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Table 1 Functions and Components of Psychotherapy and Case Management Intervention

From: Intensive psychotherapy and case management for Karen refugees with major depression in primary care: a pragmatic randomized control trial

Case Management

 Function: assist patients to gain access to medical, social, educational, vocational and other necessary services connected to their mental health needs

Components:

  • Assessing patients’ needs and goals and impact of mental illness, and incorporating patients’ strengths and progress toward goals

  • Planning goals and goal-related steps, updating the individual and community support plan, finding new resources

  • Referring and linking to resources, supports and services

  • Coordinating with medical providers, community resources and natural supports identified by each patient as important to his or her recovery process

  • Monitoring the effectiveness of the resources, supports and services being utilized, especially with respect to refugees navigating health and community systems in resettlement

  • Discussing the progress made toward goals

  • Advocating as case managers on behalf of the patients’ mental health needs with medical, legal and social systems

Psychotherapy

 Function: increase patients’ coping skills and understanding of their symptoms; alleviate symptoms and their impact

Components:

  • Facilitating mind-body awareness; teaching and practicing relaxation skills

  • Providing psychoeducation on the relationship between trauma/stress and symptoms, treatment options for mental health symptoms, use of medications, and the doctor-patient relationship in Western medical culture

  • Developing and teaching compensatory strategies for taking medications accurately and following health plan instructions that accommodate impairments in memory/concentration and other mental health symptoms

  • Applying evidence-based trauma-focused treatments to reduce symptoms of depression, anxiety, and posttraumatic stress

  • Problem-solving with patients to decrease impact of symptoms and distress by changing coping behaviors and thought patterns

  • Advocating as psychotherapists on behalf of patients’ mental health needs with medical, legal and social systems