Bogucki Olivia E, Mattson Angela B, Leasure William B, Berg Summer L, Mulholland Hannah L, Sawchuk Craig N
Division of Integrated Behavioral Health, Mayo Clinic, Rochester, MN.
Cogn Behav Pract. 2021 Nov;28(4):481-491. doi: 10.1016/j.cbpra.2021.01.006. Epub 2021 Mar 22.
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. The aim of this paper is to describe how our multi-state, multi-site integrated primary care program adapted and applied cognitive behavioral therapy in the context of COVID-19. Access to mental health care was disrupted despite burgeoning mental health concerns, necessitating novel approaches to providing care. A stepped-care approach was implemented within our primary care practice, which consisted of a combination of low-intensity, high-yield stress management and resiliency building resources and cognitive behavioral therapy that were delivered flexibly based on patient preference, technological capabilities, state ordinances, insurance coverage, and institutional policies. The lessons learned from this experience can inform other integrated primary care clinics in responding to the current and future pandemics.
2019年冠状病毒病（COVID-19）大流行一直被描述为一场“前所未有的”全球健康危机。虽然人们主要关注的是该大流行对医疗和经济的影响，但预计也会产生心理后遗症。在美国，初级保健是获得心理健康护理的主要途径，这使其成为比传统心理健康护理机构更理想的为更大比例人口提供心理服务的场所。本文旨在描述我们的多州、多地点综合初级保健项目在COVID-19背景下如何调整和应用认知行为疗法。尽管心理健康问题日益突出，但获得心理健康护理的途径却受到了干扰，因此需要采用新的护理提供方式。我们在初级保健实践中实施了一种逐步护理方法，该方法包括低强度、高收益的压力管理和恢复力建设资源与认知行为疗法的结合，并根据患者偏好、技术能力、州法令、保险覆盖范围和机构政策灵活提供。从这一经验中吸取的教训可以为其他综合初级保健诊所应对当前和未来的大流行提供参考。
