Mental Health

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Hidden Lives

Hidden Lives

True Stories from People Who Live with Mental Illness
edited by Lenore Rowntree & Andrew Boden
foreword by Gabor Mate
edition:Paperback
also available: Paperback eBook
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Faire son choix, réussir son parcours

Faire son choix, réussir son parcours

Traitement de la dépendance aux opioïdes
by CAMH
edition:eBook
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Making the Choice, Making It Work

Making the Choice, Making It Work

Treatment for Opioid Addiction
by CAMH
edition:eBook
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The Primary Care Toolkit for Anxiety and Related Disorders

The Primary Care Toolkit for Anxiety and Related Disorders

Quick, Practical Solutions for Assessment and Management
edition:eBook
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Primary Care Toolkit for Anxiety and Related Disorders

Primary Care Toolkit for Anxiety and Related Disorders

Quick, Practical Solutions for Assessment and Management
edition:Paperback
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Excerpt

TOOLKIT OVERVIEW Does This Sound Like You?

It is Friday afternoon at 4:30 p.m.; you are 1 hour behind schedule. A patient who was scheduled for a regular checkup breaks down crying because he or she is at the end of their rope.

Every medical professional knows this feeling well. You feel overwhelmed and helpless, and experience a sense of loss of control. You don’t have the time or energy to help your patient adequately, but you want to carry out your duty to provide care.

Why Was This Toolkit Created?

This toolkit has been designed specifically for primary health care professionals. As a primary care provider, you may ask yourself: why invest time in learning about anxiety and related disorders, aren’t all these conditions more or less managed the same? Anxiety and related disorders are extremely relevant to the primary health care professional as they are among the most common psychiatric conditions, with a lifetime prevalence rate of around 30%. Most patients turn to their primary care provider first for assistance; however, almost one-third of patients will present with other symptoms, such as physical symptoms (e.g., headache, gastrointestinal distress, fatigue) or depression, and if the primary diagnosis is missed, it can lead to a chronic, difficult-to-treat disorder, depression, and/or suicidality. Management specific to anxiety and related disorder subtypes can be quite different depending on the disorder; therefore, early recognition and treatment can alter the course of illness and lead to much better outcomes, early recovery, and improved quality of life for patients.

These factors underscore the need to increase the knowledge and skills of primary care physicians in managing mental illness through education programs. Numerous training programs have been developed to improve the detection and management of mental illness. Despite these efforts, most educational programs do not translate into changes in practice patterns. Although physicians invest a substantial amount of time in continuing medical education (CME) activities, studies have shown a lack of effect of formal CME if these CME initiatives are not associated with enabling or practice-reinforcing strategies. A recent study conducted by Tamburrino et al. suggested that in order for education programs to be effective, family physicians may need to monitor mental illness symptoms closely with the help of protocols and prompts. In addition, physicians best capitalize on professional development that offers distinct, finite opportunities to train for necessary skill sets that can be implemented immediately within the scope of their practice.

However, focusing solely on increasing knowledge and skills is not enough. Barriers that prevent physicians from applying this knowledge need to be taken into account. Studies suggest that one of the top barriers for family physicians in managing mental illness is lack of time. To this end, an educational program that incorporates time-efficient assessment and management strategies would aid in increasing family physicians’ interest and comfort in managing anxiety and related disorders.

How This Toolkit Will Benefit You

As a primary care provider, you probably encounter patients with anxiety and related disorders quite frequently. If you have a busy practice and need access to time efficient, user-friendly strategies and tools, this toolkit is for you. It will guide you through key features of common disorders with the help of case studies. You will work through time-efficient ways to screen, diagnose, and manage common anxiety and related disorders over the course of multiple visits. Some examples of time-efficient assessment and management tools include the following:

- Short screening questionnaires (- Printable patient self-report validated scales.
- Guidelines for pharmacotherapeutic and non-pharmacotherapeutic options.
- Treatment algorithms.
- Visit-by-visit guides.

Particularly complicated or refractory cases will, however, require consultation with or referral to a psychiatric specialist.

As you begin to work through the elements of this toolkit, its benefits will soon become apparent. The toolkit consists of an approach to care that empowers patients and promotes partnership with professionals. Although you will encourage and facilitate the screening, assessment, treatment plan development, monitoring, and management process, the work is shared with your patient, therefore reducing your time involvement while improving patient engagement, compliance, and understanding of the importance of early and timely recovery. This toolkit also has an added bonus of example case studies reflecting real-life practice (e.g., patients presenting to you with somatic symptoms, chronic tension, and comorbid physical disorders, not just obvious psychiatric symptoms).

Guidance on possible choices or actions available to you, combined with disorder-specific treatment strategies, will simplify treatment plan development for your patients, which increases the chances of treatment success. To learn about each disorder, you can follow the diagnosis, treatment, and management of our case study patient. You can progress through the case studies from start to finish, or you can select your own learning path in the Practice Case Study Index, p. xxv. The choice is yours. Well-developed directional strategies such as these empower you to take control.

What You Will Learn by Using This Toolkit

This book includes practical, concise tools that will enhance your ability to detect, assess, and diagnose patients with common anxiety disorders, obsessive-compulsive (OC) and related disorders, and trauma- and stressor-related disorders seen in primary care. You will also:

1. Understand the current treatment strategies that can optimize outcomes for patients with common anxiety, OC and related disorders, and trauma- and stressor-related disorders seen in primary care.
2. Obtain practical approaches for addressing long-term management challenges.
3. Appreciate the importance of functional recovery for patients.

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