From "Behavioral Medicine: The Challenge of Integrating Psychological and Behavioral Approaches into Primary Care" Effective Clinical Practice, March/April 2002. 5:75-83.
Figure 1. Study design using the model for practice (4 Ts). Global Severity Index (GSI) scores ranged from 38 to 80 (mean, 50, SDą 10). We defined distress as a GSI score above 60. Patients with scores in this range reported such symptoms as nervousness or shakiness, poor appetite, anxiety, or depression "quite a bit" or "extremely." *The randomization step is only necessary for the study. Ordinarily, in implementing the 4T model, patients are assigned to appropriate treatment based on assessment during triage.>