Erik Forsell

Erik Forsell

Postdoctoral Studies

Erik Forsell studies internet-delivered CBT, precision psychiatry and adaptive digital treatments for common mental health disorders.

Visiting address: M46 Karolinska Universitetssjukhuset Huddinge, 14186 Stockholm
Postal address: K8 Klinisk neurovetenskap, K8 CPF Kaldo Forsell, 171 77 Stockholm
Part of:

About me

  • I am a licenced clinical psychologist, post doc and Director of Research and Development at the Internet Psychiatry Clinic in Stockholm (internetpsykiatri.se). I also serve on the board of directors for the International Society for Research on Internet Interventions (ISRII; https://isrii.org/) and a an editor for Internet Interventions (https://www.sciencedirect.com/journal/internet-interventions).

    My research focus is implementing, delivering and optimizing internet interventions within healthcare systems in order to reach as many in need as possible and provide treatments that are as effective and efficient as they can be.

    I attenden the psychologist programme at Linköping University between 2009-2014 where my master's thesis was about ICBT for procrastination within a research project. This was my first experience providing internet interventions. After graduating I moved back to my hometown of Stockholm and came to the Internet Psychiatry Clinic as a prospective PhD-student and psychologist in five different randomized controlled trials of ICBT for insomnia, comorbid insomnia and depression, and depression during pregnancy. The focus of my doctoral thesis was adaptive treatment strategies in ICBT where patients are monitored during the early stages of treatment and those at risk of not benefitting from treatment get targeted with extra support and rescources. I defended my thesis in May of 2020, mostly via Zoom of course...

    Since then I have been working as Director of Research and Development at the Internet Psyhciatry Clinic splitting my time between research, clinical developmend and management. 


    Disseration of the year 2021: Beteendeterapeutiska Föreningen (Swedish Association of Behavior Therapy)


    Best oral presentation 2022: SweSRII 2022 - conference of the Swedish Society for Research on Internet Interventions


    PhD (Medicine doktorsexamen), Karolinska Institutet, Department of Clinical Neuroscience, 2020


    Clinical Psychologist, Linköpings Universitet, Department och Behavioral science and Learning, 2014

Research

  • Internet delivered Cognitive Behavior Therapy (ICBT) for...
    * Generalized Anxiety Disorder

    * Depression during pregnancy
    * Insomnia
    * Comorbid insomnia and depression
    * Procrastination
    And
    * Automated predicitve systems for patient outcomes in ICBT

Teaching

  • I teach primarily at the psychologist programme at Karolinska Institutet where my focus is mostly research design and philosofy of science as well as cognitive behavior therapy, internet delivered treatments and models for psychological mechanisms. I also supervise and co-supervise several PhD students.

