Talkspace and therapy success rates

 I presume you have all heard of Talkspace?  

Go see talkspace.com

It's the latest internet/IPO multibillion dollar sensation.

You go online and pick a therapist and do the whole thing - consultation, prescriptions etc online, and pay by credit card. 

 

But here's there success rate:

If my success rate was 44% experiencing clinically significant change in 8 weeks of sessions, I'd shoot myself.

In any other profession or service, that would be seen as utter failure.  Can you imagine an orthopaedic surgeon, say, with that kind of results?  Or a fashion house?  Or any estate agent?  Mental health is the only area I can think of where people get away with failure.  Oh, yes, there's one more, prisons!  76% re-arrested within 5 years in the US.

Word recognition versus comprehension

Here is a new research paper which compares word recognition to comprehension:

A pilot study to assess oral health literacy by comparing a word recognition and

comprehension tool by Khan, Ruby, Goldblatt, Schensul and Reisine

It comes to the conclusion that word recognition does not necessarily imply comprehension. 

Any primary school teacher in the UK can tell you that.

Well, at least someone has formally put it down on a paper.

And it justifies why we recommend always doing phonics before comprehension for struggling readers.

 

Curiosity didn't kill the cat, it improved learning

Somebody has finally done an experiment whose results were obvious, but we accelerated learning buffs will be grateful for the publicity!

From today's Guardian newspaper:

Curiosity improves memory by tapping into the brain’s reward system

Whom do you trust?

Last night I watch a fascinating National Geographic TV program about the vital importance of first impressions.

http://braingames.nationalgeographic.com/episode/3/

This has very strong implications for PR, marketing and selling.

In summary, the following research findings were highlighted:

1.       Putting visual clues not in plain sight, but repeating them subtley, makes a big difference.    In several scenes of the program, there were posters and pictures shown on the screen – but not as the main focus – of milk and related items.  (A cow is a related item to milk!)  After watching these scenes, people were asked to pick what they most wanted to drink from a list of 3, one of which was milk.  They all chose milk because they had subconsciously picked up on the visual clues.

2.       What you say first is the most important thing.  They showed 2 identical twins doing an interview.  The first one said something positive and then something negative about herself.  The other twin said something negative and then something positive about herself.  They repeated the interviews with several interviewers who were blind to the experiment.  They were asked to pick whom they would hire.  They all picked the twin who spoke positively FIRST.   Apparently this is called the Primary Effect.

3.       Statistics show (yeah, ok) that people are willing to spend 30% more on a known brand compared to a generic in a supermarket.

4.       People are much more adventurous if they are NOT being watched.  If you offer free money to people in the street, they are unlikely to take it if you are watching them or even if you put up a big poster with a pair of eyes!  If they think no one is watching, they will take the money much more readily.

5.       All things being equal, people will always choose things that are easier to pronounce.  For example, which 3 of the following stocks are you most likely to invest in, if you had the money and didn’t know anything about them other than their codes:

·         CLEM

·         FDW

·         TAN

·         GZR

·         BARN

·         QXM

Nearly everyone in the experiment picked CLEM, TAN and BARN.

6.       People generally will not buy into anything if they believe it’s too good to be true.  This wasn’t in the program, but there’s a section in the excellent book “Flash Boys” by Michael Lewis which I reproduce here about two guys trying to sell an astonishing piece of software to Wall Street that had an almost unbelievable back story:

They never created a PowerPoint; they never did anything more formal than sit down and tell people everything they knew in plain English.

7.   People instantly decide if a face is trustworthy or not.  70% of the reason a politician gets into power is probably because people like his face.  Just think about the recent leaders of political parties.  It may be that the only reason that Nick Clegg is Deputy Prime Minister is because he has a nice face.  Will Ed Milliband lose because he looks a bit weird?  Would UKIP have got anywhere if Farage looked like the back of a bus?

 How does this apply to selling therapy for depression, my own particular point of interest?  The point that jumps out for me is that I think the reason that therapy doesn’t sell  is because it’s too good to be true.  So what we need to do is explain exactly how it works.  And the same applies to TIR, our traumatic stress therapy.  We need some to explain it in simple terms in one paragraph.

And TIR needs a better acronym that can be pronounced as a word.

And I need to do a survey showing my face and some of my colleagues to a bunch of strangers to see which one of us is the most trustworthy!

