Retirement is often seen as a time to relax, enjoy hobbies and spend time with loved ones. However, for many older adults, it can also be a time of loneliness and isolation. According to a study by the University of Michigan National Poll on Healthy Aging, 34% of older adults felt a lack of companionship and 27% felt isolated from others during the past year.

Chronic loneliness can have detrimental effects on older adults’ physical wellbeing, mental health and life expectancy. It can even shorten life expectancy more than being overweight or sedentary, and as much as smoking. Older adults may also feel lonely as a result of health problems. For example, an older adult who has hearing loss or mobility concerns may find it difficult to interact with others socially.

Having meaningful social connections and frequent interactions may help alleviate loneliness. The seven tips below can help older adults stay connected and engaged during retirement.

• Staying connected with family and friends—Family and friends are an essential source of support and social interaction. Older adults should try to stay connected with loved ones, whether through phone calls, video chats or in-person visits. Planning regular activities or outings with family and friends can help keep relationships strong and prevent feelings of loneliness.
• Engaging with religious groups—Religious communities often offer a supportive and inclusive environment where older adults can connect with individuals who share similar values and beliefs. Many religious groups also attract people from different age groups, creating opportunities for intergenerational connections, mentorship and the sharing of wisdom and experiences.
• Joining a community group or club—Whether it’s a book club, gardening group or volunteering organization, becoming a part of a community group or club with similar interests is a great way for older adults to connect with others and build relationships while pursuing interests.
• Learning something new—Retirement provides more time to explore new hobbies and interests. Taking a class, attending a workshop or joining a discussion group are fun ways for older adults to learn something new and pass the time, and a great way to meet new people.
• Volunteering—There are many opportunities for older adults to volunteer, whether it’s at a local food bank, hospital or animal shelter. Volunteering can provide a sense of purpose and fulfillment. And it’s a great way for older adults to give back to the community while building social connections.
• Joining a home visiting program—These programs connect older adults with compassionate volunteers who provide regular companionship, meaningful conversations and support. By welcoming friendly faces into their homes, older adults can alleviate isolation, foster new friendships and create a fulfilling support network.
• Embracing technology—Technology provides many opportunities for social connection and interaction. Older adults can use social media platforms like Facebook, Instagram and NextDoor to stay in touch with family and friends, as well as online communities like Meetup to find groups and events based on interests.

When loneliness becomes too much

If feelings of loneliness persist and begin to impact older adults’ overall wellbeing, seeking professional help may be necessary. Mental health professionals can provide older adults support and guidance on coping strategies and techniques for managing loneliness.

Retirement can be a fulfilling and enjoyable time for older adults, but it can also come with feelings of loneliness and isolation. Utilizing these tips can help older adults stay connected, engaged and maintain good mental health during this new phase of life.

Magellan Healthcare Older Adult Assistance

At Magellan, we understand the unique challenges older adults may face during retirement. That’s why we offer our Older Adult Assistance program. This program is designed to provide older adults the relationships and resources they need to thrive during retirement. Visit here to learn more about our Older Adult Assistance program.

Source:

• Loneliness and Health | National Poll on Healthy Aging (healthaging.poll.org)

Human connection is critical to improving performance and overall wellbeing in a sustainable way. This topic is the focus of the upcoming Magellan Federal webinar on Wednesday, July 19^th. Leaders are encouraged to join Magellan Federal’s cognitive performance coaches for the webinar, Human Connection: Creating Conditions for Thriving Individuals & Organizations, to understand the indicators of thriving conditions, how connection drives those conditions, and learn strategies to help you implement them in your daily life.

Event panelists for this informative webinar included Dr. Jon Metzler, Senior Director of Human Performance; E. Kruise, Cognitive Performance Specialist; and Meg Helf, Cognitive Performance Specialist.

Read the Q&A below for a few insights from our experts on human connection and wellbeing.

Q: Why do we need human connection? What are the benefits?

E. Kruise: Our brains are literally wired to connect and need connection for survival. Our brains will alert us when our need for connection is threatened. When we experience social pain our brains fire in the same way as when we experience physical pain, alerting us of the threat of disconnection. Just as pain alerts us when we are physically injured. When we are experiencing disconnection, we move into self-preservation mode and become self-focused; we are more likely in this mode to perceive others and the world around as threatening. As a result, we reinforce our feelings of disconnection. Furthermore, when we feel lonely, our sleep is impacted, our health is impacted. Loneliness increases our odds of an early death more than obesity, excessive drinking, or smoking 15 cigarettes a day. When we feel connected or a sense of belonging, we not only improve our own personal well-being and performance, but we also increase group cohesion, creativity, innovation, and the well-being and performance of the entire team.

