Management of comorbid mental and somatic disorders in stepped care approaches in primary care: a systematic review

Maehder, Kerstin; Löwe, Bernd; Härter, Martin; Heddaeus, Daniela; Scherer, Martin; Weigel, Angelika

doi:10.1093/fampra/cmy122

Cited by 14 publications

(11 citation statements)

References 63 publications

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“…Having a clear and specific outcome that the intervention targets was associated with improvements in the corresponding outcome compared to control (usual care in most included trials) (Baker, Grant, & Gopalan, 2018; Reilly et al., 2015; Smith et al., 2016), for example, delaying institutionalisation, reducing depression; apart from in stepped care, where results were mixed in comparison to usual care regardless of target (Maehder et al., 2019). Broader targets (e.g.…”

Section: Resultsmentioning

confidence: 99%

What works in managing complex conditions in older people in primary and community care? A state‐of‐the‐art review

Frost

Rait

Wheatley

et al. 2020

Health Soc Care Community

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Section: Resultsmentioning

confidence: 99%

What works in managing complex conditions in older people in primary and community care? A state‐of‐the‐art review

Frost

Rait

Wheatley

et al. 2020

Health Soc Care Community

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“…Stepped care models for depression, anxiety or somatoform disorders have proven to be mostly effective and cost-effective. However, further research is needed to clarify facilitators of a successful implementation in different health care settings and for a broader range of disorders and comorbidities [10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Psychotherapists’ perspectives on collaboration and stepped care in outpatient psychotherapy—A qualitative study

et al. 2020

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Objective Stepped and collaborative care with outpatient psychotherapy as one treatment step is guideline-recommended for mental health care. To date, the experiences and evaluation of psychotherapists regarding collaboration and stepped care have been neglected. In order to improve collaborative mental health care, this qualitative study aimed at identifying psychotherapists' perspectives and needs within collaboration and stepped care. Methods Semi-structured qualitative interviews with 20 German outpatient psychotherapists were conducted and analyzed applying thematic analysis. The analysis was realized in a recursive process to first identify themes and then relate these themes back to the research questions with regard to collaboration and stepped care. Results Collaboration mainly took place in small networks, with general practitioners and psychiatrists as the most important partners and psychotherapists wishing to intensify collaboration. Main barriers for collaboration were seen in deficient resources and remuneration and in a perceived lack of esteem by other medical specialties. Stepped care was appreciated for intensified collaboration and low-threshold access to care. Doubts were cast on its implementation within current health care conditions, worries concerned a primacy of economic principles instead of patient-orientation. Among further needs, psychotherapists demanded increased knowledge about psychotherapy, especially among general practitioners. Conclusion Psychotherapists expressed ambivalent attitudes towards stepped and collaborative care, substantially influenced by health care conditions and the perceived own standing among

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“…Bachelor-level social work training programs commonly teach client-centered skills for effective communication, goal setting, and action planning. Given the need to broaden the mental health workforce and the increased popularity in stepped care interventions (Maehder et al, 2019), such programs are also well positioned to enhance treatment access by developing essential clinical skills in BSW students. While most BSW programs lack a mental health focus in their curriculum, based on preliminary findings and experience with Wave 2 students, there is a promise that BSW students with proper training and supervision can develop the skills necessary to effectively and competently deliver EBPIs, particularly with rural and traditionally underserved populations, where access to licensed clinicians is very limited.…”

Section: Discussion and Applications To Practicementioning

confidence: 99%

Modernizing Training in Psychotherapy Competencies With Adaptive Learning Systems: Proof of Concept

Renn

Areán

Raue

et al. 2020

Research on Social Work Practice

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Purpose: This proof-of-concept study assessed the feasibility, acceptability, and effectiveness of an intelligent tutoring system (ITS) as a classroom adjunct to improve training bachelor of social work (BSW) students in client engagement strategies. Methods: We codeveloped the ITS with 11 undergraduate students and pilot tested it with six BSW students enrolled in a class on telephone-based cognitive behavioral therapy (tCBT). Student competencies in tCBT were assessed by expert review of role-plays. We also examined time spent using ITS and relation with competency. Results: The majority of students (81.8%) in Wave 1 and all of the students who submitted role-plays in Wave 2 passed the clinical skills role-play. Students advancing through the ITS more quickly had better tCBT competency ratings than those progressing more slowly. Discussion: One of the most challenging aspects of training is how to competently deliver evidence-based practices. ITS has the potential to streamline and scale such training.

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Management of comorbid mental and somatic disorders in stepped care approaches in primary care: a systematic review

Cited by 14 publications

References 63 publications

What works in managing complex conditions in older people in primary and community care? A state‐of‐the‐art review

What works in managing complex conditions in older people in primary and community care? A state‐of‐the‐art review

Psychotherapists’ perspectives on collaboration and stepped care in outpatient psychotherapy—A qualitative study

Modernizing Training in Psychotherapy Competencies With Adaptive Learning Systems: Proof of Concept

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