Can the structure of speech reveal where a psychotic episode is heading?

In this episode, Bruce talks with computational psychiatrist Natalia Mota, MD, PhD, about her research showing how the structure of speech can help differentiate between emerging psychotic disorders earlier and more precisely than traditional methods alone.

Using graph theory and natural language processing, Natalia and her team transform speech into “word graphs” that mathematically measure thought fragmentation and narrative connectedness. In one striking study with first-episode psychosis patients, for example, Natalia successfully predicted emerging schizophrenia versus bipolar disorder with over 90% accuracy -- simply by analyzing how participants described a recent dream.

Together, Bruce and Natalia discuss:

• The broader clinical implications of computational psychiatry for early detection and intervention

• The classic debate between subjective clinical judgment versus statistical prediction, and why both approaches are needed

• Why Natalia’s methodology is not black-box AI

• How education and socioeconomic factors shape language

• Why technology must "keep the human in the loop”

• What speech fragmentation reveals about dementia

• The adolescent mental health crisis and social contagion

This conversation explores a powerful idea:

There are identifiable structures within natural speech patterns — and these structures can reveal a goldmine of hidden clinical information.

If you care about psychotherapy, early intervention, computational psychiatry, or the future of psychiatric diagnosis, this episode will challenge how you think about listening. -----

🔔 Don’t forget to like, comment, subscribe, and share — your support helps us keep these conversations going.

**** Natalia Mota, MD, PhD is a psychiatrist and neuroscientist with a focus on creating novel quantitative methods to measure the flow of thoughts, and to differentiate between causes of psychosis and dementia. Her current research examines speech in psychosis, wake–sleep cycles, and school-based declarative learning.

**** Bruce Wampold, PhD is a psychologist and leading psychotherapy researcher known for his work on the contextual model of psychotherapy and the science of therapeutic relationships. His research explores how and why psychotherapy works, integrating clinical insight with rigorous empirical methods.

--

The Making Therapy Better podcast is brought to you by CarePaths EHR, an electronic health record system designed to help you improve therapy outcomes.https://www.carepaths.com

Follow the Making Therapy Better project:

🌐 Website: www.makingtherapybetter.com

📺 YouTube: /@makingtherapybetter

📸 Instagram: /making_therapy_better

📘 Facebook: /makingtherapybetter

🐦 Twitter: /therapybetter

💼 LinkedIn: /9223245

Produced and edited by Kevin Riordan and Geissy Araújo. Intro/outro music by Chris Haugen, free for public use.

00:00 Bruce intro

01:35 Bruce: Kahneman's work on confidence vs. accuracy

04:33 Bruce: The practical relevance of computational psychiatry and Natalia’s work

06:39 What Is "Computational Psychiatry?"

12:28 Graph Theory for thought disorders

16:44 Research findings

23:18 Predicting clinical trajectories after first-episode psychosis

30:58 Beyond "black box AI"

35:22 Effects of culture and life experience on language usage

40:25 Applications for dementia and other disorders

45:18 Language, social bonds, and mental health

51:22 Closing remarks

55:11 Outro and farewell

Is depression really caused by a chemical imbalance — or is that one of the most enduring myths in modern psychiatry?

For decades, the serotonin theory of depression has shaped how mental health is explained, treated, and marketed to the public. But what does the science actually show — and why does evidence that challenges this narrative provoke such intense reactions?

In this provocative episode, our host Bruce Wampold sits down with Joanna Moncrieff, M.D., professor of critical and social psychiatry at University College London and a founding member of the Critical Psychiatry Network. Joanna has spent more than 30 years researching psychiatric diagnosis, antidepressant medications, and the sociocultural forces that shape modern mental health care. She is the author of well over 60 academic articles and several books, including her newest release, Chemically Imbalanced: The Making and Unmaking of the Serotonin Myth.

Together, Bruce and Joanna discuss:

• What the scientific evidence does, and does not, reveal about the connection between serotonin and depression

• What antidepressant trials really show about efficacy and placebo effects

• Emotional numbing, clinical significance, and real-world prescribing practices

• The social, political, and professional forces that influence psychiatric research and practice

• Why challenges to the chemical imbalance narrative have been so controversial

• What it means to understand depression as a human response to life, rather than a brain disease

----

🔔 Don’t forget to like, comment, subscribe, and share! Your support helps us keep these conversations going.

---

Bruce Wampold, Ph.D. | Emeritus Professor, University of Wisconsin–Madison; author of The Great Psychotherapy Debate; one of the most influential psychotherapy researchers alive today.