Q: What are a few ways to create conditions for thriving individuals?

Meg Helf:

• Self-awareness of our mindsets and how our bodies operate is a first step in understanding that other people, with different backgrounds and upbringings, hold different mindsets, and their bodies may have learned to operate differently. This deep inner self-work takes time.
• At a baseline, prioritizing a culture of connection. Creating a sense of belonging by truly seeing each other. We can do this by approaching others with patience, curiosity, generosity, and vulnerability.
• Model Humility and Curiosity – Demonstrate situational humility. Identify and share where you have gaps in knowledge, skills, or abilities. Share your areas of development and plan. Ask for help. Ask a lot of questions about others’ challenges, ideas, concerns, and feedback.
• Encourage and praise Input and Initiative – Acknowledge and appreciate questions, ideas, concerns, or challenges shared by people. Encourage everyone to share. Praise an individual’s willingness to assess and then act independently on tasks or projects.
• Provide vision and the “why” – Paint a clear picture of what success looks like. Emphasize purpose, what’s at stake, why it matters, and for whom. When people are able to connect their values and purpose to the task, goal, or project, we see an increase in motivation. Keep the purpose top of mind, discuss, and ask for clarity if uncertain.
• Seek and provide effective feedback – Provide caring, direct, and honest feedback in a timely and consistent manner. Ask for caring, direct, and honest feedback and model effectively accepting that feedback. This demonstrates that we care about each other’s success and believe in their abilities.

Q: What are the signs that there is a thriving organizational condition within the workplace?

Kruise:

• People value other’s unique interests, skill sets and abilities. In turn, people feel valued and a sense of belonging. They are empowered to bring their full authentic self.
• People take risks because they are not afraid to fail. Failure is only an opportunity to grow, get better, produce a stronger solution, etc.
• People speak up, share, and challenge each other.
• People listen to and tune into others, not just what they are saying, but also how others are feeling.
• People are taking initiative, proactive, present in the moment, and emotionally interested in their tasks.

Q: In May, the U.S. Surgeon General issued an advisory calling loneliness, isolation, and lack of connection a public health crisis calling it a “Epidemic of Loneliness and Isolation.” Do you agree or disagree that this is a public health crisis? Why?

Helf: Absolutely! Although the recent COVID pandemic has brought the awareness of isolation and loneliness into the spotlight, levels of social connection have been declining for decades. Our need as social beings is innate and ingrained in our fabric. Our ability to support each other and work together is what has made the advancement of our society possible. Mother Nature has made the bet that the best thing for our brains to do, at any given moment, is to see the world socially.

Unfortunately, various changes within our society have changed the way we develop and maintain relationships, how often we engage in meaningful connections, and with whom. Unlike the sensations of hunger, thirst, and pain, which alert us that our bodies need food, water, or care for injuries, many individuals are not as attuned to or aware of the sensations of social pain. Social pain is a real pain, alerting us that social connection is missing. Social pain literally appears on brain imaging the same as physical pain. Many of us, however, may not intuitively connect what we are feeling to the social disconnection that is driving us. Even if we are aware of our social disconnection, there is still a stigma around loneliness and may be difficult for individuals to discuss openly. Furthermore, when we experience social isolation and loneliness for long periods of time, we see a diminished ability to foster what we need most: deep meaningful connections. Social disconnection causes real changes to our brains and bodies. These changes manifest in our performance, health, cognitive functioning, longevity, and wellbeing. We, as a culture and community, need to prioritize connection at work, in our communities, and at home to reorient to what makes us function at our best: connection to other people.

Q: How does a lack of connectivity negatively impact wellbeing and productivity in the workplace?

Helf: When we don’t feel a true sense of belonging, we hide our authentic selves, we create a filter for our behavior. This impression management leads to hesitation. Instead of sharing ideas and asking questions, our focus is directed toward how we should act based on how we think we will be perceived. A culture of holding back leads to less efficiency, less innovation, and diminished performance.

Kruise: A lack of connection in the workplace increases the likelihood of individuals operating in self-preservation, or at least self-interest, mode. Thus, people are more focused on themselves and more likely to perceive what is going on around them as negative or a threat. This can lead to more conflict, less growth and development, less creativity and innovation, less collaboration, and ultimately performance suffers.

Q: Who would you benefit from attending this upcoming webinar and why?

