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Table 2 Clinician and patient themes and subthemes

From: A qualitative comparison of primary care clinicians’ and their patients’ perspectives on achieving depression care: implications for improving outcomes

Clinician themes/subthemes

Patient themes/subthemes

Theme #1 - Patient’s journey to receive depression care

Theme #1- Patient’s journey to achieving depression care

Subtheme Facilitators

Subtheme Facilitators

a. Quality improvement projects (S*)

a. Supportive family members (R*)

b. Clinic staff training (S)

b. Friendly office atmosphere (R)

c. Television advertisements for antidepressant medication (S)

Subtheme Barriers

Subtheme Barriers

a. Fragmented specialty mental health sector (S)

a. Fragmented health care system (S)

b. Fear of opening “Pandora’s box” (S, R)

b. Stigma (R)

c. Payment structure (S)

c. Rushed primary care clinicians (S)

d. Poor patient follow-up (S)

d. Clinicians appearing to lack adequate mental health expertise (C*)

e. Perceived potential for inappropriate office staff behaviors (S)

Theme #2 - Aiding patients to come to a personal understanding of depression

Theme #2 - The search for a very personal understanding of their depression

Subtheme Facilitators

Subtheme Facilitators

a. Education (C, R)

a. Family history, contact with depressed person in past (R)

b. Screening for bipolar disorder (S, Cl*)

b. History of psychotherapy or counseling (R)

Subtheme Barriers

Subtheme Barriers

a. Somatic presentation (Cl, R)

a. Somatic presentation (Cl, R)

b. Patient’s secondary gain agenda (S, R)

c. Physical pain (Cl)

d. Substance abuse (Cl)

e. Stigma (R)

Theme #3 – Supporting the patient’s therapeutic space

Theme #3 - Creation of a personalized therapeutic space

Subtheme Facilitators of an effective therapeutic space

Subtheme Facilitators of an effective therapeutic space

a. Antidepressant medication. (Cl)

a. Antidepressant medication (Cl)

b. Counseling/Psychotherapy (Cl, R, S)

b. Counseling/Psychotherapy (Cl, R, S)

c. Primary care clinician (C, Cl, R, S)

c. Primary care clinician (C, Cl, R, S)

- Multifaceted, team approach (C, Cl, R, S)

d. Therapeutic aspects of working (R, S)

- Emphasis on follow-up compliance (Cl, R)

e. Values

- Empathetic, active listening (R)

f. Nature and Family (R, S)

d. Physical activity (Cl)

g. Faith (R, S)

e. Social support (R)

h. Positive memories (Cl, R)

f. Depression prevention (Cl, R)

i. Reframing depression (Cl, R)

j. Preventing recurrent depression (Cl, R, S)

Subtheme Barriers to an effective therapeutic space

Subtheme Barriers to an effective therapeutic space

a. Emphasis on follow-up compliance (Cl, R)

a. Poor communication between the primary care clinician and other members of the care team (S, R)

b. Antidepressant side effects (Cl)

b. Depression

c. Over-reliance on antidepressant medication (Cl, R, S)

d. Antidepressant non-adherence (Cl, R)

e. Difficulties finding a good ‘fit’ with a counselor or psychotherapist (R, S)

f. Short clinic visits and busy schedules (S)

  1. *C= competency; Cl= clinical; R= relational; S= system.