Joanna Moncrieff, M.D. | Professor of Critical and Social Psychiatry at University College London; leading figure in the Critical Psychiatry Network; author of Chemically Imbalanced and multiple prior books examining antidepressants and psychiatric theory.

---

This episode was produced and edited by Geissy Araújo, Ph.D. and Kevin Riordan.

——

The Making Therapy Better podcast is brought to you by CarePaths EHR, an electronic health record system designed to help you improve therapy outcomes. [https://www.carepaths.com](https://www.carepaths.com)

---

00:00 Introduction 00:45 Meet Dr. Joanna Moncrieff

02:10 The serotonin myth: Unpacking the evidence

09:57 Antidepressants and the placebo effect

18:40 The sociology of psychiatry and antidepressants

31:06 Understanding depression: Biological vs. psychological perspectives

32:57 Clinical trials vs. real-world practice

35:11 The role of the human relationship in depression treatment

37:03 Evolutionary perspectives on depression

40:26 Challenging the serotonin theory of depression

47:03 Future of depression treatments: Psychedelics and beyond

54:57 Reframing depression: A human reaction to life's challenges

58:30 Conclusion and final thoughts

-----------------------

#MentalHealth #Depression #Psychiatry #Antidepressants #serotonin #CriticalPsychiatry #Psychotherapy #BruceWampold #JoannaMoncrieff #MakingTherapyBetter #MentalHealthScience

Intro/outro music by Chris Haugen, free for public use.

Is Cognitive Behavioral Therapy REALLY superior to Humanistic or Psychodynamic approaches? According to the scientific evidence, what factors ACTUALLY drive the change process, and what skills can therapists strengthen to get better outcomes?

In this episode of The Making Therapy Better Podcast, our host Dr. Bruce Wampold takes the guest seat in a lively conversation with a group of young Brazilian psychologists who are at the heart of a contentious debate gaining national attention in Brazil: Geissy Araújo, Ph.D., Maurício Majolo, M.S., Lucas Cardoso, and Mateus Souza, M.S.

Together, they discuss:

- The common arguments that certain theoretical orientations are superior to others

- Whether these claims are supported by the scientific evidence

- What the data actually reveal about the change process in psychotherapy

- The balance between theory, evidence, and human connection

- The path toward a more productive conversation about improving psychotherapy training and outcomes in Brazil and around the world

Bruce reminds us that therapy is not merely a set of techniques — it’s a social and relational healing practice rooted in empathy, collaboration, and meaning.

----

Be sure to also check out our related episode where Bruce and Scott Miller discuss some of these topics in greater detail:

#21: "What Makes Therapy Work?" - Scott Miller, PhD interviews Bruce Wampold, PhD (S3, E1): https://youtu.be/A0stmKy3Jnc?si=akkCENIxGBlL3Lkk

🔔 Don’t forget to like, comment, subscribe, and share — your support helps us keep these conversations going.

----

Bruce Wampold, Ph.D. | Emeritus Professor, University of Wisconsin–Madison; Author of "The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work" -- and among the most influential psychotherapy researchers alive today.

Produced and edited by Geissy Araújo, Ph.D. and Kevin Riordan.

——

The Making Therapy Better podcast is brought to you by CarePaths EHR, an electronic health record system designed to help you improve therapy outcomes.https://www.carepaths.com

Follow the Making Therapy Better project:

🌐 Website: www.makingtherapybetter.com

📺 YouTube: /@makingtherapybetter

📸 Instagram: /making_therapy_better

💼 LinkedIn: /9223245

----

00:00 Introduction to the Episode and Guest

03:25 Bruce's Journey into Psychotherapy

08:24 The Role of Personal Experience in Therapy

13:04 Common Factors in Psychotherapy

19:25 The Importance of Therapist-Patient Relationship

27:19 Cultural and Contextual Considerations in Therapy

36:08 Impact of Culturally Adapted Therapy

38:11 Debates on Empirically Supported Treatments

39:47 The Evolution of Evidence-Based Practice

42:10 The Essence of Psychotherapy

44:10 Future of Therapist Training

47:26 Science Communication in Psychotherapy

49:25 Measurement-Based Care and Therapist Improvement

01:00:22 Advice for New Therapists

01:03:08 The Role of AI and Technology in Therapy

01:04:59 Conclusion and Final Thoughts

----

#Psychotherapy #TherapySkills #Counseling #HumanisticTherapy #EmotionFocusedTherapy #PluralisticTherapy #cognitivebehavioraltherapy #TherapistTraining #ClinicalSupervision #BruceWampold #MakingTherapyBetter #MentalHealth

Intro/outro music by Chris Haugen, free for public use.

