Topical Review: Building Competency: Professional Skills for Pediatric Psychologists in Integrated Primary Care Settings

Hoffses, Kathryn W.; Ramirez, Lisa; Berdan, Louise; Tunick, Rachel A.; Honaker, Sarah Morsbach; Meadows, Tawnya J.; Shaffer, Laura A.; Robins, Paul M.; Sturm, Lynne; Stancin, Terry

doi:10.1093/jpepsy/jsw066

Cited by 32 publications

(20 citation statements)

References 34 publications

(29 reference statements)

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“…Regardless, robust training experiences will continue to be essential. Guidelines describing specific competencies for psychologists in PPC are emerging (Hoffses et al, 2016) and may serve as a blueprint for training psychologists to function in PPC settings. There is strong potential for graduate programs to expose psychology students to the emerging field of PPC psychology, and increased funding through Health Resources and Services Administration training grants also presents an opportunity for developing new curricula across levels of training.…”

Section: Discussionmentioning

confidence: 99%

Professional practices, training, and funding mechanisms: A survey of pediatric primary care psychologists.

Hoffses

Riley

Menousek

et al. 2017

Clinical Practice in Pediatric Psychology

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The integration of mental health services in primary care settings has expanded rapidly in recent years with psychologists being at the forefront of efforts to promote healthy behaviors, reduce disease, and care for behavioral, emotional, and developmental needs to promote overall health and well-being for children and families (Asarnow, Kolko, Miranda, & Kazak, 2017;Stancin & Perrin, 2014). While there are many psychologists working in pediatric primary care (PPC), little is known about the specific activities that these psychologists engage in, the training they receive, or funding mechanisms that support their work. This study sought to address this gap in the literature through a survey of psychologists working in PPC. An anonymous online survey was disseminated to members of professional organizations and listservs who were identified as having interest in PPC. Psychologists (N ϭ 65) currently practicing in PPC completed the survey by reporting on clinical roles and practices, professional training, practice settings, and funding supports in PPC settings. Results indicate that psychologists assume a number of roles in PPC including providing individual and family therapy, conducting screenings for child mental health concerns, and providing consultation to medical colleagues. Many psychologists also provide supervision and offer educational opportunities for those in related fields, such as medicine and social work. Engagement in research activities was identified as a secondary activity. It was reported that a number of clinical activities were not billed for on a regular basis. Additional areas of research will be discussed along with implications for clinical services in PPC.

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Section: Discussionmentioning

confidence: 99%

Professional practices, training, and funding mechanisms: A survey of pediatric primary care psychologists.

Hoffses

Riley

Menousek

et al. 2017

Clinical Practice in Pediatric Psychology

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“…In partnership with training program leaders in the psychiatry department, the HMHK co-directors refined training rotations for trainees (Njoroge et al, 2017). A training and supervision plan was established to support the development of clinical competencies in pediatric integrated behavioral health in pediatric primary care (e.g., Hoffses et al, 2016) and encourage fidelity to evidence-based strategies.…”

Section: Developing the Logic Model And Measurement Batterymentioning

confidence: 99%

Strategic implementation planning for integrated behavioral health services in pediatric primary care

