Area of Focus
Behavioral Health Integration in Primary Care
Access to behavioral health services is problematic for many children, adults and families, particularly in rural und underserved inner-city areas, where appointments can take two to six months to see a mental health provider. Consequently, many individuals initially seek help from their physicians (Family Medicine practitioner, Pediatrician, or Internist) for behavioral/mental health concerns, even though many of these primary care physicians report being uncomfortable and ill-prepared to address many of these behavioral presenting problems. As an alternative to referral to community providers, there is currently a national movement towards the integration of behavioral health into primary care medical practices, creating a “medical home” for patients in which their physical and behavioral health needs can be collaboratively addressed.
The Mid-America MHTTC supports integrated care efforts through training and technical assistance to health care systems, primary care practices, and behavioral health providers. While many training programs in this area have focused upon services to adults with mental health disorders, our MHTTC also covers behavioral health integration efforts in primary care practices serving children, adolescents and families. Training is delivered through on-site workshops, conference presentations, webinars, and courses which can be taken live or through distance learning platforms.
Other areas of emphasis offered by the Mid-America MHTTC include:
School Mental Health
Severe Mental Illness
Behavioral Health Workforce Development
Agency/Provider-initiated training topics
Integrated Behavioral Health Training
List of Modules
This module discusses the background and rationale for integrating behavioral health into primary care practices. The advantages of the integration of behavioral and physical health care for patients and their families, physicians, and behavioral health providers are highlighted. Helpful processes and procedures found in successful integrated care programs are described throughout. Dr. Evans ends the module with research findings supporting integrated care efficiency and effectiveness. Estimated completion time: 1 hour.
This module explains the importance of developmental monitoring and screening during the birth to 5 period of a child's life. The modules begin by discussing the impact of adverse childhood experiences on development. The differences between developmental monitoring and screening and the strengths of each measure are covered. Dr. Burt defines the role of a behavioral health provider in a primary care setting and provides resources to increase family and physician involvement in these assessment processes. Video examples are included that show children achieving or not achieving developmental milestones. Estimated completion time: 1.5 hours.
This module provides information about the composition and roles of special education team members, evaluations required for eligibility for special education, and the rights of parents whose children are identified as needing special education services. The presentation includes information on special education law, identifying IEP/IFSP team members, and preparing for a child’s IEP/IFSP meeting. The role of the integrated behavioral health provider in working with families and special educators is also discussed. Estimated completion time: 1 hour.
This module presents a formula describing how children learn and then describes different discipline options available for children. Dr. Allen describes time-out procedures in detail, including the different types of time outs, age-appropriate duration, and the evidence-based research that supports it. Ineffective strategies such as lecturing, grounding, and spanking are contrasted. Estimated completion time: 1 hour.
This module describes the different diagnoses related to anxiety in children and adolescents. A video case example of a specific phobia is provided by Dr. Valleley. The module concludes with different forms of assessments and treatment methods for anxiety disorders and a brief discussion of school refusal. Estimated completion time: 1.5 hours.
This module covers (CBT) and its primary components. Dr. Guck discusses the reciprocal interactions between environment, thoughts, emotions, behaviors, and physiology as they relate to . He describes methods such as the stages of change model, behavioral activation, preparatory and mobilizing change talk, and acceptance and commitment therapy as ways to motivate behavior change. Estimated completion time: 1.5 hours
This module describes the basics of the juvenile justice system process and the role of the integrated behavioral health professional (IBHP) in this process. Dr. Hill provides information on identifying characteristics of youth involved in the juvenile justice system and understanding mental health diagnoses most prevalent in youth involved in the juvenile justice system. She also describes behavioral intervention plans to reduce delinquent behavior and recidivism. Estimated completion time: 1 hour.
