting children and young people. What they found suggests that current training programs may not be equipping future psychologists with the tools needed to influence policy decisions that affect their clients and communities.
Missing Elements in Graduate Programs
Nearly all participants reported that their graduate training programs included little to no formal instruction on policy advocacy. Many described never hearing terms like "public policy" or "advocacy" during their entire educational experience. This absence sent a clear message that policy work was considered outside the traditional scope of psychological practice.
When policy was mentioned at all, it typically focused on compliance with existing laws rather than how to actively influence or change policy. Some participants described policy work as presented as an "aspirational idea" without any practical guidance on implementation.
Transferable Skills Exist, But Knowledge Gaps Remain
Despite the lack of formal policy training, participants identified several skills from their psychology education that proved valuable in policy work. Their training in communication, active listening, systems thinking, and understanding research evidence all translated well to working with policymakers.
Participants noted that psychologists are uniquely positioned for advocacy work because of these interpersonal and analytical skills. They described using their ability to facilitate difficult conversations and communicate complex information clearly when working with government officials.
However, participants emphasized that while they had developed useful "soft skills," they lacked crucial "hard skills" and knowledge about policy processes. Many admitted they didn't understand basic elements like how bills become laws, who the key decision makers are, or how to effectively engage with the political system.
Confidence and Professional Identity Issues
The research identified confidence as a major barrier to policy engagement. Participants described policy work as potentially intimidating and requiring a certain boldness to reach out to policymakers and assert that their voices deserve to be heard.
More fundamentally, the study revealed tension about whether policy advocacy should be considered a core responsibility of psychologists. Some participants viewed it as a moral obligation, arguing that psychologists have a duty to use their knowledge to improve lives beyond individual therapy sessions. Others seemed to view it as an optional specialty area.
This uncertainty appears rooted in traditional training approaches that emphasize individual treatment over broader systemic change, despite psychology's increasing focus on social justice principles.
Geographic Differences
The study found some differences between countries. American participants noted that their professional organization, the National Association of School Psychologists, had begun offering policy training opportunities and seemed more advanced in encouraging this type of work. British participants felt their professional organizations could do much more to support policy engagement among psychologists.
Training Recommendations
Participants suggested several ways training programs could better prepare psychologists for policy work. They recommended including basic education about how legislative systems work, who the key players are, and practical strategies for engagement.
They also suggested incorporating classroom activities like mock legislative testimony, policy analysis assignments, and opportunities to hear from psychologists already engaged in policy work. Some recommended practice placements in policy focused settings to give students hands on experience.
This research highlights a disconnect between psychology's stated commitment to social justice and the practical preparation of new professionals. If psychologists are truly meant to work toward broader social change, their training needs to reflect that mission more clearly.
The findings suggest that until policy advocacy becomes a standard part of psychology curricula, it will continue to be viewed as peripheral to the profession rather than integral to it. This may limit the potential impact psychologists could have on important social issues affecting the populations they serve.
The study authors argue that both individual training programs and professional organizations need to take greater responsibility for developing these capabilities in current and future psychologists. Without this support, the gap between psychology's social justice aspirations and actual practice may persist.
As mental health issues increasingly intersect with broader social and political factors, the ability of psychologists to engage effectively with policy makers may become even more crucial for the profession's relevance and impact.
Winter, L. A., Wood, M., & Shriberg, D. (2025). Practitioner psychologists as policy advocates, or policy as outside of our scope? Experiences and views of training in school and counseling psychology. School Psychology International, 46(2), 153-171.
How Much Engagement Really Matters in Online Therapy for Anxiety and Depression
How Much Engagement Really Matters in Online Therapy for Anxiety and Depression
As mental health treatment increasingly moves online, researchers are trying to understand what makes digital therapy most effective. A comprehensive study examining over 500 patients who received internet-based cognitive behavioural therapy for anxiety and depression has revealed important insights about how patient engagement relates to treatment success.
The Digital Therapy Landscape - CBT
Internet delivered CBT has become increasingly popular, especially since the pandemic accelerated the adoption of digital mental health services. These programs typically consist of structured modules that patients work through over several weeks, often with support from a therapist through chat or video calls. The appeal is clear: reduced waiting times, lower costs, and greater accessibility compared to traditional face to face therapy.
However, just like with in person therapy, not everyone who starts an online program completes it or benefits equally. This has led researchers to examine what factors influence success in digital mental health interventions.
Understanding Patient Engagement
The study tracked multiple aspects of how patients interacted with their online therapy platform. Researchers looked at how many modules patients started, how many activities they completed, how much time they spent logged into the system, how often they logged in, and how much they communicated with their therapists through written messages.
On average, patients started about 65% of their assigned modules and completed about 63% of assigned activities. They logged in an average of 34 times throughout treatment and spent roughly 10 hours total on the platform. Most patients exchanged regular messages with their therapists, with patients sending about 14 messages and receiving 19 messages on average.
