Seeking a wider lens for scientific rigor in emerging fields: The case of the primary care behavioral health model.

Abstract

In response to widespread recognition of the need to blend biomedical and psychosocial health care efforts, the primary care behavioral health (PCBH) model has achieved rapid uptake across the United States. Reports of its application come from military sectors, community health centers, and a variety of health care systems, large and small. Examining the PCBH model's appeal, evidence, and design forces us to confront important questions. These questions and much more are addressed in this issue of (PsycINFO Database Record

Moving effective treatment for posttraumatic stress disorder to primary care: A randomized controlled trial with active duty military.

“…Progress toward expanding practice guidelines for PTSD in primary care has been hindered by the absence of brief therapies developed for the PCBH model and validated in randomized controlled trials (Possemato, 2011). The effectiveness of the PCBH model of service delivery as a whole lacks a foundation of rigorous research (Hunter et al, 2017; Mauksch, Peek, & Fogarty, 2017; Vogel, Kanzler, Aikens, & Goodie, 2017). To our knowledge, other randomized controlled trials comparing the effect of delivering care using the primary components of the PCBH model to usual care on patient outcomes is limited to a single study published over 20 years ago (Katon et al, 1996).…”

Building research and evaluation into the Collaborative Family Healthcare Association with intention.

“…An example deploying the metaphor is of the primary care behavioral health (PCBH) model of integrated care, developed in the village as people (many of whom hail from within CFHA ranks) problem-solved a real-world demand. FSH and REC leaders have been instrumental in pushing for more rigorous testing and validation of this model (e.g., Funderburk et al, 2021; Mauksch et al, 2017) to establish a solid empirical foundation. The REC has provided training and encouraged clinician innovators to collect data on their implementation of the PCBH and publish in FSH or other journals via the “on-ramp.” Once on the bridge, the material is engaged by the scientific community, influencing decisions about methods, study design, and interpretation of results.…”

Behavioral health integration and the risks of reductionism.

“…The term integrated care has become the moniker of the Collaborative Family Health Association (CFHA), as evidenced by the frequent use of the term on the CFHA website and publications, as well as in submissions to this journal. To practice “integrated care” is fast becoming a status symbol, a “movement,” described by some with a fervor that approaches religious zeal (Mauksch, Peek, & Fogarty, 2017). But, what do we actually know about the practice environment, model, staffing, or patient population when someone says, “I practice integrated care.”…”