The Primary Care Behavioral Health (PCBH) model is a prominent approach to the integration of behavioral health services into primary care settings. Implementation of the PCBH model has grown over the past two decades, yet research and training efforts have been slowed by inconsistent terminology and lack of a concise, operationalized definition of the model and its key components. This article provides the first concise operationalized definition of the PCBH model, developed from examination of multiple published resources and consultation with nationally recognized PCBH model experts. The definition frames the model as a team-based approach to managing biopsychosocial issues that present in primary care, with the over-arching goal of improving primary care in general. The article provides a description of the key components and strategies used in the model, the rationale for those strategies, a brief comparison of this model to other integration approaches, a focused summary of PCBH model outcomes, and an overview of common challenges to implementing the model.

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 Aff ordable 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 eff ectively 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. 2017. 336 pages. Hardcover.

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 Aff ordable 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 eff ectively 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. 2017. 336 pages. Hardcover.

This article describes a training program for primary behavioral health care (PBHC) for clinical psychology interns. The authors discuss the rationale for integrating mental health into primary care and the need for additional training programs at the predoctoral internship level. A review of relevant literature suggests that effective functioning in primary care requires competence in (a) generalist psychology, (b) health psychology, (c) interdisciplinary team functioning, and (d) skills specific to primary care. The authors advocate for a relatively intensive training program to address these areas. Common intern training difficulties observed during 3 years of program implementation are discussed. Practical, lessons-learned recommendations that address these problem areas provide guidance for others seeking to develop a PBHC training program.A growing body of literature recognizes the potential value of integrating behavioral health services into the primary care arena. Researchers have found that approximately 60% of primary care visits involve some behavioral health need (Cummings, Cummings, & Johnson, 1997). Furthermore, epidemiological research suggests that although 28% of Americans in any given year meet diagnostic criteria for a mental disorder, half of these individuals do not receive any form of treatment. Of those who are treated, approximately half receive specialized mental health treatment, whereas the remaining half receive services solely through their general medical providers (Narrow, Regier, Rae, Manderscheid, & Locke, 1993;Regier et al., 1993). Thus, the existing mental health system provides specialized, intensive services to a minority of individuals with behavioral health problems. The rest receive treatment solely from their physician or receive no behavioral health services whatsoever.Traditional models of mental health care cannot adequately provide services to the large numbers of individuals presenting to primary care clinics with a host of biopsychosocial problems. Consequently, innovative service delivery models capable of providing more comprehensive behavioral health interventions to primary care populations have been developed (

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Psychologists played a crucial role in the successful implementation of integrated behavioral health care services in Department of Defense (DoD) primary care clinics. On the front lines of policy development, training programs, clinical care, and program evaluations, psychologists successfully promoted integrated care as a core component of the DoD patient-centered medical home. We review the development of integrated care and discuss the roles of psychologists in the DoD to provide an exemplar of the impact psychologists can have on the implementation and sustainment of integrated care.

The expansion of integrated, collaborative, behavioral health services in primary care requires a trained behavioral health workforce with specific competencies to deliver effective, evidence-informed, team-based care. Most behavioral health providers do not have training or experience working as primary care behavioral health consultants (BHCs), and require structured training to function effectively in this role. This article discusses one such training program developed to meet the needs of a large healthcare system initiating widespread implementation of the primary care behavioral health model of service delivery. It details the Department of Defense's experience in developing its extensive BHC training program, including challenges of addressing personnel selection and hiring issues, selecting a model for training, developing and implementing a phased training curriculum, and improving the training over time to address identified gaps. Future directions for training improvements and lessons learned in a large healthcare system are discussed.