Jon Metzler: Everyone! The concepts and strategies we discuss can be leveraged at any level of an organization in any environment or at home, with our families, hobbies, sports, activities, and social lives.

Click here to watch the replay of the July 19^th webinar.

Resources:

•  Human Connection_Creating Conditions for Thriving Individuals & Organizations.pdf
•  Human Connection_Thriving Organizational Conditions_Magellan Federal.pdf

This article was originally published on MFed and written by Tristen Wendland, MS, LPC.

When you hear the acronym PTSD (post traumatic stress disorder) most think of combat war veterans.  Post Traumatic Stress Disorder is a fairly new term.  In WWI and WWII it was referred to as shell shock or combat fatigue.  The term was developed in the 1970s after the Vietnam war when servicemembers returned with similar symptoms.  It wasn’t until 1980 that the American Psychiatric Association officially recognized it as a disorder.

According to the National Institute for Mental Health, it is estimated that around 6-7% of the US population will deal with some PTSD in their lifetime.  According to Department of Veterans Affairs, Woman are at higher risk at 8% compared to Men at 4%.   PTSD can be related to natural disaster, a serious accident, terrorist attacks, mass shootings, combat, sexual assault, or other types of violent assault.

While working for Department of Veterans affairs I had the opportunity to work with many combat veterans over my career.  One comes to mind.  He was a young Army veteran who worked in EOD (Explosive Ordnance Disposal).  During his time in the US Army, he was deployed 3 times.  During his last deployment he was injured during a mission when a bomb he was defusing exploded leaving him permanently disfigured and without the use his dominate arm.  After 8 years of skin grafts, multiple surgeries, and ongoing therapy he was ready to discuss returning to school and work.  He applied for Vocational Readiness and Employment through Department of Veterans Affairs CH31 program, and I was assigned his case.  We started off slowly with him only taking 1 class at a time.  Working up to part time school in person was a challenge.  The physical scars on his face and mangled arm were hard to miss.  Over the 5 years that I worked with him I saw him succeed and fail and celebrated his achievements and milestones and encouraged him when he stumbled.  Often having to take breaks when he stubbled back.  What I learned from him is that the will and want to work and succeed is 90% of the battle for people with emotional scars.  His goal was never to be who he was previously but to be who he is today.  A better version of himself who can feel satisfaction from employment even at a part time level.  Success was self-determined, and not dictated by a 40-hour work week or paycheck.

So, when it comes to employment what is the impact on your workforce?  According to the American Psychologic Society, the symptoms of PTSD sometimes cause significant distress for many individuals.  It impacts their social and occupational participation to a degree that is significant.  It can impact their ability to engage in selfcare and home care activities, education, and work roles as well as social and leisure activities.

What can you as an employer do to minimize or accommodate an employee suffering with PTSD? According to US Department of Labor Workers Compensation, Employees may benefit from returning to work on a part‑time basis.  Modified work schedules or shared employment can be beneficial. In terms of workplace accommodations, each person will have specific needs, and you really have to look at accommodations based on that individual. Here are some options:

• Providing instructions or job-related responsibilities in writing as well as verbal instructions.
• Offering additional training or refreshers to assist that individual with some of the memory difficulties.
• Allowing workers to maintain more flexible schedules and being able to take time off for any treatment or appointments that they have to attend.
• Permitting extra time to complete non-urgent tasks.
• Letting employees wear noise canceling headphones to reduce distractions while they’re working.
• Increasing the amount of light in the work environment to help maintain alertness and help them improve concentration.
• Removing any emotional triggers that remind the employee of the trauma that are upsetting (when possible).
• Making sure parking areas are well lit or that security personnel is available to accompany them when walking to a car or unsafe locations in the dark.

According to the Recovery Village, with treatment the prognosis is positive that PTSD symptoms can be managed.  While approximately one-third of people do not achieve full symptom elimination with treatment, most individuals experience a significant reduction in the intensity of their symptoms. It is important to understand when an employee is struggling, and performance is low there maybe underlying issues that can be accommodated or addressed by managers.

Sources:

National Institute of Mental Health. “Post-Traumatic Stress Disorder (PTSD)“ https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd .” November 2017. Accessed May 9, 2023.

U.S. Department of Veterans Affairs. “How Common Is PTSD in Adults?”  https://www.ptsd.va.gov/understand/common/common_adults.asp  February 3, 2023. Accessed May 9, 2023.

