Supported self management: Step 2: Advise
The second step of SSM is to recommend self-management, indicating (or, better, providing) the workbook or program you endorse. Explain that self-management can be effective and that you will be available to help the patient apply the skills.
Although each clinician will have a unique way of communicating the importance of self-management, here are some messages to consider (these suggestions focus on depression, but can be adapted to other problems):*
"The way you are feeling is something we can work together to change. There are some ideas in this [book] that many people have found very helpful, and that have proven to be very effective in managing low mood and depression. I would be happy to work with you to help you learn some of these new approaches and ideas so you will feel better. This would require you to do a little bit of reading, some practice at home and some regular visits with me to monitor how you are doing and help you with any obstacles or problems. Does this feel like something you would like to try?"
If you are using SSM as an adjunct to other treatment, the explanation would be modified ("I recommend treatment X – but along with X, it would be helpful to learn some self-management skills for handling [depression] better").
Some clinicians have adopted the approach of using a model from a self-management workbook (for example, see "Factors associated with causing or continuing a depressed state") to show patients how mood is affected by other factors. Going over this model readily leads to a discussion of why it would be helpful to learn skills to break a cycle of negative mood. This could also be a useful way to introduce the need for other treatments.
A similar model be used for anxiety (for example: "Factors associated with causing or continuing an anxious state").
Psychiatry in primary care toolkit
The Psychiatry in Primary Care App has been decommissioned.
The revised print version of Psychiatry in Primary Care is avaible through the CAMH store.
We have posted a number of revised chapters from the book in Treating Conditions and Disorders in the new Professionals section of camh.ca.