(PS6-B36) Developing an Ultra-brief Cognitive-behavioral Therapy Intervention (UB-CBT) for Routine Primary Care Visits

According to the World Health Organization approximately 17,491,047 Americans live with depressive disorders and 18,711,966 Americans live with anxiety disorders (WHO, 2017). More current data during the COVID-19 pandemic estimates that adults were more than three times more likely to experience depressive and anxiety disorders in 2020 compared to 2019 (Twenge & Joiner, 2020). Most depressive and anxiety disorders are treated solely in primary care settings due to limited access to specialists, but primary care providers do not receive standardized training or tools for addressing mental health symptoms as they arise in appointments (Kroenke & Unutzer, 2017; Smith-East & Neff, 2020; Young et al., 2001). During a global pandemic when need is higher than ever, it is especially important to develop scalable, accessible cognitive-behavioral interventions in primary care settings. The authors developed an ultra-brief cognitive-behavioral therapy (UB-CBT) protocol that can be taught to primary care providers in a one-hour workshop. The current project is a pilot study that examined the acceptability and feasibility of the training workshop and intervention. Researchers provided the one-hour training workshop in one University of Vermont-affiliated primary care practice with a sample of 12 primary care providers. Participants completed a survey immediately before and after training as well as 30 days after implementation with patients. Descriptive statistics assessing acceptability and feasibility were examined as well as paired-samples t-tests on several items examined across time points. Results demonstrated score increases for all items measured across time points, which indicated that providers felt more comfortable and competent addressing patient depression and anxiety in visits after completing the UB-CBT training. Providers offered feedback that the training and toolkit were “simple,” “brief,” “easy to follow,” and “well organized.” Providers suggested that it “would be helpful to include info about follow-up” and that the intervention “does not apply to crisis.” The researchers will adapt the training curriculum to address this feedback using improvement science. Data demonstrated that the UB-CBT intervention and training were well-received and feasible within the UVM Primary Care system. This work is the first step in developing a protocol that provides PCPs with tools for addressing patient depression and anxiety symptoms in their visits. The UB-CBT intervention and training have potential to increase access to evidence-based interventions for patients with depression and anxiety on a wide scale across the U.S. healthcare system.