Why do therapists keep making the same avoidable mistakes?

In this episode, Dr. Bruce Wampold sits down with Dr. Mick Cooper — Professor of Counseling Psychology at the University of Roehampton and an internationally recognized expert in humanistic, existential, and pluralistic therapies.

Together, Bruce and Mick break down common therapist mistakes and their impact on the therapeutic alliance. Through fun and helpful role-plays, they even demonstrate how these common mistakes can show up in the therapy room, and what more effective responses might look like.

--

Topics include:

• Being too passive (too much silence, not enough engagement)

• Talking too much, or saying things that just aren’t relevant

• Being too cognitive and avoiding emotion

• Letting that “therapist voice” or rigid techniques get in the way of authenticity

• Avoiding affect even when it’s clearly right there

• Colluding with the client instead of exploring the meaning

• Assuming your preferred model is the “right” one for every client

• Failing to explain how therapy works, or why what you’re doing may be helpful

Whether you're a clinician, supervisor, trainee, or simply curious about what actually happens in the therapy room, this episode offers a rare, behind-the-scenes look at the micro-skills that matter most.

What do YOU think therapists should never do? We’d love to hear your thoughts. Share your perspective in the comments!

🔔 Don’t forget to like, comment, subscribe, and share — your support helps us keep these conversations going.

--

👉 Be sure to also check out Mick's related video! 👈

How NOT to do Counseling: 13 Things to Try and Avoid

https://www.youtube.com/watch?v=GOk7mR5mFLE

——

Mick Cooper, Ph.D. | Professor of Counseling Psychology, University of Roehampton; Author of numerous books, including: Working at Relational Depth in Counselling and Psychotherapy and Psychology at the Heart of Social Change: Developing a Progressive Vision for Society. Check out his books here! https://www.amazon.com/stores/Mick-Cooper/author/B001H6PZPQ

Bruce Wampold, Ph.D. | Emeritus Professor, University of Wisconsin–Madison; Author of The Great Psychotherapy Debate

Produced and edited by Geissy Araújo, Ph.D. and Kevin Riordan.

——

The Making Therapy Better podcast is brought to you by CarePaths EHR, an electronic health record system designed to help you improve therapy outcomes.

https://www.carepaths.com

Follow the Making Therapy Better project:

🌐 Website: www.makingtherapybetter.com

📺 YouTube: /@makingtherapybetter

📸 Instagram: /making_therapy_better

💼 LinkedIn: /9223245

Intro/outro music by Chris Haugen, free for public use.

Despite decades of evidence showing that group therapy is often just as effective as individual therapy, it remains underutilized in clinical training and practice. Why?

In this episode, Dr. Bruce Wampold sits down with Dr. Cheri Marmarosh — Professor of Clinical Psychology at The George Washington University and one of the world's leading experts on group psychotherapy. Together, they discuss:

• Why training programs and reimbursement systems still prioritize individual therapy
• The relational and cultural barriers that make therapists hesitant to lead groups
• How group therapy addresses isolation, loneliness, and disconnection
• What it takes to become an effective group leader
• The challenges and possibilities of running groups online
• How group dynamics reveal the real-life patterns that shape our relationships

If you’re a clinician, educator, or simply curious about how people grow through connection, this episode will remind you that healing doesn’t happen in isolation — it happens in relationship.

Correction: Dr. Marmarosh is now a full professor. She was incorectly introduced as associate professor in the introduction.

🔔 Don’t forget to like, comment, subscribe, and share — and stay tuned for more content coming soon!

------

Cheri Marmarosh, Ph.D. | Associate Professor of Clinical Psychology, The George Washington University; Director, Group Psychotherapy Research Lab; Author of Attachment in Group Psychotherapy

Bruce Wampold, Ph.D. | Emeritus Professor, University of Wisconsin–Madison; Author of The Great Psychotherapy Debate

------

The Making Therapy Better podcast is brought to you by CarePaths EHR, an electronic health records system designed to help you improve your therapy outcomes. https://www.carepaths.com

------

Follow the Making Therapy Better project:

🌐 Website: www.makingtherapybetter.com

📺 YouTube: /@makingtherapybetter

📸 Instagram: /making_therapy_better

📘 Facebook: /makingtherapybetter

🐦 Twitter: /therapybetter

💼 LinkedIn: /9223245

------

Produced and edited by Kevin Riordan and Geissy Araújo. Intro/outro music by Chris Haugen, free for public use.

