Table 1 Mood disorders CCM core elements
Life goals self- management program | 10 weekly 30-min telephonic sessions utilizing the Life Goals program that include core modules covering management of depressive symptoms and additional modules utilized as clinically indicated (e.g., mania, wellness, foods and moods, physical activity, substance use, anxiety, psychosis, anger/irritability): |
Week 1: Introduction – Understanding your mental health and stigma | |
Week 2: Introduction (Continued) – Personal values and Life Goals | |
Week 3: Identifying personal symptoms of depression | |
Week 4: Identifying triggers and responses to depression | |
Week 5: Development of personal action plan for coping with depression | |
Week 6: Optional Session 1 | |
Week 7: Optional Session 2 | |
Week 8: Optional Session 3 | |
Week 9: Managing Your Care – Provider visit preparation | |
Week 10: Plan for continuing to work toward your Life Goals | |
Access/ continuity/ care management | 12 monthly patient telephone contacts for 1 year (in addition to the self-management program) to trouble-shoot self-management issues and summarize clinical status |
• Ad hoc contacts at either care manager or participant initiation based on clinical or other concerns, including response to participants within one business day | |
• “In-reach” to treating clinicians for hospitalization, ER visits, or specialty consultation | |
• Collaboration with family as permitted | |
• Resource referral as needed | |
Provider decision support | Provider contacts |
• Same content as clinic-based CCM | |
• Guidelines disseminated where appropriate based on AHRQ depression in primary care and APA bipolar guidelines |