Building on the success of the Victoria Division of Family Practice’s CBT Skills Group Initiative, the Vancouver Division is working with the Victoria Division to pilot a program here in Vancouver. In the pilot, we will be training a small group of family doctors to deliver cognitive behavioural therapy skills as part of their own practice to increase access to appropriate care for patients requiring low to moderate support. CBT is an evidence-based treatment for anxiety or depression. The Victoria-based Initiative has fostered collaboration between family medicine and psychiatry, and enables people to access therapeutic support covered by MSP.
UPDATE: Vancouver Division of Family Practice's CBT Skills Group is getting underway. Please refer back to this site for updates. The below links provide useful information about the program. Some links reference the Victoria program, as indicated, which is similar but not the exact same as which Vancouver is developing.
Cognitive Behavioural Therapy (CBT) is usually a short-term form of therapy with a focus on helping an individual become more aware of patterns of thinking (cognitions), feeling (emotions) and behaving. These patterns represent the unique biochemical functioning of your brain, and reflect how your brain has adapted and responded to earlier life events. However, exploring those early events is not the focus of CBT; rather, the focus is examining the way in which your response to a situation in the here-and-now can be modified to bring about positive change.
The interaction between these three aspects of our responses (thoughts, feelings, and behaviours) is powerful and frequently unrecognized.
Here is a simple illustration of how our thoughts about an event can affect how we feel and act. Imagine you awake to the phone ringing in the early morning hours. If your thought is that you are getting bad news about a relative who is sick, you may be sad and fearful. If your thought is that your work is calling to ask you to come in early, you may be irritated. If your thought is that your daughter is calling to tell you she arrived at the airport early, you may be surprised and happy. The same event can lead to many different reactions depending on our interpretation. CBT skills can help us become more aware of our interpretations and develop more flexible and helpful habits of thought and behavior.
The CBT Skills uses CBT as a basis to teach you various skills. You will learn about how your emotions work, and how these are connected to your thoughts and your behaviours. Understanding these connections will help you to work more effectively with yourself - with your mind/brain and also your body sensations - especially when you are having problems associated with depression and anxiety. You can continue to use the skills you learn - acting as a coach to yourself.
What is the evidence that CBT works?
Cognitive-behavioural therapy has been extensively researched in a wide range of psychiatric disorders. In a broad summary of the literature (Butler et al, 2006), CBT alone was found to be an effective treatment for depression, generalized anxiety disorder, panic disorder, social phobia, post traumatic stress disorder, obsessive compulsive disorder along with other disorders. CBT can also improve outcomes when delivered in conjunction with medication, especially when depression is more severe, and has been shown to reduce relapse and recurrence of depression (Segal et al, 2002).
Butler et al. The empirical analysis of cognitive-behavioural therapy: A review of meta-analyses. Clinical Psychology Review 2006;26:17–31.
Segal et al. Efficacy of combined, sequential and crossover psychotherapy and pharmacotherapy in improving outcomes in depression. J Psychiatry Neurosci 2002;27(4):281-90.
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