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1.
Dogukan Ulupinar Carlos Zalaquett So Rin Kim Jonna M. Kulikowich 《Journal of counseling and development : JCD》2021,99(1):37-46
Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed. 相似文献
2.
Michael K. Schmit Joshua C. Watson Mary A. Fernandez 《Journal of counseling and development : JCD》2018,96(1):3-14
Using a quasi‐experimental, pre–post test design of 196 persons diagnosed with serious mental illness, the authors compared the effectiveness of an integrated behavioral and primary health care (IBPH) treatment approach vs. a treatment‐as‐usual approach over a 12‐month period. A profile analysis of 5 mean difference scores, each representing a separate component of client holistic functioning, indicated that individuals receiving IBPH experienced a 24‐times greater improvement in overall functioning. Recommendations for treatment and client care are provided. 相似文献
3.
Integrated Primary Care: An Inclusive Three-World View Through Process Metrics and Empirical Discrimination 总被引:1,自引:1,他引:0
Benjamin F. Miller Tai J. Mendenhall Alan D. Malik 《Journal of clinical psychology in medical settings》2009,16(1):21-30
Integrating behavioral health services within the primary care setting drives higher levels of collaborative care, and is
proving to be an essential part of the solution for our struggling American healthcare system. However, justification for
implementing and sustaining integrated and collaborative care has shown to be a formidable task. In an attempt to move beyond
conflicting terminology found in the literature, we delineate terms and suggest a standardized nomenclature. Further, we maintain
that addressing the three principal worlds of healthcare (clinical, operational, financial) is requisite in making sense of
the spectrum of available implementations and ultimately transitioning collaborative care into the mainstream. Using a model
that deconstructs process metrics into factors/barriers and generalizes behavioral health provider roles into major categories
provides a framework to empirically discriminate between implementations across specific settings. This approach offers practical
guidelines for care sites implementing integrated and collaborative care and defines a research framework to produce the evidence
required for the aforementioned clinical, operational and financial worlds of this important movement. 相似文献
4.
Richard S. Balkin A. Stephen Lenz Julia Dell'Aquila Halie M. Gregory Miranda N. Rines Katelyn E. Swinford 《Journal of Addictions & Offender Counseling》2019,40(2):84-95
This meta‐analysis detected low effects in reducing substance use (Hedges's g = –0.11) in favor of using integrated primary and behavioral health care (IPBH) compared with treatment‐as‐usual approaches for adult patients with substance use. The impact of IPBH was limited. 相似文献
5.
Karen M. Zygowicz Stephen M. Saunders 《Journal of clinical psychology in medical settings》2003,10(2):71-77
Many healthcare professionals argue that mental health assessment should be routinely incorporated into young adults' medical health care. This project is an evaluation of the Behavioral Health Screening Measure (BHSM) that could be integrated into a primary healthcare setting to aid in the identification of mental illness in young adults. First, Receiver Operating Characteristics analysis was used to calculate a cutoff score that distinguishes a sample of 134 young adult outpatients and 233 young adult nonpatients. Second, a sample of 120 young adults that completed BHSM was divided into two groups by using the cutoff score. Analyses suggested that the two groups had significantly different scores on various measures of depression, anxiety, and general well-being. Results suggest that BHSM would be a valid screening instrument for detecting emotional problems in young adults. 相似文献
6.
Patricia J. Robinson Kirk D. Strosahl 《Journal of clinical psychology in medical settings》2009,16(1):58-71
This article provides an overview of 20 years of professional experiences with developing and implementing a model for integrating
behavioral health services into primary care. The Primary Care Behavioral Health (PCBH) model is designed to provide immediate
access to behavioral care for a large number of primary care patients by positioning a behavioral health consultant in the
exam room area to function as a core member of the primary care team. In an initial era of discovery, the authors were directly
involved in developing and testing a variety of new approaches to providing behavioral health services in general medicine.
In a second era focused on feasibility, the authors worked with Kaiser Permanente, the United States Air Force and Navy, the
Veteran’s Administration, and the Bureau of Primary Care to system test this innovative model of integrated care. Now in an
era devoted to dissemination, the authors review the various roles formal research, system level quality improvement initiatives
and stakeholder analysis play in promoting integrated care. The authors also describe current efforts to (1) create a tool
that helps systems develop integration targets and (2) use the PCBH model as a platform for teaching medical residents and
behavioral health providers to work together in a redesigned primary care team model. 相似文献
7.
