- Patti Robinson, PhD Psychologist and President Mountainview Consulting Group Portland, OR USA
- Professor Bruce Arroll MBChB, PhD, FRNZCGP (Distinguished), FRNZCUC (Honorary) Personal Chair and Elaine Gurr Chair of General Practice and Primary Health Care Head of Department Director of the Goodfellow Unit Department of General Practice and Primary
As many as 30% of primary care patients suffer from symptoms of depression, and many receive a diagnosis and an antidepressant medication as first-line treatment. People challenged by more social determinants of health are more vulnerable to development of depression symptoms, and they may experience harm from unnecessary use of antidepressant medications. In this presentation, participants will learn alternatives to using a depression symptom screening and prescribing broadly. The first alternative, informed by Focused Acceptance and Commitment Therapy (FACT), has a primary care provider or behavioral health consultant completing a brief functional assessment (love-work-play-health) and developing a behavioral health experiment to improve their quality of life in a first visit for depression. In a small randomized controlled trial, half of the patients that received this intervention were improved at a one-week follow-up. A second alternative is use of the Coping Strategy Use Scale (CSUS), a 6-item measure designed to rapidly identify the patient’s needs for coaching on skills associated with mood improvement. A post hoc analysis of a randomized controlled trial found that patients seen by a behavioral health consultant recommending the skills demonstrated higher rates of use one month after diagnosis, as well as fewer symptoms of depression.
- Discuss steps for completing an evidence-based first visit for depression in primary care.
- Describe a brief functional assessment for depressed primary care patients that generates a behavioral experiment to improve quality of life.
- Describe a 6-item screening for assessing patient rates of using skills associated with improving mood and energy.