This module defines and its key processes. Dr. Guck provides useful strategies to help practitioners incorporate techniques, such the fundamental communication skills known as OARS, focusing, change talk and how to facilitate it, and how to negotiate a treatment plan with a patient. Estimated completion time: 1 hour
This module describes how (OCD) presents in children. Dr. Valleley provides guidelines for diagnosing children with OCD and follows with empirically supported treatments for OCD. Estimated completion time: 45 minutes.
Dr. Menousek describes the types of crisis situations that present in primary care settings, such as suicidality statements, self-harm, the threat to others, drug and alcohol abuse, and reporting of potential abuse or neglect. She provides information on assessment methods and treatment options for crisis situations. Estimated completion time: 1 hour.
This module describes behavioral screening methods available in primary care settings with a focus upon pediatric assessment measures. The importance of early identification of “potential” behavioral disorders is discussed along with methods to incorporate screening procedures into primary care visits. Collaboration between primary care practitioners and behavioral health providers use screening data to make referrals for formal evaluation and treatment. Several case examples are provided. Estimated completion time: 1 hour.
Dr. Evans discusses the historical perspective of the disorder currently known as Attention Deficit Hyperactivity Disorder. Information is presented on recommended procedures for diagnosing the three types of ADHD and behavioral treatments for this disorder in children and adolescents. Estimated completion time: 1 hour.
This module describes working with adolescents and parents in therapy. Topics addressed include effective and ineffective treatment strategies, ways to encourage both adolescents and parents to participate in treatment, and improving parent-child relationships. Finally, Dr. Evans describes an effective disciplinary strategy for adolescents. Estimated completion time: 1 hour.
Dr. Evans defines and the clinical and behavioral symptoms related to this diagnosis. The module emphasizes the need for physician involvement in ruling out other physical disorders and the role of the behavioral health professional in treating this condition. Historic and modern treatment options are discussed. Estimated completion time: 1 hour.
This module discusses working with teachers and the school system to improve individual child behavior as well as overall classroom management. Dr. Evans describes some basic interventions that can be implemented on an entire class, such as the good behavior game and individual behavior interventions such as home school notes and the “new friends” procedure for improving individual social involvement. Estimated completion time: 1 hour.
This module, narrated by Dr. Ellis, Developmental and Behavioral Pediatrician, discusses medications given to children for behavioral disorders. The first half of the module highlights the general principles of pharmacology, such as how drugs work on the nervous system and the rest of the body. In the second half of the module, Dr. Ellis describes classes of medications and specific drugs used on the child and adolescent population, with consideration given to their side effects. Estimated completion time: 1 hour.
Dr. Evans discusses as a bio-behavioral problem with many interacting genetic, physiological, and behavioral factors. This module covers historical treatments of as well as current treatment approaches. Use of behavioral interventions and medication management are discussed and contrasted. Estimated completion time: 1 hour.
This training session is sub-divided into five educational modules and provides information on the application of telehealth technology to behavioral health interventions. Starting with the history of telehealth and working up to current use and best practices. Dr. Higgins also discusses legal issues that could arise when using telehealth and provides a demonstration of telehealth software. Estimated completion time: 1 hour
This module by Dr. Evans covers the business aspects of integrated behavioral health in primary care practices. He discusses the pros and cons of various business models, practical considerations such as office costs, working with insurance, creating relationships with other healthcare providers, and lessons learned from previous clinics. Estimated completion time: 1.0 hours
Drs. Moore and Gomez introduce concepts for thinking about “multiculture” in mental health delivery systems. Age, race, gender, sexual orientation and demographics are discussed. The prevalence of mental illness in these various cultural groups is discussed as well as barriers to services that prevent group members from accessing behavioral services.
SBIRT (Screening, Brief Intervention, and Referral to Treatment) is a practice that is used to screen patients for substance use. Dr. Chasek provides a background on the prevalence of substance use and the importance of SBIRT. She describes the core components of SBIRT and the screening tools and treatment options that are available. The module ends with a simulation demonstrating SBIRT techniques.