Enhancing entrance into PTSD treatment for post-deployment veterans through collaborative/integrative care

Brawer, Peter A.; Brugh, Ann; Martielli, Rich; O’Connor, Shawn P; Mastnak, Julie; Scherrer, Jeffrey F.; Day, Theodore E.

doi:10.1007/s13142-011-0097-0

Cited by 17 publications

(18 citation statements)

References 12 publications

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“…We also found evidence that behavioral activation and exposure-based interventions were an especially good fit for IBHC patients; both of these CBT-based strategies were significantly and positively related to patient rate of change. These findings should be considered in light of IBHC's broader potential: Primary care settings are thought to offer greater access and earlier access to behavioral health care than that provided by traditional mental health care settings (Blount, 1998; Brawer et al, 2011; Pomerantz et al, 2014; Robinson & Reiter, 2007). To the degree those claims are valid, current findings indicating that patients receive quality care via empirically supported interventions add supportive evidence to the promise of this innovative model.…”

Section: Resultsmentioning

confidence: 99%

“…To date, research on IBHC suggests opportunities outweigh challenges. Recent studies support its palatability among patients and providers (e.g., Funderburk et al, 2010) and speak to its potential to improve both patient access to care (Brawer et al, 2011; Pomerantz et al, 2014) and outcomes (e.g., Miller, Petterson, Teevan Burke, Phillips, & Green, 2014; Peek, Cohen, & deGruy, 2014). Lacking, however, are studies that adequately describe intervention activities of IBHC providers and the extent to which these activities represent evidence-based practices.…”

mentioning

confidence: 99%

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Diagnoses, intervention strategies, and rates of functional improvement in integrated behavioral health care patients.

Bridges¹,

Gregus²,

Rodríguez³

et al. 2015

Journal of Consulting and Clinical Psychology

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Objective Compared with more traditional mental health care, integrated behavioral health care (IBHC) offers greater access to services and earlier identification and intervention of behavioral and mental health difficulties. The current study examined demographic, diagnostic, and intervention factors that predict positive changes for IBHC patients. Method Participants were 1,150 consecutive patients (mean age = 30.10 years, 66.6% female, 60.1% Hispanic, 47.9% uninsured) seen for IBHC services at 2 primary care clinics over a 34-month period. Patients presented with depressive (23.2%), anxiety (18.6%), adjustment (11.3%), and childhood externalizing (7.6%) disorders, with 25.7% of patients receiving no diagnosis. Results The most commonly delivered interventions included behavioral activation (26.1%), behavioral medicine-specific consultation (14.6%), relaxation training (10.3%), and parent-management training (8.5%). There was high concordance between diagnoses and evidence-based intervention selection. We used latent growth curve modeling to explore predictors of baseline global assessment of functioning (GAF) and improvements in GAF across sessions, utilizing data from a subset of 117 patients who attended at least 3 behavioral health visits. Hispanic ethnicity and being insured predicted higher baseline GAF, while patients with an anxiety disorder had lower baseline GAF than patients with other diagnoses. Controlling for primary diagnosis, patients receiving behavioral activation or exposure therapy improved at faster rates than patients receiving other interventions. Demographic variables did not relate to rates of improvement. Conclusion Results suggest even brief IBHC interventions can be focused, targeting specific patient concerns with evidence-based treatment components.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Diagnoses, intervention strategies, and rates of functional improvement in integrated behavioral health care patients.

Bridges¹,

Gregus²,

Rodríguez³

et al. 2015

Journal of Consulting and Clinical Psychology

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“…21 PC-MHI services may follow an open-access model that allows for immediate referral of patients with mental health needs. 22 The specific program structure and services offered vary between facilities; some specifically refer all positive depression screens to their PC-MHI programs and some allow patients to refer themselves. 20 Nearly every VA Medical Center and most of the very large Community Based Outpatient Clinics have programs.…”

Section: Introductionmentioning

confidence: 99%

Integrated Care: Treatment Initiation Following Positive Depression Screens

et al. 2012

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“…Research conducted within the VA has found that those who were assessed in primary care by a mental health provider were far more likely to have a mental health follow-up (Bohnert, Pfeiffer, Szymanski, & McCarthy, 2013 ). Post-Traumatic Stress Disorder is a common disorder found among Veterans, and this integration of care has been found to be helpful in initiating care and lower rates of hospitalization (Bohnert, Sripada, Mach, & McCarthy, 2016 ; Brawer et al , 2011 ; Randall, Mohr, & Maynard, 2014 ). PACT utilization has also been associated with reduced ED visits for Veterans experiencing homelessness (Gundlapalli et al , 2017 ).…”

Section: Patient Aligned Care Team and Mental Healthmentioning

confidence: 99%

The role of the psychologist in the veterans administration’s patient aligned care team and huddle: A review, practical recommendations, and a call to action

Velezmoro¹

2018

Health Psych Res

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The Veterans Administration (VA)’s Patient Aligned Care Team (PACT) model has been a cornerstone of primary care in the VA healthcare system and has indicated the need for an organizational cultural shift towards interdisciplinary care. Most of the focus in PACT has been on the traditional providers of the medical model, with little attention focused on the role of the psychologist. This paper examines how psychologists can assist in the PACT model and, in particular, within the team VA huddle. Literature on the PACT model, mental health in PACT, and the advantages of the huddle are reviewed. Lessons learned within a large VA clinic are also discussed. Psychologists’ ability to be a clinician, teambuilder, and system specialist is discussed and how it benefits the PACT and the huddling process. Practical recommendations are made for how to best assist during the huddle, and how to advocate for both the huddle, and for a broader cultural shift in care.

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Enhancing entrance into PTSD treatment for post-deployment veterans through collaborative/integrative care

Cited by 17 publications

References 12 publications

Diagnoses, intervention strategies, and rates of functional improvement in integrated behavioral health care patients.

Diagnoses, intervention strategies, and rates of functional improvement in integrated behavioral health care patients.

Integrated Care: Treatment Initiation Following Positive Depression Screens

The role of the psychologist in the veterans administration’s patient aligned care team and huddle: A review, practical recommendations, and a call to action

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