U.S. Department of Labor Workers Compensation. “How PTSD is Affecting Return to Work” https://www.genexservices.com/insights/workers-comp/blog/how-ptsd-affecting-return-work  August 2019. Accessed May 9, 2023

The Recovery Village. “PTSD Statistics and Facts” https://www.therecoveryvillage.com/mental-health/ptsd/ptsd-statistics/#:~:text=70%25%20of%20adults%20experience%20at,some%20point%20in%20their%20life  May 2023. Accessed May 9, 2023.

It’s Monday—again! You wake up to another busy day of worrying how you’ll manage juggling work, family and personal commitments. As the day progresses, stress begins to take its toll, and you feel overwhelmed. Don’t worry! There’s a simple solution. Focusing a few minutes every day on enhancing your mental wellbeing can increase your resilience and help you manage stress. It’s never too late to start, even if this is something you’ve never done before.

So, let’s explore five powerful, easy-to-implement tips to improve your mental wellbeing and embark on a journey towards a calmer, happier and more fulfilling life.

Practice mindfulness

Living in the present moment without judgment can help you be more positive and better manage difficult situations when they arise. Practicing mindfulness or quieting your mind with meditation can help you to stop dwelling on the past or worrying about the future. Try physical routines such as yoga, Tai chi, and qigong to prompt mindfulness and focus on your breathing. You can learn to live your best life right now.

Take a break

Find time to do things you enjoy in small increments. Small moments of self-care can have an extremely positive impact on your mental wellbeing. Dive into the captivating world of books. Sit outside and connect with nature. Immerse yourself in thought-provoking podcasts that inspire and uplift your spirits. Or just simply unwind and let go in whatever way brings you joy.

Spend quality time with the ones you love

When you’re with loved ones, take the time to deepen connections and foster stronger relationships. Engage in conversations that help you learn more about each other’s dreams, aspirations and challenges so you can provide support to one another. Consider embarking on new adventures together, such as cooking a new recipe or taking up a fun sport. Or if you’re really up for a challenge, you can try learning a new language or how to play a musical instrument together. Explore new areas in your neighborhood, city or state, like art galleries, parks or gardens, vintage or thrift stores, farmer’s markets, specialty boutiques or shops, cultural or historical landmarks, and hidden trails or scenic spots. Discovering hidden gems with family and friends can create lasting memories. Or tantalize your taste buds by venturing into a new restaurant and indulging in a shared culinary experience. The possibilities for bonding and growth are endless when you embrace quality time with loved ones.

Prioritize sleep and healthy eating

Maintaining a regular sleep schedule and practicing proper nutrition can help you in many ways. These healthy habits work hand in hand to enhance your mood and reduce feelings of anxiety. Establishing a calming routine before bedtime can promote better sleep quality. Consider indulging in a warm bath to relax your body and mind, reading a captivating book to unwind, or listening to soothing music to create a peaceful atmosphere for restful sleep.

In addition, making mindful choices about your nutrition can help improve your mental and physical health. Choose nutrient-rich foods that nourish your body and mind. Include plenty of fresh fruits and vegetables in your meals, such as colorful berries, leafy greens and crunchy carrots. These wholesome choices provide essential vitamins, minerals and antioxidants that support your overall wellbeing and boost your mood.

Accept your thoughts and seek help when needed

It’s completely natural to feel down during challenging times, and it’s important to acknowledge and honor those emotions. Remember you don’t have to face hard times alone. Reaching out to the people who genuinely care about you can provide tremendous support and comfort, helping to uplift your spirits and bring comfort during difficult moments.

Additional mental health resources

For more information and resources to enhance your mental wellbeing, visit our award-wining behavioral health resources website, MagellanHealthcare.com/BH-Resources.

SOURCES:           Healthwise, Integrative Life Center

What do counselors, psychologists, and social workers all have in common? Each are a part of the large community of helping professions. A helping profession is a job focused on providing timely care, support, advocacy, and outreach to others in need with the intent to improve a part or the overall well-being of an individual. But what happens when there is a disproportionate group of people receiving and/or seeking help with mental illness and substance use?

The Problem

In 2019, just prior to the pandemic, more than 40 million Americans, aged 12 or older, had a substance use disorder (SUD). As noted by the CDC, the use of alcohol and other substances can lead to anxiety, depression, family problems, violence, and other health and societal outcomes. Moreover, we know that today, about 1 in 5 American adults and 1 in 5 children will experience a mental illness at some point in their lives.

When we review the latest report from the National Survey on Drug Use and Health (NSDUH), we see that Black, Hispanic or Latino, or Asian adults were less likely to receive mental health services in the past year than White or Multiracial adults. Moreover, according to NSDUH’s report, 94% of people aged 12 or older with a substance use disorder did not receive any treatment.