Mautone

Wolk

Cidav

et al. 2021

Implementation Research and Practice

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Background: Delivering physical and behavioral health services in a single setting is associated with improved quality of care and reduced health care costs. Few health systems implementing integrated care develop conceptual models and targeted measurement strategies a priori with an eye toward adoption, implementation, sustainment, and evaluation. This is a broad challenge in the field, which can make it difficult to disentangle why implementation is or is not successful. Method: This article discusses strategic implementation and evaluation planning for a pediatric integrated care program in a large health system. Our team developed a logic model, which defines resources and community characteristics, program components, evaluation activities, short-term activities, and intermediate and anticipated long-term patient-, clinician-, and practice-related outcomes. The model was designed based on research and stakeholder input to support strategic implementation and evaluation of the program. For each aspect of the logic model, a measurement battery was selected. Initial implementation data and intermediate outcomes from a pilot in five practices in a 30-practice pediatric primary care network are presented to illustrate how the logic model and evaluation plan have been used to guide the iterative process of program development. Results: A total of 4,619 office visits were completed during the 2 years of the pilot. Primary care clinicians were highly satisfied with the integrated primary care program and provided feedback on ways to further improve the program. Members of the primary care team and behavioral health providers rated the program as being relatively well integrated into the practices after the second year of the pilot. Conclusion: This logic model and evaluation plan provide a template for future projects integrating behavioral health services in non-specialty mental health settings, including pediatric primary care, and can be used broadly to provide structure to implementation and evaluation activities and promote replication of effective initiatives. Plain language abstract: Up to 1 in 5 youth have difficulties with mental health; however, the majority of these youth do not receive the care they need. Many youth seek support from their primary care clinicians. Pediatric primary care practices have increasingly integrated behavioral health clinicians into the care team to improve access to services and encourage high-quality team-based care. Definitions of “behavioral health integration” vary across disciplines and organizations, and little is known about how integrated behavioral health care is actually implemented in most pediatric settings. In addition, program evaluation activities have not included a thorough examination of long-term outcomes. This article provides detailed information on the implementation planning and evaluation activities for an integrated behavioral health program in pediatric primary care. This work has been guided by a logic model, an important implementation science tool to guide the development and evaluation of new programs and promote replication. The logic model and measurement plan we developed provides a guide for policy makers, researchers, and clinicians seeking to develop and evaluate similar programs in other systems and community settings. This work will enable greater adoption, implementation, and sustainment of integrated care models and increase access to high-quality care.

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“…Behavioral health visits conducted by pediatricians typically last 2.5 times as long as medical only visits and are typically reimbursed at lower rates than medical visits (Meadows, Valleley, Haack, Thorson, & Evans, 2011). To identify economic costs and benefits of IPC, an increased focus on the cost offset of integrating a psychologist in pediatric primary care is recommended (e.g., Hoffses et al, 2016).…”

Section: Navigating Reimbursement Challengesmentioning

confidence: 99%

Sustaining integrated behavioral health practice without sacrificing the continuum of care.

Herbst

Margolis

McClellan

et al. 2018

Clinical Practice in Pediatric Psychology

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This article describes how an innovative model of practice transformation, used by 4 integrated pediatric primary care practices over a 2 year grant period, promoted the practice of integrated primary care (IPC) behavioral health services. Practice transformation was possible through the implementation of an alternative billing strategy to enhance sustainability, effective utilization of clinical productivity to provide meaningful patient services, and the identification of strategies to further the practice of IPC. Specifically, we provide: (a) a description of the diversity of billing strategies typically used by pediatric practices utilizing integrated care and how those strategies are impacted by state health care policies; (b) a description of the grant, including the service delivery model, implementation phase, and data collection procedures; (c) results of implementation and billing/reimbursement data that were collected across the 4 practices; (d) an analysis of how billing strategies are critical in defining implementation strategies within pediatric integrated care; and (e) lessons learned about how billing strategies must be flexible and amenable to change over time to stay current with ever-changing health care policies and reimbursement models. Implications for Impact StatementThis article describes how an innovative model of practice transformation, used by 4 integrated pediatric primary care practices over a 2 year grant period, promoted the practice of integrated behavioral health services in primary care. We provide lessons learned about financing primary care using innovative billing strategies beyond the use mental health diagnoses and billing codes, which enable psychologists to focus more on preventative and health behavior change services.

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Topical Review: Building Competency: Professional Skills for Pediatric Psychologists in Integrated Primary Care Settings

Cited by 32 publications

References 34 publications

Professional practices, training, and funding mechanisms: A survey of pediatric primary care psychologists.

Professional practices, training, and funding mechanisms: A survey of pediatric primary care psychologists.

Strategic implementation planning for integrated behavioral health services in pediatric primary care

Sustaining integrated behavioral health practice without sacrificing the continuum of care.

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