1 - (OP3) Developing and Implementing Group Therapy Services in Primary Care Integrated Behavioral Health

Introduction: The mental health treatment gap remains an important target for psychological science. One population-based approach aimed at improving access to evidence-based care involves integrating behavioral health services within primary care (Sawchuk et al., 2020). Integrated behavioral health (IBH) programs offer patients a variety of stepped care options, including group therapy services. Short-term psychotherapy groups offered in primary care are a promising avenue for increasing access to evidence-based interventions for common presenting behavioral health concerns.

Method: Starting in 2014, Mayo Clinic’s IBH program developed a range of both in-person and virtual brief groups (ranging between 4-8 sessions) including, cognitive behavioral therapy for insomnia (CBT-I), both CBT and acceptance and commitment therapy (ACT) coping with anxiety and depression , exposure therapy for anxiety, attention deficit hyperactivity disorder coping skills, senior vitality, and coping skills for teens. We have worked to streamline referral processes and ordering sets to facilitate efficient integration of group services within our practice.

Results: Offering group therapy within our primary care IBH program expands accessibility to evidence-based treatment options for patients served within our practice. Groups also provide an opportunity for patients to connect with and learn from other individuals who face similar challenges. Correspondingly, the development, integration, and refinement of referral and scheduling processes has been critical to the successful implementation of group therapy programming. Representative outcomes showed that among participants of the in-person CBT-I group who completed feedback questionnaires between 2019-2023, 105/110 (95.5%) endorsed that they would recommend the group to others with insomnia and sleep problems either “quite a bit” or “very much.” To date, among participants who completed feedback for the virtual CBT-I group (which has been implemented more recently), 23/24 (95.8%) individuals endorsed that they either “agree” or “strongly agree” that they would recommend the group to others.

Discussion: Group therapy services within primary care IBH programs represent an efficient approach to address the mental health treatment gap by increasing patient capacity while reducing treatment duration.

Reference:

Sawchuk, C. N., Mulholland, H., Trane, S., Lebow, J. R., Puspitasari, A., & Lombardi, N. (2020). What to do when evidence-based treatment manuals are not enough? Adapting evidence-based psychological interventions for primary care. Cognitive and Behavioral Practice, 27(4), 377-391.