{"id":1828,"date":"2016-05-23T17:35:55","date_gmt":"2016-05-24T00:35:55","guid":{"rendered":"https:\/\/phcprimarycare.org\/?p=1828"},"modified":"2016-04-27T14:45:55","modified_gmt":"2016-04-27T21:45:55","slug":"a-new-series-cognitive-behavioral-therapy-in-primary-care-practice","status":"publish","type":"post","link":"https:\/\/phcprimarycare.org\/?p=1828","title":{"rendered":"A New Series: Cognitive Behavioral Therapy in Primary Care Practice"},"content":{"rendered":"<p>This is a five part series on integration of cognitive behavioral therapy (CBT) into primary care practice written by Karen Stephens PhD,<!--more--><\/p>\n<p><strong>INTRODUCTION:<br \/>\n<\/strong>CBT is the \u201cgold standard\u201d psychological treatment for individuals with a wide range of pain problems. It can reduce pain, distress, pain interference with activities, and disability. And it may well have positive benefits for common comorbid conditions such as depression, diabetes, and cardiovascular disease. It has been shown to be effective regardless of the particular licensing or background of the provider, as long as they have an understanding of basic CBT concepts and skills, and can even be effective in web-based applications. Brief in-office CBT is not designed to replace referral to a professional mental health provider with his\/her diagnostic skills and therapy and\/or medication options when this seems more appropriate.<\/p>\n<p><strong>CBT is not just for the licensed behaviorist! These CBT Mini Lessons can be used by:<\/strong><\/p>\n<ol>\n<li>The PCP him\/herself (using appropriate billing codes to cover the extra 5-10 minutes),<\/li>\n<li>Office staff such as nurses, medical assistants, behavioral health providers (using Health &amp; Behavior codes billed to PHC)<\/li>\n<li>A co-located Beacon-credentialed behavioral health provider (billed to Beacon)<\/li>\n<\/ol>\n<p>Having practiced as a cognitive behavioral therapist for 40 years, I\u2019ve seen CBT techniques used effectively in individual and group settings, in both clinical and psycho-educational venues, and provided by both professional and para-professional providers.<\/p>\n<p><strong>What are the advantages of bringing CBT into the primary care office?<\/strong><\/p>\n<ol>\n<li><strong>PCP is<\/strong> <strong>best qualified <\/strong>to understand Member\u2019s medical history and current needs.<\/li>\n<li>Interventions are made when the <strong>Member is<\/strong> <strong>most motivated<\/strong> for change, i.e., the very moment when they are asking for help<\/li>\n<li>Providing behavioral alternatives allows the PCP to <strong>manage the Member\u2019s pain more safely<\/strong><\/li>\n<li>CBT interventions with home practice recommendations and handouts are quite <strong>effective in the primary care<\/strong> setting<\/li>\n<li><strong>Avoid the<\/strong> <strong>stigma and wait time <\/strong>sometimes associated with referral to a behavioral health specialist<\/li>\n<\/ol>\n<p><strong>What are the basic goals for using CBT for pain management?<\/strong><\/p>\n<ul>\n<li><strong>Improved relationship with health professional<\/strong>\u2014Member not shuffled off elsewhere, workable alternatives to medication changes<\/li>\n<li><strong>Increased functional activities<\/strong>\u2014Focus changes from Member saying, <em>\u201cI can\u2019t\u2026\u201d<\/em> to Member asking, <em><em>\u201cHow can I\u2026?\u201d<\/em><\/em><\/li>\n<li><em><em>\u00a0<\/em><\/em><strong>Improved mood and quality of life<\/strong>\u2014Decreased depression, more optimism and self-confidence, less risk of side effects from medication<\/li>\n<li>,\u00a0<strong>Improved symptom control<\/strong>\u2014Better awareness of pain cycles, reducing use of unworkable strategies for managing pain<\/li>\n<li><strong>Improved self-management<\/strong>\u2014Reliance on self rather than others to provide solutions<\/li>\n<li><strong>Reduction in unnecessary visits<\/strong>\u2014Reliable self-management options rather than unnecessary appointments when pain increases<\/li>\n<\/ul>\n<p>Mini Lesson 1: Cognitive Restructuring<\/p>\n<p>MIni Lesson 2: Mindfulness and Relaxation Exercises<\/p>\n<p>Mini Lesson 3: Goal Setting \u00a0Mini Lesson<\/p>\n<p>4: Scheduling Fun, Enjoyment, and Achievement<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This is a five part series on integration of cognitive behavioral therapy (CBT) into primary care practice written by Karen Stephens PhD,<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1828","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.2 - 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