Improving Supervisor Confidence in Responding to Distressed Health Care Employees.

Background: Professional distress and burnout are increasingly common among health professionals. This trend prompted stakeholders at a large multicenter health care system to survey supervisors for improvement opportunities. The stakeholders learned that workplace leaders lacked tools and direction for appropriately responding to distressed employees.

Using session recordings to understand the content of community-based treatment for childhood anxiety disorders and response to technology-based training.

Objective: The goal of the current study is to advance efforts to increase the quality of care for childhood anxiety disorder (CADs) through (1) detailing the content of community-based treatment sessions, (2) exploring the validity of therapist surveys, (3) examining the influence of setting differences, and (4) testing the effects of a technology-based training on use of nonexposure strategies.

Methods: Thirteen therapists were randomly assigned to technology-based training in the use of exposure therapy or treatment as usual (TAU) for CADs. Therapeutic techniques were coded from 125 community-based treatment sessions.

Study What You Do: Developing a Psychotherapy Tracking Database in a Large-Scale Integrated Behavioral Health Service.

Purpose: Many individuals with behavioral health challenges receive services in primary care, and integrated behavioral health (IBH) programs can help increase access to evidence-based interventions. IBH programs can benefit substantially from integrating standardized tracking databases that allow for the implementation of measurement-based care to evaluate patient-, clinician-, and practice-level outcomes. We describe the development and integration of Mayo Clinic's pediatric and adult primary care psychotherapy tracking database.

Cognitive processing therapy for posttraumatic stress disorder due to COVID-19-related traumas: A case study.

Coronavirus disease 2019 (COVID-19) has been associated with a multitude of physical, psychological, and psychosocial issues including posttraumatic stress disorder (PTSD). While the presence of posttraumatic symptoms has been reported in the general population, little is known about the prevalence of PTSD in patients who experienced a traumatic COVID-19 infection or sequelae. There are currently no documented reports on the treatment of PTSD in patients with COVID-19-related index traumas.

Patient Satisfaction and Recommendations for Delivering a Group-Based Intensive Outpatient Program via Telemental Health During the COVID-19 Pandemic: Cross-sectional Cohort Study.

Background: Although group-based intensive outpatient programs (IOPs) are a level of care commonly utilized by adults with serious mental illness, few studies have examined the acceptability of group-based IOPs that required rapid transition to a telemental health (TMH) format during the COVID-19 pandemic.

Objective: The aim of this study was to evaluate patient satisfaction and future recommendations for a group-based IOP that was transitioned to a TMH format during the COVID-19 pandemic.

Methods: A 17-item patient satisfaction questionnaire was completed by patients at discharge and covered 3 areas: IOP TMH satisfaction, future recommendations, and video technology challenges.

Cognitive behavioral therapy for depressive disorders: Outcomes from a multi-state, multi-site primary care practice.

Background: Individuals with depressive disorders often present to and seek treatment in primary care. Integrated behavioral health services within this setting can improve access to evidence-based cognitive behavioral therapy (CBT). However, limited information exists on the effectiveness of CBT for depression in primary care.

Rapid Adoption and Implementation of Telehealth Group Psychotherapy During COVID 19: Practical Strategies and Recommendations.

Behavioral health services have been tasked with rapidly adopting and implementing teletherapy during the SARS-CoV-2/COVID-19 pandemic to assure patient and staff safety. Existing teletherapy guidelines were developed prior to the pandemic and do not capture the nuances of rapidly transitioning in-person individual and group-based treatments to a teletherapy format. In this paper, we describe our approach to quickly adapting to a teletherapy technology platform for an intensive outpatient program (IOP) guided by cognitive and behavioral modular principles for adults with serious mental illness.

Adaptations of an Integrated Behavioral Health Program During COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic has consistently been described as an "unprecedented" global health crisis. While the focus has been primarily on the medical and economic impact of the pandemic, psychological sequelae are anticipated. Primary care is the main point of access for mental health care in the United States, making it the ideal locale to provide psychological services for a larger proportion of the population than traditional mental health care settings.

