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Thursday, November 13, 2008

Stepped Care

A trend in how people are understanding optimal treatment for depression is seen in the UK NICE guidelines on depression management, which adopt a "stepped care" approach. This means that an intervention should start with a basic approach and move systematically towards more intensive treatments if the basic interventions are not successful. This fits, in theory, with the idea that many (perhaps most) episodes of depression and mild and self-limited, but that at the other end of the spectrum, many episodes are highly persistent and recurrent (link to a paper on the topic) and need long-term proactive care. This is an idea that is gaining wider acceptance in Canada, see article in the Sudbury Star.