Integrated primary care, now instituted in many areas of the country, is both the service that integrates medical and mental health primary care and the practice of defining the problem brought by a patient without using "medical" or "mental" as inevitable distinctions. This volume makes the case for this approach, shows how to implement it, and describes some successful programs. It will be attractive to medical managers, plan administrators, physicians, and mental health providers.
This timely new edition of Integrated Behavioral Health in Primary Care brings the reader up to speed with the changing aspects of primary care service delivery in response to the Patient-Centered Medical Home (PCMH), the Triple-Aim health approach, and the Patient Protection and Affordable Care Act. Drawing on research evidence and years of experience, the authors provide practical information and guidance for behavioral health care practitioners who wish to work more effectively in the fast-paced setting of primary care, and provide detailed advice for addressing common health problems such as generalized anxiety disorder, depression, weight issues, sleep problems, cardiovascular disorders, pain disorders, sexual problems, and more. New to this edition are chapters on population health and the PCMH; children, adolescents, and parenting; couples; managing suicide risk; and shared medical appointments. This paperback edition was previously published in hardcover in 2017.
An integrated, collaborative model for more comprehensivepatient care Creating Effective Mental and Primary Health Care Teamsprovides the practical information, skills, and clinical approachesneeded to implement an integrated collaborative care program andsupport the members of the care team as they learn this new,evidence-based, legislatively mandated care delivery system. Uniquein presenting information specifically designed to be used in anintegrated, collaborative care workflow, this book providesspecific guidance for each member of the team. Care managers,consulting psychiatrists, primary care providers, andadministrators alike can finally get on the same page in regard topatient care by referring to the same resource and employing acommon framework. Written by recognized experts with broadresearch, clinical, implementation, and training experience, thisbook provides a complete solution to the problem of fragmentedcare. Escalating costs and federal legislation expanding access tohealthcare are forcing the industry to transition to a new model ofhealth care delivery. This book provides guidance on navigating thechanges as a team to provide the best possible patient care. Integrate physical and behavioral care Use evidence-based treatments for both Exploit leading-edge technology for patient management Support each member of the collaborative care team Strong evidence has demonstrated the efficacy of a collaborativecare approach for delivering mental health care to patients in aprimary care setting. The field is rapidly growing, but fewresources are available and working models are limited. This bookprovides a roadmap for transitioning from traditional methods ofhealth care to the new integrated model. Providers ready to move tothe next level of care will find Creating Effective Mental andPrimary Health Care Teams an invaluable resource.
Comprehensive, wise, and incredibly practical, this exciting volume walks through the joys and challenges of an entirely new vision of behavioral health consultation in primary care settings. Gently, and with good humor, the authors show how to avoid key errors, and provide a detailed, point by point guideline for success in an effective and needed new form of practice. You will forever think differently about the proper role of behavioral health providers in health care delivery. Even better, you will be prepared to do something about it. -- Steven C. Hayes, University of Nevada The Primary Care Behavioral Health (PCBH) model is fast emerging as the future of integration between mental health and primary care services. As the first book to detail the model, Behavioral Consultation and Primary Care: A Guide to Integrating Services explains in hands-on terms how to achieve truly integrated care. From starting up a new PCBH service to evaluating its outcome, clinicians and medical administrators alike will find much of value here. Written by two veteran Behavioral Health Consultants (BHCs), the Guide offers a wealth of practical advice for all levels of therapists entering primary care. Every detail of BHC work is discussed, ranging from key job competencies to proven strategies for navigating challenging new terrain. Detailed case examples also bring theory to life for a wide variety of common clinical problems. Real-world features designed to help establish a service and ease the transition from specialty mental health to primary care: -Specific administrative recommendations for setting up a BHC office, scheduling patients, billing, and staffing -Start-up checklist, chart note templates, handouts for generating referrals, and other valuable tools -Chapters outlining the therapeutic approaches and assessment methods best suited to BHC work -Creative strategies for influencing that new colleague--the primary care provider-Case examples to illustrate typical consultations with children, adults, and older adults, as well as innovative group approaches -Tips for handling ethical concerns unique to the PCBH model, and professional and personal challenges unique to the primary care setting The authors’ lively and engaging style is accessible to a wide range of professionals, so seasoned practitioners and neophytes--as well as the administrators who hire them--will find this material totally accessible. In addition to assisting professionals in the field, the Guide is perfectly suited for use in a variety of graduate classes and residency training programs.
Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. These models of care are patient-centered. population focused, and delivered by a multidisciplinary team of medical professionals. This book is practical, office-based, comfortably accessible, and intended for mental health professionals, primary care and medical specialists, and professional health students, residents, and other professionals working in integrated care environments.