Feasibility and Initial Outcomes of a Group-Based Teletherapy Psychiatric Day Program for Adults With Serious Mental Illness: Open, Nonrandomized Trial in the Context of COVID-19.

Background: In the context of the COVID-19 pandemic, many behavioral health services have transitioned to teletherapy to continue delivering care for patients with mental illness. Studies that evaluate the outcome of this rapid teletherapy adoption and implementation are pertinent.

Objective: This single-arm, nonrandomized pilot study aimed to assess the feasibility and initial patient-level outcomes of a psychiatric transitional day program that switched from an in-person group to a video teletherapy group during the COVID-19 pandemic.

Cognitive Behavioral Therapy for Anxiety Disorders: Outcomes From a Multi-State, Multi-Site Primary Care Practice.

Background: Anxiety disorders are among the most common mental health conditions. Individuals with anxiety typically seek services in primary, rather than specialty, care. While there is significant evidence supporting the efficacy and effectiveness of cognitive behavioral therapy (CBT) for anxiety disorders, there have been no naturalistic studies reporting anxiety-specific treatment outcomes in primary care.

Health Promotion Programs and Policies in the Workplace: An Exploratory Study With Alaska Businesses.

Introduction: We examined health insurance benefits, workplace policies, and health promotion programs in small to midsize businesses in Alaska whose workforces were at least 20% Alaska Native. Participating businesses were enrolled in a randomized trial to improve health promotion efforts.

Methods: Twenty-six Alaska businesses completed from January 2009 through October 2010 a 30-item survey on health benefits, policies, and programs in the workplace.

The Role of the Patient-Centered Medical Home in Treating Depression.

Purpose Of Review: This review discusses the role of the patient-centered medical home (PCMH) in treating depression, focusing on findings from primary care-based studies and their implications for the PCMH.

Recent Findings: Pharmacotherapy, psychotherapy, and collaborative care are evidence-based treatments for depression that can be delivered in primary care and extended to diverse populations. Recent research aligns with the core components of the PCMH model.

Barriers and bridges to implementing a workplace wellness project in Alaska.

Context: The vast, rugged geography and dispersed population of Alaska pose challenges for managing chronic disease risk. Creative, population-based approaches are essential to address the region's health needs. The American Cancer Society developed Workplace Solutions, a series of evidence-based interventions, to improve health promotion and reduce chronic disease risk in workplace settings.

Examining the effectiveness of pain rehabilitation on chronic pain and post-traumatic symptoms.

Patients with co-morbid chronic pain and post-traumatic stress disorder (PTSD) pose significant treatment challenges. This study evaluated the effectiveness of an interdisciplinary pain rehabilitation program (IPRP) in improving pain and PTSD outcomes, as well as reducing medication use. In addition, the mediating effect of pain catastrophizing, which is theorized to underlie the pain and PTSD comorbidity, was examined.

Analysis of Posttraumatic Stress Disorder, Depression, Anxiety, and Resiliency Within the Unique Population of Spontaneous Coronary Artery Dissection Survivors.

Background Mental health after spontaneous coronary artery dissection (SCAD), a cause of myocardial infarction in young women, remains largely unexplored. We assessed the prevalence and severity of psychiatric symptoms after SCAD. Methods and Results Individuals with confirmed SCAD who consented to the Mayo Clinic "Virtual" Multicenter SCAD Registry were sent the Posttraumatic Stress Disorder Diagnostic Scale for , Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Anxiety Sensitivity Index, Connor-Davidson Resilience Scale, 36-Item Short-Form Health Survey, and an SCAD-specific questionnaire.

Initial outcomes of a real-world multi-site primary care psychotherapy program.

