Behavioral Consultation and Primary Care

Robinson, Patricia J.; Reiter, Jeffrey T.

doi:10.1007/978-0-387-32973-4

Cited by 151 publications

(209 citation statements)

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“…To realize this potential, policies that both encourage and support integration are needed. Several key processes are needed to enable primary care providers to collaborate better with behavioral health providers: increased reimbursement and education at the practice level, 7 workforce expansion, shared training, payment reform that favors team approaches, outcomes and population-based care to balance the isolating effects of fees for service, telehealth initiatives, and other incentives that support shared care. As we continue to better understand the importance of integration efforts, support can take place at the local community level as well as through state-based and national initiatives.…”

Section: Discussionmentioning

confidence: 99%

Primary Care, Behavioral Health, Provider Colocation, and Rurality

Miller

Petterson

Levey

et al. 2014

The Journal of the American Board of Family Medicine

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Purpose: The purpose of this study was to characterize the proximity of primary care and behavioral health service delivery sites in the United States and factors influencing their colocation.Methods: We geocoded the practice addresses of primary care and behavioral health providers found in the Centers for Medicare & Medicaid Services' National Plan and Provider Enumeration System Downloadable File to report where colocation is occurring throughout the country.Results: The extent to which primary care physicians are colocated with behavioral health providers is strongly associated with rurality. Specifically, 40.2% of primary care physicians in urban areas are colocated with behavioral health providers compared with 22.8% in isolated rural areas and 26.5% in frontier areas. However, when controlling for number of primary care physicians at a location, the odds of colocation actually are greater for physicians in a frontier area than those in urban areas (odds ratio, 1.289; P < .01).Conclusions :

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Section: Discussionmentioning

confidence: 99%

Primary Care, Behavioral Health, Provider Colocation, and Rurality

Miller

Petterson

Levey

et al. 2014

The Journal of the American Board of Family Medicine

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“…46 The Agency for Healthcare Research and Quality's 2008 review of evidence on the efficacy of integrated care indicates that numerous organizational and financial barriers to successful integration persist; few clinical trials, however, describe barriers to implementation or the strategies employed to overcome them. 3 For instance, one trial identified limited time as a barrier to implementing a 2-step screening process for depression in the primary care setting.…”

Section: Discussionmentioning

confidence: 99%

Integrating Behavioral and Physical Health Care in the Real World: Early Lessons from Advancing Care Together

Davis

Balasubramanian

Waller

et al. 2013

The Journal of the American Board of Family Medicine

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Background: More than 20 years ago the Institute of Medicine advocated for integration of physical and behavioral health care. Today, practices are integrating care in response to recent policy initiatives. However, few studies describe how integration is accomplished in real-world practices without the financial or research support available for most randomized controlled trials.Methods: To study how practices integrate care, we are conducting a cross-case comparative, mixedmethods study of 11 practices participating in Advancing Care Together (ACT). Using a grounded theory approach, we analyzed multiple sources of data (eg, documents, practice surveys, field notes from observation visits, semistructured interviews, online diaries) collected from each ACT innovator.Results: Integration requires making changes in organization and interpersonal relationships. During early integration efforts, challenges related to workflow and access, leadership and culture change, and tracking and using data to evaluate patient-and practice-level improvement emerged for ACT innovators. We describe the strategies innovators are developing to address these challenges.

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“…The Primary Care Behavioral Health model (PCBH; Robinson & Reiter, 2007) is one of the most commonly used models. In a PCBH model, psychologists are embedded into the primary care setting and serve as behavioral health consultants (BHC) to the medical providers; the BHC provides brief, focused assessments and interventions for patients referred by their primary care provider Cigrang, Dobmeyer, Becknell, Roa-Navarrete, & Yerian, 2006;Goodie, Isler, Hunter, & Peterson, 2009;Wilson, 2003;Zeiss & Karlin, 2008).…”

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confidence: 99%

Treatment of active-duty military with PTSD in primary care: Early findings.

Cigrang

Rauch

Avila

et al. 2011

Psychological Services

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The study presents early findings from an ongoing pilot study of a cognitive–behavioral treatment for assisting active-duty military members with deployment-related posttraumatic stress disorder (PTSD) designed for use by psychologists working in an integrated primary care clinic. Treatment protocol is based primarily on Prolonged Exposure but also includes elements of Cognitive Processing Therapy that were adapted for use in primary care. Individuals were recruited from the population of patients consulted to the psychologist by primary care providers during routine clinical care. The 15 participants include active-duty or activated reserve Operation Iraqi Freedom and Operation Enduring Freedom veterans seeking help for deployment-related PTSD symptoms, with a PTSD Checklist-Military Version score 32, and interest in treatment for PTSD in primary care. Baseline and 1-month posttreatment follow-up evaluations were conducted by an independent evaluator. Five participants (33%) dropped out of the intervention after one or two appointments. Using the last observation carried forward for intent-to-treat analyses, the results showed that PTSD severity, depression, and global mental health functioning all significantly improved with the intervention. Fifty percent of treatment completers no longer met criteria for PTSD.

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Behavioral Consultation and Primary Care

Cited by 151 publications

References 0 publications

Primary Care, Behavioral Health, Provider Colocation, and Rurality

Primary Care, Behavioral Health, Provider Colocation, and Rurality

Integrating Behavioral and Physical Health Care in the Real World: Early Lessons from Advancing Care Together

Treatment of active-duty military with PTSD in primary care: Early findings.

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