Brain Changeability

Before scientists discovered the degree to which even adult brains continue to change throughout the lifespan, it was widely assumed that a problem like addiction involves brain patterns that may be permanent. Brain scientists don’t believe that anymore, and neither should you! In addition to providing scientific justification for a hope in more sustainable healing and recovery, we take advantage of these exciting discoveries in Fortify to offer many specific practical strategies that can help speed up brain changes associated with more lasting freedom from compulsive-addictive patterns.

Risk Factors

While there’s tons of valuable scientific investigation into the direct experience of compulsive-addictive patterns, few realize how much rigorous study has also gone into the many different precursor environmental and lifestyle conditions that set people up for these same problems (making it more or less likely that addiction keeps showing up in our lives). By focusing priority attention on these risk and protective factors in Fortify, we help people identify unique, underlying contributors to their own struggle that can inform a more comprehensive plan for reaching deeper, more lasting freedom.

Lifestyle Interventions

It's not just lifestyle patterns setting people up for problems like addiction that have received scientific attention. There’s also a mountain of evidence exploring the impact of specific adjustments to these same lifestyle and environmental factors when it comes to finding greater healing and recovery. The scope of these findings provides crucial, extensive scientific backing to the hopeful education provided in Fortify’s training.

Mindfulness

One of the lifestyle adjustments receiving the most scientific attention is studying what happens when people infuse their experiences, especially painful ones, with more space, silence, and stillness. As people learn to approach a difficult problem from a gentler, calmer place, research consistently documents how that problem changes significantly for the better: less pain, less struggle, less relapse. That matters a lot for people facing compulsive-addictive patterns - and that’s why we provide practical training and guidance throughout Fortify in how exactly to take a more mindful approach to these struggles.

Behavior Change

Over the last three decades in particular, a remarkable level of attention has gone to scientifically analyzing key mechanisms and processes involved in reaching legitimate and lasting behavioral change. We’ve paid particular attention to the take-away discoveries in creating both our technological infrastructure, and the specific content and strategies within our online platforms and mobile apps.

Gamification

It was the surprising research on gamification that prompted our ongoing interest in leveraging gaming dynamics as a supportive, creative enhancement to people’s ongoing healing journeys. On a variety of levels, we continue to find ways in which this lighter-hearted, playful approach can help shift people out of a “fight or flight” mentality - into a more resilient, open place where deeper learning and growth can take place.

Digital Health & Education

As recently as twenty years ago, we were just beginning to explore the idea that people could communicate on this strange thing called “the internet.” Over the last decades, our appreciation continues to expand rapidly at what that world-changing innovation can mean for remote education, as well as complementary, long-distance support for people facing different behavioral or health challenges. Developments in both of these areas have been crucial in shaping the specific pedagogical, design and technological decisions in Fortify - including in developing tech to help facilitate better professional-client communication and collaboration.

