How can I integrate counselling into the management of chronic physical health conditions in my practice?

Integrating counselling into the management and care of patients with chronic physical health conditions involves adopting a stepped-care approach that prioritises low-intensity psychosocial and psychological interventions tailored to the patient's physical abilities and preferences.

Start with assessment and recognition of depression or psychological distress in patients with chronic physical health problems, considering factors such as functional impairment, social isolation, and comorbidities.

Offer low-intensity psychosocial interventions such as individual guided self-help based on cognitive behavioural therapy (CBT), computerised CBT, structured group physical activity programmes, or group-based peer support programmes. These interventions should be adapted to the patient's physical limitations and coordinated with their physical health care team.

Where face-to-face counselling is not feasible due to mobility or other difficulties, consider delivering psychological interventions by telephone or other remote means.

Ensure that counselling and psychological interventions are delivered by competent practitioners who receive regular supervision and use treatment manuals and outcome measures to monitor efficacy.

For patients with more severe or persistent symptoms, escalate care according to the stepped-care model, which may include high-intensity psychological interventions, medication, or referral to specialist services.

Collaborate closely with multidisciplinary teams and share treatment plans with patients and carers to provide integrated, person-centred care.