Selected publications

Articles

All other publications

Grants

  • Development and testing of two treatments for excessive worry in routine psychiatric care: internet based treatment for adults with generalized anxiety disorder (GAD)
    CIMED junior grant
    1 January 2025 - 31 December 2027
  • Swedish Research Council
    1 January 2025 - 31 December 2028
    Self-injury is a growing health crisis among youth, and the strongest risk factor for suicide attempts. Scalable treatments are needed but lacking. We have recently shown that a brief digital treatment, IERITA (Internet-delivered Emotion Regulation Individual Therapy for Adolescents), can be efficacious and cost-effective. However, not all patients respond sufficiently to the standard treatment procedure. Now we aim to implement and evaluate IERITA within regular health services and optimize treatment outcomes. First, we will develop and validate a classification tool to predict non-remission (continued self-injury after treatment). This tool will subsequently be used in the second step: a randomized controlled trial (N=341) between 2025 to 2028, which compares adaptable to standard IERITA. Adolescents allocated to adaptable IERITA and classified as likely non-remission in treatment week four will recieve adapted IERITA (e.g., personalized dose and treatment delivery) for the remaining eight weeks. We will (1) follow participants one- three- and twelve-month post-treatment
    (2) use self-reports and blinded assessments
    (3) study distal effects in national registers
    (4) investigate several clinically relevant outcomes
    and (5) conduct cost-effectiveness analyses. If successful, more patients could receive evidence-based treatment for self-injury, and treatment outcomes could be improved. In extension, queues to care may be reduced, and suicide attempts and suicides prevented.
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2025 - 31 July 2026
    Research idea and purposeSelf-injury is a growing and urgent health crisis among youth and the strongest risk factor for suicide attempts. Scalable and evidence-based treatments are needed but lacking. We have recently shown that a brief digital treatment, IERITA (Internet-delivered Emotion Regulation Individual Therapy for Adolescents), can be efficacious compared to treatment as usual only. However, not all patients respond sufficiently to the standard treatment procedure, and established efficacy does not guarantee successful uptake in regular care. This project aims to implement and evaluate IERITA in real-world settings and optimize treatment outcomes. A planning grant creates opportunities to test the project´s feasibility, an essential part of preparation for a large-scale study.Work plan, methods and project realisationFirst, a classification tool to predict continued self-injury after treatment (non-remission) will be developed and subsequently used in a randomized controlled pilot trial (N=30) comparing adaptable to standard IERITA. Adolescents allocated to adaptable IERITA and classified as likely non-remission in treatment week four will change to adapted IERITA (e.g., personalized dose and treatment delivery) for the remaining eight weeks. Feasibility will be evaluated through the number of completed treatment parts, degree of participation in data collection, satisfaction, adherence, and therapist time. Clinically relevant outcomes will also be measured, which include remission (primary clinical outcome), frequency of self-injurious behaviour, suicidality and level of functioning. Participants will be followed up one- and three months post-treatment. The project will be conducted within regular health care services in several regions which we have collaborated with previously. Patient organizations and health professionals will contribute to increasing relevance and feasibility. The budget includes salaries for the project manager and patient organization, and a smaller part for operating costs.Societal relevance and utilisationSelf-injury is rapidly increasing, posing severe risks for youths. The queue to healthcare services is long, and current treatments are costly and not widely or equally accessible. If this project is successful, more youths across the country could receive effective early intervention for self-injury, with the hope of reduced waiting times, equal care, and suicide preventive effects.
  • Development and testing of two treatments for excessive worry in routine psychiatric care: internet based treatment for adults with generalized anxiety disorder (GAD)
    ALF-medicine project funding
    1 January 2024 - 31 December 2026
  • Development and testing of two treatments for excessive worry in routine psychiatric care: internet based treatment for adults with generalized anxiety disorder (GAD)
    ALF-medicine project funding
    1 January 2023 - 31 December 2023
  • Development and testing of two internet interventions for excessive worry in regular psychiatric care: internet based treatment for adults with generalized anxiety disorder (GAD)
    Region Stockholm stöd för klinisk postdoktor
    1 January 2022 - 31 December 2025
  • Development and testing of two treatments for excessive worry in routine psychiatric care: internet based treatment for adults with generalized anxiety disorder (GAD)
    CIMED junior grant
    1 January 2022 - 31 December 2024
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2022 - 31 December 2026
    About 15% of mothers suffer from postpartum depression, which besides their suffering often affects the relation to the child and partner negatively. Depression during pregnancy constitutes a high risk for postpartum depression, and better screening and access to treatment is needed.Mom2B is a mobile application aimed towards all pregnant individuals, and includes screening for depression. If detected, general information regarding health care for depression is presented. We want to randomize half of these indicated risk users to instead receive targeted information about guided, internet-based CBT (ICBT) for depression during pregnancy.Our hypothesis is that more of these will start our evidence-based ICBT and lower their symptom levels and risk for postpartum depression 8-10 weeks after delivery, measured with structured interview and registry data. We also expect the strategy with targeted information and ICBT to be beneficial from a health economic perspective. ICBT is preceded by an assessment, and during the 12-week treatment the participant works with a self-help material while actively supported by a psychologist via text messages. We have evaluated the ICBT-program used in this study with positive results, but in line with other research on ICBT we have seen that more support and adjustments are often asked for. In line with Personalized Care, we will thus randomize some of those seeking ICBT, via Mom2B or other channels, to receive more personalized care by letting them choose type of visits (physical/video/telephone) and get extra visits with a midwife with the purpose of better adjusting the care to their needs. Others will receive no extra visits and are randomized to type of visit. For sub-analyses, some also choose type of visit but receive no extra visits, and vice versa.Our hypothesis is that personalized ICBT will lead to increased treatment engagement and patient empowerment, as well as reduced symptoms and risk for postpartum depression.
  • Development and testing of two treatments for excessive worry in routine psychiatric care: internet based treatment for adults with generalized anxiety disorder (GAD)
    ALF-medicine projekt funding
    1 January 2022 - 31 December 2022

Employments

  • Postdoctoral Studies, Department of Clinical Neuroscience, Karolinska Institutet, 2023-2026

Degrees and Education

  • Degree Of Doctor Of Philosophy, Department of Clinical Neuroscience, Karolinska Institutet, 2020

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