S04 – Cognitive-Behavioural Therapy Group Medical Visits: From Shared Care Pilot to Successful Provincial Spread

S04 – Cognitive-Behavioural Therapy Group Medical Visits: From Shared Care Pilot to Successful Provincial Spread

Thursday, Oct. 19
14:30 – 15:30 (1 hr)
Meeting Room: Port McNeill (4th floor – North Tower)
Joanna Cheek*, MD; Erin Burrell, MD; Joanna Cheek, MD

CanMEDS Roles:

  1. Collaborator
  2. Collaborator
  3. Leader

At the end of this session, participants will be able to: 1) Outline the steps that enabled a rapid increase in accessibility of publicly funded self-management skills training for mental health; 2) Compare virtual versus inperson experiences, including symptom changes, satisfaction ratings, and preferences for group medical visits; and 3) Describe how cofacilitating is an efficient and valuable way to train primary care providers to run mental health group medical visits.

Psychiatrists trained family physicians to deliver manualized eight-week cognitive behavioural therapy–based skills groups, addressing the unmet need for early intervention for people with depression and anxiety. The program served over 5,100 patients with inperson groups from 2015 to 2019 in large urban centres in British Columbia, with up to 34 groups running in a given month, by 19 physicians. A centralized referral centre was the key to a lean, economically sustainable administrative structure. It increased participant acceptability as they could choose between various group offerings. In 2018, a nonprofit society was formed to administrate the program, financially sustained through overhead physician payments, no-show fees, and the health authority funding an administrative assistant. When the COVID-19 pandemic began in 2020, the team pivoted to telehealth. Virtual groups were offered within a week, and a comparable-sized program resumed within three months. Quality improvement data indicated patient improvements and satisfaction ratings comparable to those obtained with inperson groups. Many patients reported that the telehealth format was preferred or made the groups accessible for the first time. Shared care funded the provincial spread of the program, with experienced physician facilitators able to train new physicians in distant communities virtually through cofacilitation. With expansion and funding, the group prioritized equity, diversity, and inclusivity as key values, with many learnings along the way. More than 10,000 patients have now been served, and virtual groups will remain part of the ongoing program, postpandemic.


  1. Maheshwari O, Burrell E, Cheek J, et al. Virtual cognitive behavioural therapy skills group medical visits: assessing effectiveness and accessibility during COVID-19. BC Medical Journal 2022;64(9):383–389.
  2. Cheek J, Tomorri C, Burrell E. Implementing cognitive behavioral therapy skills group medical visits in primary care: a pilot project. BC Medical Journal 2019;61(8):316–323.