Depressed Parents' Treatment Needs and Children's Problems in an Urban Family Medicine Practice

Hankerson

Scorza

et al. 2014

APT

Self Cite

Interpersonal Counseling (IPC) comes directly from interpersonal psychotherapy (IPT), an evidenced-based psychotherapy developed by Klerman and Weissman. It [IPC?] is a briefer, more structured version for use primarily in non-mental health settings, such as primary care clinics when treating patients with symptoms of depression. National health-care reform, which will bring previously uninsured persons into care and provide mechanisms to support mental health training of primary care providers, will increase interest in briefer psychotherapy. This paper describes the rationale, development, evidence for efficacy, and basic structure of IPC and also presents an illustrated clinical vignette. The evidence suggests that IPC is efficacious in reducing symptoms of depression; that it can be used by mental health personnel of different levels of training, and that the number of sessions is flexible depending on the context and resources. More clinical trials are needed, especially ones comparing IPC to other types of care used in the delivery of mental health services in primary care.

Section: Introductionmentioning

confidence: 99%

Interpersonal Counseling (IPC) for Depression in Primary Care

Hankerson

Scorza

et al. 2014

APT

Self Cite

“…A two-page screening survey will include the PHQ-9, demographic information, literacy level assessment, and depression treatment history / preferences [ 52 ]. Participants will submit their completed survey to the CHW in a private church space, who will quickly assess for suicidality by examining responses to Question #9 of the PHQ-9.…”

Section: Data Collection and Managementmentioning

confidence: 99%

Study protocol for comparing Screening, Brief Intervention, and Referral to Treatment (SBIRT) to referral as usual for depression in African American churches

Hankerson

Shelton

et al. 2022

Trials

Background Depression is a leading cause of disability worldwide. African American adults, compared to White adults, are half as likely to be screened for depression in primary care settings. Disparities in depression screening contribute to poor clinical outcomes, as African Americans with depression are more disabled and sicker longer compared to Whites. African American churches are trusted settings that provide access to supports for depression. Indeed, in the first study of its kind, the investigators found that 20% of adults in African American churches screened positive for depression using the Patient Health Questionnaire-9 (PHQ-9). However, no subjects with a positive screen (PHQ-9 ≥ 10) accepted a treatment referral when offered by research personnel. Community Health Workers, who are trusted paraprofessionals from the target community, may bridge the gap between depression screening and treatment. The investigators have trained and certified 112 Community Health Workers from 45 African American churches in New York City to deliver an evidence-based intervention called Screening, Brief Intervention, and Referral to Treatment (SBIRT). Thus, the aim of the current study is to test the impact of Community Health Worker-delivered depression screening in Black churches on engagement with clinical services. Methods Using a hybrid type 1 effectiveness-implementation design, we propose a 2-arm, mixed-methods cluster randomized controlled trial. Church study sites will be randomized to either SBIRT (intervention arm) or referral as usual (usual care arm). This trial will be conducted with 600 church members across 30 churches (300 intervention; 300 usual care). Our primary outcome is treatment engagement, defined as attending a depression-related clinical visit. Secondary outcomes will be changes in Mental Health-Related Quality of Life and depressive symptoms at 3 and 6 months post-screening. Lastly, we will conduct a concurrent, mixed-methods (qualitative-quantitative) process evaluation to assess contextual facilitators and barriers of screening and referral. Discussion This is the first randomized trial of a church-placed, community health worker-delivered intervention for depression in African American populations. This study may provide a novel and effective approach to increasing depression identification and treatment linkage in economically disadvantaged populations with high depression rates. Trial registration ClinicalTrials.govNCT04524767. Registered on 21 August 2020.

“…Interpersonal psychotherapy: evaluation, support, triage derives from our experience following over 3000 primary care or family practise patients (Das et al, 2005; Vidair et al, 2011). Our systemic follow-up studies of depressed patients in primary care clearly demonstrate that depression complicates the course and treatment of chronic medical illness, contributes to increased utilization of expensive emergency room services and results in increased frequency of patient visits.…”

Section: Rationalementioning

confidence: 99%

“…A quarter to one third of family practise patients screen positive for elevated mood symptoms (e.g., Coyne, Fechner-Bates, & Schwenk, 1994; Vidair et al, 2011). Furthermore, for patients seeking treatment for depression, the first point of contact is often their primary care clinic (Coyne et al, 1994), and over half of the patients diagnosed with major depressive disorder are treated in primary care (Rubenstein et al, 2007; Shapiro et al, 1984).…”

Section: Rationalementioning

confidence: 99%

“…Based on our primary care follow-up studies, we have found that patients who screen positive for depression usually receive antidepressant medication and little or no attention to their psychosocial circumstances (Weissman et al, 2010). When patients who screened positive for depression were asked what help they would like, over a third said, they wanted to talk to their doctor or a mental health professional about their problems even if they were receiving medication (Vidair et al, 2011). There are often no support and engagement strategies for those patients who need to be referred for longer treatment, resulting in poor adherence to medication, high rates of relapse and a net result of poor and costly outcomes (Sturm & Wells, 1995; Wells, Schoenbaum, Unützer, Lagomasino, & Rubenstein, 1999; Weissman et al, 2010).…”

Section: Identifying Depression In Primary Carementioning

confidence: 99%

See 1 more Smart Citation

Interpersonal Psychotherapy: Evaluation, Support, Triage

Clin Psychology and Psychoth

Verdeli

2012

Self Cite

Depression is highly prevalent and debilitating among medically ill patients. As high as one third of the primary practise patients screen positive for depression symptoms and over half of the patients diagnosed with major depressive disorder are treated in primary care. However, current primary care service arrangements do not efficiently triage patients who screen positive for depression into appropriate treatments that reflect their individual needs and preferences. In this paper, we describe a tool that aims to fill the gap between screening the patients for depression and triaging them to appropriate care. This is a three-session adaptation of interpersonal psychotherapy: ipt; evaluation, support, triage (IPT-EST). We first outline IPT-EST procedures that aim to provide structure and content to primary care practitioners who identify patients with positive depression symptoms, thus assisting the practitioners to explore the patients’ psychosocial triggers of depression, give basic strategies to manage these interpersonal stressors and provide decisions tools about triaging patients with severe/persistent depression into appropriate treatment.