Integrated Behavioral Health in Primary Care: Step-by-Step Guidance for Assessment and Intervention

As many as 70% of primary care visits in the United States are related to behavioral health needs. Additionally, many common medical problems seen in primary care involve poor health habits that may initiate, exacerbate or perpetuate symptoms and poor functioning. Unfortunately, health care providers often lack the time and/or training to help patients manage these problems in evidence-based ways beyond medication prescriptions.

The authors of this book draw on research evidence and years of experience to provide practical information and guidance for health care practitioners, especially behavioral health care providers who wish to work more effectively in this fast-paced setting.

Interwoven through each chapter are practical tips for success and traps to avoid. The book includes a rich array of reproducible assessment questions, patient handouts, and sample scripts. All of these help the clinician alter his or her assessment and intervention skills in a manner that leads to focused interactions that work well within the fast pace of primary care.

Detailed guidance is provided for these common health problems: generalized anxiety disorder, panic disorder, depression, tobacco use, weight issues, sleep problems, diabetes, asthma, irritable bowel syndrome, cardiovascular disorders, pain disorders, and sexual problems. Special chapters cover cultural competency, special concerns for older adults, and "health anxiety."

A companion website has been created for purchasers of this book. In it they will find downloadable copies, for noncommercial use, of the many useful forms and patient handouts available in the book.

This comprehensive book belongs on the bookshelf of a range of clinicians including psychologists and social workers, as well as family physicians, physician assistants, nurses, and health care educators.

These four highly experienced behavioral health consultants (BHCs) use the 5A's model of behavior change (assess, advise, agree, assist, arrange) to offer insightful instruction to medical and behavioral health providers working together in primary care settings. Relying on rigorous reviews of evidence as well as creativity derived from experience, the authors methodically address the most common problems in primary care, ranging from postpartum depression to prescription medication abuse. This is a desktop reference for practicing BHCs and a basic text for health psychology and medical social work students.
--Patricia J. Robinson, PhD, author of Behavioral Consultation and Primary Care and Treating Depression in Primary Care

This text is the `missing behavioral link' for the family physician. It is both The 5-Minute Consultant and a valuable reference text all wrapped up in one. I will use it often and heartily recommend it to colleagues who want to provide better care.
--Thomas McKnight, MD, MPH, AFR, Col., Family Medicine Clinic, Hurlburt Field, FL

The authors have provided an extraordinary set of resources for behavioral health professionals working in primary care. They offer a useful conceptual framework to guide practice as well as a toolbox replete with sample transcripts, checklists, and patient handouts.
--Cynthia D. Belar, PhD, ABPP, Executive Director, Education Directorate, American Psychological Association; coauthor of Clinical Health Psychology in Medical Settings: A Practitioner's Guidebook, Second Edition

This book describes and embodies the best of behavioral health consultant practice. It is focused, economical, practical, and capable of making a crucial difference. It gives the reader a plethora of useful tools and careful instructions on how to use them. It is grounded in evidence and built on experience. I think its usefulness will keep growing as behavioral health practice in primary care grows beyond co-located separate services into an integrated approach that is as undifferentiated as the needs of the patients we serve.
--Alexander Blount, EdD, Director of Behavioral Science, Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worster

This timely volume is important for all administrators, psychologists, and physicians who focus on the reality that there is no effective primary health care without the integration of medicine and psychology. The authors have gone through the trials, tribulations, and successes of generating behavioral health and medicine collaboration. Through this volume they share the insight and knowledge gained from their initiatives.
--Rodger Kessler, PhD, ABPP, Berlin Family Health, Fletcher Allen Health Care, Montpelier, VT