Kari Leibowitz is a Stanford Interdisciplinary Graduate Fellow and doctoral candidate in Psychology at Stanford University. Her research with Dr. Alia Crum in the Stanford Mind & Body Lab helps us understand and harness mindsets to improve health, well-being, and performance. To give healthcare teams the tools to shape patient mindsets and improve healthcare outcomes, she developed the Medicine Plus Mindset Training, which she has delivered to all of Stanford Primary Care as well as other clinics in the Bay Area. Kari received her undergraduate degree from Emory University, and her work has taken her all over the world as she organized the 2013 visit of the Dalai Lama to Emory, co-led three summers of Emory’s Tibetan Mind/Body Sciences study abroad program in India, and served as a U.S.-Norway Fulbright scholar. As a Fulbright scholar, Kari lived in Tromsø, Norway, north of the Arctic Circle, and studied mindsets about winter. In addition to publishing her academic work in numerous peer-reviewed outlets, Kari has delivered talks and workshops on how to leverage the power of mindset to international audiences. Her writing on this topic has appeared in The Atlantic and The New York Times.
Honors & Awards
Stanford Interdisciplinary Graduate Fellow, Office of the Vice Provost for Graduate Education (2018-2021)
Stanford Graduate Fellow, Office of the Vice Provost for Graduate Education (2015-2018)
Fulbright Scholar, U.S.-Norway Fulbright Commission (2014-2015)
Changing mindsets about side effects.
2021; 11 (2): e040134
Given research showing that the very act of communicating side effects can increase their likelihood, how can providers inform patients about side effects while upholding their oath to do no unnecessary harm? An emerging approach provides a potential solution: truthfully describe certain minor side effects as a sign the treatment is active and working in the body. This approach focuses on instilling adaptive mindsets about the meaning of side effects while still keeping patients informed. This article describes existing research suggesting that this approach can be helpful in improving experience and outcomes in treatments for pain, hypertension and allergy. Compared with control groups given a standard, empathetic message about side effects, patients who were informed that side effects are a sign treatment is working were less anxious about side effects and rated them as less threatening and intense. A longitudinal, randomised controlled trial of this approach in patients receiving oral immunotherapy for food allergies found that describing side effects as a sign treatment was working reduced the rate at which patients contacted providers with concerns about side effects and led to greater increases in a biomarker of allergic tolerance from pretreatment to post-treatment (peanut-specific blood IgG4). In unveiling this approach, this article also raises important issues regarding which treatments and symptoms this approach should be applied to. Finally, we outline questions future research should address to further understand and leverage this approach.
View details for DOI 10.1136/bmjopen-2020-040134
View details for PubMedID 33526496
The Role of Patient Beliefs in Open-Label Placebo Effects
2019; 38 (7): 613–22
Recent research on open-label placebos, or placebos administered without deception or concealment, suggests that they can be effective in a variety of conditions. The current research sought to unpack the mechanisms underlying the treatment efficacy of open-label placebos.A health care provider induced an allergic reaction in 148 participants via a histamine skin prick test. Participants were then exposed to 1 of 4 conditions additively leveraging various mechanisms of open-label placebo treatments: a supportive patient-provider relationship, a medical ritual, positive expectations, and a rationale about the power of placebos.There were no main effects of condition on allergic responses. However, participant beliefs about placebos moderated the effect of open-label placebo treatment condition on physiological allergic reactions: the condition including all 4 components of open-label placebos (a supportive patient-provider relationship, a medical ritual, positive expectations, and a rationale about the power of placebos) significantly reduced physiological allergic reaction among participants with a strong belief in placebos compared with participants in the control group.Participants' beliefs about placebos interact with information from the provider to reduce physiological allergic reactions in response to an open-label placebo treatment. This study underscores the importance of measuring and understanding how participants' beliefs influence outcomes of treatment, and furthers our understanding of when and how open-label placebo treatments work. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
View details for DOI 10.1037/hea0000751
View details for Web of Science ID 000472220600006
View details for PubMedID 31021124
Changing Patient Mindsets About Non-Life-Threatening Symptoms During Oral Immunotherapy: A Randomized Clinical Trial.
