The development and pilot testing of a Focused Education and Psychotherapy Program (FEPP) for treatment of depression in general practice

Abstract

Background:

Studies demonstrating efficacy of psychological therapies have predominantly been conducted in specialist psychiatric settings. Investigation of the effectiveness of these therapies when provided by general practitioners (GPs) in their specific work setting is lacking and much needed.

Objectives:

To develop and pilot test a new education and treatment program to assist GPs manage patients with a depressive illness. The Focused Education and Psychotherapy Program (FEPP) is intended to provide GPs and patients with a treatment and education program for the management of depressive illness using a psychological intervention within the cost and time constraints of general practice.

Methods:

Following consultation, we developed a draft program. This program incorporates established psychological therapies, Interpersonal Counselling (IPC) and Cognitive Behavioural strategies with patient education in a general practitioner manual and accompanying patient handbook. FEPP was reviewed by focus groups and was pilot tested using a simulated depressed patient who Mailed the program with four GPs.

Results:

Consultation and pilot testing of the program identified important issues for both GPs and their patients. These were incorporated into the final version of the program, which includes a 12-week acute phase of treatment followed by a maintenance program and is based on IPC and cognitive behavioural strategies, and patient and GP education utilising a manualised format.

Conclusions:

A practical and accessible form of psychological treatment for the general practice setting has been developed. Effectiveness of this program now needs to be established.