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Journal ArticleDOI

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

12 Sep 2013-Social Work in Health Care (Soc Work Health Care)-Vol. 52, Iss: 8, pp 752-787
TL;DR: Results indicate that social workers feel prepared for general practice in IBH settings, but would benefit from additional training in IBh-specific competency areas identified in the survey, which can help guide social work training to improve workforce preparedness for practice inIBH settings in the wake of health care reform.
Abstract: The Affordable Care Act has led to a widespread movement to integrate behavioral health services into primary care settings. Integrated behavioral health (IBH) holds promise for treating mild to moderate psychiatric disorders in a manner that more fully addresses the biopsychosocial spectrum of needs of individuals and families in primary care, and for reducing disparities in accessing behavioral health care. For behavioral health practitioners, IBH requires a shift to a brief, outcome-driven, and team-based model of care. Despite the fact that social workers comprise the majority of behavioral health providers in IBH settings, little research has been done to assess the extent to which social workers are prepared for effective practice in fast-paced primary care. We conducted a survey of social workers (N = 84) in IBH settings to assess the following: (1) Key competency areas for social work practice in IBH settings and (2) Self-rated preparedness for effective practice in IBH settings. Online snowball sampling methods were used over a period of 1 month. Results indicate that social workers feel prepared for general practice in IBH settings, but would benefit from additional training in IBH-specific competency areas identified in the survey. Findings can help guide social work training to improve workforce preparedness for practice in IBH settings in the wake of health care reform.
Citations
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Journal ArticleDOI
TL;DR: An approach to practice is described in which social workers integrate micro, mezzo, and macro practice efforts across service systems and, along with allied health and social service professionals, effectively and efficiently address major problems of living within the environmental context.
Abstract: Establishing a prevention-focused integrative approach to practice is of critical importance for social work. The Affordable Care Act promotes a shift from fragmented health care delivery toward integrated models of service delivery that emphasize prevention. This shift prompts the need for practitioners who understand the interrelationship among mental health, substance use, and physical health care, and who are prepared to address these needs through a collaborative prevention-focused approach. This article describes such an approach to practice in which social workers integrate micro, mezzo, and macro practice efforts across service systems and, along with allied health and social service professionals, effectively and efficiently address major problems of living within the environmental context. Suggestions regarding curriculum implementation and policy advocacy are discussed.

9 citations


Cites background from "Professional competencies and train..."

  • ...As a start, Horevitz and Manoleas (2013) have detailed professional competencies and training needs of professional social workers in integrated health settings....

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  • ...Social workers, who are trained as generalists with a biopsychosocial perspective, are likely candidates for filling behavioral health roles in primary care (Horevitz & Manoleas, 2013)....

    [...]

Journal ArticleDOI
TL;DR: In this paper, a growing need to prepare social workers capable of providing integrated behavioral health care in multidisciplinary settings serving at-risk youth is identified. But, the need to train social workers is not addressed.
Abstract: Recent workforce trends in healthcare point to a growing need to prepare social workers capable of providing integrated behavioral health care in multidisciplinary settings serving at-risk youth. T...

8 citations

Journal ArticleDOI
TL;DR: Preliminary evaluation results from the initial implementation of the IMBTP within an MSW program which emphasizes rural practice suggest that an intentional focus on relationships enhances the knowledge-building and skill development that are inherently emphasized in most training programs.
Abstract: The provision of behavioral health care services is dramatically changing. Specific components of the Affordable Care Act (ACA) encourage states to develop integrated models of service delivery that emphasize preventative services. This shift prompts the need for providers who understand the interrelationship among physical and behavioral health and who are prepared to practice in an interprofessional and team-based approach. This article presents preliminary evaluation results from the initial implementation of the Integrated Mental and Behavioral Health Training Program (IMBTP) within an MSW program which emphasizes rural practice. The IMBTP is funded through federal grants aimed at increasing the number of behavioral health providers nationwide. Results suggest that an intentional focus on relationships enhances the knowledge-building and skill development that are inherently emphasized in most training programs. Including opportunities for relationship-building both among trainees and with program faculty, clinical supervisors, and interprofessional colleagues may improve learning outcomes in behavioral health training programs.

8 citations


Cites background from "Professional competencies and train..."

  • ...Implementation of these policy changes has led to widespread efforts to integrate behavioral health services in primary care settings, resulting in a pressing need for more well-trained behavioral health providers (Horevitz & Manoleas, 2013; Mechanic, 2012)....

