McLean Hospital 115 Mill Street Belmont, MA 02478
Courtney Beard, PhD, is an assistant professor of psychology in the Department of Psychiatry at Harvard Medical School, and at McLean Hospital serves as director of the Cognition and Affect Research and Education (CARE) Laboratory and assistant director of the Behavioral Health Partial Hospital Clinical Research Program.
Dr. Beard’s research aims to delineate cognitive and affective mechanisms underlying psychiatric disorders and to develop treatments to target these mechanisms. She is a clinical psychologist with expertise in anxiety disorders and cognitive behavioral therapy.
Dr. Beard’s Cognition and Affect Research and Education (CARE) lab conducts research to delineate cognitive and affective mechanisms underlying psychopathology, translate these findings into new treatments, and implement these treatments in real world settings.
One of the lab’s main focuses is on interpretation bias in emotional disorders. Daily life constantly requires the resolution of ambiguity. For example, not getting a job or a friend not returning a call can be interpreted in multiple ways. The way in which individuals automatically resolve the countless such ambiguous situations encountered each day has a large impact on their affect and behavior. Interpretation bias, the tendency to resolve ambiguity negatively, is a crucial therapeutic target due to its causal maintaining role in emotional disorders. Theoretical models propose that interpretation bias maintains a vicious cycle in which an individual experiences the world as more hopeless or threatening—which heightens negative affect—increases behavioral avoidance and more biased cognition.
Interpretation bias maintains psychopathology not only due to its direct effect on affect, but also through cascading and interacting effects with other cognitive processes, contributing to a pervasive maladaptive cognitive style. Individuals with this cognitive vulnerability have difficulty generating multiple interpretations for ambiguous situations, more easily get “stuck” in repetitive negative thinking, have poor emotion regulation, and more suicidal ideation. A CARE lab study showed that in a psychiatric hospital sample, interpretation bias was a better predictor of suicidal ideation at discharge than any other demographic or clinical variable available. Dr. Beard’s paradigm for measuring interpretation bias, the Word Sentence Association Paradigm, has been adapted and used by many research labs in the US and internationally.
Dr. Beard’s lab also studies cognitive bias modification. Cognitive behavioral therapy (CBT) targets interpretation bias via cognitive restructuring, an explicit process involving post-hoc reappraisals of situations. However, patients face challenges when attempting to apply cognitive techniques. The automatic nature of interpretation bias may be especially difficult to change through explicit methods because it can operate unintentionally, and outside of awareness. Additionally, CBT is an effortful method that may be challenging for individuals under stress.
In contrast, cognitive bias modification (CBM) interventions are computerized cognitive training tasks designed to encourage healthier mental habits. These interventions have the potential to augment existing treatments, such as cognitive behavioral therapy, and to provide a low-intensity, low-cost, stand-alone treatment. Dr. Beard conducted the first randomized controlled trials of CBM as a treatment for anxiety disorders. Her R34 grant funded by NIMH is the first to develop a transdiagnostic, personalized CBM treatment and methods for implementing this new treatment in primary care. Dr. Beard has been involved in projects testing the effects of CBM for a wide range of emotional disorders including anxiety disorders, fear of cancer recurrence, and depression. Together, these projects have the potential to improve the available treatment options for individuals with anxiety and depression, who are among the highest utilizers of health care.
As assistant director of the Behavioral Health Partial Hospital Clinical Research Program, Dr. Beard oversees the integration of research and clinical work. Partial hospitals provide a bridge between inpatient and outpatient treatment, helping individuals experiencing acute crises rapidly gain behavioral skills to better manage their symptoms. The Behavioral Health Partial Hospital Program (BHP) exemplifies an integrative approach in which research informs clinical practice and clinical practice informs research.
Dr. Beard disseminates patient feedback to program staff and identifies areas of strength and possible improvement for the BHP. She directs a research forum each month, during which the research team disseminates recent findings to staff and trainees. Dr. Beard founded and chairs the BHP’s Patient Advisory Board, a 10-person group that includes BHP patients and staff. The advisory board provides guidance to the BHP’s research program regarding research priorities and procedures.
Additionally, Dr. Beard oversees research training and mentorship to many types of trainees, including clinical psychology post-doctoral fellows, pre-doctoral interns, practicum students, undergraduate student visitors, and BHP mental health counselors. BHP trainees are involved in the entire research process and regularly present their work in poster presentations, symposia, and peer-reviewed manuscripts.
Beard C, Amir, N. A multi-session interpretation modification program: changes in interpretation and social anxiety symptoms. Behaviour Research and Therapy. 2008;46(10):1135-41.
Beard C, Sawyer AT, Hofmann SG. Efficacy of attention bias modification using threat and appetitive stimuli: a meta-analytic review. Behavior Therapy. 2012;43(4):724-40.
Beard C, Millner A, Forgeard MJC, Fried EI, Hsu KJ, Treadway M, Leonard CV, Kertz S, Björgvinsson T. Network analysis of depression and anxiety symptom relationships in a psychiatric sample. Psychological Medicine. 2016;46(16):3359-3369.
Belmont campus - Recreation Building, Room 130