Focused Physiological Skills
This ALM aims to educate GP’s with the skills required to interview and diagnose conditions associated with Psychological disorders. Psycho-education forms a large part of the delivery, with participants exploring and discussing the key components of CBT and Motivational interviewing and Acceptance Commitment Therapy. The aim of the 3 day workshop is to train with a view to implement skills in the general practice setting.
Mental illness is widespread in Australia, results from the 2007 National Survey of Mental Health and Wellbeing, conducted by the Australian Bureau of Statistics (ABS) indicate that one in five people age 16 to 85 years’ experience one of the common forms of mental illness (anxiety and depression being highest prevalent)
GP’s require a basic understanding of common psychological disorders for appropriate mental health planning and referral. Continued Education in this area is a requirement to claim Medicare incentive payments. The GP is exposed to high levels of Mental Health comorbidity in general practice and as such needs to be well equipped to manage such conditions. Psychotherapy and Counselling form part of the GP treatment repertoire and are very useful in managing mental health conditions.
Cognitive behaviour therapy is an effective treatment for mild to moderate depression, generalised anxiety disorder, panic disorder with or without agoraphobia, social phobia, post-traumatic stress disorder, and childhood depressive and anxiety disorders. At its simplest, it can take the form of an exercise prescription, teaching relaxation techniques, assistance with sleep hygiene, scheduling pleasurable activities and guiding the patient through thought identification and challenge. With some basic training in the area, GPs are well placed to provide basic cognitive behaviour therapy treatments, particularly to patients at the mild end of the spectrum of mental health disease, as they already know their patients well and have a therapeutic alliance with them. (Aschim et al. 2011)
Cognitive behaviour therapy is a valuable resource for time poor doctors as it provides a structure for mental health consultations so that GPs can use their time more efficiently. General practitioners with an interest in mental health disorders are encouraged to become familiar with this technique by researching it further and locating a suitable training program to familiarise themselves with the skills and strategies. They can then start to implement this in their practice settings and may even be pleasantly surprised by the outcomes (Harden 2012)
In a recent study of rural GP’s, The GPs studied reported CBT as being an appropriate technique in general practice and one that delivered good outcomes (Pierce and Pearce 2011)
In another recent study conducted in 2011 by Aschim et al. it was found that GPs who learn to master CBT report experiencing positive effects with regard to their consultation skills in general.
Research into health related behaviour change highlights the importance of motivation, ambivalence and resistance. Motivational interviewing is a counselling method that involves enhancing a patient’s motivation to change by means of four guiding principles, represented by the acronym RULE: Resist the righting reflex; Understand the patient’s own motivations; Listen with empathy; and Empower the patient. Recent meta-analyses show that motivational interviewing is effective for decreasing alcohol and drug use in adults and adolescents and evidence is accumulating in others areas of health including smoking cessation, reducing sexual risk behaviours, improving adherence to treatment and medication and diabetes management. (Hall, K Gibbie, T and Lubman, D ,2012)
Acceptance and Commitment Therapy, known as ‘ACT’ (pronounced as the word ‘act’) is a mindfulness based behavioural therapy that challenges the ground rules of most Western psychology. It utilizes an eclectic mix of metaphor, paradox, and mindfulness skills, along with a
wide range of experiential exercises and values-guided behavioural interventions. ACT has proven
effective with a diverse range of clinical conditions; depression, OCD, workplace stress, chronic
pain, the stress of terminal cancer, anxiety, PTSD, anorexia, heroin abuse, marijuana abuse, and even
schizophrenia. (Zettle & Raines, 1989;Twohig, Hayes & Masuda, 2006;Bond & Bunce, 2000; Dahl, Wilson& Nilsson, 2004; Branstetter, Wilson, Hildebrandt & Mutch, 2004) as cited in Harris 2006.
The goal of ACT The goal of ACT is to create a rich and meaningful life, while accepting the pain that inevitably goes with it.
CBT, Motivational Interviewing and Acceptance Commitment Therapy are all covered within this training package.