Lauren has been working for Interactive Health Systems for 16 years developing the content, process and testing of interactive psycho-educational software, as well as implementing and administrating its use within corporations and healthcare organizations.

1. When was the last time you had a good
conversation with a computer?
Lauren Gould
310.600.8123 lgould@gte.net
InterActive Health Systems, Inc.

2. Roger L. Gould, M.D.
 1965: head of UCLA Outpatient & Community
Psychiatry Program - new delivery system needed
 1970: did research on adult development - framework
 1975: wrote “Transformations, Growth and Change in
Adult Life” - integration with daily practice
 1980: received a grant to develop a practical model of
short term therapy - conversion to learning model
 Founder of IHS and producer of the Model &
Methodology behind the Products - created computer-
assisted therapy
InterActive Health Systems, Inc.
InterActive Health Systems, Inc.

3. History of IHS (and TLP)
 1985: started in CIGNA Wellness program with
2,000 users
 1990: utilized in various settings with 4,000
outpatient users and 8,000 inpatient users
 1995: incorporated into treatment of 2,000
outpatient managed care users
 2000: evolved into Self Help sessions for
employees and consumers on the Internet
InterActive Health Systems, Inc.
InterActive Health Systems, Inc.

4. What is the TLP?
 It is a 10 session computer-assisted brief
therapy program that helps patients...
 pinpoint a particular problem that is a
primary source of stress
 learn how to think more clearly about the
issue and how they respond to the situation
 develop an effective course of action for
resolving the problem and reducing the
stress
InterActive Health Systems, Inc.
InterActive Health Systems, Inc.

5. Sample of User Data (CYA / “others”)
 feeling powerless - no where to go - being useless - unwanted &
worthless - angry & betrayed - lonely & depressed - uncomfortable,
dirty & abnormal - almost crying when somebody says I love or care
about you
 I know longer tell myself or believe that I can’t do
something I put my mind to.
 I am able to feel good about myself, new beliefs, and
capable of seeing the good in myself.
InterActive Health Systems, Inc.

6. Validation
 The UCLA/Kaiser comparison and follow-up study
finds the TLP to be a powerful Self Help tool.
 This study corroborates 7 independent studies of
the TLP between 1985-1996.
 Studies have reported that the TLP is appropriate for
all diagnostic categories except psychosis and
organic disease.
 In each study, there is strong evidence that this tool
meets the criteria of an effective and desirable
therapy.
InterActive Health Systems, Inc.

7. Other Products
1983 - Developmental Stress Profile (DSP)
1984 - Team Effectiveness Audit (TEA)
1985 - Therapeutic Learning Program (TLP)
1990 - Discover, Decide and Act (DDA)
1992 - Stress Check (for Physicians)
1993 - The Eating Conflict
1994 - FOCUS (Outpatient Clinical Triage)
1995 - Self Help chats for Prodigy
1996 - Mastering Stress CD-ROM
1998 - Mastering Stress Online
InterActive Health Systems, Inc.
InterActive Health Systems, Inc.

8. And Markets
• Outpatient Wellness programs
• Community Mental Health Centers
• Inpatient Psychiatric Hospitals
• Health Maintenance Organizations
• Employee Assistance Programs
• Outpatient Mental Health Clinics
• Government and Educational Programs
• Corporate Business market
• Consumer Self Help Audience
InterActive Health Systems, Inc.
InterActive Health Systems, Inc.

9. Advantages of using a Computer
 Private & confidential
 Self-directed & self paced
 Promotes honest disclosure
 Assists other modalities of care
 Self documenting (database storage)
 Multiple delivery platforms & settings
 Facilitates standardization & customization
InterActive Health Systems, Inc.

10. The Method
 Takes people through a step-by-step behavior
change process that mediates the user’s thinking
and mirrors the critical thinking of a professional.
 Engages people in a context specific, accurate
and “emotionally alive conversation” until the
individual reaches resolution.
 Helps people make choices that enable them to
develop a new and healthier level of personal
power.
InterActive Health Systems, Inc.

11. A Model for Behavior Change
Behavior change is a complex cognitive and
emotional process that requires a partial
transformation of the individual’s world view.
Stage 1: Building Motivation
Stage 2: Exploring Options
Stage 3: Reducing Irrational Fear
Stage 4: Managing Self Image
InterActive Health Systems, Inc.

12. Products
Therapeutic
Mastering Learning
Stress Program
FOCUS
Discover, Decide & Act
Stage 1 Stage 2 Stage 3 Stage 4
InterActive Health Systems, Inc.

13. TLP: computer-assisted brief therapy
 Identifying Stress Related Problems, Conflicts & Symptoms
 Clarifying Goals and Focusing on Action
 Thinking Through the Consequences of Taking Action
 Uncovering Hidden Motives, Fears of Failure & Success
 Exploring Anger & Guilt as Obstacles to Action
 Confronting Issues of Self Esteem
 Examining Old Detrimental Patterns of Behavior
 Understanding the History of Self-doubts
 Analyzing a Current Incident Involving a Self-doubt
 Evaluating the Changes Experienced during the Course
InterActive Health Systems, Inc.

14. Our Outpatient Services using TLP & FOCUS
 Our computerized intake served a triage function with special
emphasis on symptoms, impairments, substance abuse,
depression, psychotic disorders, danger to self, to others or
from others.
 Compared to other providers in a managed care company
 53% of our patients improved
versus 32% in the rest of the network
 41% stayed the same versus 58%
 6% regressed versus 10%
 This increase in functioning was obtained in 7.2 session
(with our model and tool) versus an 11 session average for
the other therapists on the panel.
InterActive Health Systems, Inc.
InterActive Health Systems, Inc.

