Behavioral Consultation and Primary Care- A Guide To Integrating Services

2nd Edition

In this book we present readers a guide for providing health and MH care in a radically different fashion- one that begins to better meet the needs of the population. Called Primary Care Behavioral Health (PCBH) this model of care involves delivery of Behavioral Health Consultant (BHC) services in a PC clinic and differs in many respects from traditional MH care. It is also designed to change the way PC is conducted. As noted by Strosahl (1998), an early developer and proponent of the PCBH model, this model is best considered as a form of health care rather than mental health care. The goal is not to replace the specialty MH care system, but rather to improve the treatment of behavioral problems in PC. In doing so, the functioning of the PC system in general can improve, and attention to other health needs of the population can increase.

1. LIST of Figures

1.F.1 Figure 1.1 Distribution of Mental Health and Substance Abuse Care

3.F.1 Figure 3.1 Interview questions (and desired answers) for BHC position applicants

3.F.2 Figure 3.2 Common tasks for a Behavioral Health Assistant (BHA)

3.F.3 Figure 3.3 Questions for interviews with Behavioral Health Assistant (BHA) applicants

5.F.1 Figure 5.1 Behavioral Health Consultant Core Competency Tool

5.F.1 Figure 5.1 Behavioral Health Consultant Core Competency Tool (Jeff Reiter’s conflicted copy 2015-07-28)

6.F.1 Figure 6.1 PCP RN Core Competency Tool

7.F.1 Figure 7.1 Core processes of psychological flexibility

7.F.2 Figure 7.2 Pillars of Psychological Flexibility and suggested therapeutic actions

9.F.1 Figure 9.1 Content for a flier introducing BHC services

9.F.2 Figure 9.2 Components of a BHC initial visit

9.F.3 Figure 9.3 A Behavioral Health Consultant’s introduction

9.F.4 Figure 9.4 A Behavioral Health Assistant’s introduction of BHC services

9.F.5 Figure 9.5 Life context questions for adults

9.F.6 Figure 9.6 Life context questions for children and teens

9.F.7 Figure 9.7 Functional analysis questions

9.F.8 Figure 9.8 Example of behavioral health prescription pad

9.F.9 Figure 9.9 Components of a BHC follow-up visit

9.F.10 Figure 9.10 Questions for assessing patient improvement

9.F.11 Figure 9.11 Questions for assessing patient experience with plan implementation

9.F.12 Figure 9.12 BHC SOAP notes for the initial visit

9.F.13 Figure 9.13 PCBH chart review tool

10.F.1 Figure 10.1 The BHC Start-up Checklist

10.F.2 Figure 10.2 Example of poster announcing BHC services

10.F.3 Figure 10.3 GATHER An example of a BHC educational handout

10.F.4 Figure 10.4 Educational handout providing information on connecting patients with the BHC

10.F.5 Figure 10.5 Example of a BHC shadowing note sheet

10.F.6 Figure 10.6 Example of a PCP_RN survey concerning patients PCPs_RNs would like BHCs to see

10.F.7 Figure 10.7 Example of BHC _Request of the Week_ communication to PCPs and RNs

10.F.8 Figure 10.8 Example of an educational handout for BHC’s to use to teach PCPs and RNs strategies for talking with the patient about BHC services

10.F.9 Figure 10.9 An example of an educational handout to encourage PCPs and RNs to refer a broad range of patients to the BHC

10.F.10 Figure 10.10 BARRIERS to Using BHC BUB Questionaire

10.F.11 Figure 10.11 BARRIERS to Same-day Services (BUS) Questionaire

10.F.12 Figure 10.12 Example of a relapse prevention plan that BHCs can use as an educational tools

11.F.1 Figure 11.1 Dr. Gather’s schedule for Monday

11.F.2 Figure 11.2 Example of a BHC daily practice management sheet

11.F.3 Figure 11.3 Neurodevelopmental PCBH pathway statement

11.F.4 Figure 11.4. Janet’s Duke Health Profile scores at the initial and follow-up consultations

12.F.1 Figure 12.1 Handout for the Life Path Class