An innovative mental health program to support patients within primary care

These groups are offered by your physician colleagues to help you and your patients feel more resourced with the ever-increasing challenge of mental health needs in primary care. During the pandemic, all groups are offered virtually and available for any patient across British Columbia. These virtual groups will continue to be offered after in-person groups resume.

What is the CBT Skills Group program?

The Cognitive Behavioural Therapy (CBT) Skills Group program is an eight-week group medical visit for adult patients (17.5-75 years old) who want to learn practical tools to improve their mental health.

The CBT Skills Group program is a transdiagnostic course that integrates basic neuroscience concepts with introductory mindfulness and cognitive behavioural therapy skills and teaching.

It is delivered as an eight-week series of 90-minute group medical visits, with up to 16 patients per group. Patients learn practical tools to recognize, understand and manage patterns of feeling, thinking and behaving. They learn to be conscious of their choices as they respond to life stressors, and explore options for living a fuller, richer life, more aligned with what they value most.

During the pandemic, all groups are offered virtually and available for any patient across British Columbia. These virtual groups will continue to be offered after in-person groups resume.

Physician FAQ

What is the cost of the program for patients?

There is a $65 initial deposit, which is returned if the patient attends at least 7 of the 8 groups. Every patient is provided an online version of the workbook at the time of registration. Patients who want to purchase a hard copy of the workbook may do so for an additional $30 plus shipping. If a hard copy is preferred, but there is financial hardship, the fee can be reduced. Please email admin to inquire.

The group sessions are covered by MSP and billed as a Group Medical Visit (Psychiatrists: G78763-G78781; Family physicians: P13763-P13781) so there is no direct cost to the patient.

Once patients register for a group, they can modify their booking up until two weeks prior to the group start date. After that time, they will not be able to change the booking and we will not refund the cost of the program.

What are the evaluation results of the CBT Skills Group Program?

In an evaluation of the Victoria program, 63% of those enrolled in the program, completed it (i.e. attended 6/8 sessions) (n=1848). Those who completed the program reported 94% satisfaction, and nearly all participants would recommend the program to others. Self-efficacy was markedly improved, with 93% of completers reporting confidence in their ability to manage their mental health symptoms. Quantitative measurements of symptom severity showed statistically and clinically significant improvements, with large to very large effect sizes for completers. Referring family physicians ranked the value of the program at 4.7/5, indicating that the program had a positive impact on their patients’ mental health, increased access to mental health care, and somewhat reduced the need to refer to specialist services. Providers of the groups, both psychiatrists and family physicians, reported high levels of satisfaction and acceptability. See Oct 2019 and Nov 2022 issues of the BCMJ for articles describing results of the pilot and of virtual groups.

Referring To The Program

The CBT Skills Program is physician-led and operated.  

As your colleagues, we are asking you to help us help you by ensuring the patients you refer are suitable and prepared for group-based learning.

We do not have an intake office or triage clinicians to screen patients. We depend on you.

Please review our inclusion and exclusion criteria to understand which patients will be likely to benefit from the program, as well as those who won’t, and who may end up demoralized from trying to participate in the wrong kind of service. 

As well, our administrative team is lean and we require referral forms to be filled out completely. 

The more skilled you become at selecting patients and completing the one referral form, the better able we will be to quickly and effectively support patients within your ever-increasing panel.

Thank you!

 

How do I refer to the program?

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STEP 1

Determine if your patient is a good fit for the program by using our inclusion and exclusion criteria.

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STEP 2

Ask your patient about their comfort with participating in an online classroom-like group and inform them there is a $65 initial deposit, which is returned if they attend at least 7 of the 8 groups. Every patient is provided an online version of the workbook at the time of registration. Patients who want to purchase a hard copy of the workbook may do so for an additional $30 plus shipping. If a hard copy is preferred, but there is financial hardship, the fee can be reduced. Please email admin to inquire. If your patient is interested, have them fill out the PHQ9 form.

