Brief behaviour change strategies for distressed patients in primary care

Gum, Amber M.; Epstein‐Lubow, Gary; Gaudiano, Brandon A.; Wittink, Marsha N.; Horvath, Carol

doi:10.1136/bmj.l5360

Cited by 2 publications

(2 citation statements)

References 21 publications

(30 reference statements)

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“…Typically, the initial step is “watchful waiting,” followed by guided self‐help, preferably delivered via the internet or mobile technology, and then by traditional evidence‐based psychotherapy, with psychotherapy plus antidepressant medication as the final step for more severe or chronic cases (van Straten, Seekles, van't Veer‐Tazelaar, Beekman, & Cuijpers, ). The relevance of interventions such as LifeStories is particularly clear in primary care settings, where physicians may be able to identify that depression is a problem, but are limited in terms of time and resources as to how to respond effectively and efficiently (Gum, Epstein‐Lubow, Gaudiano, Wittink, & Horvath, ). If ultimately found to be safe and efficacious in larger scale studies, LifeStories could play a useful role as part of a stepped‐care approach for treating depression in primary care due to its low‐cost and ease of delivery.…”

Section: Discussionmentioning

confidence: 99%

Pilot randomized controlled trial of a video self‐help intervention for depression based on acceptance and commitment therapy: Feasibility and acceptability

Gaudiano

Davis

Miller

et al. 2020

Clin Psychology and Psychoth

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A common setting where depression is identified and treated is in primary care, where there is a need for low-intensity and cost-effective interventions to be used as part of a stepped-care model. The current study involved a pilot, parallel-group, randomized controlled trial of a video self-help intervention for primary care patients based on acceptance and commitment therapy (ACT). The intervention, called LifeStories, consisted of storytelling vignettes of patients describing their use of ACTconsistent coping skills for depression. Primary care patients were recruited to determine feasibility, acceptability, and potential clinical effects of the intervention.Twenty-one participants were assigned to use LifeStories over a period of 4 weeks, and 19 participants were assigned to an attention-matched comparison group. Qualitative feedback indicated that participants using LifeStories found the intervention to be engaging and useful in transmitting key ACT principles. Furthermore, those receiving LifeStories rated their level of "transportation" or immersion in the videos higher than the control group. Both conditions showed large improvements in levels of depression at a 12-week follow-up. There were no significant differences in symptom outcomes between groups; however, because this was a pilot study, it was not powered to detect differences between interventions. Both conditions additionally showed smaller effect size changes in psychological flexibility, a key ACT mechanism.The results suggest LifeStories to be a feasible and acceptable psychological intervention that may improve depression, and further research is warranted to determine its effectiveness as part of a stepped-care approach to treating depression in primary care. K E Y W O R D Sacceptance and commitment therapy, depression, mHealth, primary care, self-help, steppedcare

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Section: Discussionmentioning

confidence: 99%

Pilot randomized controlled trial of a video self‐help intervention for depression based on acceptance and commitment therapy: Feasibility and acceptability

Gaudiano

Davis

Miller

et al. 2020

Clin Psychology and Psychoth

View full text Add to dashboard Cite

show abstract

“…Muitas pessoas, pelos mais diferentes motivos, procuram os serviços de Atenção Primária à Saúde (APS) apresentando alguma forma de mal-estar emocional 1 . Há, historicamente, uma tendência de a Biomedicina moderna 2 classificar essas perturbações emocionais em múltiplos diagnósticos sindrômicos, tratados prioritariamente de intervenções farmacológicas.…”

Section: Introductionunclassified

Entre “centrado na pessoa” e “freestyle”: a abordagem do sofrimento mental comum em residências de medicina de família e comunidade

Castro,

Wenceslau,

Ferreira

2024

Interface (Botucatu)

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Este trabalho apresenta um estudo qualitativo sobre a abordagem do sofrimento mental comum (SMC) em programas de residência de Medicina de Família e Comunidade de Minas Gerais. Foram realizadas entrevistas semiestruturadas com 16 participantes de três programas de residência, entre março e maio de 2022. A interpretação dos dados seguiu os princípios da Análise Temática de Braun e Clarke. Para os participantes, o SMC é uma demanda frequente na Atenção Primária que deve ser abordada, principalmente com intervenções psicossociais. Contudo, os participantes reconhecem que não têm aplicado essas intervenções nos moldes recomendados pela literatura. Os entrevistados relatam conhecer diversas técnicas de intervenção, mas só sabem aplicar algumas, com destaque para os componentes do "método clínico centrado na pessoa". Esse fato contribui para despertar emoções negativas, como angústia e frustração, e aumentar o número de referenciamentos desnecessários para outros profissionais.

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Brief behaviour change strategies for distressed patients in primary care

Cited by 2 publications

References 21 publications

Pilot randomized controlled trial of a video self‐help intervention for depression based on acceptance and commitment therapy: Feasibility and acceptability

Pilot randomized controlled trial of a video self‐help intervention for depression based on acceptance and commitment therapy: Feasibility and acceptability

Entre “centrado na pessoa” e “freestyle”: a abordagem do sofrimento mental comum em residências de medicina de família e comunidade

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