Skip to main content

Provider Training: Recognizing the Relevance of Behavioral Medicine and the Importance of Behavioral Health Consultation and Referral

  • 525 Accesses

Abstract

The clinical case for behavioral medicine as a critical component of primary care integrated health is firmly established (Fisher et al., 2011). Behavioral conditions such as depression, anxiety and substance use disorder, stress and adjustment disorders, and lifestyle habits such as smoking, overeating, and lack of exercise all contribute to worse outcomes and higher costs for patients with chronic medical conditions (Kathol et al., 2005). Behavioral conditions such as depression, anxiety, substance-related disorders, and trauma are highly comorbid with NCDs, representing more than 40% of patients seen in primary care (Wang et al., 2007). Behavioral treatments such as the Diabetes Prevention Program for prediabetes (Diabetes Prevention Program Research Group, 2011), the Primary Care Behavioral Health (PCBH) for behavioral conditions (Robinson & Reiter, 2016), and the Collaborative Care Model (CCM) for comorbid medical and behavioral chronic conditions (Ratzliff, Unutzer, Katon, & Stephens, 2016) have proven effective in improving medical (e.g., blood sugar, blood pressure) and patient-reported behavioral (e.g., depression, anxiety) clinical outcomes.

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-319-93003-9_4
  • Chapter length: 22 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   59.99
Price excludes VAT (USA)
  • ISBN: 978-3-319-93003-9
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   74.99
Price excludes VAT (USA)
Hardcover Book
USD   119.99
Price excludes VAT (USA)

References

  • American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, & American Osteopathic Association. (2007). Joint principles of the patient-centered medical home. Retrieved from: http://www.aafp.org/dam/AAFP/documents/practice_management/pcmh/initiatives/PCMHJoint.pdf

  • American Hospital Association. (2016). The state of the behavioral health workforce: A literature review. Retried from: http://www.aha.org/content/16/stateofbehavior.pdf

  • American Psychological Association, Interprofessional Seminar on Integrated Primary Care Work Group. (2016). A curriculum for an interprofessional seminar on integrated primary care. Retrieved from: http://www.apa.org/education/grad/curriculum-seminar.aspx

  • Badash, I., Kleinman, N., Barr, S., Jang, J., Rahman, S., & Wu, B. (2017). Redifining health: The evolution of health ideas from antiquity to the era of value-based care. Cureus, 9(2), e1018. https://doi.org/10.7759/cureus.1018.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Bao, Y., McGuire, T., Chan, Y., Eggman, A., Ryan, A., Bruce, M., … Unutzer, J. (2017). Value-based payment in implementing evidence-based care: The mental health integration program in Washington state. AJMC, 23(1), 48–53.

    Google Scholar 

  • Beachum, A., Van Sickle, K., Khatri, P., Ali, M., Reimer, D., Farber, E., & Kaslow, N. (2017). Meeting evolving workforce needs: Preparing psychologists for leadership in the patient-centered medical home. American Psychologist, 72(1), 42–54.

    CrossRef  Google Scholar 

  • Bennett-Levy, J., Richards, D., Farrand, P., Christensen, H., Griffiths, K., Kavanagh, D., … Williams, C. (2010). Oxford guide to low intensity CBT interventions. Oxford, NY: Oxford University Press.

    Google Scholar 

  • Block, G., Aar, K., Romanelli, R., Block, T. J., Hopkins, D., Carpenter, H. A., … Block, C. H. (2015). Diabetes prevention and weight loss with a fully automated behavioral intervention by email, web, and mobile phone: A randomized controlled trial among persons with prediabetes. Journal of Medical Internet Research, 17(10), E240. https://doi.org/10.2196/jmir.4897

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Chiles, J. A., Lambert, M. J., & Hatch, L. (2002). Medical costs offset: a review of the impact of psychological interventions on medical utilization over the past three decades. In N. A. Cummings, W. T. O’Donohue, & K. E. Ferguson (Eds.), The impact of medical cost offset on practice and research: Making it work for you (pp. 47–56). Reno, NV: Context Press.

    Google Scholar 

  • Dartmouth-Hitchcock. What is value-based care? Retrieved from: http://www.dartmouth-hitchcock.org/about_dh/what_is_value_based_care.html on May 15 2017.

  • Dawson, K., Bryant, R., Harper, M., Tay, A., Rahman, A., Schafter, A., & Van Ommeren, M. (2015). Problem management plus (PM1): A WHO transdiagnostic psychological intervention for common mental health problems. World Psychiatry, 14(3), 354.

    CrossRef  Google Scholar 

  • Diabetes Prevention Program Research Group. (2011). 10-year follow-up of diabetes incidence and weight loss in the diabetes prevention program outcomes study. Lancet, 374(9702), 1677–1686.

    CrossRef  Google Scholar 

  • Djuric, Z., Segar, M., Orizondo, C., Mann, J., Faison, M., Peddireddy, N., … Locke, A. (2017). Delivery of health coaching by medical assistants in primary care. Journal of American Board of Family Medicine, 30, 362–370.