Objective: Although anxiety, mood, and adjustment disorders are commonly treated in primary care, little evidence exists regarding psychotherapy outcomes within this setting. The primary objective of this study was to describe outcomes of a large-scale primary care psychotherapy program.

Methods: Patients (N = 2772) participated in cognitive behavioral therapy (CBT) as part of a multi-site primary care program.

A quality improvement project aimed at adapting primary care to ensure the delivery of evidence-based psychotherapy for adult anxiety.

Primary care patients frequently present with anxiety with prevalence ratios up to 30%. Brief cognitive-behavioural therapy (CBT) has been shown in meta-analytic studies to have a strong effect size in the treatment of anxiety. However, in surveys of anxious primary care patients, nearly 80% indicated that they had not received CBT.

Evidence-Based Psychotherapy in Primary Care.

The functional and financial effects of untreated psychiatric disorders within primary care have led to the development of novel service delivery models to improve access to high-quality, evidence-based mental health treatments. Cognitive-behavioral therapy (CBT) is an efficacious and effective psychotherapeutic approach for treating a broad range of mental health conditions. CBT is a practical, skill-building approach that emphasizes self-efficacy and self-management of symptoms while working toward defined and measurable treatment goals.

Development and implementation of a psychotherapy tracking database in primary care.

Introduction: Although there is a rapid increase in the integration of behavioral health services in primary care, few studies have evaluated the effectiveness of these services in real-world clinical settings, in part due to the difficulty of translating traditional mental health research designs to this setting. Accordingly, innovative approaches are needed to fit the unique challenges of conducting research in primary care. The development and implementation of one such approach is described in this article.

Changes in Physical Activity Barriers among American Indian Elders: A Pilot Study​.

The objective of the present study was to assess whether selfreported physical activity barriers could be reduced among American Indian elders who participated in a 6-week randomized physical activity trial that compared the use of a pedometer only to that of pedometers with step-count goal setting. Elders (N = 32) were compared on the Barriers to Being Physically Active Quiz after participating in a pilot physical activity trial. Elders were classified into high- and low-barrier groups at baseline and compared on self-reported physical activity, health-related quality of life, pedometer step counts, and 6-minute walk performance.

Non-pharmacological treatment of depression: a systematic review and evidence map.

Background: The comparative effectiveness of non-pharmacological treatments of depression remains unclear.

Methods: We conducted an overview of systematic reviews to identify randomised controlled trials (RCTs) that compared the efficacy and adverse effects of non-pharmacological treatments of depression. We searched multiple electronic databases through February 2016 without language restrictions.

Barriers to Cancer Care among American Indians and Alaska Natives.

Introduction: Cancer is among the leading causes of death in American Indians and Alaska Natives (AI/ANs), with rates increasing over the last two decades. Barriers in accessing cancer screening and treatment likely contribute to this situation.

Methods: We administered structured clinical interviews and conducted descriptive and multiple linear regression analyses of demographic, health, spiritual, and treatment factors associated with self-reported barriers to cancer care among 143 adult AI/AN oncology patients.

Panic attacks and panic disorder in the American Indian community.

Panic disorder is a common mental health condition, but little is known about panic disorder in non-Caucasian populations. The purpose of this study is to describe the epidemiology, clinical features, and comorbidities of panic attacks and panic disorder in two large American Indian (AI) tribes (N=3084). A culturally-adapted version of the Composite International Diagnostic Interview assessed panic attacks, panic disorder, and various psychiatric comorbidities.

Outcomes of a 6-week cognitive-behavioral and mindfulness group intervention in primary care.

Introduction: Cognitive-behavioral and mindfulness-based interventions are established treatments for depressive and anxiety disorders; however, there is a lack of research for these interventions in primary care settings. The current study evaluates an evidence-based group intervention provided to primary care patients with a variety of mood and anxiety concerns.

Method: Participants included 54 adult primary care patients who attended at least four sessions of a six-session cognitive-behavioral and mindfulness group.