Comparing standard Primary Care Behavioral Health with an extended version adding guided self-help – A single-blind randomized trial evaluating superiority, non-inferiority, and cost-effectiveness

Primary Care Behavioral Health (PCBH, in Swedish IBH) is a model for managing mental health in primary care including short accessible interventions.

All professions share a primary care mindset and the goal is to increase patients’ quality of life and decrease the burden on primary care.Clinicians in PCBH use short contextual assessments followed by brief interventions (BI) which target the patient’s current problem and aim to teach new coping skills.

BI are inspired by Cognitive Behavioral Therapy (CBT) but it is not standardized and have not been systematically evaluated.

There is currently little knowledge of how much patients benefit from contextual assessments and BI and if patients would benefit more from more structured CBT.We conduct a large single-blind randomized controlled trial to find out if extended PCBH, i.e. adding an extended pre-treatment assessment followed by guided, structured CBT self-help when suitable, can increase the treatment effects compared to standard PCBH, i.e a contextual assessment followed by BI.

If not, we want to use a non-inferiority test to see if standard PCBH has at least the same effect as extended PCBH.

In addition to this, we want to investigate and compare the cost-effectiveness and the availability of care for the two different ways to implement PCBH.PCBH has already the potential to increase the quality of primary care and our study might guide future implementations of PCBH to increase effectiveness and utilize resources better.