Why Representation Matters

This data is critical and highlights the need for representation on many fronts within helping professions. For example, research shows that negative stereotypes and stigma surrounding mental illness and substance abuse has led to the presence of self-stigma among those experiencing mental illness and substance use disorders. Self-stigma in turn has interfered with a person’s willingness to seek help and treatment.

Increasing representation among our workforce of counselors, social workers, and psychologists can be a critical step to improving strategic outreach to underrepresented and marginalized groups that do not typically seek treatment. Moreover, improving representation among these professions can also inform our communication strategies that effectively support individuals across a range of age brackets, with cultural and linguistic differences, and other important attributes that should inform our ability to provide targeted and effective care.

Our Commitment to a Diverse Workforce

At Magellan Federal, we are committed to diversifying our team of employees and provider network because we desire to reach and serve all who are in need. As such, we are committed to removing real and perceived barriers to care and we do this in part by practicing cultural humility within our organization and with those whom we serve in our communities.

As we continue to grow and diversify, we make intentional efforts to understand each person’s wholistic identity, commit ourselves to an ongoing process of compassionate self-awareness and inquiry, remain open and teachable, and we remember that society and culture is ever evolving, and we must as well.

If you possess these values, we invite you to join our team! Click the links below to learn more.

• To learn more about becoming an employee at Magellan Federal, visit our Careers page.
• To join our Network of EAP Providers, click here.
• To learn more about the services and solutions we provide to our customers, click here.

Black, Indigenous and People of Color (BIPOC) are at risk of experiencing trauma due to mental and emotional injury from a variety of causes.

If you have experienced such trauma, you may find that your relationships are impacted. Consider these strategies to protect and manage your closest relationships and all that are important to you.

Recognize triggers

We can be triggered by and experience racism.

The impacts can go beyond our own emotional pain and psychological distress to affect our relationships. When we feel triggered, it’s important to:

• Identify your emotions—Are we feeling surprise, fear, sadness, disgust, anger? It can be helpful to name to our emotions so we can use our knowledge about how to deal with them and seek help if necessary.
• Recognize the validity of your emotions—We are right to feel the way we do, and we don’t need to waste our energy questioning that. It’s important to take the time to understand how we are feeling.
• Manage your emotions—When we know what we are feeling, we are in a better place to be in control of how to approach and react to people and situations. This can have beneficial impacts for our relationships.

Set boundaries

With family members and friends, co-workers and even strangers, we must feel safe to be ourselves and feel respected. Setting and sticking to personal boundaries can help. Here’s how you can do it:

• Prioritize needs—Take the time to think through where you stand, what you can and cannot tolerate, and what makes you feel happy or uncomfortable.
• Anticipate resistance—Expect that others may not easily understand your boundaries, especially if they have different backgrounds or personalities.
• Communicate boundaries—Clearly and directly let others know of your boundaries and reiterate them if you feel they are being overstepped.
• Distance yourself if necessary—If you feel disrespected or have your boundaries crossed repeatedly, it may be time to cut off further interactions to protect your emotional wellbeing.

Practice self-care

We are our own best advocates. It is vitally important that we take time to do the things that make us happy, keep us healthy and give us an outlet from negativity. Not only will our wellbeing improve, but our relationships will also benefit. Try these:

• Try a delicious new recipe—Taking time to enjoy cooking or baking can be relaxing and fruitful when it’s time to eat!
• Enjoy quiet time to rest or nap—Sometimes it can be hard to take a break. Take the opportunities as they arise and enjoy every moment!
• Catch up for a visit or phone call with a loved one—Connecting with others can increase your sense of safety, belonging and security.
• Read a book or start a hobby—Keep your mind active and engaged in activities that bring you joy.
• Volunteer—Giving of yourself to help others can improve your confidence, self-esteem and life satisfaction.
• Get outside for fresh air and exercise—Sunshine and nature have been proven to boost mood.

Additional emotional support resources

For more on BIPOC mental health, visit our website for July BIPOC Mental Health Awareness Month, MagellanHealthcare.com/BIPOC-MH, and be sure to check out the BIPOC mental health tip sheets and awareness campaign toolkit.

You can also check out a recording from our webinar, “BIPOC mental health and relationships.”

On May 3, the U.S. Surgeon General issued an advisory calling attention to the public health crisis of loneliness, isolation, and lack of connection, calling it an “Epidemic of Loneliness and Isolation.”