#GroupTherapy #Psychotherapy #Therapy #CheriMarmarosh #BruceWampold #AttachmentTheory #MentalHealth #PsychotherapyResearch #Loneliness #Teletherapy #ClinicalTraining #MakingTherapyBetter #MentalHealth

Has the rise of telehealth truly reduced inequities in who has access to psychotherapy? Who is being left behind? How did COVID-19 impact the prevalence of mental illness? These are just a few of the questions Bruce explores in this timely episode with Dr. Mark Olfson, one of the leading experts on mental health services in the U.S. ...And the answers may surprise you!

It's no secret that the mental health landscape in countries like the U.S. is shifting rapidly — with rising demand for services, changes in who delivers psychotherapy, and new modalities like telehealth and AI transforming the way people receive care. But what do the data tell us about how these changes are actually impacting population mental health, and mental health services?

If you’re a clinician, researcher, or anyone interested in the systems that shape mental health, and mental health services, this episode is for you!

Featuring:

**** Mark Olfson, MD, MPH | Professor of Clinical Psychiatry, Columbia University; Psychiatrist, New York State Psychiatric Institute

**** Bruce Wampold, PhD | Emeritus Professor, University of Wisconsin–Madison; Author of The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work

🔔 Don’t forget to like, subscribe, and share — and stay tuned for more content on the science of psychotherapy and healing!

----

The Making Therapy Better podcast is brought to you by CarePaths EHR, an electronic health records system designed to help you improve your therapy outcomes. (https://www.carepaths.com)

----

Follow the Making Therapy Better project!

Website: http://www.makingtherapybetter.com

YouTube: / @makingtherapybetter Instagram: ( / making_therapy_better

Facebook: / makingtherapybetter

Twitter: / therapybetter

LinkedIn: / 9223245

----

The Making Therapy Better podcast is produced and edited by Kevin Riordan and Geissy Araujo. Intro/outro music is by Chris Haugen and is free for public use.

----

#MentalHealthServices #Psychotherapy #Therapy #MindBody #MarkOlfson #BruceWampold #Healing #UW-Madison #Columbia #clinicalpsychology #PsychotherapyResearch #MentalHealth

Dive into placebo effects in clinical trials, psychotherapy, and even conditions like Parkinson’s. Can a sugar pill really help someone heal? And what if it’s not just the pill, but the expectation of benefit, that drives the outcomes?

In this episode, Dr. Bruce Wampold sits down with Dr. John Kelley, one of the world’s leading placebo researchers, to explore how belief, expectation, empathy and the therapeutic relationship profoundly influence outcomes in both medicine and psychotherapy. Plus, they unpack a groundbreaking study that not only changed how we think about placebo effects, but how we think about healing itself.

👉 If you're a clinician, researcher, or just curious about the mind-body connection, this one’s for you.

🧠 Featuring:

• John Kelley, PhD | Deputy Director of the Program in Placebo Studies & the Therapeutic Encounters, Harvard Medical School; Licensed Psychologist, Massachusetts General Hospital
• Bruce Wampold, PhD | Emeritus Professor, University of Wisconsin - Madison; Author of The Great Psychotherapy Debate

🔔 Don’t forget to like, subscribe, and share — and stay tuned for more deep dives into the science of healing.

----

The Making Therapy Better podcast is brought to you by CarePaths EHR, an electronic health records system designed to help you improve your therapy outcomes. (https://www.carepaths.com)

----

Follow the Making Therapy Better project!

Website: http://www.makingtherapybetter.com

YouTube: / @makingtherapybetter

Instagram: ( / making_therapy_better

Facebook: / makingtherapybetter

Twitter: / therapybetter

LinkedIn: / 9223245

----

The Making Therapy Better podcast is produced and edited by Kevin Riordan and Geissy Araujo.

Intro/outro music is by Chris Haugen and is free for public use.

----

#PlaceboEffect #Psychotherapy #Therapy #MindBody #JohnKelley #BruceWampold #Healing #Expectations #clinicalpsychology #HarvardMedicalSchool #PsychotherapyResearch #MentalHealth

In this inspiring episode, Bruce sits down with Dr. Louis Castonguay from Pennsylvania State University to delve into the evolution and current state of psychotherapist training and education. The discussion covers a broad range of topics, from the risks of holding rigidly to Cognitive Behavioral Therapy (CBT) in training programs to importance of intellectual humility and the diminishing focus on foundational psychotherapy skills. Dr. Castonguay argues for an integrated training model that emphasizes trans-theoretical skills and exposing trainees to a wider range of theoretical orientations and perspectives, perhaps especially in programs that will still primarily focus on CBT. The episode also touches on the broader social and existential relevance of psychotherapy in today's complex world. This episode is a must-listen for anyone interested in the future of psychotherapist training and supervision.

