Intelligent real-time therapy: Harnessing the power of machine learning to optimise the delivery of momentary cognitivebehavioural interventions

James Kelly, Patricia Gooding, Daniel Pratt, John Ainsworth, Mary Welford, Nicholas Tarrier

    Research output: Contribution to journalArticlepeer-review


    Background Experience sampling methodology (ESM) [Csikszentmihalyi, M. & Larson, R. (1987). Validity and reliability of the experience-sampling method. Journal of Nervous and Mental Disease, 175(9), 526536] has been used to elucidate the cognitivebehavioural mechanisms underlying the development and maintenance of complex mental disorders as well as mechanisms involved in resilience from such states. We present an argument for the development of intelligent real-time therapy (iRTT). Machine learning and reinforcement learning specifically may be used to optimise the delivery of interventions by observing and altering the timing of real-time therapies based on ongoing ESM measures.Aims The aims of the present article are to outline the principles of iRTT and to consider how it would be applied to complex problems such as suicide prevention.Methods Relevant literature was identified through use of PychInfo.Results iRTT may provide an important and ecologically valid adjunct to traditional CBT, providing a means of balancing population-based data with individual data, thus addressing the "knowledgepractice gap" [Tarrier, N. (2010b). The cognitive and behavioral treatment of PTSD, what is known and what is known to be unknown: How not to fall into the practice gap. Clinical Psychology: Science and Practice, 17(2), 134143] and facilitating the delivery of interventions in situ, thereby addressing the "therapyreal-world gap".Conclusions iRTT may provide a platform for the development of individualised and multifaceted momentary intervention strategies that are ecologically valid and aimed at attenuating pathological pathways to complex mental health problems and amplifying pathways associated with resilience. © 2012 Informa UK, Ltd.
    Original languageEnglish
    Pages (from-to)404-414
    Number of pages10
    JournalJournal of Mental Health
    Issue number4
    Publication statusPublished - Aug 2012


    • Cognitive behaviour therapy (CBT)
    • Ecological momentary intervention (EMI)
    • Experience sampling methodology (ESM)
    • Intelligent real-time therapy (iRTT)
    • Smartphone
    • Suicide prevention


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