in this sense it is an effective way of improving the efficacy and quality of the service that primary care practitioners are already providing furthermore given this introducing primary carebased cbt or talkingtherapy equivalents is likely to be costsaving relative to introducing standalone programmes increasing reimbursements of nonprimary care practitioner provided therapies especially where alternative practitioners are private or investing in capacity building for the delivery of psychological therapies in particular in countries with weak primary care systems and where there are high levels of stigma around mental illness introducing cbt to primaiy care is not likely to be the most efficient use of resources