New models of care for psychology in Canada's health services.

Abstract

Psychological services in health care have expanded beyond traditional areas of mental health to the full spectrum of health disorders, as research has increasingly shown the importance of psychological processes in health outcomes. Behavioural and psychological factors can contribute to the onset, course, or severity of many chronic diseases, and psychology has much to offer with clinically and cost-effective interventions. Good principles of care, involving appropriate assessment, evidence-based interventions, and close collaboration with other health care providers, are vital for effective chronic disease management, but can be difficult to realise given issues of timely access, patient volumes, and availability of psychological services in publicly funded health care. This article provides an overview of psychological interventions in diverse areas of health psychology, with examples of innovative Canadian clinical service delivery models, particularly focussing on integrated screening and treatment for cardiac patients, computerized delivery of insomnia treatment, screening and brief intervention prior to joint replacement surgery, and on-site psychological consultation for family physicians. The case examples, developed and implemented in Winnipeg, Manitoba, demonstrate components for consideration when redesigning psychological service models, such as more systematic approaches to identifying patient needs, stepped levels of care that increase intensity of service relative to need, integration into systems already handling large patient volumes, innovative use of technology, and location of psychological resources "in situ" for timely, brief access. Although still in early stages of development and evaluation, these models show promise for improved access and enhanced ability to deliver psychological service to relevant patient volumes.

Increasing access to mental health care through government-funded psychotherapy: The perspectives of clinicians.

“…This is an interesting finding because focusing on psychological distress in relation with health problems was not a core principle of either the IAPT or the Australian ATAPS or Better Access programs. This may be a result of the increasing recognition in Canada of the integral role that mental health professionals play in the treatment of major health problems (Graff, Kaoukis, Vincent, Piotrowski, & Ediger, 2012). Additionally, there was strong agreement that anxiety and mood disorders and schizophrenia and other psychotic disorders should be included and prioritized within a government-funded psychotherapy program (see Tables 2 and 3).…”

Analisis Koping dan Pertumbuhan Pasca-trauma pada Masyarakat Terpapar Konflik

“…Distancing coping adalah mengabaikan masalah dengan menolak memikirkan masalah atau mengasumsikan bahwa masalah tidak pernah dialami sebelumnya. Ini dicirikan oleh dorongan untuk melarikan diri dari situasi yang penuh tekanan (Graff, Kaoukis, Vincent, Piotrowski, & Ediger, 2012). Untuk mendapatkan ketenangan dalam diri, individu bertanggung jawab pada diri dan masalah yang dihadapi.…”

Psychology’s Gordian Knot: Problems of identity and relevance.

“…Thus, integrating psychologists into primary care can enhance the availability and quality of mental health services (Bluestein & Cubic, 2009). Additionally, psychological interventions can effectively address and treat the psychosocial dimensions of diverse health conditions such as cardiovascular diseases and insomnia (Graff, Kaoukis, Vincent, Piotrowski, & Ediger, 2012), as well as diabetes, cancer, and chronic pain (see Hunsley, 2002 for a review). As health care costs in Canada continue to rise (Canadian Institute for Health Information, 2014), focus is being placed on preventive care (e.g., Government of Canada, 2006; Public Health Agency of Canada, 2009).…”