Professional competencies and training needs of professional social workers in integrated behavioral health in primary care

Abstract: With the passage of the Patient Protection and Affordable Care Act (PPACA) and ongoing health care reform efforts, this is a critical time for the social work profession. The approaches and values embedded in health care reform are congruent with social work. One strategy is to improve care for people with co-morbid and chronic illnesses by integrating primary care and behavioral health services. This paper defines integrated health and how the PPACA promotes integrated health care through system redesign and payment reform. We consider how social workers can prepare for health care reform and discuss the implications of these changes for the future of the profession.

Abstract: Objective: Behavioral and physical health services are increasingly being integrated, with care provided by interprofessional teams of physicians, nurses, social workers, and other professi...

Abstract: This study presents preliminary feasibility and acceptability data on the use of virtual patient (VP) simulations to develop brief assessment skills within an interdisciplinary care setting. Results support the acceptability of technology-enhanced simulations and offer preliminary evidence for an association between engagement in VP practice simulations and improvements in diagnostic accuracy and clinical interviewing skills. Recommendations and next steps for research on technology-enhanced simulations within social work are discussed.

Abstract: The growth of the Primary Care Behavioral Health model (PCBH) nationally has highlighted and created a workforce development challenge given that most mental health professionals are not trained for primary care specialization. This work provides a review of the current efforts to retrain mental health professionals to fulfill roles as Behavioral Health Consultants (BHCs) including certificate programs, technical assistance programs, literature and on-the-job training, as well as detail the future needs of the workforce if the model is to sustainably proliferate. Eight recommendations are offered including: (1) the development of an interprofessional certification body for PCBH training criteria, (2) integration of PCBH model specific curricula in graduate studies, (3) integration of program development skill building in curricula, (4) efforts to develop faculty for PCBH model awareness, (5) intentional efforts to draw students to graduate programs for PCBH model training, (6) a national employment clearinghouse, (7) efforts to coalesce current knowledge around the provision of technical assistance to sites, and (8) workforce specific research efforts.

Abstract: This book is an attempt to demonstrate, through clinical cases from the authors’ experience, that collaboration between behavioral-health clinicians and medical treaters is not only possible, from clinical, financial, and administrative perspectives, it actually leads to improved outcomes The text comprises over 30 cases that take place in a variety of healthcare settings, demonstrating both the pitfalls of noncollaborative care and the success that can occur when behavioral and medical healthcare providers collaborate in a variety of ways The book is divided into several sections, with cases highlighting organizational issues along with focused topics in primary care, women’s health, specialty medical care, patients with chronic medical illness, psychiatric disorders in primary care, and pain The chapters are co-written by the psychologists, physicians, behavioral-health clinicians, and other treaters who provided the multispecialty care to the patients whose cases are discussed The book begins with a chapter by the editors titled “Primary Care Is the De Facto Mental Health System,” which reviews the data illustrating that most patients with mental illness present to nonpsychiatric/primary-care settings for treatment of medical complaints that may be complicated (or even caused) by their psychological conditions The authors further note that the current primary medical care system bears the cost for these untreated and undertreated diagnoses It is in this chapter that the editors frame their message: that the most effective treatment setting is a medical/psychological collaborative-care model in primary-care practice—calling this “the holy grail of medicine” The following chapter elucidates “The Three-World View” that is referred to in nearly all of the subsequent chapters as a model describing how healthcare organizations operate simultaneously in the clinical, financial, and operational worlds The multitude of cases that follow are generally quite readable and clear, although somewhat repetitive of the core message They take place in diverse geographic and treatment settings with a broad variety of payor systems, providing a large variety of examples of systems in which collaboration was effective The treatment settings described include staff model HMOs, emergency departments, community health centers in rural settings, multidisciplinary pain clinics in urban academic centers, and others While demonstrating the clear clinical benefit of communication, treatment planning, and professional respect among treaters of a single patient, each case also demonstrates the practical, financial, and administrative challenges encountered in contemporary medical systems Perhaps the most encouraging aspect of the text is the assortment of settings in which collaboration has worked to improve outcome, allowing for a more reasonable and measured use of resources, decreases in distress and physical symptoms, and lessened strain on an overtaxed healthcare system Overall, this book will be most helpful to primary-care physicians and healthcare administrators; in particular, those who are finding it challenging to access mental health treatment for their patients or who are interested in optimizing collaboration in their practices For most psychiatrists, especially for those who practice C–L psychiatry, the basic message (that interdisciplinary collaboration involving communication, respect, and a treatment plan that is understood and accepted by all involved) is likely a matter of course I would recommend this book to any clinician who treats patients with psychiatric and medical comorbidity and is attempting to create a collaborative practice This book is also useful for trainees who are attempting to understand the pitfalls and challenges associated with practice outside of academic medical centers, where collaborative connections are likely less established and so require the thoughtful approaches outlined in these cases

