Hear From Our Current Students

The professors were extremely passionate about various aspects of the field, and that passion translated into the classroom and made students really want to learn. The amount of knowledge I have gained has stuck with me as well. Even in a profession that isn't overtly related to anthropology, it's still the study of people, and having an understanding of how different people and cultures interact, exist, etc. has helped me be a better analyst that can examine a variety of different perspectives and address the biases that may impact my thinking processes. I have lived in several different countries in the past few years to pursue my Master's, and even living in a new place with an anthropologist mindset helped me assimilate into new ways of living, cultures, and interactions, the knowledge I gained wasn't just limited to classroom applications.

Kailyn Johnson, Cyberthreat Analyst, B.A., Class of 2016

"Through training in a primary care setting as a health behavior change consultant, I gained experience working with primary care providers and the electronic medical record system as part of a patient care team. I specifically trained in brief interventions for stress management, weight management, sleep, chronic pain, diabetes, smoking cessation, and panic attacks. In my training, I observed the incredible value of integrated care work and the clear impact psychologists can have in primary care.

While integrated behavioral health practice stands in contrast to ‘specialty’ practice in that it is brief, short-term, and directive; I found these elements to add substantially to the value of integrated behavioral health (IBH) in a fast-paced, high volume, collaborative medical setting without detracting from supportive, individualized care. I also thoroughly enjoyed participating in an integrated behavioral health environment due to the enhanced collaboration with other healthcare professionals, the volume and diversity of patient presentations, and the broad range of skills I was able to begin to develop in the significant, necessary field of behavioral health.

Indeed, while there is a lot in the world that cannot be changed, behavior can be modified. From my experience, integrated behavioral health works to make health behavior change achievable, and helps to put control back into the hands of people who are approaching lifestyle modification. Behavior and overall health are intricately intertwined, and I am certainly grateful for the opportunity to train in a field which is integral to enhancing well-being and reducing healthcare burden. I further look forward to learning more within IBH and am especially excited to apply knowledge acquired from IBH training to rural settings in my future."

Clinical Psychology Doctoral Student

The professors were extremely passionate about various aspects of the field, and that passion translated into the classroom and made students really want to learn. The amount of knowledge I have gained has stuck with me as well. Even in a profession that isn't overtly related to anthropology, it's still the study of people, and having an understanding of how different people and cultures interact, exist, etc. has helped me be a better analyst that can examine a variety of different perspectives and address the biases that may impact my thinking processes. I have lived in several different countries in the past few years to pursue my Master's, and even living in a new place with an anthropologist mindset helped me assimilate into new ways of living, cultures, and interactions, the knowledge I gained wasn't just limited to classroom applications.

Kailyn Johnson, Cyberthreat Analyst, B.A., Class of 2016

"Training in integrated care has forwarded my understanding of what it means to be a practicing clinician and expanded the scope of the clinical expectations I have for myself. Previously, I understood mental health as a distinct silo from physical health: doctors cure physical ailments, mental health providers alleviate mental symptomology. My integrated care experience has demonstrated that mental and physical health are not only intertwined, but often dependent on one another. In the integrated setting, I have experienced how enhancing someone's physical health (e.g. improved sleep, diet, exercise, and decreased stress) can curtail mental health barriers, promoting a healthier, more fulfilling life. For example, patients who have been able to improve the quality of their sleep, and exercise more regularly, have shared that they are less anxious, experience higher levels of self-worth and meaning in life, and have bettered their relationships with their loved ones.

Likewise, in my practice in more traditional specialty mental health care, I have witnessed how attenuating depressive and anxious symptomology can boost overall physical health and capacity to participate more fully in daily life. Through these traditionally "distinct" settings, I have come to honor the interconnected nature of mind and body, and have developed a professional obligation to address both in every setting in which I practice. I now regularly use techniques from the integrated care setting in my specialty mental health services. I view my role as an overall health practitioner, rather than one who is only concerned with traditional mental disorders. This newfound understanding and commitment to a more global approach to care has expanded the number of settings in which my work is integral, and advanced the services I provide to my patients.”