What Really Drives Success
The most significant finding was that persistence in engaging with treatment content mattered most for outcomes. Patients who started more modules and completed more activities showed greater improvements in their anxiety and depression symptoms. This relationship held true regardless of whether patients started treatment with mild or more severe symptoms.
Interestingly, other measures of engagement proved less important than expected. The total time patients spent on the platform and how frequently they logged in were not strongly associated with better outcomes. In fact, for anxiety treatment, spending more time logged in was sometimes associated with slightly worse outcomes, possibly because patients who were struggling more needed to spend additional time navigating the platform or seeking help.
The amount of written communication between patients and therapists also did not predict treatment success. This finding surprised researchers, though they note that the quality of communication, rather than quantity, might be more important. The study also could not separate time spent in video calls with therapists from other platform activities, which limits conclusions about different types of therapist support.
Early Signs of Improvement
One unexpected discovery was that patients showed symptom improvement even before they began working through the therapy modules. This was particularly striking for anxiety symptoms, where patients experienced significant improvements between their initial assessment and starting the first treatment module.
This early improvement may result from several factors, including the relief of finally seeking help, the therapeutic effect of completing detailed assessments of their mental health, or the hope generated by receiving a personalized treatment recommendation. Understanding this phenomenon better could help optimize the early stages of digital therapy programs.
The Role of Initial Severity
Patients who started treatment with more severe symptoms tended to show greater improvements over the course of therapy. This pattern appeared for both depression and anxiety treatment. However, the researchers note that even patients classified as having "clinical level" symptoms had moderate rather than severe levels of distress, so this finding might partly reflect statistical tendencies rather than true differences in treatment responsiveness.
Implications for Patients and Providers
These findings offer practical guidance for both people considering online therapy and the professionals who provide it. For patients, the research suggests that consistently working through treatment modules and activities is more important than spending excessive time on the platform or communicating frequently with therapists.
This doesn't mean that therapist support is unimportant, but rather that the key is steady progress through the structured treatment content. Patients shouldn't worry if they're not spending hours each day on the platform or sending multiple messages to their therapist. What matters more is showing up consistently and completing the assigned work.
For therapy providers, the findings suggest that efforts to improve engagement should focus on helping patients complete modules and activities rather than simply increasing time spent on the platform. This might involve making content more accessible, providing clearer instructions, or offering targeted support when patients get stuck.
This research contributes to growing understanding of how digital mental health interventions work in real world settings. Unlike controlled research studies that often exclude patients with multiple conditions or mild symptoms, this study examined patients receiving routine clinical care, providing insights that are more likely to apply to typical treatment scenarios.
The effectiveness of internet delivered CBT in this naturalistic setting, while modest, was consistent with previous research. Both patients with mild and more severe initial symptoms experienced meaningful improvements, though those with higher initial distress showed greater absolute changes.
The study opens several avenues for improving online therapy. A better understanding of why early symptom improvement occurs could help optimize the initial stages of treatment. Research into how different types of therapist communication affect outcomes could guide decisions about when to use chat versus video calls.
The findings also suggest that treatment platforms could be designed to better promote the type of engagement that matters most: consistent completion of therapeutic activities. This might involve gamification elements, progress tracking, or personalized reminders that encourage steady participation.
As digital mental health services continue to evolve, this research provides valuable evidence that quality engagement matters more than quantity. For the millions of people who might benefit from online therapy, these insights suggest that effective treatment is achievable through consistent, focused participation rather than intensive time commitments.
The study reinforces that online CBT can be an effective treatment option for anxiety and depression when delivered thoughtfully and when patients engage meaningfully with the content. As our understanding of digital therapy engagement continues to develop, these findings offer a foundation for creating more effective and accessible mental health care.
Hammerfald, K., Jahren, H. H., & Solbakken, O. A. (2025). The association between patient engagement and treatment outcome in guided internet-delivered CBT for anxiety and depression. Frontiers in Psychology, 16, 1494729.
Digital Therapy Shows Promise for Older Adults with Depression and Anxiety
Digital Therapy Shows Promise for Older Adults with Depression and Anxiety
Mental health challenges affect millions of older adults worldwide, with depression impacting about 28% and anxiety affecting 16.5% of people aged 60 and older. These conditions can significantly reduce quality of life and increase health risks, yet many seniors struggle to access traditional mental health services due to cost, long waiting lists, and stigma.
A recent comprehensive study offers hope through technology. Researchers analyzed 11 clinical trials involving 1,578 participants to examine whether internet-based cognitive behavioural therapy (ICBT) could effectively help older adults manage depression and anxiety symptoms.
What is ICBT?
