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Unread November 10th, 2004, 11:27 AM
roland rogiers roland rogiers is offline
Join Date: Nov 2004
Location: belgium
Posts: 9
Default Re: Treating Depression in Primary Care (medical) settings

Dear Sir,

Don't know what happened on my way to the forum, but I lost two times my answer.
Thank you for your interest. What we are doing in Belgium? At the Ghent University, Dept. General Practice, we developed some training packages, in which we try to implement cognitive behavior interventions in general practice.
Topics: anxiety, depression and insomnia. Motivating chronic users of benzodiazepines and Medical Unexplained Complaints are in the pipeline.
For example: module depression: 15 hours. We provide this training for GPs in vocational training (year 2+3) and more experienced GP.
1. alerting signals, diagnosing depression and talking about suicidal ideas + management of suicidal patient
2.scheme for indication criteria short term treatment by the GP. Assessing resources, skills in making the complaints concrete, personality disorder, global social functioning, motivation
3. psycho-education : construction of a common "sickness-theory" (what is depression? Why do I have a depression?) and common "treatment-theory": what can I do about it: drug treatment (by a GP, using guidelines & EBM) and non-drug treatment.
4. activating the patient by use of the miracle question ( de Shazer) and working with scales
5. some principles of cognitive therapy: identifying disfunctional ideas and cognitive patterns and how to challenge them
6. some ideas about follow up, relapse prevention and referral

Some GP are member of a intervision group and have some booster sessions and recently back up from a internal forumgroup
Feedback: not easy to implement in GP but they feel more comfortable in working with depressive patients and they work more goal-oriented.
We don't have done any research about our model, but we hope we can do so the next years.
I saw that you are working on a dept gen practice and I'm interested in your experiences and ideas about these topics
Kind regards
Roland Rogiers
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