(PS12-A24) Implementing a Publicly-funded Cognitive Behaviorual Therapy Model in a Diverse Region During a Global Pandemic: Ways to Increase Joy of Delivering CBT Amidst Implementation Challenges

The Ontario Structured Psychotherapy (OSP) Program is an initiative funded by the government of Ontario to provide access to free, short-term, cognitive-behavioural therapy to people in the community experiencing depression, anxiety, or anxiety-related concerns. OSP is offered through multiple OSP networks across Ontario. Each network comprises one Network Lead Organization (NLO) and multiple Service Delivery Sites (SDS). This poster will first provide an overview of the OSP Program, and then describe the characteristics and outcomes of one NLO – the OSP-Brampton-Halton-Mississauga Region (OSP-BHM) managed by CarePoint Health. Notably, the OSP-BHM network launched during the midst of the pandemic in 2021. This poster will highlight the challenges, lessons, and joyous milestones reached while establishing the OSP-BHM program.

OSP is based on a “stepped-care” model, wherein clients are offered the lowest appropriate level of clinician contact to start treatment and are ‘stepped-up’ to higher level of clinician contact as needed. The “lower-intensity” services include self-guided workbooks with telephone coaching or clinician support and internet-based self-guided CBT with asynchronous support. Meanwhile, the ‘higher-intensity’ service is a weekly session with a clinician. OSP is committed to measurement-based care to facilitate and monitor client progress through weekly questionnaires to track progress. The program uses progress monitoring to determine recovery and reliable improvement rates.

OSP-BHM serves a diverse population in its catchment area. Since 2021, the OSP-BMH network has received 1516 referrals (including self-referrals and from primary care). Approximately 47% of clients seek treatment for posttraumatic stress, 16% for depression and low mood, 15% for generalized anxiety and worry, 6% for unexpected panic attacks and agoraphobia fears, 5% for OCD, 5% social anxiety and 3% health anxiety. Clients range across the lifespan, with the mean age of 39.8. Approximately 45% of clients identify as White, 24% Asian, and 12% Black. To date, results show a 36.5% recovery rate and 56.4% reliable improvement rate.

Some challenges noted during the beginning operations of OSP-BHM in 2021, included facilitating a network of clinicians across diverse organizational settings and from diverse training backgrounds, as well as promoting accessibility of our services to underserved, racialized populations. To overcome challenges, we created a community of practice using technology and team building and co-learning experiences. We adapted our clinical consultation model to include a role for a clinical consultant and health equity lead whose focus is on coaching within an anti-oppressive anti-racist framework. Finally, we introduced measures to support clinician wellness and foster enjoyment of learning and delivering CBT.