Loneliness is the feeling of being isolated, or alone. It isn’t always tied to the amount of time you spend with other people but can come from a gap between the relationships you have and the ones you need or want.

There may not be a magic cure for loneliness, but there are healthy ways to cope and reconnect socially and regain a sense of belonging. Here are five steps to reduce loneliness:

1. Try helping someone else – Helping just one person at one time is a way to connect that improves the life of another, makes you feel better about yourself, and can be a great way to help people and meet others who share your interests. You can smile and be friendly, stop to help a neighbor, volunteer your time or donate food.
2. Think about getting a pet or finding a way to interact with animals – A pet can be a great companion, and source of comfort and may also lower stress and blood pressure. If you can’t have a pet, there are many volunteer opportunities to help animals in every community.
3. Take care of the relationships you already have – Reaching out to friends and family can help strengthen your sense of belonging. Set aside a few hours a week to connect. There doesn’t have to be a specific reason to call, and the call doesn’t have to be that long. A familiar look or a loving smile can change our experience instantly, even if we are far away or unable to see each other. You never know how reaching out to just one person may connect you to others.
4. Find new connections through activities you enjoy – Start or restart a hobby. Take a class to learn something new. Check out programs at the library or community center. You can invite friends or acquaintances you want to get to know better. Alternatively, you can go alone and meet people who share at least one interest of yours.
5. Talk with a counselor – It can be hard to make changes on your own and scary to think about being in social situations. If loneliness makes it hard for you to go about your day, a counselor can help.

As you think about taking small steps, remember the importance of self-care to help you feel better from the inside out. Exercise, healthy eating, proper sleep, sunshine and meditation are good ways to improve your emotional health.

Sources:

• Healthwise
• Surgeon General’s Advisory on Our Epidemic of Loneliness and Isolation – PDF

Evidence-based or evidence-informed treatment? Confused? You are not alone. Often used interchangeably, the terms “evidence-based” and “evidence-informed” in healthcare are two very different things. So, what do they really mean?

What is evidence-based treatment?

Evidence-based care is considered the gold standard in treating behavioral health conditions. Typically, “evidence-based” refers to an individual intervention that is based on quantitative research studies conducted in controlled, blinded settings and proven to be effective across a wide range of environments and people. Medications and other treatments that receive U.S. Food and Drug Administration (FDA) approval for a certain indication are also considered evidence-based.

What is evidence-informed treatment?  

 Evidence-informed care is an approach that shows promise but lacks enough proof of success to be viewed as a gold standard. Practitioners take bits and pieces from a variety of research, including evidence-based interventions and apply them to a condition. This produces something uniquely tailored to a certain need. Unlike evidence-based treatments, evidence-informed treatments don’t have results from research in controlled settings that demonstrate their effectiveness across a wide range of settings and people. When considering medication and other drug-like treatments, evidence-informed interventions have not received FDA approval for the condition they are treating. This is called “off-label” use.

Examples of evidence-based treatments

• Cognitive behavioral therapy (CBT) is a type of talk therapy that has proved effective in the treatment of anxiety, depression, addictions, phobias and certain physical health conditions. CBT focuses on changing automatic negative thoughts that can contribute to and worsen mental health and substance use symptoms. CBT has more evidence supporting it than any other psychological therapy.
• Acceptance and commitment therapy (ACT) is a type of mindful talk therapy that helps individuals stay focused on the present moment and accept thoughts and feelings without judgment. Over 200 randomized controlled trials have proven ACT is an effective treatment for depression, psychosis, chronic pain, substance use disorder, post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder and social phobia.
• Dialectical behavior therapy (DBT) is a type of talk therapy based on CBT and specially adapted for people who experience emotions very intensely. Nine published randomized controlled trials and five controlled trials of DBT have proven its effectiveness for treating borderline personality disorder, including in highly suicidal women.
• Exposure and response prevention (ERP) therapy is a form of CBT that encourages individuals to engage with their obsessive thoughts without carrying out their associated compulsions. Treatment begins with placing individuals in situations which cause a tolerable level of anxiety and gradually build up to settings they find more difficult. ERP has been proven effective for treating obsessive-compulsive disorder in numerous clinical trials.
• Eye movement desensitization and reprocessing (EMDR) therapy is a mental health treatment technique that involves moving your eyes a specific way while you process traumatic memories. The goal of EMDR is to help individuals heal from trauma or other distressing life experiences. Since the first EMDR clinical trial in 1989, dozens of other clinical trials have proven this technique is effective and faster for the treatment of post-traumatic stress disorder.
• Transcranial magnetic stimulation (TMS) is a noninvasive treatment that was first used to treat depression in individuals who were nonresponsive to other treatments. TMS involves using a magnetic coil to influence the brain’s natural electrical activity and has full FDA approval for the treatment of major depressive disorder, obsessive-compulsive disorder, migraines and smoking cessation.
• Esketamine is an FDA-approved nasal spray used to treat severe treatment-resistant depression. Esketamine was found effective in a phase 3, double-blind, active-controlled study conducted at 39 outpatient centers from August 2015 to June 2017. The study involved nearly 200 adults with moderate to severe depression and a history of not responding to at least two antidepressants.
• Fluoextine is an antidepressant medication that is approved by the FDA to treat depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder and panic disorder. It belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs) and works by increasing the activity of serotonin in the brain. Data based on a group of 9,087 patients who were included in 87 different randomized clinical trials confirms that fluoxetine is safe and effective in the treatment of depression from the first week of therapy.

