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

  • Ronald R. O’Donnell
Chapter

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.

References

  1. 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
  2. American Hospital Association. (2016). The state of the behavioral health workforce: A literature review. Retried from: http://www.aha.org/content/16/stateofbehavior.pdf
  3. 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
  4. 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. CrossRefPubMedPubMedCentralGoogle Scholar
  5. 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
  6. 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.CrossRefGoogle Scholar
  7. 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
  8. 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 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 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
  10. 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.
  11. 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.CrossRefGoogle Scholar
  12. 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.CrossRefGoogle Scholar
  13. 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.CrossRefGoogle Scholar
  14. 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 CrossRefPubMedGoogle Scholar
  15. 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
  16. 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 CrossRefPubMedPubMedCentralGoogle Scholar
  17. 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 CrossRefPubMedGoogle Scholar
  18. 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
  19. 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 CrossRefPubMedGoogle Scholar
  20. 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 CrossRefPubMedGoogle Scholar
  21. 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 CrossRefPubMedGoogle Scholar
  22. 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.CrossRefGoogle Scholar
  23. 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.CrossRefGoogle Scholar
  24. 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.CrossRefGoogle Scholar
  25. 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 CrossRefPubMedPubMedCentralGoogle Scholar
  26. 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 CrossRefPubMedGoogle Scholar
  27. Lucas, H. (2014). New technology and illness self-management: Potential relevance for resource-poor populations in Asia. Social Science & Medicine, 1, 9.Google Scholar
  28. 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 CrossRefPubMedGoogle Scholar
  29. 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 CrossRefGoogle Scholar
  30. Milani, R., Bober, R., Lavie, C. (2016). The role of technology in chronic disease. Progress in Cardiovascular Diseases, 58, 579–583.CrossRefGoogle Scholar
  31. 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 CrossRefPubMedGoogle Scholar
  32. Modern Healthcare. Demand for mental health services soars amid provider shortage. December 31, 2016. Accessed from: http://www.modernhealthcare.com/article/20161231/TRANSFORMATION03/161229942
  33. Mountain View Consulting Group. About. 2017. Retrieved from https://www.mtnviewconsulting.com/about/
  34. 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.CrossRefGoogle Scholar
  35. 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
  36. 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.
  37. 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.CrossRefGoogle Scholar
  38. 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 CrossRefPubMedGoogle Scholar
  39. Ratzliff, A., Unutzer, J., Katon, W., & Stephens, K. (2016). Integrated care: Creating effective mental and primary health care teams. Hoboken, NJ: Wiley.Google Scholar
  40. Robinson, P., & Reiter, J. (2016). Behavioral consultation and primary care: A guide to integrating services (2nd ed.). Geneva, Switzerland: Springer International Publishing.CrossRefGoogle Scholar
  41. 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.CrossRefGoogle Scholar
  42. United States Air Force (USAF). (2011). Primary behavioral health care services practice manual: Version 2. San Antonio: TX.Google Scholar
  43. 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.CrossRefGoogle Scholar
  44. 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 CrossRefPubMedPubMedCentralGoogle Scholar
  45. 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
  46. 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
  47. Zimmet, P. (2003). The burden of type 2 diabetes: Are we doing enough? Diabetes & Metabolism, 29(4 Pt 2), 6S9–6S18.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.College of Health SolutionsArizona State UniversityPhoenixUSA

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