Addressing the Workforce Crisis in Integrated Primary Care 总被引:1,自引:1,他引:0
F. Alexander Blount Benjamin F. Miller 《Journal of clinical psychology in medical settings》2009,16(1):113-119
8.
William T. O’Donohue Nicholas A. Cummings Janet L. Cummings 《Journal of clinical psychology in medical settings》2009,16(1):94-100
One of the reasons integrated care has not become a dominant service delivery model is the unmet training agenda. This article
argues that the typical mental health professional is not trained to adequately address the challenges of integrated care.
To insure competency both a macro and clinical training agenda are needed. At the macro-level, mental health professionals
need to understand healthcare economics and basic business principles as any integrated care service delivery system is embedded
and driven by economic forces. Integrated care practitioners also need some basic business skills to understand these forces
and to create and manage a financially viable system, given the future flux of the system. Traditional mental health professionals
also do not have the clinical skills to implement integrated care. Integrated care is not simply placing a traditionally trained
mental health professional and letting them practice specialty mental health in a medical setting. Thus, the special skills
needed in integrated care are enumerated and discussed. Finally, a new degree program is described as it is time given the
huge need and advantages of integrated care to develop specialty training in integrated care. 相似文献
9.
Gail E. Wright Jerry C. Parker 《Journal of clinical psychology in medical settings》1999,6(2):203-210
The Veterans Health Administration under the direction of Kenneth Kizer, M.D., has faced the challenge of providing high-quality health care while controlling costs. Under Dr. Kizer's direction, VA hospitals are moving toward managed patient centered primary care. Hospital organization, funding, and clinical practices have been changed. Reorganization has meant a variety of possibilities for psychologists employed in the VA system. 相似文献
10.
11.
《Cognitive and behavioral practice》2021,28(4):481-491
The coronavirus disease 2019 (COVID-19) pandemic has consistently been described as an “unprecedented” global health crisis. While the focus has been primarily on the medical and economic impact of the pandemic, psychological sequelae are anticipated. Primary care is the main point of access for mental health care in the United States, making it the ideal locale to provide psychological services for a larger proportion of the population than traditional mental health care settings. The aim of this paper is to describe how our multi-state, multi-site integrated primary care program adapted and applied cognitive behavioral therapy in the context of COVID-19. Access to mental health care was disrupted despite burgeoning mental health concerns, necessitating novel approaches to providing care. A stepped-care approach was implemented within our primary care practice, which consisted of a combination of low-intensity, high-yield stress management and resiliency building resources and cognitive behavioral therapy that were delivered flexibly based on patient preference, technological capabilities, state ordinances, insurance coverage, and institutional policies. The lessons learned from this experience can inform other integrated primary care clinics in responding to the current and future pandemics. 相似文献
12.
Susan H. McDaniel Pieter LeRoux 《Journal of clinical psychology in medical settings》2007,14(1):23-32
This paper describes the application of family psychology to the primary care setting—in service, education and training,
and scholarship. Primary care family psychology integrates family systems with biopsychosocial theory, yielding an approach
that is uniquely suited to the generalist demands of primary care. This approach attends especially to the effects of relationships
on health and healthcare, using the family as a potential resource to the patient just as the healthcare team is a resource
to the clinician. Training opportunities in primary care family psychology are growing. The University of Rochester School
of Medicine and Dentistry fellowship is described as an example, with core primary care family psychology training in four
different clinical sites: Family Medicine, Internal Medicine, Pediatrics, and Obstetrics/Gynecology.
Susan H. McDaniel is Professor of Psychiatry & Family Medicine, Director of Family Programs & the Wynne Center for Family
Research in Psychiatry, and Associate Chair of Family Medicine, University of Rochester School of Medicine and Dentistry,
Rochester, New York. Dr McDaniel also directs the Primary Care Family Psychology Fellowship.
Picter LeRoux is Associate Professor of Psychiatry & Pediatrics, and Director of the Family Therapy Training Program in Psychiatry,
University of Rochester School Medicine and Dentistry, Rochester, New York. Dr. LeRoux also heads the Pediatric Track of the
Primary Care Family Psychology Fellowship. 相似文献
13.
We review factors that influence children's use of primary health care services. Predictors of pediatric health care use include child health status, child mental health, parent and family functioning, demographic characteristics, and access to health care services. Health services research is marked by inconsistencies due to varying approaches to measurement, population sampling, and analysis, and models that do not incorporate situational factors. We present recommendations for practicing clinicians and discuss suggestions for future research to help identify additional factors that may influence a parent's decision to seek help from pediatric physicians. Health care use is determined by multiple factors, and complex models will lead to improved strategies for maximizing health status and establishing optimal pediatric care. 相似文献
14.
