Interventions and Models of Their Delivery to Reduce the Burden of Mental Illness: Reply to Commentaries.

Our article in the January issue of Perspectives on Psychological Science (Kazdin & Blase, 2011) recommended developing a portfolio of models to deliver psychotherapeutic interventions with the goals of reaching a larger and more diverse segment of the population in need of mental health services and reducing the burden of mental illness. The commentaries offer several novel extensions to advance the goals. Among the topics raised in the commentaries are the role of moderating influences, the importance of a public health model for intervention research and application, the need to organize and manage our knowledge base and current treatments more effectively, the potential utility of priming-based interventions, the importance of cost measures, and novel applications to extend treatment broadly to veterans in need of services. The commentaries stimulated additional points to address the original goals including the utility of identifying interventions (e.g., lifestyle changes) that can reach many people in need and that can have broad outcome effects on mental and physical health, the importance of "disruptive innovations" (i.e., innovations that qualitatively change the nature of what and how services are delivered) from a business perspective, and the need for improved assessment to track the burden of mental illness in an ongoing way and to evaluate subgroups not being reached with our current interventions.