Open Access
Stepped Care 2.0 is founded on the principle of open access. This means that care is available to anyone on a same-day basis through multiple access point modalities. This upstream approach ensures that people get care at the right time and context, regar
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Stepped Care 2.0: A Paradigm Shift in Mental Health
Stepped Care 2.0: A Paradigm Shift in Mental Health
Peter Cornish
Stepped Care 2.0: A Paradigm Shift in Mental Health
Peter Cornish Counseling and Psychological Services University of California Berkeley, CA, USA
ISBN 978-3-030-48054-7 ISBN 978-3-030-48055-4 (eBook) https://doi.org/10.1007/978-3-030-48055-4 © Springer Nature Switzerland AG 2020 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Foreword
Once upon a time, mental health services were provided almost exclusively in weekly, 50-min, individual therapy appointments by doctoral-level practitioners operating from their favored theoretical orientations, often with little regard to the research evidence or their patients’ preferences. Individual therapy and ideological singularity did not frequently result in salubrious patient outcomes, but did reduce clinical complexity and shared decision-making. And rarely, outside of public health or community circles, did one hear laments about the mountains of underserved or untreated patients. That is not a fairy tale or a clinical dystopia, but the practice paradigm 40+ years ago when I began clinical training. To be sure, scores of practitioners and researchers in the interim urged care innovations, but those advances largely proved scattered one-trick ponies: add selfhelp, deliver brief therapy, hire paraprofessionals, conduct more groups, offer e-health and apps, reduce the number of sessions, provide tele-therapy, develop massive open online courses, render only evidence-based treatments, and emphasize population interventions. Meanwhile, the worldwide prevalence of mental disorders rises, wait lists for public care climb, and
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