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  #1  
Unread September 4th, 2004, 09:38 PM
James Pretzer James Pretzer is offline
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Default Treating Depression in Primary Care (medical) settings

There's been quite a bit of work in recent years trying to improve the treatment of depression in medical settings since many depressed individuals either seek treatment from their primary care physician or seek treatment for physical complaints when the main problem is depression. It is great that CT is an effective treatment for depression. Unfortunately, simply publishing treatment guidelines regarding when to prescribe antidepressants and when to refer for therapy has not proven to be an effective way to improve the quality of care that most patients recieve.

A recent Medscape article (http://www.medscape.com/viewarticle/487742) describes an ambitions new project and gives an idea of what is needed to produce system-wide improvement. Links within the article give additional information and include a good bibliography on related topics (http://www.depression-primarycare.or...commended/#top).
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  #2  
Unread November 7th, 2004, 06:22 PM
roland rogiers roland rogiers is offline
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Default Re: Treating Depression in Primary Care (medical) settings

I'm working as a psychologist and trained CBtherapist in the Dep. of General Practice, Faculty of Medicine, Ghent University, Belgium.Some years ago, we developed some courses (15 hours p. course) "non drug approach" for general practitioners in vocational training & experienced GP's. We are trying to implement cognitive behavioral interventions into primary care. Topics: depression, anxiety disorders, insomnia. Medical Unexplained Complaints is in the pipeline. I was wondering if I could contact some colleagues who are doing same work.
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  #3  
Unread November 8th, 2004, 02:14 AM
mugwump mugwump is offline
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Default Re: Treating Depression in Primary Care (medical) settings

Good afternoon

in australia, a fair bit of effort is being put into training GPs in CBT and associated psychological strategies. some research is also being done related to this.


some good websites related to this are
www.beyondblue.org.au and go to the websites related to research


these webistes refer specifically to training for GPs in psychological strategies
http://www.spheregp.com.au/
www.gpcare.com

good luck with it
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  #4  
Unread November 8th, 2004, 06:55 PM
roland rogiers roland rogiers is offline
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Default Re: Treating Depression in Primary Care (medical) settings

Good evening,Mr. /Ms Mugwump
Was my first contact with bol and bingo, thanks to you.
Did some surfing to the very interesting sites you suggested. I will contact them hoping we could exchange some ideas and experiences.
Thank you very much.
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  #5  
Unread November 8th, 2004, 08:12 PM
mugwump mugwump is offline
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Default Re: Treating Depression in Primary Care (medical) settings

Good luck with the searching


the sphere group is particulary focused on gps and training them in cbt - it has trained a significant number of gps in cbt using experienced gps as part of the training team. on that website their is a pdf file --- which outlines a study to examine the effectiveness of teaching gps cbt

be interested to hear what you are doing in belguim


regards
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Paul Ryan
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  #6  
Unread November 10th, 2004, 11:27 AM
roland rogiers roland rogiers is offline
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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.
Content:
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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