Working with Complexity in Integrated Behavioral Health Settings

  • Macaran A. BairdEmail author
  • C. J. Peek
  • William B. Gunn
  • Andrew Valeras


This chapter provides a practical approach for understanding and dealing with patient “complexity” in a health care context. Complexity is defined as the interaction of patient, provider, and care delivery variables, which intermingle to create situations where usual treatments are not working—or not working as well as patients and clinicians are expecting. These situations can only be understood by looking at the complex interaction of those variables and adopting new models of understanding and implementing new care-giving strategies. The chapter begins with a review of different approaches to dealing with complexity within the USA and in Europe. A particular method and clinical checklist is described in detail. A “real world” application, the Complex Continuity Clinic, using this and other methods of engaging patients in complex situations, is outlined, with clinical examples. Finally, the important implications of a complexity approach to emerging health care reform is described, shedding light on how effective approaches that embrace complex biopsychosocial health issues can result in greater quality and reduced costs.


Care Plan Medical Complexity Care Coordination Primary Care Practice Health Care Team 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Macaran A. Baird
    • 1
    Email author
  • C. J. Peek
    • 1
  • William B. Gunn
    • 2
  • Andrew Valeras
    • 3
  1. 1.Department of Family Medicine and Community HealthUniversity of Minnesota Medical SchoolMinneapolisUSA
  2. 2.NH/Dartmouth FPR ProgramConcordUSA
  3. 3.New Hampshire Dartmouth Family Medicine ResidencyConcordUSA

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