Dr. Louis Castonguay was awarded the Lifetime Contribution Award by the Society for Psychotherapy Research and is the author of numerous books including How and Why Are Some Therapists Better Than Others?: Understanding Therapist Effects.

Dr. Bruce Wampold, your host, is one of the most prominent psychotherapy researchers alive today and has co-authored the hugely influential books on this topic: The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work and the newest edition of Persuasion and Healing: A Comparative Study of Psychotherapy

----

The Making Therapy Better podcast is brought to you by CarePaths EHR, an electronic health records system designed to help you improve your therapy outcomes. (https://www.carepaths.com)

----

Follow the Making Therapy Better project!

• Website: http://www.makingtherapybetter.com
• YouTube: https://www.youtube.com/@makingtherapybetter
• Instagram: (https://www.instagram.com/making_therapy_better
• Facebook: https://www.facebook.com/makingtherapybetter
• Twitter: https://twitter.com/therapybetter
• LinkedIn: https://www.linkedin.com/groups/9223245/

----

The Making Therapy Better podcast is produced and edited by Kevin Riordan.

Intro/outro music is by DELOSound and is free for use under the Pixabay Content License.

----

In this engaging episode, Bruce sits down with Dr. Julia Frank to discuss their collaboration on the newly revised edition of 'Persuasion and Healing,' a groundbreaking book on the science and philosophy of psychotherapy originally written by Julia’s father, Jerome Frank. The book has shaped generations of psychotherapists—including Bruce himself—and remains one of the most influential works in the field. Bruce and Julia delve into the rich history behind the seminal work, Jerome Frank’s unique background, the evolution of psychotherapy research, and the critical role of myth and ritual in therapeutic outcomes. This episode is essential listening for anyone interested in the fundamental principles that underpin the effectiveness of psychotherapy across various approaches.

Julia Frank, M.D. is emeritus faculty at the George Washington University School of Medicine, director of the Five Trimesters Clinic for pregnant and postpartum women, and co-author of the 2025 edition of 'Persuasion and Healing: A Comparative Study of Psychotherapy.’ Bruce Wampold, Ph.D. is a leading psychotherapy researcher, developer of the contextual model of psychotherapy, and co-author of ‘The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work.’

----

The Making Therapy Better podcast is brought to you by CarePaths EHR, an electronic health records system designed to help you improve your therapy outcomes. (https://www.carepaths.com)

----

Follow the Making Therapy Better project:

• Website: http://www.makingtherapybetter.com
• YouTube: https://www.youtube.com/@makingtherapybetter
• Instagram: (https://www.instagram.com/making_therapy_better
• Facebook: https://www.facebook.com/makingtherapybetter
• Twitter: https://twitter.com/therapybetter
• LinkedIn: https://www.linkedin.com/groups/9223245/

----

The Making Therapy Better podcast is produced and edited by Kevin Riordan.

Intro/outro music is by DELOSound and is free for use under the Pixabay Content License.

----

Why haven’t psychotherapy outcomes improved in decades, despite hundreds of new treatment models and thousands of new randomized controlled trials?

In this special episode of the Making Therapy Better podcast, renowned psychotherapy researchers Bruce Wampold and Scott Miller discuss how the field’s obsession with inventing and testing treatment methods may have distracted us from strengthening the relational skills that we know drive better treatment outcomes. Bruce and Scott explore why therapy outcomes have plateaued, what makes some therapists consistently more effective than others, and how clinical training must evolve to focus on measurable interpersonal skills.

Bruce Wampold, Ph.D. is Emeritus Professor at the University of Wisconsin–Madison and among the most influential psychotherapy researchers alive today. Scott Miller, Ph.D. is the founder of the International Center for Clinical Excellence and a pioneer in improving clinical training through deliberate practice and measurement-based care.

----

The Making Therapy Better podcast is brought to you by CarePaths EHR, an electronic health records system designed to help you improve your therapy outcomes. (https://www.carepaths.com)

----

Follow the Making Therapy Better project:

- Website: (http://www.makingtherapybetter.com)

- Instagram: (https://www.instagram.com/making_therapy_better)

- Facebook: (https://www.facebook.com/makingtherapybetter)

- Twitter: (https://twitter.com/therapybetter)

- LinkedIn: (https://www.linkedin.com/groups/9223245/)

----

The Making Therapy Better podcast is produced and edited by Kevin Riordan.

Intro/outro music is by DELOSound and is free for use under the Pixabay Content License.

----