Atlas›Domains›Domain IX
Domain IX of XVI

Biomedical, neuro & digital

104guides
1,623weighted interventions
2000median founding year
256510mean Agape · Logos · Mythos

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Domain synthesis

What "healing" means here

In this domain, healing mostly means measurable symptom reduction or restored function. The treatment is delivered by someone else, such as a prescriber, a device team, a rehabilitation profession or a software product, and the psychotherapist works alongside it. The guides are explicit that these are "not a psychotherapy" IX-001 IX-015 IX-021 IX-056 IX-089.

Several families of modality share this framing:

  • Pharmacological and somatic treatments frame change as symptom relief while a medicine or stimulation acts. Anxiolytics reduce symptoms "while they are taken" IX-005. DBS "is not a cure", and symptoms are likely to return if stimulation stops IX-021. Spinal cord stimulation is "a pain management tool, not a cure" IX-023. Wake therapy is "the fastest antidepressant known" but unstable IX-034.
  • Rehabilitation professions define healing as restored participation and independence. Occupational therapy works on "the things they want and need to do in everyday life" IX-056. Physiotherapy restores movement and function IX-057. Recreational therapy aims to "restore, remediate and rehabilitate" IX-062. IPS treats competitive work as the goal IX-063.
  • End-of-life and integrative frameworks widen the scope:
  • Palliative care relieves suffering "whether physical, psychosocial or spiritual" IX-069.
  • Psycho-oncology states that no psychological method treats cancer itself IX-084.
  • Engel's biopsychosocial model was proposed against the narrowness of biomedicine IX-081.

One tension recurs. Many entries are labelled contested or experimental, and the guides separate what developers claim from what independent reviewers find. Examples include cranial electrotherapy IX-026, photobiomodulation IX-027, ILF neurofeedback IX-051, HeartMath IX-041, hyperbaric oxygen IX-031 and audio-visual entrainment IX-055. A second tension: digital products "add nothing by [themselves]" outside a therapeutic relationship IX-095, yet are scaled precisely to need less clinician time IX-086 IX-089.

What "the self" or "the person" is here

The dominant image is the person as a biological system of circuits, receptors and rhythms:

  • Receptors: cholinergic and dopamine signalling IX-003 and GABAergic action IX-007.
  • Circuits: treated as targets for stimulation or lesion IX-017 IX-021 IX-028 IX-029.
  • Rhythms: the circadian clock IX-032 IX-033 IX-035.
  • Metabolism: genotype IX-012, and brain energy metabolism, as in Palmer's claim that "mental disorders are metabolic disorders of the brain" IX-104.

Biofeedback and neurofeedback picture a person who can learn to sense and control internal states that are normally hidden:

The Greens add an older image: a body ready to accept "psychogenic programming" IX-038.

Rehabilitation sees an occupational, embodied person defined by daily roles, routines and environment IX-056 IX-062 IX-065. Families are included in that picture IX-065 IX-084.

Engel and Uexküll's psychosomatics rejects mind–body dualism outright IX-081. Palliative care's "total pain" (Saunders) treats the person as physical, psychosocial and spiritual at once IX-069.

Digital phenotyping offers a newer image: a "human phenotype in situ" that can be quantified moment by moment from smartphone data IX-100.

Mechanisms of change the domain names

Pharmacological. The guides name these drug mechanisms, often with explicit hedging: - receptor action: muscarinic modulation of dopamine circuits IX-003, GABA systems IX-007, NMDA antagonism IX-009 - anti-inflammatory or gut pathways, labelled "hypothesis, not established" IX-013 - nutrient correction of methylation or oxidative pathways IX-105 - dietary pathways via the microbiome and HPA axis IX-103

Stimulation and lesion. Circuit-level change comes from: - repeated stimulation altering circuit activity IX-017 IX-018 IX-021 - an induced seizure IX-015 IX-016 - interrupting a circuit with a permanent lesion IX-028 IX-029 - closed-loop detection and interruption IX-022

A sympathetic "reset" is proposed for stellate ganglion block, though the DoD calls its mechanism unknown IX-030.

Chronobiological. Change comes from re-timing or strengthening the body clock IX-032 IX-033 IX-036, or from removing the blue-light darkness signal so it no longer disrupts rhythms IX-035.

Operant learning and physiological training. - Kamiya: discrimination, then voluntary control through reinforcement IX-045. - Reinforced EEG change toward norms IX-048 IX-050. - Lehrer and Vaschillo: "exercising" the baroreflex IX-040. - Meuret: raising end-tidal CO2 IX-042.