The journal of allergy and clinical immunology. In practice
BACKGROUND: Oral immunotherapy (OIT) can lead to desensitization to food allergens, but patients can experience treatment-related symptoms of allergic reactions that cause anxiety and treatment dropout. Interventions to improve OIT for patients are needed.OBJECTIVE: To determine whether fostering the mindset that non-life-threatening symptoms during OIT can signal desensitization improves treatment experience and outcomes.METHODS: In a randomized, blinded, controlled phase II study, 50 children/adolescents (28% girls, aged 7-17, M=10.82, SD=3.01) completed six-month OIT for peanut allergies. Patients and their parent(s) had monthly clinic visits at the Sean N. Parker Center for Allergy & Asthma Research between 1/5/2017-8/3/2017. All families received identical symptom management training. In a 1:1 approach, 24 patients and their families were informed that non-life-threatening symptoms during OIT were unfortunate side effects of treatment, and 26 patients and their families were informed that non-life-threatening symptoms could signal desensitization. Families participated in activities to reinforce these symptom mindsets.RESULTS: Compared to families informed that symptoms are side effects, families informed that symptoms can signal desensitization were less anxious (B=-0.46, 95% CI (-0.76 to -0.16), p=0.003), less likely to contact staff about symptoms (5/24[9.4%] vs. 27/154[17.5%] instances, p=0.036), experienced fewer non-life-threatening symptoms as doses increased (BInteraction=-0.54(-0.83 to -0.27), p<0.001), less likely to skip/reduce doses (1/26[4%] vs. 5/24[21%] patients, p=0.065), and showed greater increase in patient peanut-specific blood IgG4 levels (BInteraction=0.76(0.36 to 1.17), p<0.001).CONCLUSION: Fostering the mindset that symptoms can signal desensitization improves OIT experience and outcomes. Changing how providers inform patients about non-life-threatening symptoms is a promising avenue for improving treatment.
View details for PubMedID 30682576
When Your Doctor "Gets It" and "Gets You": The Critical Role of Competence and Warmth in the Patient-Provider Interaction.
Frontiers in psychiatry
2019; 10: 475
Background: Research demonstrates that the placebo effect can influence the effectiveness of medical treatments and accounts for a significant proportion of healing in many conditions. However, providers may differ in the degree to which they consciously or unconsciously leverage the forces that produce placebo effects in clinical practice. Some studies suggest that the manner in which providers interact with patients shapes the magnitude of placebo effects, but this research has yet to distill the specific dimensions of patient-provider interactions that are most likely to influence placebo response and the mechanisms through which aspects of patient-provider interactions impact placebo response. Methods: We offer a simplifying and unifying framework in which interactions that boost placebo response can be dissected into two key dimensions: patients' perceptions of competence, or whether a doctor "gets it" (i.e., displays of efficiency, knowledge, and skill), and patients' perceptions of warmth, or whether a doctor "gets me" (i.e., displays of personal engagement, connection, and care for the patient). Results: First, we discuss how this framework builds on past research in psychology on social perception of competence and warmth and in medical literature on models of effective medical care, patient satisfaction, and patient-provider interactions. Then we consider possible mechanisms through which competence and warmth may affect the placebo response in healthcare. Finally, we share original data from patients and providers highlighting how this framework applies to healthcare. Both patient and provider data illustrate actionable ways providers can demonstrate competence and warmth to patients. Discussion: We conclude with recommendations for how researchers and practitioners alike can more systematically consider the role of provider competence and warmth in patient-provider interactions to deepen our understanding of placebo effects and, ultimately, enable providers to boost placebo effects alongside active medications (i.e., with known medical ingredients) and treatment in clinical care.
View details for DOI 10.3389/fpsyt.2019.00475
View details for PubMedID 31333518
View details for PubMedCentralID PMC6619399
Providers' Demeanor Impacts Patient Perceptions of Visit Length.
Journal of general internal medicine
View details for PubMedID 30215175
Physician Assurance Reduces Patient Symptoms in US Adults: an Experimental Study.
Journal of general internal medicine
View details for PubMedID 30128787
- Making mindset matter. BMJ (Clinical research ed.) 2017; 356: j674-?