ICBT delivers the proven principles of cognitive behavioural therapy through digital platforms, including websites and mobile apps. Instead of meeting face-to-face with a therapist, users access structured programs that include interactive activities, educational content, and therapeutic exercises. Many programs also provide messaging features to facilitate communication with trained professionals.
This approach offers several advantages for older adults, including lower costs, greater accessibility from home, and the ability to work through materials at their own pace. The flexibility can be particularly valuable for seniors who may have mobility issues or reside in areas with limited access to mental health services.
The Research Results
The analysis revealed encouraging findings for both depression and anxiety symptoms. When compared to control groups, ICBT showed moderate effectiveness in reducing depressive symptoms and small to moderate benefits for anxiety symptoms. These improvements were statistically significant, indicating that they were unlikely to be due to chance.
The researchers discovered some interesting patterns about what works best. Programs lasting eight weeks or longer were more effective for depression, while shorter programs under eight weeks showed better results for anxiety. This suggests that depression may require more time for meaningful improvement, while anxiety symptoms can respond more quickly to intervention.
Delivery Methods Matter
The study found that how ICBT is delivered influences its effectiveness. Programs using slideshow formats proved more beneficial than other digital platforms for both depression and anxiety. This finding suggests that structured, presentation-style content may be easier for older adults to navigate and absorb.
Surprisingly, standardized programs proved more effective than those tailored to individual needs. While this contradicts the common assumption that personalized treatment is always superior, it may reflect the current state of personalization technology or suggest that well-designed standard programs can effectively meet the needs of most users.
Understanding the Limitations
The researchers acknowledge several important limitations. The analysis included only 11 studies, which limits the broad applicability of these findings. Most data were obtained from participants' self-reported symptoms, which can sometimes be subjective or influenced by cultural factors.
Additionally, the studies varied in their design and implementation, making it challenging to identify exactly which components of ICBT are most crucial for success. Future research will need to address these gaps to strengthen the evidence base.
Looking Forward
This research contributes to the growing body of evidence that digital mental health interventions can be valuable tools for older adults. As technology becomes more integrated into healthcare, ICBT could help bridge the gap between the high demand for mental health services and the limited availability of traditional therapy.
The findings suggest that ICBT shouldn't be viewed as a replacement for all traditional therapy but rather as a complementary option that can make mental health support more accessible. For many older adults, particularly those in underserved areas or with limited mobility, digital therapy could provide crucial support that might otherwise be unavailable.
Healthcare providers and policymakers should consider these results when developing mental health services for aging populations. As the global population continues to age, innovative approaches like ICBT may become increasingly essential for addressing the mental health needs of older adults.
The research indicates that with proper development and implementation, digital therapy programs can offer meaningful benefits for older adults struggling with depression and anxiety. While more research is needed to refine these approaches, the current evidence provides a solid foundation for optimism about the role of technology in supporting mental health among seniors.
Qiu, Y., Wu, M., Liu, J., Li, C., Yu, Y., Zeng, L., ... & Chen, G. (2025). Effectiveness of information technology-based cognitive behavioral therapy on depression and anxiety symptoms among older adults: Systematic review and meta-analysis. General Hospital Psychiatry, 93, 9-19.
Common Cognitive Expectations and Standards that Interfere With Your Relationship
The way we think about our relationships has a huge impact on how we feel and act. Here are five common mental habits that I often see in my practice as a psychologist that focus on couples counselling:
Selective Attention
We tend to focus on certain parts of our partner’s behaviour while ignoring others. For example, we might hang onto their words but overlook their actions—or vice versa. If you only notice the things that frustrate you, you might be missing the bigger picture.
Attributions
This is all about how we explain our partner’s actions. Say they don’t answer your question right away, do you assume they’re distracted or that they’re trying to control the relationship? Our assumptions about why someone does something can either create understanding or fuel conflict(Dattilio 2010).
Expectations
We all have ideas about how our partners will react in certain situations. If you believe that sharing your feelings will make them angry, you might hold back. But what if that assumption isn’t true? Sometimes, our expectations stop us from taking actions that could actually improve our relationships (Dattilio 2010).
Assumptions
These are the deep-seated beliefs we have about people and love. For instance, a woman might assume that men don’t need emotional connection, leading her to keep her distance. These assumptions often come from past experiences, but they don’t always reflect reality (Dattilio 2010).
Standards
Everyone has an idea of what a relationship should be like. Some people believe partners should share everything with no boundaries. Others think personal space is a must. When our standards clash with reality (or with our partner’s expectations), tension can build (Dattilio 2010).
Recognizing these hidden thought patterns can help us break free from misunderstandings and connect more deeply. Next time you catch yourself making an assumption or holding onto a rigid expectation, take a step back. A little awareness can go a long way in making love last and help your relationship stay strong.
Dattilio, F. M. (2010).Cognitive-behavioral therapy with couples and families: A comprehensive guide for clinicians.The Guilford Press.
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