 Examples of evidence-informed treatments   

Response Disequilibrium Therapy (RDx)—Based on the response disequilibrium model, RDx puts patients in charge of implementing their own treatment procedure outside of therapy sessions in the same environments that trigger their symptoms so they can learn new behaviors to replace and control their previous responses to distressing situations.

While preliminary findings from case studies involving 19 participants with OCD suggest RDx may be a promising alternative to traditional OCD treatments, future research is needed to determine its effectiveness across a wide range of settings, people and problems to classify it as an evidence-based intervention.

• Pregabalin (an FDA-approved anticonvulsant medication and fibromyalgia treatment) has been used off-label to treat generalized anxiety disorder, social anxiety disorder, bipolar disorder, insomnia and chronic pain conditions other than fibromyalgia. For pregabalin to be used for these conditions in an evidence-based manner, the FDA would have to approve their use for each specific condition.
• Risperidone (an atypical antipsychotic medication approved by the FDA for the treatment of schizophrenia, bipolar disorder and autism-associated irritability) has been used in a variety of off-label ways, including to treat borderline personality disorder, post-traumatic stress disorder (PTSD) and bipolar disorder. To date, the FDA has not approved risperidone to treat these three conditions.

Are mental health and wellness apps evidence-based or evidence-informed?

These days, you can’t browse the web or use most apps on your phone without seeing an ad for a wellbeing or therapy program or app. Used alone or to supplement traditional treatment and promote wellbeing, not all mental health, substance use and wellbeing apps use evidence-based practices, nor have they been extensively researched in treating specific conditions. Wellbeing and therapy apps are typically considered:

• Evidence-based when evidence-based interventions are fully implemented on the platform and followed by users in the same manner they would be if they were being delivered during face-to-face treatment. For example, the original evidence-based model below is used in a wellbeing app that delivers CBT digitally and all steps are followed as listed.
  1. Identify troubling situations or conditions in your life.
  2. Become aware of your thoughts, emotions and beliefs about these problems.
  3. Identify negative or inaccurate thinking.
  4. Reshape negative or inaccurate thinking.
• Evidence-informed when only certain components of evidence-based interventions are implemented on the platform, and/or the app only fully implements or uses components of evidence-informed interventions. For instance, if a wellbeing app provides CBT and only asks users to identify troubling thoughts and become aware of their thoughts, emotions and beliefs about these problems, it is evidence-informed because it does not ask users to identify and reshape negative or inaccurate thinking.

When considering using an app for yourself, your patients, your employees or your members, ask yourself these questions:

• Are the treatments used in the app based on quantitative research?
  • Were the studies conducted in controlled, blinded settings?
  • Are the treatments proven to be effective across a wide range of environments and people?
• Are all treatment steps included in the process, or has the process been watered down?
• Have the treatments used in the app received FDA approval for a certain indication, if FDA approval is possible?

Magellan’s approach to evidence-based versus evidence-informed treatments and mental health, wellbeing and substance use apps

The American Psychiatric Association and the American Psychological Association both consider evidence-based interventions preferred approaches for the treatment of psychological conditions.

