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. -----

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**** 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.

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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

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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

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

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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.

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

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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)

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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

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#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.

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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.

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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.

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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

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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

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

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