Bridging the Gap Between Complexity Science and Clinical Practice by Formalizing Idiographic Theories: A Computational Model of Functional Analysis

The past decades of research have seen an increase in statistical tools to explore the complex dynamics of mental health from patient data, yet the application of these tools in clinical practice remains uncommon. This is surprising, given that clinical reasoning, e.g., case conceptualizations, largely coincides with the dynamical system approach. We argue that the gap between statistical tools and clinical practice can partly be explained by the fact that current estimation techniques disregard theoretical and practical considerations relevant to psychotherapy. To address this issue, we propose that case conceptualizations should be formalized. We illustrate this approach by introducing a computational model of functional analysis, a framework commonly used by practitioners to formulate case conceptualizations and patient-tailored treatment targets.We outline the general approach of formalizing idiographic theories with differential equations, drawing on the example of a functional analysis for a patient suffering from panic disorder. We specified the system using a series of non-linear differential equations and simulated different scenarios; first, we simulated data without intervening in the system to examine the effects of avoidant coping on the development of panic symptomatic. Second, we formalized two clinical interventions commonly used in cognitive behavioral therapy (CBT; exposure and cognitive reappraisal) and simulated their effects on the system.The first simulation indicated that for our example patient, persistent avoidance behavior leads to an increase in catastrophic interpretations of panic-related stimuli, followed by panic symptomatic. The second simulation study illustrated differential effects of the formalized CBT interventions for this patient. All tested interventions (exposure, cognitive reappraisal and combination) could decrease panic levels in the system. Formalizing clinical theories is promising in bridging the gap between complexity science and clinical practice, and can help fostering more rigorous scientific practices in psychotherapy. More precise case conceptualizations can subsequently improve intervention planning and treatment outcomes. We discuss applications in psychotherapy and future directions, amongst others concrete ways to combat technical barriers and extending the framework to incorporate interactions between individual systems, relevant for modeling social learning processes. With this report, we hope to stimulate future efforts in formalizing clinical frameworks.