Blowing my own trumpet and casting scorn on others... again

Today in The Guardian, the Daily Telegraph, Newsweek and elsewhere, there is a report of a scientific experiment at a US university to see if applying magnets to the brain improves memory.  The results are published in Science magazine.  
So it must be true then.
Well, not so fast.
Firstly, there were 16 treatment subjects.
Yes, 16.  A miserably small number.
The improvements were "20 to 25%" over the control, but only lasted 24 hours.
We don't know how many other papers on the same topic were not published due to failure.

We did something with memory in India.  We took 100,000 women.  That's a sample size of 6000 times bigger.
We made most of them literate.  They learnt 50 letters of the Hindi alphabet and how to string them into sentences.  The effect lasted a lot longer than 24 hours.   (We don't think literacy fades much if they keep practising.)  Our control group - the other hundreds of millions that we didn't put on our course - didn't get literate.  So the improvement was from zero words a minute reading ability to say an average of 10 words a minute.  That's 10 divided by 0 is.... an infinite improvement!

http://news.sciencemag.org/brain-behavior/2014/08/rebooting-memory-magnets

Tories discuss stripping benefits claimants who refuse treatment for depression

From today´s Sunday Telegraph:

http://www.telegraph.co.uk/news/politics/conservative/10964125/Tories-discuss-stripping-benefits-claimants-who-refuse-treatment-for-depression.html

According to the government, 46 per cent of benefit claimants receiving Employment and Support Allowance, the main benefit for ill and disabled people, have mental health problems.
...
Estimates based on government figures suggest the state spends up to £1.4 billion a year – more than £3.5 million per day - on ESA for these claimants with mental health issues.

That's 260,000 claimants.
So if you can cure 50% of them of depression at a cost of £2700 per person, the cost will be £700m and the benefit will be £700m.

For £2700 per person, I will happily volunteer to be the therapist.  And I only need to get a 50% cure rate.

Tory MPs allege that claimants are just unwilling to avail themselves of the services available.  Obviously they don't know that the waiting list for CBT is several months in many areas, and the alleged benefit of CBT doesn't kick in for 6 months anyway.  
See http://www.biomedcentral.com/1471-244X/14/19

How to reduce crime through literacy part 2

The adult population of the UK is 51 million.

10% of them are Scottish.

5.2 million adults are illiterate in England ( reading age of 11 or below).[1]  So probably 5.5 million adults are illiterate in the UK.  (I’ve seen large numbers banded about for Scotland but I don’t believe them!)

9.2 million adults in the UK have criminal records.[2]

Let us assume that 25% of these actually went to prison.

(I checked with Howard League for Penal Reform but even they don’t know the total number of people who have been to prison, so I am using this as a rough way of getting the number.)

So we’re assuming that 2.3 million UK adults have been to prison.

48% of criminals have a reading age of 11 or below.[3]

So let's work with a manageable sample:

1000 people leave school.

102 will be illiterate (5.2 million out of 51 million).

45 will go to prison (2.3 million out of 51 million).

48% of prisoners are illiterate.  Which is 22 of them.

So of our 102 illiterates, 22 of them will end up in prison.

That’s 20%. 

Let's just emphasise that.  If we've got our assumptions correct, for every child you allow to leave school illiterate (reading age of 11 or below), a fifth of them will end up in prison. 

So let’s say we halve the number of illiterates leaving school, then maybe only 11 of our illiterates end up in prison instead of 22.

So we could reduce the prison population by 11/45 which is about 25%.

Let's just emphasise that.  If we reduce the number of illiterates leaving school by a half, we could reduce the prison population by a quarter.

(We haven't proven causality here of course, we're just saying there's a jolly good chance that we're right!)

But can we reduce the illiterates by half?

In our research trial of our literacy program ReadingWise English last year, in one secondary school, 30% of the struggling readers went from “illiterate” (below reading level 1) to literate (level 1 or above) in just a 20 hour intervention.  In fact their average reading age increase was 23 months.

That was only 20 hours.  So yes, we can reduce the illiterates by half.

At a rough cost per child of £262[4] for the software and say £3,000 for a Teaching Assistant for one week for 10 children (salary and premises and amortise a computer), so that’s £300, so let’s be conservative and say £1000 per child total cost.

And you’ll save £37k per prisoner.  Not to mention the staggering rest of the cost of policing and arresting and trying the poor buggers.   So that’s £5k against a lot more than £37k.

A no brainer.

My case rests.

---

[1] http://www.literacytrust.org.uk/adult_literacy/illiterate_adults_in_england

[2] http://www.npia.police.uk/en/7403.htm

[3] http://www.civitas.org.uk/crime/factsheet-EducationinPrisons.pdf

[4] £5000 for a school of average 939 pupils with 20% of them on the program.