Abstract: The general view of descriptive research as a lower level form of inquiry has influenced some researchers conducting qualitative research to claim methods they are really not using and not to claim the method they are using: namely, qualitative description. Qualitative descriptive studies have as their goal a comprehensive summary of events in the everyday terms of those events. Researchers conducting qualitative descriptive studies stay close to their data and to the surface of words and events. Qualitative descriptive designs typically are an eclectic but reasonable combination of sampling, and data collection, analysis, and re-presentation techniques. Qualitative descriptive study is the method of choice when straight descriptions of phenomena are desired.

Abstract: Researchers and program developers in medical education presently face the challenge of implementing and evaluating curricula that teach medical students and house staff how to effectively and respect- fully deliver health care to the increasingly diverse populations of the United States. Inherent in this challenge is clearly defining educational and training outcomes consistent with this imperative. The traditional notion of competence in clinical training as a detached mastery of a theoretically finite body of knowledge may not be appropriate for this area of physician education. Cultural humility is proposed as a more suitable goal in multicultural medical education. Cultural humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and nonpaternalistic clinical and advocacy partner- ships with communities on behalf of individuals and defined populations.

Abstract: Chapter 1 Introduction Chapter 2 Planning the Digital Survey Chapter 3 Sampling Chapter 4 Writing Survey Questions Chapter 5 Designing and Developing the Survey Instrument Chapter 6 Conducting the Survey Chapter 7 Processing and Analyzing the Survey Data Chapter 8 Reporting the Survey Results Chapter 9 Concluding Comments Appendix A: American Association for Public Opinion Research, Code of Ethics Appendix B: Commonly Used Survey Questions

Abstract: Background: This research study evaluates the effectiveness of a multifaceted intervention program to improve the management of depression in primary care. Methods: One hundred fifty-three primary care patients with current depression were entered into a randomized controlled trial. Intervention patients received a structured depression treatment program in the primary care setting that included both behavioral treatment to increase use of adaptive coping strategies and counseling to improve medication adherence. Control patients received "usual" care by their primary care physicians. Outcome measures included adherence to antidepressant medication, satisfaction with care of depression and with antidepressant treatment, and reduction of depressive symptoms over time. Results: At 4-month follow-up, significantly more intervention patients with major and minor depression than usual care patients adhered to antidepressant medication and rated the quality of care they received for depression as good to excellent. Intervention patients with major depression demonstrated a significantly greater decrease in depression severity over time compared with usual care patients on all 4 outcome analyses. Intervention patients with minor depression were found to have a significant decrease over time in depression severity on only 1 of 4 study outcome analyses compared with usual care patients. Conclusion: A multifaceted primary care intervention improved adherence to antidepressant regimens and satisfaction with care in patients with major and minor depression. The intervention consistently resulted in more favorable depression outcomes among patients with major depression, while outcome effects were ambiguous among patients with minor depression.

Abstract: The World Wide Web (WWW) is increasingly being used as a tool and platform for survey research. Two types of electronic or online surveys available for data collection are the email and Web based survey, and they constitute the focus of this paper. We address a multitude of issues researchers should consider before and during the use of this method of data collection: advantages and liabilities with this form of survey research, sampling problems, questionnaire design considerations, suggestions in approaching potential respondents, response rates and aspects of data processing. Where relevant, the methodological issues involved are illustrated with examples from our own research practice. This methods review shows that most challenges are resolved when taking into account the principles that guide the conduct of conventional surveys.