Integrated Care: A Guide for Effective Implementation provides a detailed, thoughtful, and experience-based guide to the complex and potentially overwhelming process of implementing an integrated care program. The advantages of integrated care from both the clinical and administrative perspectives are many, including better detection of illness, improvement in overall health outcomes, a better patient care experience, flexibility in responding to policy and financial changes, and an emphasis on return on investment. The book addresses the emerging framework of core principles for effective integrated care, reviews the most up-to-date research on implementation, and presents practice-based experience to serve as a guide. This information is useful in both traditional integration of behavioral health into general medical settings (often primary care) or integrating general medical care into a specialty mental health or substance use treatment setting. Because administrators, clinicians, policy makers, payers and others need guidance in determining what effective implementation looks like, the authors offer a three-part examination of the key components of an implementation strategy and explore the elements essential for success. The book is grounded in the authors' real-world expertise and offers readers practical, accessible information and support: Often efforts to implement an integrated care program fail because the model is more than just "plug and play." To address this misconception, the authors explore the successful implementation from every angle -- from leadership, primary care, therapist, psychiatric provider, and policy perspectives. As procedural and institutional hurdles are being overcome, codes for integrated care have been adopted. Accordingly, the book provides in-depth coverage of finance and funding models, challenges to billing, and emerging payment models. Each of the chapter authors were selected for their direct clinical experience in various integrated environments, their leadership in ushering teams through these initiatives, and/or their deep knowledge of payment and policy barriers. Impediments to the widespread implementation of evidence-based programs include payment and regulatory barriers, lack of a workforce trained in effective collaboration, and cultural differences between the worlds of primary care and behavioral health care. Integrated Care: A Guide for Effective Implementation helps health care leaders and providers overcome these obstacles to implement a successful, patient-centered integrated care program.
The goals of Integrated Care: Working at the Interface of Primary Care and Behavioral Health are to educate psychiatrists about the fundamental shift underway in health care and to prepare them to be successful and effective in the new health care arena. The passage and implementation of the Patient Protection and Affordable Care Act presents an opportunity for newly insured patients and for funding models of integrated care, enabling psychiatrists to have a more significant population-level impact. The only book of its kind, the guide defines integrated care, reviews the evidence base, and addresses the three potential benefits of this model of care: improved outcomes, cost containment, and enhanced patient experience (also known as the "triple aim"). The new models of integrated care presented in this book are population-based, which is the key to improved outcomes, and they represent a change in how medicine in general and psychiatry in particular will approach health care delivery moving forward. The book's features are both high-impact and user-friendly: The book is divided into two sections, "Behavioral Health in Primary Care Settings" and "Primary Care in Behavioral Health Care Settings," with Section 1 focused on improving the detection and treatment of behavioral health conditions by integrating behavioral health services into primary care settings and Section 2 focused on improving the health status of patient populations with serious mental illness by integrating primary care into behavioral health treatment. Each chapter presents a set of "core principles of effective collaborative care," which serve as a guide for the structure and provision of care for the varying models, regardless of the setting. Contributors provide dozens of examples that highlight the impact psychiatrists can make in achieving the triple aim of improved outcomes, cost containment, and enhanced experience. Detailed case vignettes integrated throughout the book bring concepts to life and help clinicians to understand and improve the patient-provider relationship. The information presented in these chapters allows both practicing psychiatrists and those in training to develop a skill set essential to designing, working in, teaching, or promoting an integrated care program within a health care system. Evidence based and timely, Integrated Care: Working at the Interface of Primary Care and Behavioral Health is a must read for clinicians in the brave new world of health care reform.
Series Foreword -- Acknowledgments -- Introduction -- I.A Primer on Integrated Primary Care -- Chapter 1. Overview of Integrated Primary Care -- Chapter 2. Fundamentals of Primary Care Behavioral Health Integration -- Chapter 3. Conducting the Behavioral Health Consultation Appointment -- II. Common Conditions Treated in Primary Care Behavioral Health -- Chapter 4. Depression -- Chapter 5. Anxiety -- Chapter 6. Insomnia -- Chapter 7. Diabetes -- Chapter 8. Chronic Pain -- Chapter 9. Asthma -- III. Future Directions -- Chapter 10. Future Directions in Training, Funding, and Research -- References -- About the Author
The authors of this book draw on research evidence and years of experience to provide practical information and guidance for health care practitioners, especially behavioral health care providers who wish to work more effectively in this fast-paced setting. Interwoven through each chapter are practical tips for success and traps to avoid. The book includes a rich array of reproducible assessment questions, patient handouts, and sample scripts. All of these help the clinician alter his or her assessment and intervention skills in a manner that leads to focused interactions that work well within the fast pace of primary care.
Patients with chronic conditions often need psychosocial support and brief counseling to help them make the lifestyle and behavioral changes required to prevent disease complications. This innovative text, with contributions from respected clinicians and researchers in all arenas of behavioral health, provides comprehensive training for all health professionals including those in medicine, nursing, social work, mental health, and clinical and health psychology who desire targeted evidence-based training in Behavioral Health skills . Rich case examples drawn from typical patient presentations demonstrate the relationship between physical and psychological health and the complexity of behavior change in chronic illness. This text is a timely, relevant and practical resource for all members of the primary care team. It prepares team members to work in the model of patient-centered integrated care in accordance with the recommendations of the Affordable Health Care Act (ACA) and the National Committee for Quality Assurance (NCQA) medical home standards for identifying patient needs and providing coordinated and comprehensive patient care. It focuses on knowledge and skills needed for working with the most common chronic conditions such as diabetes, obesity, chronic pain, cardiovascular conditions, sleep disorders, geriatric conditions, cancer-related conditions, and substance abuse. It includes chapters on epidemiological trends in chronic illness and systems medicine. Theories of health behavior and behavior change and evidence-based interventions provide a foundation for skill development, followed by detailed coverage of the requirements for behavioral management of specific chronic conditions. Sample referrals and consultation notes provide concrete examples of how the behavioral health specialist might respond to a referral. . Key Features: Provides comprehensive graduate-level training for the role of Behavioral Health Specialist Describes the health promotion and counseling skills needed to function as part of an integrated health team Focuses on proficiencies needed for working with common chronic conditions Addresses the psychosocial components of primary care disorders Includes case examples demonstrating the relationship between physical and psychological health and the complexity of behavior change in chronic illness