Clinical Psychology Doctoral Student

The professors were extremely passionate about various aspects of the field, and that passion translated into the classroom and made students really want to learn. The amount of knowledge I have gained has stuck with me as well. Even in a profession that isn't overtly related to anthropology, it's still the study of people, and having an understanding of how different people and cultures interact, exist, etc. has helped me be a better analyst that can examine a variety of different perspectives and address the biases that may impact my thinking processes. I have lived in several different countries in the past few years to pursue my Master's, and even living in a new place with an anthropologist mindset helped me assimilate into new ways of living, cultures, and interactions, the knowledge I gained wasn't just limited to classroom applications.

Kailyn Johnson, Cyberthreat Analyst, B.A., Class of 2016

It has been an honor to be able to gain training in integrated behavioral health (IBH). Despite being ostensibly divergent from traditional models of mental healthcare delivery, IBH represents a true expression of a psychological approach - understanding the interconnectedness of physical and mental health. The chronic pain group I co-facilitate is a good example of this. In it, we try to enhance the quality of patients’ lives with behavioral strategies that supplement their medical treatments, or provide a path forward after other options have been exhausted. During health behavior change consultations, I have seen how patient health is impacted by a number of glaring and impactful psychosocial factors. The inroads to improved health outcomes comes through behavioral intervention. Often, it is indecipherable which variables are causing the other, and behavioral strategies give patients, mental health professionals, and medical doctors greater opportunity for effective and lasting intervention.

Based on a population health model, IBH has also made me a more effective clinician who is capable of having a broader impact on my community. Not only does IBH meet people where they are at (the doctor’s office) and thus access populations that may not otherwise seek out mental health services, it also provides for expedient delivery of effective and evidence-based behavioral strategies that improve health outcomes. I have integrated some of these skills into my non-IBH clinical work as a result, and it has paid off in clinical outcomes driven by better stress management, lower substance use, and improved sleep, among others.

The determinants of health are not just constrained to the field of medicine. As a psychologist-in-training, I have become convinced of the role of behavioral medicine in contributing to overall well-being, and have seen this in practice in integrated models of care. I hope to continue being involved in this field, helping to narrow the divide between medicine and behavioral health for the mutual benefit of these disciplines and more importantly, for the optimization of the lives of individuals in our care.

Clinical Psychology Doctoral Student

Student perspective after attending the 2018 Rochester Behavioral Health Integration Annual Symposium:

In the two and a half days of the conference, I was able to attend presentations ranging from new approaches to treating chronic pain in primary care, to critical components to make teams function effectively (in healthcare and beyond), to developing data management systems for quality improvement in integrated care settings, to how to use Electronic Medical Record data to formulate and answer real-world questions about care, to a systematic review of patient outcomes associated with PCBH services, to stigma’s effect on African Americans’ engagement with mental health treatment in primary care, to a conversation with the editors of the journal, Families, Systems and Health, and beyond.

The scope of the conference was wide, as the 600+ attendees represented professionals from several disciplines – administrators, behavioral health professionals, medical providers, researchers, and others. This made for great interdisciplinary discussion and also meant that people approached every workshop and presentation from rather distinct backgrounds.

It makes sense that everyone attending the conference seemed to be a champion and advocate for integrated care. Some clinics had been using some form of integration since the 1990s, while others were brand new to (but sold on) the topic. In the 20 years that CFHA has been in existence and held conferences, the 2018 conference was the most well-attended. Attendance grew by more than 150 attendees from the previous year, and an explanation of this growth is that integrated care continues to grow and is the future of how healthcare will be delivered and billed for (using value-based payment systems). The Director of CFHA, Neftali Serrano, PhD, explained that the location of the conference was intentional, as Rochester, NY is the birthplace of George Engel, the physician who initially made the call for the “biopsychosocial model” in the 1970s. This was appropriate, given that the spirit behind Engel’s model lives on in the work of CFHA and in the members attending the conference.

