A Topographical Map Approach to Representing Treatment Efficacy: A Focus on Positive Psychology Interventions

How can we help translate research findings into clinical practice? There is now a very large body of research available on the outcome of various treatment strategies. But to be readily useful for clinical application, the relative strengths and burdens of different clinical approaches need to be made readily apparent. Meta-analytic reviews help condense research information into the broader brush-strokes of effect sizes, but the individual treatments that contribute to such averages often vary widely in their content, format, and level of therapist/patient burden, leaving clinicians with limited guidance on what specific techniques will give patients “the most bang for their buck.”

In this article, we introduce a new method for translating meta-analytic findings from multiple controlled intervention trials into a clinically useful, easy-to-navigate treatment selection guide. Specifically, we propose a graphic display strategy for capturing the potential benefit and cost-effectiveness of different therapeutic techniques by representing them as heights along a topographical map. As an initial model for illustrating this approach, we mapped 50 positive psychology interventions from a recent meta-analytic review by Bolier et al. (2013) at two different levels of specificity (i.e., “resolutions”). We first identified six core intervention domains (for the “low-resolution” map) and twenty more specific intervention subdomains (for the “high-resolution” map) using a card sorting procedure. We then mapped the “hill” corresponding to each intervention domain or subdomain based on its average effect size (indicated by vertical height), number of studies contributing to this effect size (indicated by width), and therapist/client burden (indicated by shading). The geographical placement of domains or subdomains on the map was determined by their conceptual similarity (e.g., interventions involving some form of abstract causal reasoning were grouped closer together than interventions involving concrete mental imagery, etc.), to provide a sense of the general conceptual “direction” in which beneficial interventions can be found.

The resulting maps revealed several interesting patterns within the positive psychology intervention “landscape,” such as stronger and more consistently positive effects of future-focused interventions (including goal-pursuit and optimism training) than past- or present-focused ones.

By integrating both qualitative and quantitative information about varying therapeutic approaches into a single topographical display, this method offers a promising solution to the “information overload” problem faced by today’s scientifically-minded clinicians and dissemination-minded researchers.

Read the full paper: Gorlin, E. I., Lee, J. & Otto, M. W. (2017). A Topographical Map Approach to Representing Treatment Efficacy: A Focus on Positive Psychology Interventions. Cognitive Behaviour Therapy, 1-19. doi:10.1080/16506073.2017.1342173

 

 

 

 

 

Photo by: Gabriel Caparó