Mental Health Series – Understanding Treatment Modalities

May is Mental Health Month Awareness Month. In recognition of this, the EAP is offering a series of posts about mental health resources and options for help.  This week, we discuss treatment modalities.

There are many ways in which people address stress or mental health issues. Sometimes people can cope on their own via engaging in wellness, healthy lifestyle, or self-help activities. Other times, it’s beneficial to seek professional assistance or more structured guidance.

Below, we review some treatment modalities and how they might be useful to you. The EAP website has more detailed information on common mental health interventions. We describe a few in depth below.

Psychotherapy

Psychotherapy encompasses a broad group of treatments that essentially involve conversations (“talk therapy”) between individuals and providers to address mental health, stress, and other life issues. Some components include:

• Participants: individual, group, couple, family
• Length of treatment: short or long
• Kind of support: emotional, goal-oriented, problem-solving
• Types: There are a number of psychotherapy techniques, such as Psychodynamic Therapy, Psychoanalysis and Cognitive behavioral Therapy (CBT) (discussed in detail below

Cognitive Behavioral Therapy (CBT)

Anne Chosak, PhD, Director of the CBT Program at MGH, provides an overview of CBT in this video

What is CBT?

A psychological intervention that helps people to better understand their emotional habits in order to modify unhealthy and unhelpful patterns and change reactions, emotions, and behaviors.

How does CBT help?

• Changing distorted thinking can impact how we react, behave, and feel
• The diagram below from the Beck Institute (named after the founder of CBT) shows how all these systems feed off of one another

How does CBT work?

• Individuals develop and learn to use problem-solving & coping skills
• These skills allow for  the modification of distorted thinking, based on recognition of more accurate perceptions of reality
• CBT utilizes a number of techniques and processes that are tailored to the set of circumstances & needs of the individual
• This requires trial and error & practice
• Individuals establish a skill set that they can easily access & rely on in different scenarios

Who can benefit from CBT?

CBT is used with a variety of mental health conditions and situations, such as:

• Depression
• Anxiety disorders
• Eating disorders
• Substance use disorders
• Stress

SilverCloud iCBT Program for MGB

For some, online CBT (iCBT) can be helpful and convenient. SilverCloud is a free online, self-directed CBT course, which includes some additional well-being activities, for individuals with low to moderate levels of depression or anxiety. SilverCloud can help clients manage their symptoms using modules on several topics, including depression, anxiety, stress, insomnia, and resilience.

Employees, IHP students and household members (over the age of 18) can access this program via a mobile device or desktop computer. Referrals can be done via your PCP, the EAP or self-referral.

Medication Management

John Herman, MD, Medical Director, MGB Employee Assistance Program offers a video overview of Medication Management.

What is medication management for mental health?

Medication management uses a variety of medications or combinations of medications to treat mental health conditions.

How does medication management help?

Mental health medications can be an important part of a treatment program.

• Medications can offer relief when non-medicine alternatives are not successful or when multiple interventions are warranted
• The medication course may be short or long-term or intermittent

How does the medication management process work?

• The first step is for the provider to do a thorough assessment of the patient’s psychiatric presentation, medical history, and other current medications for any medical issues
• Not all medications work in the same way for everyone
• Side effects are common but not necessarily permanent. It’s important to discuss side effects with your provider, rather than abruptly stopping use of meds, which can lead to withdrawal symptoms
• Once you find the right dose or combination of medications, your provider will continue to follow you and make adjustments as needed
• It is common for providers to modify medication regimens as needed, based on patient report of symptoms, or monitoring of lab values, such as blood pressure and cholesterol

Who can benefit from medication management?

There are many who may find relief from symptoms through medication management or medication management in combination with other treatments. This is especially helpful when other interventions are not successful. Some common treatable conditions include:

• Anxiety disorders (including panic attacks & PTSD)
• Depression
• Bipolar disorder
• Sleep problems
• ADHD
• Schizophrenia

Find our previous Mental Health Month features here:

• Understanding the Therapy Experience