15. Quote from Satisfied User
 The single most helpful benefit I got was the
Action Step. I use it all the time. It has
become a mantra.
How do I feel, do I want to feel like this, can I
change it, what are the consequences, can I
live with them? Yes - take the action.
It gave me a concrete useable tool for
everyday life.
InterActive Health Systems, Inc.
InterActive Health Systems, Inc.

16. Mastering Stress:
a guided self-help software program
 Managing Symptoms
 helps you describe your “stress picture” and create a
plan for minimizing the negative effects of stress.
 Resolving Problems
 gives you the tools to analyze the factor that cause
stress and develop an effective strategy for
resolution.
 Getting Help
 assists you in recognizing how you may benefit from
additional resources and overcome any obstacles to
utilizing them.
InterActive Health Systems, Inc.

17. Discover, Decide & Act:
personal development for adolescents
 The Questions...
 What is happening in your life?
 How are you dealing with it?
 What do you really want to do about it?
 The Sessions...
 Managing Stress
 Resolving Problems
 Dealing with Adults
 Pressure from Peers
 Taking Action
 Overcoming Obstacles
InterActive Health Systems, Inc.

18. Interactive Content for
the Relationship Domain
 Creating a Vision of Your Ultimate Relationship
 Describing Your Ideal Partner
 Acknowledging what makes You Compatible
with Your Ideal Partner
 Identifying Inner Reservations about Your
Ultimate Relationship
 Understanding the Challenges of Dating
 Designing Your Personal Action Plan
InterActive Health Systems, Inc.

19. The Target
Physical
Health
Mental Personal
Health Development
Behavior Change
SOFTWARE
Individual Growth & Well-being
Conflict Resolution
InterActive Health Systems, Inc.

20. The Dynamics of Behavior Change
Smoke
Awareness
Discover of external
pressure Don’t Smoke
Resolution
Decide Don’t Smoke
of the
Smoke
internal
conflict
Commitment
& ACT to Action
DON’T SMOKE and Follow
through
InterActive Health Systems, Inc.

21. usage and research
 In addition to delivering information, each behavior
change software program gathers important
information in a database. This makes it easier to
study, modify and improve over time.
The software functions on many levels...
 a prevention program
 an intervention program
 a personal development program
 a research tool
InterActive Health Systems, Inc.

22. Behavior Change Software
Stage 1: INCREASE AWARENESS
Define Problem / Goal
Consider Motivational Conflict
Stage 2: ESTABLISH INTENTION
Commit to Exploring Options
Decide on a Strategy
Stage 3: TAKE ACTION
Experiment with Different Actions
Overcome Irrational Fears
Stage 4: REVIEW RESULTS
Incorporate Success
Increase Self Esteem
InterActive Health Systems, Inc.

23. 4 STEP INTERVENTION PROCESS
COMPUTER
WORK
GROUP
DYNAMICS
INDIVIDUAL
EFFORT
FOLLOW
PERSONAL WORKSHEET UP
InterActive Health Systems, Inc.

24. The Future is NOW!
 WHAT
 A Developmental Diary or Electronic Journey
 At home &/or Online at CyberSelf.com
 WHY
 to increase awareness
 to facilitate action
 to enhance well-being
 HOW
 personal resource menus that provide insight
 a “smart” program with dynamic customization capabilities
 an “intelligent” database, where the usefulness and value
grows with the user.
InterActive Health Systems, Inc.
Lauren Gould, 1998

25. The Digital Diary
Marketing Mailer
CD-ROM installation
Journal
User database
Workbook
Online updates
Phone support
from “Knowledge Base”
& referral system
InterActive Health Systems, Inc.
Lauren Gould, 1998

26. A Shift in Perspective
 What problems do I want to address?
 What life goals do I want to achieve?
 What pain do I want to diminish?
 What good feelings do I want to experience?
 What bad patterns do I want to stop?
 What healthy habits do I want to practice?
 What negative labels do I want to overcome?
 What life skills do I need to improve?
 What needs do I want to satisfy?
 What fundamental right do I need to exercise?
 What irrational thinking do I want to replace?
 What healthy beliefs do I need to incorporate?
InterActive Health Systems, Inc.
Lauren Gould, 1998

27. The Conversational Paradigm
LISTEN
 We use multiple choice menus that represent a range
of options that are user friendly or “experience near.”
THINK
 We test conditions, set variables and define branching
logic based on a set of pre-defined assumptions.
SPEAK
 Then we build, display and print individualized
statements that communicate the user’s thoughts and
feelings.
InterActive Health Systems, Inc.

28. Design Guidelines
 The requirements for quality and consistency are..
 users feel comfortable, understood and
respected
 users feel encourages to share information at
their own pace
 users should not feel overexposed
 modules are personal, private and confidential
 modules are easy to use, with no previous
computer experience needed
InterActive Health Systems, Inc.

29. Interactive Objectives
 To
 actively involves users in non-threatening communication,
 allows users to find themselves and express their thoughts and feelings,
 guides users from a general or vague sense of pending issues to clarity,
 educates users about common issues and misconceptions,
 promotes honest reflective thinking by uncovering errors in perception,
 helps users develop a more realistic self-appraisal,
 surfaces the users’ dilemma or conflict that is inhibiting,
 facilitates options exploration and decision making,
 provides a positive framework to sort out and overcome obstacles,
 validates users’ frustrations and concerns,
 normalizes users' hesitations, fears and doubts,
 enhances users' motivation to reach their desired outcome.
InterActive Health Systems, Inc.

30. InterActive Health Systems, Inc.