Process - Physician - Fraser Health Authority

SUPPORTED SELF‐MANAGEMENT FOR DEPRESSIONSTEP TWO: HELP THE PATIENT FIND A STARTING POINTPt isinactive/isolatedBEHAVIOURAL ACTIVATION- Identifying target areas (eg Social Contact, Self Care)- Setting goals (Specific, Realistic, Scheduled)Page 18Patient is feelingoverwhelmed,“can’t cope”Patient has overlynegative thoughtsPatient hasanxiety/tensionREALISTIC THINKING-Identifying depressive thoughts‐Coming up with realistic thoughts-Challenging depressive thinking‐Practicing realistic thinkingPROBLEM SOLVING-Identifying a mildly difficult problem-Coming up with actions-Evaluating pros and cons, Choosing-Making a planRELAXATION TRAINING‐Getting CD or downloading audiofile‐Practicing weeklyPage 30Page 39Free download:www.comh.ca/selfcare/The Antidepressant Skills Workbook is available for free download at www.comh.ca/selfcare/.Also available at that website are: translations into French, Chinese and Punjabi; an audiobookversion; versions for adolescents and the workplace; and other useful clinical tools.REFERENCES:• Bilsker D, Goldner EM. Training GPs to prescribe depression self‐management. In TheOxford Guide to Low‐intensity CBT Interventions, Oxford University Press (expected 2010).• Bilsker D, Anderson E. Supported Self Management for depression in primary care. InPsychiatry in Primary Care: A Concise Canadian Handbook, Centre for Addiction & MentalHealth (expected 2010).• Bilsker D, Anderson J, Samra J, Goldner EM, Streiner D (2009). Behavioural interventions inprimary care. Canadian Journal of Community Mental Health 27: 179‐189.154