Melinda A. Stanley Gretchen J. Diefenbach Derek R. Hopko Diane Novy Mark E. Kunik Nancy Wilson Paula Wagener 《Journal of psychopathology and behavioral assessment》2003,25(4):273-280
Clinical features of older primary care patients with GAD (PC-GAD; n = 22) were examined relative to older patients with GAD recruited for two academic clinical trials (M. A. Stanley, J. G. Beck, et al., 2003; J. L. Wetherell, M. Gatz, & M. G, Craske, 2003) and to a sample of older primary care patients without psychiatric diagnoses (No Dx; n = 10). Comparisons revealed similar levels of worry, anxiety, depressive symptoms, quality of life, and functional status between the PC-GAD subsample and patients recruited for academic trials, although primary care patients were older, less well educated, and more ethnically diverse. The PC-GAD subgroup, however, reported greater symptom severity, reduced quality of life, and poorer perceived general health, mental health, and vitality than the No Dx subgroup (2 = .23–.43). Service utilization was not different between PC-GAD and No Dx subgroups, with the exception of psychotropic medication use. The Penn State Worry Questionnaire (PSWQ) and an abbreviated version of this measure may be useful for identifying late-life GAD in primary care. Cutoff scores of 50 and 22 on the full and abbreviated versions of the PSWQ, respectively, demonstrated excellent specificity, sensitivity, and positive predictive value. Negative predictive value was less impressive, probably as a result of high base rates for GAD in this sample. 相似文献
15.
Holly L. Miller Scott E. Hall Sawyer A. Hunley 《Journal of Contemporary Psychotherapy》2004,34(2):117-124
A study was conducted to identify value perceptions of primary care physicians and Professional Clinical Counselors on integrative health care. Surveys were collected from 54 primary care physicians and 33 Professional Clinical Counselors in Central Ohio. Quantitative and qualitative results indicate favorable perceptions and opportunities for professional collaboration. 相似文献
16.
《Journal of aggression, maltreatment & trauma》2013,22(1-2):541-552
Abstract Living through a terrorist event or under threat of attack affects both mental and physical health. A nation's primary care system plays a critical role under such circumstances. This article reviews the American experience after September 11, 2001 and advocates for integration of mental and physical health services in primary care settings as a key counter-terrorism strategy. Americans put their trust in primary care providers. The nation's healthcare system must develop and implement a strategy that informs and supports primary care providers in meeting the mental health needs of a nation confronted by terrorism. 相似文献
17.
Rodger Kessler Dale Stafford Randall Messier 《Journal of clinical psychology in medical settings》2009,16(1):4-12
Psychology and other behavioral health professions have amassed a broad empirical and clinical literature suggesting many
medical presentations are best responded to with the addition of evidence based behavioral interventions. Despite this, psychology
has not achieved a regular presence as part of medical practice. We suggest specific reasons for the current state of affairs
including clinical, operational, societal labels, financial and training dimensions. Medical, psychological, administrative,
and financial perspectives are reviewed. If the goals of health care system reform are to be reached then we must identify
and challenge the current limitations of health care. This paper will identify the elements that need to be changed in order
for psychology to be integrated into medicine rather than excluded from its policy, planning and operations. 相似文献
18.
19.
Sean D. Roberts Daniel Stroud Matthew J. Hoag Katie E. Massey 《Journal of counseling and development : JCD》2017,95(1):45-55
This article details a 3‐year outdoor behavioral health care outcome study. Hierarchical linear modeling was used to analyze data from 186 young adults in a wilderness therapy program. Participants completed the Outcome Questionnaire–45.2 (Lambert et al., 2004 ) 6 times from Week 1 to 18‐month postdischarge follow‐up. Results indicated that clinically and statistically significant change occurred in treatment. Rates of change varied, and posttreatment scores remained stable, thus demonstrating that in‐treatment gains were maintained. Implications and recommendations for future research are discussed. 相似文献
20.
王红漫 《医学与哲学(人文社会医学版)》2005,(15)
集中梳理和总结有关中国农民初级卫生保健,特别是农村卫生投入和补偿机制、农村公共卫生和预防保健的文献,结合实地调研中发现的问题和矛盾,分析当今中国初级卫生保健的倾向、面临的问题,和当前我国卫生资源科学、合理利用以及可持续发展的滞碍所在,从理论与实证研究的角度提出未来的工作方向和政策建议。 相似文献