Table 2 Characteristics of stepped care services by site
From: Delivering stepped care: an analysis of implementation in routine practice
| Â | Site A Northern Urban/Rural | Site B Northern Urban | Site C Southern Urban/Rural | Site D Southern Urban |
|---|---|---|---|---|
Site | Specialist Trust-led | Primary Care-led | Specialist Trust | Primary Care led with Specialist Trust partner |
Assessment | Qualified mental health practitioner face to face | Para-professional or qualified mental health worker face to face | Senior mental health worker in a GP based clinic triaging direct to steps from written information or following telephone or face to face appointment | Para-professional or psychologist face to face |
Step 2 low-intensity | Guided self-help delivered by para-professionals; group classes by para-professionals and qualified mental health workers | Guided self-help delivered by para-professionals; group classes by para-professionals and qualified mental health workers | Self-directed cCBT,1 guided self-help and group classes by para-professionals and qualified mental health workers | Guided self-help delivered by para-professionals, cCBT, group classes by para-professionals |
Step 3 high-intensity | Short-term evidence-based psychological interventions delivered by a mental health practitioner or practice-based counsellor | Short-term psychological interventions including brief CBT delivered by a mental health practitioner | Short-term psychological interventions including brief CBT and group work delivered by trained para-professionals and mental health practitioners | Psychology, and counselling |
Step 4 high-intensity | Complex evidence-based psychological interventions delivered by psychological services, CMHT, 2 or the psychiatric service | Specialised psychological treatment delivered by community mental health teams, psychology and psychotherapy services working within the specialist mental health trust | Not specified | Psychology, psychotherapy and community mental health teams |
Step 5 high-intensity | Crisis teams, self-harm liaison and in-patient admission by specialist clinical teams | Crisis teams, self-harm liaison and in-patient admission by specialist clinical teams | Not specified | Not specified |