    CrossRef  Google Scholar 

  • Dobmeyer, A., Hunter, C., Corso, M., Nielsen, M., Corso, K., Polizzi, N., & Earles, J. (2016). Primary care behavioral health provider training: Systematic development and implementation in a large medical system. Journal of Clinical Psychology in Medical Settings, 23, 207–224. https://doi.org/10.1007/s10880-016-9464-9

    CrossRef  PubMed  Google Scholar 

  • Fisher, E., Fitzgibbon, M., Glasgow, R., Haire-Joshu, D., Hayman, L., Kaplan, R., … Ockene, J. (2011). Behavior matters. American Journal of Professionelle Medicine, 40(5), e15–e30.

    Google Scholar 

  • Gentry, S., & Badrinath, P. (2017). Defining health in the era of value-based care: Lessons from England of relevance to other health systems. Cureus, 9(3), e1079. https://doi.org/10.7759/cureus.1079

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Hall, J., Cohen, D. J., Davis, M., Gun, R., Blount, A., Pollack, D. A., … Miller, B. F. (2015). Preparing the workforce for behavioral health and primary care integration. Journal of the American Board of Family Medicine, 28, S41–S51. https://doi.org/10.3122/jabfm.2015.s1.150054

    CrossRef  PubMed  Google Scholar 

  • Health Resources and Services Administration/National Center for Health Workforce Analysis; Substance Abuse and Mental Health Services Administration/Office of Policy, Planning and Innovation. (2015). National projections of supply and demand for behavioral health practitioners: 2013–2025. Rockville, MD. HRSA.

    Google Scholar 

  • Hubley, S., & Miller, B. (2016). Implications of healthcare payment reform for clinical psychologists in medical settings. Journal of Clinical Psychology in Medical Settings, 23, 3–10. https://doi.org/10.1007/s10880-016-9451

    CrossRef  PubMed  Google Scholar 

  • Kathol, R. G., Butler, M., McAlpine, D. D., & Kane, R. L. (2010). Barriers to physical and mental condition integrated service delivery. Psychosomatic Medicine, 72(6), 511–518. https://doi.org/10.1097/PSY.0b013e3181e2c4a0

    CrossRef  PubMed  Google Scholar 

  • Kathol, R. G., deGruy, F., & Rollman, B. L. (2014). Value-based financially sustainable behavioral health components in patient-centered medical homes. The Annals of Family Medicine, 12(2), 172–175. https://doi.org/10.1370/afm.1619

    CrossRef  PubMed  Google Scholar 

  • Kathol, R. G., McAlpine, D., Kishi, Y., Spies, R., Meller, W., Bernhardt, T., … Gold, W. (2005). General medical and pharmacy claims expenditures in users of behavioral health services. Journal of General Internal Medicine, 20, 160–167.

    CrossRef  Google Scholar 

  • Katon, W., Russo, J., Lin, E., Schmittdiel, J., Ciechanowski, P., Ludman, E., … Von Korff, M. (2012). Cost-effectiveness of a multicondition collaborative care intervention: A randomized controlled trial. Archives of General Psychiatry, 69(5), 506–514.

    CrossRef  Google Scholar 

  • Kazak, A., Nash, J., Hiroto, K., & Kaslow, N. (2017). Psychologists in Patient-Centered Medical Homes (PCMHs): Roles, evidence, opportunities, and challenges. American Psychologist, 72(1), 1–12.

    CrossRef  Google Scholar 

  • Kim, K., Choi, J., Choi Em Nieman, C., Joo, J., Lin, F., Gitlin, L., & Han, H. (2016). Effects of community-based health worker interventions to improve chronic disease management and care among vulnerable populations: A systematic review. American Journal of Public Health, 106(4), e3–e28. https://doi.org/10.2105/AJPH.2015.302977

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Kowitt, S., Tang, P., Peples, M., Duni, J., Peskin, S., & Fisher, E. (2017). Combining the high tech with the soft touch: Population health management using eHealth and peer support. Population Health Management, 20(1), 3. https://doi.org/10.1089/pop.2016.00

    CrossRef  PubMed  Google Scholar 

  • Lucas, H. (2014). New technology and illness self-management: Potential relevance for resource-poor populations in Asia. Social Science & Medicine, 1, 9.

    Google Scholar 

  • McDaniel, S. H., Grus, C. L., Cubic, B. A., Hunter, C. L., Kearney, L. K., Schuman, C. C., … Miller, B. F. (2014). Competencies for psychology practice in primary care. American Psychologist, 69(4), 409. https://doi.org/10.1037/a0036072

    CrossRef  PubMed  Google Scholar 

  • Michaelides, A., Raby, C., Wood, M., Farr, K., & Roro-Ramos, T. (2016). Weight loss efficacy of a novel mobile diabetes prevention program delivery platform with human coaching. BMJ Open Diabetes Research and Care 4, e000264. https://doi.org/10.1136/bmjdrc-2016-000264

    CrossRef  Google Scholar 

  • Milani, R., Bober, R., Lavie, C. (2016). The role of technology in chronic disease. Progress in Cardiovascular Diseases, 58, 579–583.

