Impact of a cognitive behavioural therapy training program on family physician practices: Cross-sectional study in Norway.

Abstract

To investigate changes in FPs' self-reported clinical practices after participation in a comprehensive 1-year cognitive behavioural therapy (CBT) training course. Cross-sectional study. Norway. Family physicians. Impact of the CBT training course on FPs' delivery of CBT to patients and their use of referral to specialized mental health care providers. Of the 217 FPs who had participated in the training course between 2009 and 2016, 124 completed the survey (response rate=57.1%); 99.2% of participating FPs reported using CBT tools daily in patient consultations, more than three-quarters reported changing the way they organized their workdays to accommodate CBT, and 75.0% reported using structured CBT consultations at least monthly after completing the course. The most common patient groups receiving structured CBT were those experiencing mild or moderate depression (22.8%), anxiety disorders (30.4%), or a combination of an anxiety disorder and depression (43.5%). The odds of making fewer referrals to specialized mental health care providers were 5.4 times higher among FPs who used Socratic questioning (P=.02), 4.7 times higher among those who provided consultation summaries (P=.01), and 3.3 times higher among those who had participated in a refresher course (P=.05). Comprehensive training in CBT promotes the use of CBT tools and strategies in family practice. Further longitudinal research (ideally randomized controlled studies) on patient outcomes related to CBT provided in family practices is required.