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STEP 3

If your patient scores 18 or lower on the PHQ9 and is not suicidal, then fill out the one referral form. The referral form is for all CBT Skills Programs: Foundations course, Level 2 groups, Raising Resilient Kids and Pilot Programs. When submitting the referral form please ensure you have filled out all portions of the form or it cannot be accepted and will be returned to you.

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STEP 4

Fax the referral form out to 778-265-0298. This number is also on the top right-hand corner of the referral form.

Referral forms have been embedded in MOISOscar, Med Access (type CBT in search window), and Wolf (type CBT in search window) and is expected to be embedded in Intrahealth soon. Did we miss your EMR? Contact us with your EMR and we will get our form embedded there too.

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STEP 5

Once the referral is accepted, we will contact the patient via email and they can self-select into a group of their choice at a time that suits their schedule. If the patient completes a group (attends 6/8 sessions) they will be contacted about level 2 groups that we offer

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How can the CBT Skills Group Program meet patient demand for the service?

Offering group medical visits as a centralized service allows for a small number of facilitators to meet the high patient demand for the service. 

Becoming A Facilitator

Who are the CBT Skills Group facilitators and how are they trained?

The CBT Skills Group facilitators are local psychiatrists and family physicians who have been trained to offer the groups in a group medical visit setting. One or more experienced psychiatrists train local family physicians who are interested to offer this service to their community. There are four phases of the training:

  1. The family physician participates in a group facilitated by a family physician or psychiatrist facilitator
  2. The family physician co-facilitates a group in a minor role with a family physician or psychiatrist facilitator
  3. The family physician co-facilitates a group in a major role with a psychiatrist
  4. The family physician solo-facilitates five groups with patient outcome data and feedback analyzed.

This training program was designed for family physicians. We are currently exploring training options for mental health professionals (e.g., counsellors, social workers).

What is the training composed of?

Training currently involves participation at various levels, with supervision provided by a psychiatrist. Depending on your level of interest and future plans, the following provides an approximation of the time you can expect to dedicate:

  • Phase I (observer-participant) – 1 series of eight  90-120 minute weekly group sessions with minimal preparation required 
  • Phase II (co-facilitation minor) – 1 or more series of eight 90-120 minute weekly group sessions; some pre-group preparation required, depending on your background knowledge and skills, pre-group preparation may take 2-5 hours a week 
  • Phase III (co-facilitation major) – 1 or more series of eight 90-120 minute weekly group sessions; depending on your background knowledge and skills, pre-group preparation may take 3-10 hours a week 
  • Phase IV (solo-facilitation) – 5 series of eight 90-120 minute weekly group sessions;
    • 8-10 hours per week for preparation for the first two solo groups
    • 1 hour per week for preparation for remaining and subsequent groups

Is the facilitator training CME accredited?

The CBT Skills Group Training program is CME accredited. Family physician trainees are eligible for up to 3 Mainpro + credits per hour of training to a total of 156 credits.

What are the options for delivering the CBT Skills Group Program?

Once trained, facilitators can offer the service using three delivery models:

  1. Provide the program to their own patient panel.
  2. Partner with other family physicians in a group practice and offer the program to their patients.
  3. Partner with other trained facilitators, their Division of Family Practice, and the CBT Skills Groups Society* to offer groups in their local community.

The delivery model is dependent on the trained physicians, the needs of the community, partnership with the Division of Family Practice,  and their current practices, and the size and geography of the community.

*Physicians are responsible for maintaining and storing their patient’s medical records, completing their billing and paying administrative overhead related to the program.

IF YOU ARE INTERESTED IN PARTICIPATING IN CBT SKILLS GROUPS FACILITATOR TRAINING PLEASE COMPLETE THIS SURVEY >

Read the BCMJ article on the Effectiveness and accessibility of virtual Cognitive Behavioural Therapy Skills Group medical visits during COVID-19

Read the BCMJ article on the success of the CBT Skills Program and find out how it could benefit you and your patients.

CBT Skills Spread Initiative: Building a program to support doctor and patient mental health.