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Journal ArticleDOI
TL;DR: In this paper, the authors examined child temperament, maternal parenting stress, and maternal-child interaction as predictors of child health, while controlling for poverty, parental relationship status, and the number of children in the household factors known to impact health.
Abstract: Considering the relationship between maternal and child factors that influence child health is key to understanding child wellbeing. Several studies have considered the contributions of familial and environmental factors on child health outcomes. Expanding on this research, this study examines child temperament, maternal parenting stress, and maternal–child interaction as predictors of child health, while controlling for poverty, parental relationship status, and the number of children in the household factors known to impact health. Multinomial regression analysis of the Fragile Families and Child Wellbeing Study year one data set, n = 3712, was conducted to test three hypotheses: higher child emotionality will be predictive of lower child health rating, higher parenting stress will be predictive of lower child health ratings, and, higher levels of maternal–child interaction will be predictive of higher child health ratings. Findings indicated that all study variables were significant predictors of child health ratings [− 2 Log likelihood = 6657.40, χ2 215.661, p < .001, Nagelkerke R2 .067], demonstrating the importance of temperament, parenting stress, and maternal–child interaction when considering child health. Social workers working with children and families in a variety of settings may want to target these factors to improve health outcomes of children.

7 citations

Journal ArticleDOI
TL;DR: This article explored field supervisors' and students' perceptions of how well-prepared graduates are in general and specific clinical competencies, and found that a significant consensus around perceptions of competencies for which graduates are prepared as well as those with which they struggle.
Abstract: In 2008 the Council on Social Work Education made the decision to adopt a competency based assessment as a requirement for re-accreditation. The 2015 EPAS recommends extending the broad competencies for specialty practice, and also further defining the broad competencies into more specific skills. This study explored field supervisors’ and students’ perceptions of how well-prepared graduates are in general and specific clinical competencies. The study was a mixed method design that included a quantitative survey and follow-up focus groups. Results suggested a significant consensus around perceptions of competencies for which graduates are prepared as well as those with which they struggle. This article presents both qualitative and quantitative findings of the study and their implications for increased coordination between faculty of graduate social work programs and field representatives.

7 citations

References
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Journal ArticleDOI
TL;DR: The general view of descriptive research as a lower level form of inquiry has influenced researchers conducting qualitative research to claim methods they are really not using and not to claim the method they are using: namely, qualitative description.
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.

9,029 citations


Additional excerpts

  • ...Consistent with recommendations for descriptive qualitative research (Sandelowski, 2000) the authors then met to discuss themes and to ensure agreement on key themes in the respondents’ answers....

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Journal ArticleDOI
TL;DR: Cultural humility is proposed as a more suitable goal in multicultural medical education that incorporates a lifelong commitment to self-evaluation and self-critique and to developing mutually beneficial and nonpaternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.
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.

2,277 citations


"Professional competencies and train..." refers background in this paper

  • ...For example, Tervalon and Murray-Garcia (1998) describe the concept of “cultural humility,” which places the clinician in a fundamentally different juxtaposition with the patient....

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Book
23 Nov 2011
TL;DR: This chapter discusses the design and development of the Survey Instrument, and the challenges faced in processing and Analyzing the Survey Data.
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

1,059 citations


"Professional competencies and train..." refers background in this paper

  • ...Because there is no database of IBH clinics (i.e., no known population) (Selm & Jankowski, 2006), links to the survey were sent out to IBH listservs and posted on professional message boards such as www.cfha.net, part of the Collaborative Family Health Care Association, a national professional…...

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Journal ArticleDOI
TL;DR: A multifaceted primary care intervention improved adherence to antidepressant regimens and satisfaction with care in patients with major and minor depression.
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.

822 citations


"Professional competencies and train..." refers background in this paper

  • ...The latter is consistent with several evidence-based interventions that emphasize manualized treatment and clinical algorithms (stepped care) for depression and anxiety such as the IMPACT trials and the CALM studies (Areán al., 2008; Ayalon, Areán, Linkins, Lynch, & Estes, 2007; Katon et al., 1996)....

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Journal ArticleDOI
TL;DR: This methods review shows that most challenges are resolved when taking into account the principles that guide the conduct of conventional surveys.
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.

758 citations

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Integrated behavioral health (IBH) holds promise for treating mild to moderate psychiatric disorders in a manner that more fully addresses the biopsychosocial spectrum of needs of individuals and families in primary care, and for reducing disparities in accessing behavioral health care.