TY - JOUR
KW - Clinical Competence/standards
KW - Cooperative Behavior
KW - Delivery of Health Care, Integrated/methods/organization & administration
KW - Great Britain
KW - Health Services Accessibility/organization & administration
KW - Health Services Needs and Demand
KW - Humans
KW - Information Services/supply & distribution
KW - Mental Disorders/therapy
KW - Mental Health Services/organization & administration
KW - Primary Health Care/organization & administration
KW - Psychotherapy
KW - Quality Improvement
KW - Staff Development
AU - D. A. Richards
A1 - 
AB - OBJECTIVE: To introduce stepped care as a method of organizing the delivery of treatments, and to consider the factors necessary for implementation. METHOD: Stepped care is described within the context of strategies such as collaborative care that aim to increase access to mental health care through the improved coordination of care between primary and specialist mental health services. Results from the implementation of stepped care in the United Kingdom and elsewhere are used to highlight the factors required for introducing stepped care into routine services. Issues to address when implementing high-volume services for common mental health problems are derived from this experience. RESULTS: Stepped care sits within the continuum of organizational systems, from situations where responsibility rests almost entirely with primary care clinicians to systems where all patients are managed by specialists for the entire duration of their treatment. Its core principles of delivering low-burden treatments first, followed by careful patient progress monitoring to step patients up to more intensive treatment, are easy to articulate but lead to considerable implementation diversity when services attempt to work in this manner. Services need to ensure they have specific staff competency training, including skills in delivering evidence-based treatments, access to telephony, and smart patient management informatics systems. CONCLUSIONS: Stepped care can provide the delivery system for supported self-management. To be successful, health systems need high levels of clinical outcome data and appropriately trained workers. Further attention is required to ensure equity of access and to reduce patient attrition in these systems.
BT - Canadian journal of psychiatry.Revue canadienne de psychiatrie
C5 - Education & Workforce; HIT & Telehealth
CP - 4
CY - Canada
IS - 4
JF - Canadian journal of psychiatry.Revue canadienne de psychiatrie
N2 - OBJECTIVE: To introduce stepped care as a method of organizing the delivery of treatments, and to consider the factors necessary for implementation. METHOD: Stepped care is described within the context of strategies such as collaborative care that aim to increase access to mental health care through the improved coordination of care between primary and specialist mental health services. Results from the implementation of stepped care in the United Kingdom and elsewhere are used to highlight the factors required for introducing stepped care into routine services. Issues to address when implementing high-volume services for common mental health problems are derived from this experience. RESULTS: Stepped care sits within the continuum of organizational systems, from situations where responsibility rests almost entirely with primary care clinicians to systems where all patients are managed by specialists for the entire duration of their treatment. Its core principles of delivering low-burden treatments first, followed by careful patient progress monitoring to step patients up to more intensive treatment, are easy to articulate but lead to considerable implementation diversity when services attempt to work in this manner. Services need to ensure they have specific staff competency training, including skills in delivering evidence-based treatments, access to telephony, and smart patient management informatics systems. CONCLUSIONS: Stepped care can provide the delivery system for supported self-management. To be successful, health systems need high levels of clinical outcome data and appropriately trained workers. Further attention is required to ensure equity of access and to reduce patient attrition in these systems.
PP - Canada
PY - 2012
SN - 1497-0015; 0706-7437
SP - 210
EP - 215
EP - 
T1 - Stepped care: a method to deliver increased access to psychological therapies
T2 - Canadian journal of psychiatry.Revue canadienne de psychiatrie
TI - Stepped care: a method to deliver increased access to psychological therapies
U1 - Education & Workforce; HIT & Telehealth
U2 - 22480585
VL - 57
VO - 1497-0015; 0706-7437
Y1 - 2012
ER -