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Brief Treatment Approaches for Addressing Chronic Pain in Primary Care Settings
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
In primary care there are three major models for integrating behavioral healthcare: the Care Management Model (e.g., Witt, Garrison, Gonzalez, Witt, & Angstman, 2017; Dobscha et al., 2009), the Primary Care Behavioral Health Model (PCBH; Hunter, Goodie, Oordt, & Dobmeyer, 2017; Vogel, Kanzler, Aikens, & Goodie, 2017), and the Transdisciplinary (e.g., PCP education) Model (McGeary, McGeary, Nabity, et al., 2016).
Leveraging Integrated Health Services to Promote Behavioral Health Among Women with Disabilities
Published in Kathleen A. Kendall-Tackett, Lesia M. Ruglass, Women’s Mental Health Across the Lifespan, 2017
Colleen Clemency Cordes, Rebecca P. Cameron, Ethan Eisen, Alette Coble-Temple, Linda R. Mona
The nature of the behavioral health services provided in the context of IBH is at least, in part, a function of the level of integration within the clinic system (Heath et al., 2013), and can range from co-located specialty mental health services providing traditional mental health services in the context of a 50-minute clinical hour, to fully integrated services with shared cultures and service delivery mechanisms and workflows. Full integration in practice is most commonly delivered in the context of the Primary Care Behavioral Health (PCBH) model of care, where a behavioral health consultant (BHC), typically a psychologist, social worker, or licensed professional counselor, provides mental and behavioral healthcare to patients in 15- to 30-minute visits, with follow-up typically limited to one to four visits, though intermittent treatment across the lifespan is not uncommon, similar to the provision of medical services in primary care (Robinson & Reiter, 2007).
Simple questions with complex answers
Published in Jed A. Yalof, Anthony D. Bram, Psychoanalytic Assessment Applications for Different Settings, 2020
David J. York, Alan L. Schwartz
The assessment described in this chapter took place within the context of a primary care practice embedded in a large, nonprofit hospital system. Within the practice, there are three dedicated mental health professionals who function in the role of Behavioral Health Consultants (BHC), one of whom is a psychologist who specializes in psychological assessment. The clinical role of the BHC is consistent with the Primary Care Behavioral Health (PCBH) model, the purpose of which is to support Integrated Behavioral Health (IBH); that is, the active, complementary collaboration between behavioral health and primary care providers within the same setting (Robinson & Reiter, 2017). In such an integrated practice, the BHC is the mental health expert on the primary care team and provides immediate collaboration, consultation, and access for patients through their medical providers. BHCs are typically introduced to patients by their primary care physicians during office visits, referred to as a “warm handoff”; this direct connection provides an opportunity for the BHC to assess the patient’s needs, provide consultation regarding treatment planning to the primary care team, as well as provide psychoeducation and interventions for the patient during their initial contact (Robinson & Reiter, 2017). Consistent with the PCBH philosophy, psychological assessment in the primary care setting remains limited to the use of symptom-oriented screening tools such as the nine-item Patient Health Questionnaire (PHQ-9; Kroenke, Spitzer & Williams, 2001) or the seven-item Generalized Anxiety Disorder scale (GAD-7; Spitzer, Kroenke, Williams, & Lowe, 2006). Requests for assessment to establish or provide a differential psychiatric diagnosis, understand personality factors, or examine cognitive functioning to guide treatment are referred to a wait list. This system allows the psychologist to function within the streamlined role of the BHC while in the primary care practice but also to provide comprehensive full-battery assessments through the psychological assessment service.
An Evaluation of an ACT-Based “Aging Resiliently” Group
Published in Clinical Gerontologist, 2022
Dana B. Goetz, Elizabeth W. Hirschhorn
An increasing number of older veterans with mental illness are seeking care through the Veterans Health Administration (VHA; Wiechers, Karel, Hoff, & Karlin, 2015). As veterans age, they may also experience difficult life adjustments and transitions (e.g., Brodaty et al., 2001; Damman, Henkens, & Kalmijn, 2015). Thus, the VHA workforce must be prepared to increase access to effective mental health care for older veterans. Primary Care Behavioral Health (PCBH) clinics may be one way to do this because these clinics use a population-based approach to treat a high volume of patients by offering interventions that are brief, group-based, and transdiagnostic (applies to more than one condition) (Strosahl, 1998). To better meet the needs of older veterans, providers must determine which types of brief group interventions can effectively target the range of problems that are associated with aging.
“It’s a place that gives me hope”: A qualitative evaluation of a buprenorphine-naloxone group visit program in an urban federally qualified health center
Published in Substance Abuse, 2021
Sunny Lai, Erica Li, Alexis Silverio, Robin DeBates, Erin Lee Kelly, Lara Carson Weinstein
To increase uptake of MOUD, some organizations have advocated for “low-threshold” models to substance use care.4,12,14,16 While there is no universal standard, proposed features typically address accessibility and treatment design barriers.14 In our study, program participants mentioned 3 specific areas that facilitated their participation and engagement in the program: ease of access, integration in primary care, and group-based visit model. Rapid-entry scheduling enables people to access treatment quickly, which increases the proportion of people who initiate treatment.4 Group-based models increase access to MOUD and provide unique supportive mechanisms, such as emotional support, accountability, shared identity, and community.17 Integration in primary care can increase access to primary care, behavioral health, and psychosocial services, destigmatize treatment for substance use disorder, and facilitate care coordination and team-based care.18 Our findings provide qualitative support for the benefits of a “low-threshold” model.
Child, Family, and School Behavioral Health Care in the Military Health System
Published in Military Behavioral Health, 2020
Michael E. Faran, Patti L. Johnson, Paul K. Ban, James C. Sarver, Lindaya J. Brown, David T. Orman, Edward A. Brusher, Dennis M. Sarmiento, Christopher G. Ivany, Mark D. Weist
During the same timeframe as the Army Medical Department stood up the Behavioral Health Service Line, Primary Care within the Army adopted and implemented a Patient-Centered Medical Home (PCMH) model (U.S. Department of Defense, 2013), which transitioned all primary care clinics throughout the Army to PCMHs. Within the PCMH framework and in collaboration with the Army’s Behavioral Health Service Line, BH providers were integrated into each PCMH under the program title Primary Care Behavioral Health. The Army’s Primary Care Behavioral Health program is similar to the Veteran’s Affairs Primary Care Mental Health Integration which also embeds BH providers into primary care. The benefits of BH integration and collaboration within primary care are summarized elsewhere (Arsanow et al., 2015; Blackmore et al., 2018; Collins et al., 2010; Crowley & Kirschner, 2015; Gouge et al., 2016; Schlesinger et al., 2017; Tyler et al., 2017 ).