Low Intensity CBT for clients with chronic disease identified by allied health professionals

Supporting people with long term-conditions is a major challenge of health services globally (UN Secretary General, 2011). An increasing prevalence of long-term conditions and soaring costs create an urgent need to redesign health services (Tinetti, Fried, & Boyd, 20132). The case for integrating physical and mental health care is compelling. However, its translation into practice, both locally and internationally, is beset by health system siloes, service gaps, care coordination governance, agreement on what constitutes ‘value’ and cultural difference between professional groups (Naylor et al, 2016).

Individuals with a mental health diagnosis often experience many barriers to engaging in physical activity such as lack of motivation, increased physical comorbidities, pain and the side effects of medication (Firth et al, 2016a, 2016c). Evidence suggests that people who are “activated:, that is, have the knowledge, skills and confidence to manage their health effectively, are more likely to make healthy lifestyle choices and have better health outcomes and care experiences (Hibbard & Greende, 2013). Time spent with collaborating with health care providers is therefore key to providing resources and coaching that encourage self-management.

Remedy Healthcare delivers a broad range of health services across Australia, our multidisciplinary team, with expertise across both physical and mental health, provide us a unique opportunity to implement strategies to improve the overall health of clients. Recently, we have implemented an innovative model of care that leverages existing chronic disease management and care coordination programs with MindStep; a co-located Low intensity cognitive behavioural therapy (LiCBT) program to successfully integrate physical and mental health care in the private sector. This service now has the capacity to provide “dose-specific” levels of coaching required by the person to “activate” clients to engage in healthy lifestyle interventions such as physical activity, diet, sleep, and social engagement and address co-morbid mental health concerns, such as anxiety and depression.

During this presentation we will share outcomes of both the health coaching programs and MindStep Lowintensity cognitive behavioural therapy program and preliminary results for people when both programs are used in concert. We will also share our exciting plans for future service directions.