in psychological therapies: Access, effectiveness and efficiency: Narrative literature review.
Furthermore, this research supports the New Zealand Ministry of Health's (2012) initiative to implement a stepped care
system within the primary mental health sector, and suggests that these new methods of mental health support are likely to be well received by New Zealanders.
A partnered approach to opioid management, guideline concordant care and the stepped care
model of pain management.
: a method to deliver increased access to psychological therapies.
Implications for mental health specialty providers are also conceptually ambiguous: by more effectively managing depression in primary care, CCD may reduce the need for referral to specialty care; on the other hand, more depressed patients may be identified as a result of CCD, and the "stepped care
" approach may facilitate referral of patients not responding to primary care-based treatment.
(1) The authors assessed a 3-stage protocol of stepped care
, progressing to the next stage if improvement was inadequate after 3 months: Stage I comprised patient education, footwear modifications, and a metatarsal pad placed proximal to the involved nerve; stage II, injection of steroids with local anesthetic or local anesthetic alone; and stage III, surgery.
* Stepped care
, which included the computerized intervention but in which the number of subsequent telephone-based contacts depended on the patient's response to the initial intervention.
" allows the selection of the least intrusive intervention to achieve clinical change for an individual.
The recent Stepped Care
for Affective Disorders and Musculoskeletal Pain (SCAMP) trial showed that optimization of antidepressants in conjunction with a self-management behavioral program reduced depressive and pain symptoms.
A randomized controlled trial, the Stepped Care
for Affective Disorders and Musculoskeletal Pain (SCAMP) study, suggests that a combination approach might also work for people suffering pain in addition to a psychiatric disorder.
The patients, recruited from two Los Angeles public safety-net clinics between August 2005 and July 2007, were randomized to either modestly enhanced usual care or collaborative stepped care
and then followed over 18 months.
Among their topics are the epidemiology of mental illness, the service user perspective, suicide and self-harm, emergencies in primary care, asylum seekers and refugees, collaborative care and stepped care
, the role of practice nurses, and undertaking mental health research in primary care.