Any More Specific Questions About Our Science?
What's the scientific background for your Fortify Well-being Surveys?
The monthly well-being surveys have developed over many years of study and development from a team of Ph.D. researchers in psychology and family studies. As much as possible, individual survey questions were adapted or inspired by existing measures, including: the Center for Epidemiological Studies Depression Scale (CES-D), the Oxford Happiness Inventory, the State Trait Anxiety Inventory, the Peace of Mind Scale, the State Hope Scale, the Perceived Stress Scale, the UCLA Loneliness Scale, the Self-Compassion Scale (SCS), the Relate Inventory, the Hypersexual Behavior Inventory and the OQ-45. On a broader structural level, we follow here what is called “dimensional assessment,” which aims to capture progression along a full spectrum extending from various levels of distress (depression, anxiety, post-traumatic stress, physical discomfort, shame, discouragement, isolation, etc.), to their corresponding states of health (happiness, peace, healing from trauma, physical wellness, self-compassion, hope, connection, etc). This innovative approach to measurement is increasingly being embraced as the crucial next step for measurement and assessment (see the 2017 paper by 39 leading academics, “The hierarchical taxonomy of psychopathology (HiTOP): A dimensional alternative to traditional nosologies”). We were also inspired to go in this direction by popular scales such as the Positive and Negative Affect Schedule (PANAS) and the OECD Subjective Well-Being Scale, which have measured both positive and negative experiences effectively for many years. By helping Fortify members see their progress along a broader spectrum spanning negative and positive indicators, we believe this will help better document the full dimensions of a comprehensive change process, while also providing ongoing encouragement for people to continue seeking even deeper healing.
Is there a scientific background for the Fortify Lifestyle Inventories?
There sure is! Each of the nine areas of lifestyle adjustments we’ve chosen to focus on (Environment, Sleep, Exercise, Nutrition, Mental Diet, Social Support & Accountability, Stress, Meaning & Purpose, and Mindfulness) have been confirmed in many hundreds of studies as potentially significant influences on healing and recovery from compulsive-addictive patterns. In addition, the extra questions made available as optional assessments are drawn directly from many empirical studies we’ve personally reviewed. Bottom line: the medical research clearly documents (through different overlapping lines of observational, correlational, and controlled evidence) the value of not only paying attention to lifestyle contributors to addiction, but also thinking more seriously about how to adjust these in a better direction as a way to spark deeper healing from compulsive-addictive patterns.
How does your approach in Fortify compare to other methods to help people find change?
The approach we take in Fortify wasn’t developed in a vacuum. Rather than an entirely different approach, our effort reflects an eclectic attempt to bring together anything we’ve found already proving to help deepen healing and spark more lasting freedom. That includes aspects of behavioral activation, narrative psychology, cognitive behavioral approaches, mindfulness, and spiritual-based approaches like the 12 steps. Our belief is there are many different ideas and strategies that can be helpful - and that what uniquely strengthens someone can vary significantly from one moment to another. If that’s true, then why not let people see the whole smorgasbord of options? Consistently, people tell us they are encouraged by very different parts of the Fortify training and platform.
What’s the scientific background of the team behind Fortify?
The core research members of our research team have a combined 45 years of research experience—with over 65 peer-reviewed publications, and many other professional publications and books. Our broader advisory team has many other decades of research and counseling experience, with many additional scholarly publications. The experts who have informed and influenced the development of Fortify include professionals from clinical and counseling psychology, family studies, and neuroscience.
What kind of research and evaluation has been done on the results and outcomes associated with apps and platforms like this one?

When you look across online tools to help people find more healing, one thing you find is most online interventions center around one strategy - with the most highly researched one, for example, online "CBT – cognitive behavioral therapy." As one researcher notes, "Despite the large number of health care apps developed so far, the majority has only simple functionality and does little more than provide information" (Becker, et al. 2014)

So how does this matter for results? One central finding in an in-depth review of internet-delivered interventions promoting health behavior change in 43,236 different participants was that "interventions that incorporated more behavior change techniques tended to have larger effects than interventions that incorporated fewer techniques\" (Web, et al., 2010). As another scholar summarized, "research shows that workplace interventions are more effective when they involve evidence-based principles that offer a variety of engagement modalities" (Cancelliere, et al. 2011).

Dr. Joseph Grenney, author of The Influencer, concurs: "it is not the strategies in-and-of themselves that make the difference, it is how many of the strategies you choose to employ at one time; the more strategies, the more successful the odds of changing the behavior."

2012 study reviewed 3336 paid health and fitness apps in Apple's iTunes store with a focus on 3 main psychological factors that can drive behavior change, as identified by the Precede-Proceed Model (PPM). Namely, devices can be tools, mediums, or social actors. These are (1) predisposing, which increase the user’s capability; (2) enabling, which facilitates an authentic experience for users; and (3) reinforcing. These 3 factors assist the user in establishing and strengthening relationships and performing the required actions repeatedly (all three components are a part of our apps). Check out what they found:

Most of the apps were coded as either predisposing or enabling with only 6.65% of apps classed as reinforcing. Only 1.86% (62/3336) of apps included all 3 factors, which may help explain why health behaviors have not shifted dramatically since the emergence of apps. (West et al., 2012)

One conclusion evident in the existing research, then, is that apps that provide support in different ways, through multi-strategy approaches, have deeper impacts than those that do not.

1 Fogg BJ. Persuasive Technology: Using Computers to Change What We Think and Do. In: Persuasive Technology: Using Computers to Change What We Think and Do. Waltham, MA: Morgan Kaufmann; 2002

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