[Short-term interventions offered by les centres locaux de services communautaires (CLSC) to people living with anxiety or depressive disorders: Results of the longitudinal component of the Shared Knowledge study]. / Les interventions de courte durée offertes par les centres locaux de services communautaires (CLSC) aux personnes traversant un épisode de troubles anxieux ou dépressifs : une étude longitudinale au Québec.

Context In Quebec, adult mental health (AMH) first-line teams are mandated to provide psychosocial services to people living with mental health difficulties, including anxiety and mood disorders. Following the establishment of new clinical guidelines in 2017, the duration of interventions was not to exceed 15 sessions, with some exceptions. Objectives The overall aim of the longitudinal component of the Shared Knowledge study was to evaluate the care experience of individuals with an anxiety or depressive disorder receiving a short-term intervention (<15 sessions) by first-line AMH teams, and the evolution of recovery over time. Specifically, the objectives were to: 1) determine the appreciation of short-term interventions by service users; and 2) assess the evolution over time of the symptomatology, functioning and quality of life and recovery of individuals receiving short-term interventions. Method A mixed method longitudinal design was used. Telephone interviews were conducted with participants, in which the following variables were quantitatively and qualitatively assessed: appreciation of services received, quality of relationship with the provider (INSPIRE), depressive symptoms (PHQ-9), anxiety symptoms (GAD-7), global functioning (WHODAS), quality of life (ReQOL), and personal recovery (ERTAD). Linear mixed model analyses were performed to examine changes over time on quantitative measures. Content analysis was performed on the qualitative data. Results A total of 63 individuals participated in an interview before the start of their intervention and 22 of them participated after the end of this intervention. Statistical analyses showed a significant improvement in anxiety symptoms, quality of life, and personal recovery, but no difference was observed in depressive symptoms and level of functioning. Nearly half (47.4%) of participants reported that the intervention they received had "completely" met the need that had led them to seek help, and 33.3% felt "completely" equipped or empowered in their recovery. The quality of the relationship with the caregiver, the opportunity to take part in decision-making, and the personalization of the intervention according to their needs and preferences were some of the elements that were particularly appreciated. Conclusion Short-term interventions seem to be appreciated and produce positive effects in many people suffering from anxiety or depressive disorders. However, they remain insufficient for a number of them. A personal recovery measure should be used in conjunction with symptomatology and functioning scales to monitor the progress of people using first-line mental health services.

A pragmatic randomized controlled trial of a group self-management support program versus treatment-as-usual for anxiety disorders: study protocol.

BACKGROUND: The integration of a personal recovery-oriented practice in mental health services is an emerging principle in policy planning. Self-management support (SMS) is an intervention promoting recovery that aims at educating patients on the nature of their mental disorder, improving their strategies to manage their day-to-day symptoms, fostering self-efficacy and empowerment, preventing relapse, and promoting well-being. While SMS is well established for chronic physical conditions, there is a lack of evidence to support the implementation of structured SMS programs for common mental disorders, and particularly for anxiety disorders. This study aims to examine the effectiveness of a group-based self-management support program for anxiety disorders as an add-on to treatment-as-usual in community-based care settings. METHODS/DESIGN: We will conduct a multicentre pragmatic randomized controlled trial with a pre-treatment, post-treatment (4-month post-randomization), and follow-ups at 8, 12 and 24-months. TREATMENT AND CONTROL GROUPS: a) group self-management support (10 weekly 2.5-h group web-based sessions with 10-15 patients with two trained facilitators); b) treatment-as-usual. Participants will include adults meeting DSM-5 criteria for Panic Disorder, Agoraphobia, Social Anxiety Disorder, and/or Generalized Anxiety Disorder. The primary outcome measure will be the Beck Anxiety Inventory; secondary outcome measures will comprise self-reported instruments for anxiety and depressive symptoms, recovery, self-management, quality of life, and service utilisation. STATISTICAL ANALYSIS: Data will be analysed based on intention-to-treat with a mixed effects regression model accounting for between and within-subject variations in the effects of the intervention. DISCUSSION: This study will contribute to the limited knowledge base regarding the effectiveness of structured group self-management support for anxiety disorders. It is expected that changes in patients' self-management behaviour will lead to better anxiety management and, consequently, to improved patient outcomes. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05124639 . Prospectively registered 18 November 2021.

Getting better my way: Feasibility study of a self-management support tool for people with mood and anxiety disorders.

OBJECTIVE: Self-management support is recognized as an important component of the management of mood and anxiety disorders. The goal of this feasibility study was to evaluate the acceptability, implementation and perceived usefulness of a new comprehensive self-management tool (Getting better my way) in four care settings in Quebec, Canada. METHOD: Care providers offered the tool to people with difficulties related to mood or anxiety disorders during a 7-month period. A sample of 71 participants filled out an online survey and 27 accepted to participate in a follow-up interview. Focus groups were conducted with 82 care providers. RESULTS: Satisfaction ratings were high for the tool overall, the likelihood of recommending it to friends, its attractiveness and interest, and its completion time. Perceived usefulness was high overall and was not related to most demographic and clinical variables. No adverse effects were reported. CONCLUSION AND IMPLICATIONS FOR PRACTICE: The study highlights that Getting better my way is a comprehensive recovery-oriented tool, considered useful, acceptable and feasible to use in a variety of settings offering services for mood and anxiety disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).