Summary: Even though many psychological treatments are backed by solid science, they often fail to produce lasting change because people forget much of what they learn in sessions and struggle to form new habits. Recent work highlights a widespread disconnect between the guidance patients receive in therapy and the behaviors they actually adopt afterward.
Research indicates that most patients remember only about 30% of clinical information, and forming new routines can require months without the right support. By adding straightforward, evidence-based supports—such as well-timed reminders, cues that link new actions to existing routines, and brief habit-building strategies—clinicians can help patients retain more of what they learn and turn it into lasting change.
Key facts:
- Memory retention gap: On average, patients retain roughly one-third of the information discussed during clinical sessions.
- Habit formation timeline: Establishing a new behavior can take anywhere from about 18 days to several months, often as long as 36 weeks.
- Practical enhancements: Low-cost interventions like text reminders, brief memory supports, and habit cues can substantially improve adherence and outcomes.
Source: UC Berkeley
Allison Harvey expected to study hard when she signed up for an 11-week parenting course earlier this year.
Harvey, a UC Berkeley professor who studies memory, habit formation, and sleep, took careful notes, completed weekly homework, and actively engaged with the course instructors—who are experienced clinical psychologists. She was more diligent than many of her classmates, including her husband.
Yet when the program ended she discovered a familiar problem: despite her effort, she had already forgotten many of the practical lessons she had intended to put into practice.
“I was far short of where you’d want a patient to be at the end of 11 sessions,” she said, using her experience as a personal example of a broader issue facing evidence-based psychological treatments.
Evidence-based psychological treatments—such as cognitive behavioral therapy, trauma-focused interventions, and other scientifically tested approaches—are effective for many mental health problems. Still, their real-world impact can be limited when patients do not remember treatment content or cannot convert insights into routine behaviors. Harvey’s recent paper in Behaviour Research and Therapy examines how modest, science-informed adjustments could make these interventions more effective and longer lasting.
Memory gaps in health care
A key barrier to treatment success is the persistent mismatch between what clinicians explain during sessions and what patients retain afterward. Clinicians may provide accurate, helpful guidance, but without follow-up or memory support, much of that information is lost.
Harvey emphasizes that human memory is fallible. Empirical studies show patients typically recall only about 30% of the points discussed in a consultation or therapy session. Errors occur at multiple stages: encoding new information, storing it, and retrieving it when needed.
When patients forget key treatment instructions or strategies, adherence suffers and clinical improvements can stall or disappear. Addressing this memory gap is therefore essential to improving the real-world effectiveness of evidence-based treatments.
Habits take time — and effort
Memory is only one piece of the puzzle. Building a new behavior into everyday life is a gradual process that often requires repeated practice and the right environmental supports. Social and health psychology research places the time to habit formation broadly between a few weeks and many months.
There are proven techniques to speed and solidify habit change—like pairing a new behavior with an existing routine, setting clear cues, and reinforcing the behavior consistently—but these are not always emphasized in clinical care. When therapy focuses mainly on knowledge or skills without concrete habit-building plans, patients may understand what to do yet still struggle to do it consistently.
In short, many treatments leave two gaps: patients forget much of the content, and those who remember still face barriers to turning intended behaviors into regular habits. Addressing both memory and habit formation is critical to closing that gap.
“We have effective treatments, but they need enhancements to produce larger, more durable benefits,” Harvey says. “That’s the scientific challenge: how to augment existing therapies in ways that are practical, scalable, and grounded in basic research.”
Ongoing sleep research seeking solutions
Harvey’s current work, supported by the National Institutes of Health, focuses on sleep interventions as a test case for memory and habit-based enhancements. One simple but promising approach is the use of tailored text messages that deliver cues, reminders, and brief follow-ups timed to support behavior change.
For example, an automated bedtime message might state a concrete plan: “At 10 p.m., I will dim the lights and put my phone down.” A morning check-in asks whether the goal was met. Participants who report success receive positive reinforcement, such as a light-hearted fact, while those who did not are encouraged to try again the next night. Early findings suggest these low-cost prompts can help people form healthier sleep habits.
Harvey argues these kinds of augmentations can be added before, during, or after therapy sessions without increasing session length or cost. They carry minimal risk and, when informed by cognitive science and habit research, can meaningfully boost outcomes.
Her broader aim is to bridge disciplinary silos—bringing together insights from cognitive psychology, education research, and social psychology—to design practical supports that improve both short-term learning and long-term behavior change in mental and physical health care.
Reflecting on the parenting course she attended as a participant, Harvey notes that while the class contained valuable content, much of it faded from memory and never became automatic. Her experience underscores the need for modest, evidence-based supports to help patients retain and apply treatment lessons over time.
About this memory and mental health research news
Author: Jason Pohl
Source: UC Berkeley
Contact: Jason Pohl – UC Berkeley
Image: The image is credited to Neuroscience News
Original research: Open access. “Maximizing benefits from evidence-based psychological treatments: Memory support and habit formation as key strategies” by Allison Harvey et al., Behaviour Research and Therapy.
Abstract
Maximizing benefits from evidence-based psychological treatments: Memory support and habit formation as key strategies
Evidence-based psychological treatments (EBPTs) are designed to reverse psychological processes that contribute to the onset or persistence of mental illness. Developed and validated through rigorous scientific research, EBPTs are effective across a wide range of conditions and often serve as frontline therapies. However, there is room to improve their real-world impact.
This paper examines two complementary strategies for enhancing EBPT outcomes. First, it addresses the robust finding that patients typically recall only about one-third of the treatment points discussed in session. Poor memory for treatment content reduces adherence and undermines clinical gains. The authors describe the development and testing of a Memory Support Intervention (MSI) that draws on cognitive psychology and education science to boost patient recall of key treatment points.
Second, the paper highlights habit formation as an underused but powerful approach for sustaining therapeutic gains. While EBPTs often seek to reduce maladaptive behaviors and promote adaptive ones, principles from habit science have not been systematically integrated. To fill this gap, the Habit-based Intervention (HABITs) was developed to incorporate explicit habit-forming strategies into EBPTs.
Both MSI and HABITs are intended as adjunctive supports that enhance standard EBPTs without lengthening sessions. The authors emphasize the value of drawing on diverse fields of basic science to discover scalable, low-cost methods that improve both short- and long-term treatment outcomes.