Download COGNITIVE BEHAVIOR THERAPY AND DIALECTICAL BEHAVIOR

Jitender Sareen MD, Tanya Sala MD,
Jacquelyne Wong MA, Debbie Whitney PhD, Jolene Kinley PhD





Jitender Sareen, MD
Jacquelyne Wong, MA
Debbie Whitney, PhD
Jolene Kinley, PhD
Natalie Meyer – tireless admin support
Improve access to CBT in the region
CBT is evidence-based treatment
Long wait-times, if available at all
 Usual mode of delivery is individual and/
or small group format
 Large guided self-help class format is a
novel method of delivery









Enhance capacity for delivering CBT classes at HSC and
other regional sites.
Adapt the format and content of the classes for delivery to
vulnerable groups with limited access to services.
Train peer leaders to deliver classes.
Create a toolkit for future use by sites implementing CBT
classes.
Measure outcomes as well as client and family member
satisfaction in a rigorous manner.
Create an online course version of the classes for those
clients who are unable to attend in person.
1.
2.
3.
4.
Cognitive Therapy
Behavior Therapy
Healthy Living, Sleep
Assertiveness/Anger, ProblemSolving
Mindfulness exercise every session
A. Old service delivery model
12-18 months
Referral
Screening
Visit
Group
Therapy
B. New service delivery model
3-6 months
Referral
Screening
Visit
Education
Classes
Self-help strategies
encouraged
Group
Therapy
Patients attend a minimum of 4
education classes in order to be
eligible for group therapy.




4-session classes running for 2 years
Mood and Anxiety symptoms
>300 patients treated
After completing 4 classes:
 Depression groups
 Anxiety groups
 Obsessive Compulsive Disorder groups






Occupational Stress Injury Clinic (OSI)
Crisis Response Centre (CRC)
Interlake
May 25 – Facilitator training
Plan for two additional training days in 2016
Potential additional sites:
 ADAM
 MDAM
 Victoria Hospital
 Grace Hospital
 Shared Care

Symptom measures:






Patient Health Questionnaire-9 Item (PHQ-9)
Generalized Anxiety Disorder-7 Item (GAD-7)
DSM-5 Cross-Cutting Symptom Measure – Adult
Clinical Global Impression Scale (CGI-I)
World Health Organization Disability Assessment
Schedule 2.0 (WHODAS)
Patient Satisfaction Measures:
 Session Rating Scale
 Evaluation of CBT Education Class



Initial CBT screening appointment
Each Class
CBT groups:
 First group
 Every 4th group
 Final group

Toolkit:
 Reduce administrative burden
 CBT fidelity
 Consistency

Online Course:
 Increase access in rural and remote areas
 Increase access for patients with conflicting time
commitments – work, school, child-care, etc.










Anxiety Disorders Association of Manitoba
Mood Disorders Association of Manitoba
Crisis Response Centre
St. Boniface Hospital Mental Health Program
Clinical Health Psychology Program
Victoria Hospital Mental Health Program
Child and Adolescent Mental Health Program
Interlake-Eastern Regional Health Authority
Grace Hospital Psychiatric Ambulatory Program
Veterans Affairs Operational Stress Injuries clinic