    CrossRef  Google Scholar 

  • Milani, R., & Franklin, N. (2017). The role of technology in healthy living medicine. Progress in Cardiovascular Diseases, 59, 487. https://doi.org/10.1016/j.pcad.2017.02.001

    CrossRef  PubMed  Google Scholar 

  • Modern Healthcare. Demand for mental health services soars amid provider shortage. December 31, 2016. Accessed from: http://www.modernhealthcare.com/article/20161231/TRANSFORMATION03/161229942

  • Mountain View Consulting Group. About. 2017. Retrieved from https://www.mtnviewconsulting.com/about/

  • Muller, A., Alley, S., Schoeppe, S., & Vandelanote, C. (2016). The effectiveness of e-&mHealh interventions to promote physical activity and healthy diets in developing countries: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 13, 109.

    CrossRef  Google Scholar 

  • Munder, T., Wilmers, F., Leonhart, R., Linster, H. W., & Barth, J. (2010). Working alliance inventory-short revised (WAI-SR): Psychometric properties in outpatients and inpatients. Clinical Psychology & Psychotherapy, 17, 231–239.

    Google Scholar 

  • National Committee for Quality Assurance. (2014). Standards and guidelines for NCQA’s patient centered medical home (PCMH). Retrieved from http://store.ncqa.org/index.php/2014-pcmh-standards-andguidelines-epub-single-user.html.

  • Patel, V., Chowdhary, N., Rahman, A., & Verdeli, H. (2011). Improving access to psychological treatment: Lessons from developing countries. Behaviour Research and Therapy, 49, 523–528.

    CrossRef  Google Scholar 

  • Rahman, A., Hamdani, S., Awan, N., Bryant, R. A., Dawson, K. S., Khan, M. F., … van Ommeren, M. (2016). Effect of a multicomponent behavioral intervention in adults impaired by psychological distress in a conflict-affected area of Pakistan: A randomized clinical trial. Journal of the American Medical Association, 316(24), 2609–2617. https://doi.org/10.1001/jama.2016.17165

    CrossRef  PubMed  Google Scholar 

  • Ratzliff, A., Unutzer, J., Katon, W., & Stephens, K. (2016). Integrated care: Creating effective mental and primary health care teams. Hoboken, NJ: Wiley.

    Google Scholar 

  • Robinson, P., & Reiter, J. (2016). Behavioral consultation and primary care: A guide to integrating services (2nd ed.). Geneva, Switzerland: Springer International Publishing.

    CrossRef  Google Scholar 

  • Serrano, N., Cos, T. A., Daub, S., & Levkovich, N. (2017). Using standardized patients as a means of training and evaluating behavioral health consultants in primary care. Families, Systems, & Health, 35, 174–183.

    CrossRef  Google Scholar 

  • United States Air Force (USAF). (2011). Primary behavioral health care services practice manual: Version 2. San Antonio: TX.

    Google Scholar 

  • Wang, P. S., Simon, G. E., Avorn, J., Azocar, F., Ludman, E. J., McCulloch, J., … Kessler, R. C. (2007). Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: A randomized controlled trial. Journal of the American Medical Association, 298, 1401–1411.

    CrossRef  Google Scholar 

  • Wayne, N., Perez, D., Kaplan, D., & Rivo, P. (2015). Health coaching reduces HbA1c in type 2 diabetic patients from a lower-socioeconomic status community: A randomized controlled trial. Journal of Medical Internet Research, 17(10), e224. https://doi.org/10.2196/jmir.4871

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • World Health Organization. (2008). Task shifting: Rational redistribution of tasks among health workforce teams: Global recommendations and guidelines. Geneva, Switzerland: World Health Organization.

    Google Scholar 

  • World Health Organization. (2016). Problem management plus (PM+): Individual psychological help for adults impaired by distress in communities exposed to adversity (generic field-trial version 1.0). Geneva, Switzerland: World Health Organization http://www.who.int/mental_health/emergencies/problem_management_plus/en/. Accessed 31 March 2017.

    Google Scholar 

  • Zimmet, P. (2003). The burden of type 2 diabetes: Are we doing enough? Diabetes & Metabolism, 29(4 Pt 2), 6S9–6S18.

    CrossRef  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ronald R. O’Donnell .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Verify currency and authenticity via CrossMark

Cite this chapter

O’Donnell, R.R. (2018). Provider Training: Recognizing the Relevance of Behavioral Medicine and the Importance of Behavioral Health Consultation and Referral. In: Duckworth, M., O'Donohue, W. (eds) Behavioral Medicine and Integrated Care. Springer, Cham. https://doi.org/10.1007/978-3-319-93003-9_4

Download citation