At Magellan, we are leading the way in providing innovative, impactful behavioral healthcare solutions. When developing new and enhancing existing offerings , like our digital cognitive behavioral therapy (DCBT) programs, we always start with evidence-based treatments and adhere fully to all tenets. Magellan Healthcare’s DCBTs have been heavily researched in the studies below:

• FearFighter® for anxiety, panic and phobia (now available online in Spanish)
  • Computer-aided CBT self-help for anxiety and depressive disorders: Experience of a London clinic and future directions. L. Gega, I. Marks, D. Mataix-Cols. Journal of Clinical Psychology: In Session (2004), Vol. 60 (2), 147-157.
  • Computer-aided vs. tutor-delivered teaching of exposure therapy for phobia/panic: Randomized controlled trial with pre-registration nursing students. L. Gega, I.J. Norman and I.M. Marks. International Journal of Nursing Studies 44 (2007) 397-405.
  • The feasibility and effectiveness of computer-guided (CBT) (FearFighter) in a rural area. L. Hayward, A.D. MacGregor, D.F. Peck, P. Wilkes. Behavioural and Cognitive Psychotherapy (2007) 35, 409-419.
• MoodCalmer for depression (now available online in Spanish)
  • Saving clinician’s time by delegating routine aspects of therapy to a computer: A randomized controlled trial in phobia/panic. I.M. Marks, M. Kenwright, M. McDonough, M. Whitaker and D. Mataix-Cols (2004).
  • Technology-based advances in the management of depression: Focus on the COPE program. Disease Management and Health Outcomes. J.H. Greist, D.J. Osgood-Hynes, L. Baer and I.M. Marks (2000) 7, 4.
• RESTORE® for insomnia and other sleep difficulties (now available online in Spanish)
  • Implementing computer-based psychotherapy among veterans in outpatient treatment for substance use disorders. E.D.A. Hermes and R.A. Rosenheck. Psychiatric Services 67:2, February 2016, 176-183.
  • Cognitive behavioral therapy for insomnia enhances depression outcomes in patients with comorbid major depressive disorder and insomnia. R. Manber, J.D. Edinger, J.L. Gress, M.G. San Pedro-Salcedo, T.F. Kuo, T. Kalista. SLEEP, Vol. 31, No. 4, 2008, 489-495.
  • Logging on for better sleep: RCT of the effectiveness of online treatment for insomnia. N. Vincent and S. Lewycky. SLEEP, Vol. 32, No. 6, 2009, 807-815.
  • Sleep locus of control and computerized cognitive-behavioral therapy (cCBT). N. Vincent, K. Walsh, and S. Lewycky. Behaviour Research and Therapy, 48 (2010), 779-783.
• SHADE for substance use disorder
  • Randomized controlled trial of cognitive-behavioural therapy for coexisting depression and alcohol problems: Short-term outcome. A.L. Baker, D.J. Kavanagh, F.J. Kay-Lambkin, S.A. Hunt, T.J. Lewin, V.J. Carr and J. Connolly. Addiction, 105, (2009) 87-99.
  • Clinician-assisted computerised versus therapist-delivered treatment for depressive and addictive disorders: A randomised controlled trial. F.J. Kay-Lambkin, A.L. Baker, B. Kelly and T.J. Lewin. Medical Journal Australia, 195, 3, 1 August 2011.
  • Computer-based psychological treatment for comorbid depression and problematic alcohol and/or cannabis use: A randomized controlled trial of clinical efficacy. F.J. Kay-Lambkin, A.L. Baker, T.J. Lewin and V.J. Carr. Addiction, 104, 278-388 (2009).
• ComfortAble® for chronic pain
  • Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. D.M. Ehde, T.M. Dillworth and J.A. Turner. American Psychologist (2014), Vol. 69, No. 2, 153-166.

We further validate this research with outcomes from practical application of our solutions. By doing this, we ensure our clients and members receive only high-quality products and services that work in the real world—where it really matters.

SOURCES:

• ACT is an Empirically-Supported Therapy: Background and Clinical Evidence
• Act Theory: Acceptance and Commitment Therapy Explained
• CBT Explained: An Overview & Summary of CBT
• Dialectical Behavior Therapy
• EDMR Therapy
• Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder: Current Perspectives – PMC
• The Evidence for Cognitive Behavioural Therapy in any Condition, Population or Context: A Meta-review of Systematic Reviews and Panoramic Meta-analysis
• Fluoxetine: a review on evidence-based medicine
• National Library of Medicine: Pregabalin
• National Library of Medicine: Risperidone
• New Therapy Shows Promise for Swift Treatment of Obsessive Compulsive Disorder – Association for Psychological Science – APS
• Psychiatry.org – Study Supports Effectiveness of New Fast-Acting Antidepressant, Esketamine Nasal Spray
• Transcranial Magnetic Stimulation
• VR therapy for OCD Can Enhance the Delivery of Exposure Response Prevention
• What is Evidence-Based Therapy: 3 EBT Interventions