Jitender Sareen MD, Tanya Sala MD, Jacquelyne Wong MA, Debbie Whitney PhD, Jolene Kinley PhD

 Jitender Sareen, MD  Jacquelyne Wong, MA  Debbie Whitney, PhD  Jolene Kinley, PhD  Natalie Meyer – tireless admin support

 Improve access to CBT in the region  CBT is evidence-based treatment  Long wait-times, if available at all  Usual mode of delivery is individual and/ or small group format  Large guided self-help class format is a novel method of delivery

 Enhance capacity for delivering CBT classes at HSC and other regional sites.  Adapt the format and content of the classes for delivery to vulnerable groups with limited access to services.  Train peer leaders to deliver classes.  Create a toolkit for future use by sites implementing CBT classes.  Measure outcomes as well as client and family member satisfaction in a rigorous manner.  Create an online course version of the classes for those clients who are unable to attend in person.

1. Cognitive Therapy 2. Behavior Therapy 3. Healthy Living, Sleep 4. Assertiveness/Anger, Problem- Solving Mindfulness exercise every session

Referral Screening Visit Education Classes Group Therapy Self-help strategies encouraged 3-6 months months A. Old service delivery model B. New service delivery model Patients attend a minimum of 4 education classes in order to be eligible for group therapy.

 4-session classes running for 2 years  Mood and Anxiety symptoms  >300 patients treated  After completing 4 classes:  Depression groups  Anxiety groups  Obsessive Compulsive Disorder groups

 Occupational Stress Injury Clinic (OSI)  Crisis Response Centre (CRC)  Interlake  May 25 – Facilitator training  Plan for two additional training days in 2016  Potential additional sites:  ADAM  MDAM  Victoria Hospital  Grace Hospital  Shared Care

 Symptom measures:  Patient Health Questionnaire-9 Item (PHQ-9)  Generalized Anxiety Disorder-7 Item (GAD-7)  DSM-5 Cross-Cutting Symptom Measure – Adult  Clinical Global Impression Scale (CGI-I)  World Health Organization Disability Assessment Schedule 2.0 (WHODAS)  Patient Satisfaction Measures:  Session Rating Scale  Evaluation of CBT Education Class

 Initial CBT screening appointment  Each Class  CBT groups:  First group  Every 4 th group  Final group

 Toolkit:  Reduce administrative burden  CBT fidelity  Consistency  Online Course:  Increase access in rural and remote areas  Increase access for patients with conflicting time commitments – work, school, child-care, etc.

 Anxiety Disorders Association of Manitoba  Mood Disorders Association of Manitoba  Crisis Response Centre  St. Boniface Hospital Mental Health Program  Clinical Health Psychology Program  Victoria Hospital Mental Health Program  Child and Adolescent Mental Health Program  Interlake-Eastern Regional Health Authority  Grace Hospital Psychiatric Ambulatory Program  Veterans Affairs Operational Stress Injuries clinic