Neuroplastic and rehabilitative learning. - Pairing stimulation or feedback with the person's own movement attempt IX-079 IX-080. - Prism adaptation IX-073. - Mirror visual feedback IX-060. - Adaptation, substitution and habituation in vestibular work IX-074. - Practice and transfer in CI therapy IX-059.

Psychological mechanisms carried through digital media: - emotional processing, habituation and corrective information IX-092 - behavioural experiments that drop safety behaviours IX-093 - facing an avatar that gradually concedes power IX-094 - the CBT model inside each programme IX-086 IX-087 IX-090

Behaviour change runs through COM-B and the 93-technique taxonomy IX-082, and through motivational interviewing in dietary work IX-103.

Relationship. Several guides place the active ingredient in contact itself: reaching a trained human quickly in a crisis IX-101, or treating a client's AI use as coping behaviour to be understood IX-098.

Shared techniques

Breath is central to biofeedback: resonance breathing near six breaths a minute IX-040, capnometry-paced breathing IX-042, HeartMath heart-focused breathing IX-041, and Peniston's rhythmic breathing IX-046.

Attention and imagery appear as: - autogenic phrases with "positive imagery" IX-038 - an "alert calmness" with a single focus IX-045 - hypnagogic reverie IX-046 - recall of a "regenerative" feeling IX-041 - graded motor imagery IX-060 - the relaxation response IX-085

Practice and exposure recur: - twice-daily home practice IX-038 IX-040 - exposure in VR IX-092 - habituation in vestibular work IX-074 - coordinating exposure work with anxiolytics IX-005 - intensive repetitive training IX-059 IX-071 IX-077

Movement and touch mostly come through the rehabilitation professions: - body awareness and psychomotor physiotherapy IX-057 - sensory integration IX-066 - Snoezelen environments IX-067 - Bobath handling IX-070 - exercise as a NICE option for depression IX-061

Voice shows up as LSVT LOUD's amplitude work IX-071, speech and language therapy IX-058, and the therapist voicing an avatar in real time IX-094.

Story and word take several forms: - psychoeducation and informed-consent conversations IX-001 IX-005 IX-023 - dignity therapy and meaning-centred psychotherapy IX-069 IX-084 - orientation information repeated through the day IX-068

Group and community formats include group SMART-3RP IX-085, chronic disease self-management groups IX-082, holistic group programmes IX-065, moderated peer communities IX-101 and peer workers in VR delivery IX-093.

Relationship is the psychotherapist's constant role across the domain. The guides describe it as: - collaborative care, adherence and ambivalence conversations, and passing on warning signs IX-001 IX-002 IX-006 - owning the crisis pathway, which apps do not IX-089

Developmental or stage models

The domain contains no developmental psychology of the self. It does name several stepped, sequenced and phased models.

Stepped care: - NICE CG113's stepped care, which offers a choice between psychological and drug treatment at step 3 IX-005 - the NICE four-level model of psychological support in cancer IX-084 - stepping up or ending within NHS Talking Therapies IX-087

Sequences inside a treatment: - Triple chronotherapy: wake therapy, then sleep-phase advance, then morning light IX-034 IX-036. - Graded motor imagery: limb recognition, then imagined movement, then mirror work IX-060. - Instrument-to-independence sequences, where the person learns with feedback and then performs the skill without it: - Kamiya: discrimination, then control IX-045 - the Greens: training with the instrument, then without it IX-038 - Tübingen SCP training: practice with feedback, then transfer IX-049

Packaged phases: - Peniston's multi-component package with booster sessions IX-046 - SMART-3RP's intake, eight weekly groups and provider sessions IX-085 - AVATAR-Extended's initial session plus twelve sessions IX-094 - the standard one-month LSVT protocols IX-071 - weekly ICBT modules IX-086

Phases of the illness course: - For spinal cord stimulation: informed decision, trial, implant, and living with ongoing pain afterwards IX-023. - Palliative care is "most effective when considered early in the course of the illness" IX-069. - Holistic neuropsychological rehabilitation is a post-acute programme IX-065.

Distinctive contribution

This domain sets the psychotherapist beside treatments they do not and must not deliver. It specifies the boundaries of that role (no doses, settings or protocols) and the collaborative tasks that remain: referral, consent, monitoring, crisis planning and integration IX-001 IX-015 IX-089.

It also brings what other domains largely lack: - dated regulatory and evidence-status checking, with contested methods labelled as such IX-026 IX-051 IX-097 - explicit physiological and circuit-level accounts of change - a grounding in function, occupation and participation, through the rehabilitation professions IX-056 IX-063

All 104 guides in this domain

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