I found it especially useful to learn from other clinicians about researching integrated care outcomes. For instance, in one presentation documenting integrated care among federally qualified health centers (FQHC’s) in Philadelphia, researchers chose to use two measures to identify the level of integration of each site – the Integrated Practice Assessment Tool (IPAT) and the Self-Assessment Checklist for Integrating Behavioral Health. I was familiar with the former measure, but was new to the Integration Self-Assessment Checklist, an interesting 37-item measure. These researchers found that using both tools helped them get a better understanding of a particular site’s level of integration, as well as allowing them to break down the specific components of integrated care that co-varied with other clinic qualities.

I was also able to learn from clinicians at sites similar to where I do my supervised clinical work (Partnership Health Center in Missoula, MT). Individuals working in family medical residency programs in Federally Qualified Health Centers throughout the country have found unique ways to integrate clinical psychology students, including allowing them to conduct shared visits with medical residents. Additionally, they are often available for warm hand-offs. I think these concepts could potentially be integrated into the places where I work. I feel fortunate to have attended this conference, and energized to bring some of the ideas I learned into my research and clinical work.

Why should I care about IBH?

The behavioral and physical health care systems are in transition. The integration of Behavioral Health into the Primary Care setting is a movement which is gaining momentum due to the passage of the Affordable Care Act in 2010. More and more, employers expect professionals to have integrated health skills to serve consumers in a changing service delivery environment. Up to 75% of all mental health care is delivered in the primary care setting.

What is a behavioral health specialist?

Behavioral health specialists (BHS) have a wide breadth of knowledge that spans general health problems, common clinical health psychology problems, as well as child and family problems. General health problems may include generalized anxiety disorder, panic, post-traumatic stress, bereavement, mood disorders, eating disorders, substance misuse or abuse and somatization. Common clinical health psychology problems seen in a primary care setting may include chronic pain, diabetes, HIV/AIDS, obesity, hypertensions, sleep disorders, cardiovascular disease, sexual disorders, tobacco misuse or dependence, and women's health issues. BHS's also help with child and family problems such as developmental disorders, Autism spectrum disorder, ADHD, conduct disorders, learning disabilities, pediatric health, asthma, and family problems cause by parenting skills and relationship difficulties. These are only examples of the breadth of knowledge behavioral health specialist can receive referrals for.

Often, psychological roles are conceptualized as highly specialized, hour-long appointments with a single, couple, or family-based client. However, in the primary care setting, BH's aim to use brief consulting or warm handof session efficiently

usually within the same day as the patient's primary care appointment. They often see patients consecutively throughout the day, and aim to treat the patient's symptoms in four sessions or less. We often consult and collaborate with primary care providers to implement intermittent visits strategies and flexible patient contact strategies to best treat all of the patient's physical and mental health symptoms. BHS's are able to use brief consultation methods to triage a patient's mental health status and level of chemical dependency in order to better facilitate case management, referrals, and treatment recommendations. Flexibility is key within the primary care setting, and BHS's should be prepared to provide unscheduled services when needed, build and maintain relationships with all staff members, be available for on-demand phone consultations, and work to equalize the load carried by the professionals within the building.

As a part of the integrated team in a primary care settings BHS's understand the organizational mission, and the policies and procedures of the practice. They are trained to understand and apply risk management protocols, adhere to the ethical standards of the practice, and follow professional standards. Administratively, BHS's document patient referrals, treatment, and consultation in a timely way, and are trained and complete electronic health records and billing activities in a timely way.

Are there resources to support my studies of IBH?

Yes, UM offers several opportunities to support students interested in IBH. Click the button below to find out more information!

Sources adapted from:
Robohm, J. (2014) Core characteristics of Primary Care ethics. Presentation: Getting started as a behavioral health consultant.

The work upon which this web site is based was funded through a grant awarded by the Montana Healthcare Foundation.

Disclaimer: The statements and conclusions on this site are those of the Grantee and not necessarily those of the Montana Healthcare Foundation. The Montana Healthcare Foundation makes no warranties, express or implied, and assumes no liability for the information contained on this site.