Ultra-Brief CBT for Primary Care Visits: Pilot Training and Implementation

This study evaluated the feasibility and acceptability of an Ultra-Brief Cognitive-Behavioral Therapy (UB-CBT) intervention for depression and anxiety symptoms in routine primary care visits. The UB-CBT is responsive to the limited access to specialized mental health services, particularly evidence-based interventions, for individuals with depressive and anxiety disorders in the U.S. Most Americans with symptoms of depression and anxiety first report their concerns to their primary care provider (PCP) in routine visits, and the UB-CBT was designed to provide tools for managing these symptoms during these interactions. The UB-CBT training workshop was developed and piloted with 38 providers at three adult primary care and four family medicine sites in Vermont. PCPs completed questionnaires before and after the training. Data were analyzed using mixed qualitative and quantitative methods. Regarding training targets, most providers (79.7%) reported that they learned new information about depression and anxiety treatment and even more providers (88.6%) learned new information about how to address these symptoms in visits. From pre- to post-training, mean scores for provider attitudes toward psychotherapy and perceived competence talking to patients about mental health symptoms and therapy increased, but means scores for perceived comfort in talking to patients about mental health concerns decreased slightly. Data illustrated that most providers found the training and intervention highly feasible and acceptable. Providers especially liked the user friendliness and general feasibility of the intervention. Providers offered ideas about developing online versions of the material and raised some concerns about their ability to administer the intervention in a timely manner. The discussion outlines several steps that will address these concerns and improve the UB-CBT training experience and intervention. The UB-CBT intervention and training program have potential to increase patient access to mental health tools in primary care.