BMT Roadmap was a feasible HIT intervention to implement in HSCT caregivers. BMT Roadmap was associated with increased activation and decreased burden, but quality of life lowered across hospitalization. Findings support the need to further develop caregiver-specific self-directed resources and provide them both inpatient and outpatient across the HSCT trajectory.
Objective: As pediatric behavioral health concerns are increasingly identified and addressed within pediatric primary care and family medicine practices, behavioral health providers (BHPs) in integrated primary care (IPC) are often faced with not only addressing the psychosocial needs of their child patients, but also confronting the needs of those patients' caregivers. Given the extensive body of evidence demonstrating that child mental health is associated with caregiver mental health, continued discussions of addressing caregiver mental health within the integrated care context are warranted. Method: The current paper will discuss obstacles to establishing family-centered comprehensive behavioral care including ethical concerns around informed consent, scope of practice, and dual relations, and various practice considerations. Results: The obstacles are greater for establishing family-centered comprehensive behavioral care within pediatric settings compared to family practice settings due to the additional practice considerations. The potential benefit to children and the broader family system may warrant the effort. Conclusions: By identifying and discussing these issues, BHPs working within pediatric and family medicine settings are encouraged to engage in active dialogue with hospital and clinic administrators to overcome systemic barriers and to think flexibly about how BHPs might expand upon existing approaches in order to utilize the IPC opportunity to address parent mental health concerns that may otherwise impede a child's treatment progress.
Implications for Impact StatementTreating adult caregivers within pediatric primary or family care settings has the potential of vastly improving the mental health of the entire family. Integrated pediatric primary care provides an ideal setting for behavioral health providers to provide holistic family care. To do this effectively, ethical and practical barriers must be discussed and dismantled.
Objective: Given the increased demand for pediatric primary care providers to manage adolescent depression, the current study examines the association between burnout and provider comfort and perception of feasibility managing adolescent depression. Method: Data were collected from 52 pediatricians at a Midwest academic health center. Results: Higher scores on depersonalization were associated with lower provider-reported comfort managing adolescent depression. Emotional exhaustion and personal accomplishment were not associated with provider-reported comfort managing adolescent depression. None of the burnout domains were associated with the provider-reported perception of the feasibility managing adolescent depression in this setting. Limitations and recommendations for future research regarding the impact of behavioral health training on burnout are discussed. Conclusions: The interpersonal stress dimension of burnout is associated with less comfort managing depression. Adding positive systematic interventions, such as behavioral health trainings that support pediatricians in the management of behavioral health may have impact on burnout.
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