FAST Programs Offer Brief, Evidence-Based Mental Health Treatment for Primary Care
Erin Schoenfelder Gonzalez, Ph.D.
PAL Consultant
With the growing “mental health tsunami” in the aftermath of the pandemic, primary care providers face even more challenges holding the front line to support youth mental health. Increasing attention is moving to Integrated Primary Care (IPC), in which behavioral health services are provided by mental health professionals embedded within a primary care clinic. IPC is shown to reduce many barriers to accessing specialty mental healthcare and has potential to reach families with limited resources or who would otherwise struggle to access services. At the same time, primary care requires flexibility and efficiency; PCPs need educational tools they can use in brief meetings, and mental health professionals need treatments they can deliver in briefer visits or with little or no session preparation time.
The First Approach Skills Training (FAST) suite of programs are free, evidence-based treatment workbooks developed through the Seattle Children’s PAL Line with the goal to increase IPC treatment access, service capacity, and youth mental health outcomes. The user-friendly FAST workbooks consist of modules that mental health professionals can use in IPC and other nontraditional care settings in which full-length therapy treatments (e.g., 12-18 weeks of hour-long individual sessions) are unrealistic. With funding from the Washington Healthcare Authority and iterative input from primary care stakeholders across the state, specialists from Seattle Children’s modified full-length treatments for common youth mental health concerns into bite-sized “chunks” and created worksheets that PCPs and primary care-based mental health professionals can use with minimal training and preparation.
Currently, there are FAST programs for 6 different clinical concerns:
-FAST-Anxiety: exposure-therapy based activities for a range of common child and teen anxieties
-FAST-Behavior: parent behavior management training for childhood disruptive behavior and attention problems for ages 4-12
-FAST-Depression: behavioral activation workbook for mild-to-moderate depressive symptoms
-FAST-Parenting Teens: Parent skills training for caregivers of teens with challenging behavior or ADHD, or use as an adjunct to individual adolescent therapy
-FAST-Trauma: brief cognitive-behavioral trauma therapy for traumatic experiences and resulting posttraumatic symptoms
-FAST-Early Childhood (coming soon): Developmentally-informed coaching for parents of children ages 1-4 years old
As the name implies, FAST programs are intended to be the “first approach” to treating common mild-to-moderate behavioral or mental health symptoms. FAST offers an initial step consisting of a 2-page handout for each program that PCPs can look at together with patients or send home. These 2-page handouts and other resources can be found on the PCP page of the FAST website. The modular workbooks can then be used to provide an initial course of therapy in as few as 4 sessions. Consistent with a “stepped care” model in which treatment intensity and amount is tailored to the patient’s clinical severity, some patients with more serious symptoms or risk behaviors may go on to or immediately require a full course of treatment in a specialty care setting or emergency support services.
Use of FAST tools in a Stepped Care model of integrated mental health treatment
Primary care practices interested in learning about the FAST programs can check out the website at www.seattlechildrens.org/FAST to access all the 2-pagers, workbooks, and 2-hour initial training videos for free. The FAST team at Seattle Children’s continues to provide free live trainings to IPC physicians and mental health clinicians within Washington state desiring hands-on practice and troubleshooting on use of the programs, as well as free bi-weekly consultation calls about FAST and other issues common to IPC.
Please reach out to our program at FAST@seattlechildrens.org for more information about live trainings, consultation, or use of FAST in your practice. We appreciate the opportunity to continue to learn together with you and your colleagues as you support child and teen mental health in your practice.
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Updated PAL Care Guide Published
We published an updated version of our "Primary Care Principles for Child Mental Health" Care Guide this summer.
Please email us if you would like a paper copy mailed to you. Allow at least one month for printing and processing.
You can also download the Care Guide on our website.
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Upcoming CME Conferences
December 3, 2022
Location: Vancouver
February 11, 2023
Location: virtual conference
April 22, 2023
Location: Bellingham
June 3, 2023
Location: virtual conference
Visit our website for the most updated information on upcoming conferences and to view slides from our previous conferences.
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