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The Impact of Brief Interventions on Functioning Among those Demonstrating Anxiety, Depressive, and Adjustment Disorder Symptoms in Primary Care: The Effectiveness of the Primary Care Behavioral Health (PCBH) Model

Abstract

Limited scalability combined with limited opportunities for patients to receive evidence-based interventions in traditional behavioral health treatment models for anxiety and depression creates a gap in access to adequate care. Primary Care Behavioral Health (PCBH) is one model of treatment in which behavioral health consultants (BHC) work directly within primary care settings, but there is limited evidence regarding the effectiveness of this model of care. The functional outcomes and appointment characteristics of Beneficiaries (N = 5402) within the military healthcare system were assessed. The study sample was predominately Caucasian, female, military dependents seen for 2 to 4 appointments. A reliable change index revealed that 17.2% showed reliable improvement and 2.4% showed reliable deterioration (p < .05). Of individuals with a severe Behavioral Health Measure-20 score at baseline, 81.5% showed some improvement at their final appointment, with 33% demonstrating reliable improvement. A mixed model analysis was used to determine the predictive value of appointment characteristics. All relations were significant (p < .001), except the between-subjects effect of appointment duration. Appointment duration revealed individuals reported worse functioning at the start of atypically long appointments. Individuals with generally longer intervals between appointments reported worse functioning, but an atypically long interval predicted better functioning at the following appointment. As it relates to number of appointments, individuals with more total appointments reported worse functioning outcomes, with generally better functioning across appointments. Overall, these data support the effectiveness of time-limited care provided through the PCBH model.

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Correspondence to Kevin M. Wilfong.

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Kevin M. Wilfong, Jeffrey L. Goodie, Justin C. Curry, Christopher L. Hunter, and Phillip C. Kroke have no conflicts of interest to report.

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The Uniformed Services University’s Human Research Protections Program Office reviewed the protocol for this study and determined that it not to meet the criteria defining research involving human subjects at 32 CFR 219.102, and applicable DoD policy guidance. As such, this protocol did not require Institutional Review Board (IRB) review.

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Wilfong, K.M., Goodie, J.L., Curry, J.C. et al. The Impact of Brief Interventions on Functioning Among those Demonstrating Anxiety, Depressive, and Adjustment Disorder Symptoms in Primary Care: The Effectiveness of the Primary Care Behavioral Health (PCBH) Model. J Clin Psychol Med Settings (2021). https://doi.org/10.1007/s10880-021-09826-9

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Keywords

  • Primary care
  • Psychotherapy outcome
  • Integrated care
  • Behavioral health consultation