This relapse prevention plan template should be filled out by a patient with their Behavioral Health Care Manager in the months prior to completing an episode of Collaborative Care. The purpose of a relapse prevention plan (RPP) is to remind a patient to continue doing the things that make them feel better, assess their own symptoms and warning signs, and know when to ask for more help if it is needed. In other words, a RPP is a self-management tool for patients. We also have a Relapse Prevention Plan Template available in English.
Implementation Tool: Clinical Resources
Relapse Prevention Plan Template
This relapse prevention plan template is intended to be filled out by a patient with their Behavioral Health Care Manager in the months prior to completing an episode of Collaborative Care. The purpose of a relapse prevention plan (RPP) is to remind a patient to continue doing the things that make them feel better, assess their own symptoms and warning signs, and to ask for more help if it is needed. In other words, a RPP is a self-management tool for patients. We also have a Relapse Prevention Plan Template (Spanish) available in Spanish.
Case Review: Care Manager with Psychiatric Consultant
An outline of what a Behavioral Health Care Manager should be prepared to discuss about a patient with a Psychiatric Consultant during a consultation.
Introducing your Care Team
Educating your patients about Collaborative Care and what they can expect from it is crucial to the care model’s success. Patient engagement and ownership of their care plan are key aspects of patient-centered team care, one of the five principles of Collaborative Care. Use this template to introduce your Collaborative Care team to patients. Also available in Spanish.
Problem Solving Treatment (PST)
Problem-Solving Treatment (PST) is a brief form of evidence-based treatment that was originally developed in Great Britain for use by medical professionals in primary care. It is also known as Problem-Solving Treatment – Primary Care (PST-PC). PST has been studied extensively in a wide range of settings and with a variety of providers and patient populations.
PST teaches and empowers patients to solve the here-and-now problems contributing to their depression and helps increase self-efficacy. It typically involves six to ten sessions, depending on the patient’s needs. The first appointment is approximately one hour long because, in addition to the first PST session, it includes an introduction to PST techniques. Subsequent appointments are 30 minutes long.
PST is not indicated as a primary treatment for: substance abuse/dependence, acute primary post-traumatic stress disorder, panic disorder, new onset bipolar disorder, new onset psychosis.
Help Clinic Staff Talk with Patients About the PHQ-9
This tool is designed to help clinic support staff with answers to frequent questions they may hear from patients about the PHQ-9.
It’s best for support staff to have the opportunity to role play and practice before using the PHQ-9 with patients. It can also be helpful for support staff to keep this someplace where they can refer to it, as needed, when they get questions from patients.
Relapse Prevention Plan (Spanish)
Depression can occur multiple times during a person’s lifetime. The purpose of a relapse prevention plan is to help the patient understand their own personal warning signs. These warning signs are specific to each person and can help the patient identify when depression may be starting to return so they can get help sooner – before the symptoms get bad. The other purpose of a relapse prevention plan is to help remind the patient what has worked for him/her to feel better. The relapse prevention plan should be filled out by the Behavioral Health Care Manager and the patient together.
The English version of the Relapse Prevention Plan can be found here.
Tips for Discussing Trauma During an Initial Assessment
Introduction
Trauma can increase the risk of health, social, and emotional problems. Despite the high prevalence of patients with a past history of trauma, few clinics or Collaborative Care teams have a protocol for addressing it. These three tips can help clinicians safely and effectively discuss the trauma history of their patients during their initial assessment.
A printable PDF is available for download; however, please note that this document may not conform to the WCAG-2 accessibility standards.
Discussing Past Trauma with Patients During an Initial Assessment
Many patients with depression have experienced trauma in their lives. Discussing the past traumas in a patient’s life can be tricky due to the risk of re-traumatization or re-triggering the symptoms related to Post-Traumatic Stress Disorder (PTSD). It is also common for the patient to dissociate as a defense mechanism to avoid their past trauma. We have compiled a few tips to help clinicians talk with their patients about past trauma and safely learn their stories during an Initial Assessment.
This is only the beginning of a very complex subject. For more information about caring for patients with trauma history, please read “TIP 57: Trauma-Informed Care in Behavioral Health Services” by SAMHSA.
Tip 1
To prevent re-traumatizing or re-triggering PTSD symptoms, encourage the patient to respond with short, concise descriptions of the trauma.
- Ask for a 2-3 sentence or <25 word description to get a general sense of the trauma.
- Be directive and feel free to stop the discussion if you see the patient is having trouble containing their emotions.
- Normalize the extreme difficulty patients often have when re-telling their stories.
Tip 2
Don’t start with a checklist! Patients often have post-injury concerns and interpret trauma uniquely.
- Encourage the patient to tell their story in their own words.
- Ask open-ended questions.
- Remember, you don’t need all the details to make the diagnosis or treat depression!
Tip 3
If you notice the patient dissociate, work with them to help them get grounded and then educate them on dissociation.
- A way to help ground the patient is to direct them to engage in their immediate environment.
- Once they are grounded, educate them on dissociation.
Tips adapted from: Stephens, K., & Bentham, W. (2010, June 17). PTSD in Primary Care. Mental Health Integration Program (MHIP) Webinar.
Relapse Prevention Plan (Generic)
The purpose of a relapse prevention plan is to help the patient understand their own personal warning signs. These warning signs are specific to each person and can help the patient identify when their mental health is declining so they can get help sooner – before the symptoms get bad.
The other purpose of a relapse prevention plan is to help remind the patient what has worked for them before to help them feel better. The relapse prevention plan should be filled out by the Behavioral Health Care Manager and the patient together.
Introducing your Care Team (Spanish)
Educating your patients about Collaborative Care and what they can expect from it is crucial to having Collaborative Care work well. Patient engagement and ownership of their care plan are key aspects of Patient-Centered Team Care, one of the five principles of Collaborative Care. Use this template to introduce your Collaborative Care team in Spanish to patients. Also available in English.