Working With Medical Patients in Integrated Primary Care
For individuals in the U.S. & U.S. territories
The expansion of behavioral health integration in primary care settings over the past two decades has been facilitated by significant developments in models of integrated care.
In the primary care behavioral health model of integration, clinicians are integrated into primary care as behavioral health consultants to provide focused, evidence-based assessment and intervention to patients as well as consultative recommendations to the primary care provider. This arrangement of systemic and holistic care encourages patients and families to learn and implement self-management strategies that improve functioning and quality of life while also decreasing symptoms.
In this video program, Dr. Anne Dobmeyer demonstrates her work as a behavioral health consultant with a patient who is experiencing difficulties with managing diabetes, and shows also how a psychologist and primary care physician work together to provide seamless, team-based care.
The primary care behavioral health model of service delivery is a population-health model in which behavioral health clinicians function as integrated primary care team members to improve the primary care treatment of a wide range of behavioral health conditions, adverse health behaviors, and chronic medical problems.
As behavioral health consultants (BHCs), clinicians provide focused, evidence-based assessment and intervention to patients, as well as consultative recommendations to the primary care provider (PCP). Patients and families work with the BHC to learn and implement self-management strategies to improve functioning and quality of life and to decrease symptoms. BHCs provide verbal feedback to PCPs on each patient, including recommendations for specific actions the PCP can take during future interactions with the patient.
Appointments with the BHC typically last 20 to 30 minutes, and episodes of care for a particular problem often range from 1 to 4 appointments. Mirroring the pace of primary care, BHCs see a large volume of patients, often meeting with 10 to 14 patients per day.
The use of brief appointments and shorter courses of care allows services to be provided to a high volume of patients, consistent with a population health approach. Patients who need more intensive, specialized mental health treatment are referred to higher levels of care in a stepped care approach.
BHCs provide services for a wide range of conditions and patient populations.
Services are available to patients across the age spectrum, and may focus on improving health behaviors, managing chronic illness, preventing onset of health or mental health problems, addressing sub-clinical mental health symptoms, or treating clinical mental health disorders (Strosahl, 1998; Robinson & Reiter, 2016; Hunter, Goodie, Oordt, & Dobmeyer, 2017; Dobmeyer, 2017).
Anne C. Dobmeyer is a board certified clinical health psychologist who has been actively involved in implementation and training in integrated primary care for the past 16 years. She has established fully integrated primary care behavioral health services in family medicine, internal medicine, and women's health clinics, and provided training and consultation to clinics and medical centers across the country.
Her publications and presentations primarily focus on training, implementation, and evaluation of integrated primary care programs.
Dr. Dobmeyer obtained her PhD from Utah State University and completed a post-doctoral fellowship in clinical health psychology at Wilford Hall Medical Center. She has served as president of the American Board of Clinical Health Psychology and is currently a trustee of the American Board of Professional Psychology.
- Dobmeyer, A. C. (2013). Primary care behavioral health: Ethical issues in military settings. Families, Systems, and Health, 31, 60–68.
- Dobmeyer, A. C. (2017). Psychological treatment of medical patients in integrated primary care. Washington, DC: American Psychological Association.
- Dobmeyer, A. C., Hunter, C. L., Corso, M. L., Nielsen, M. K., Corso, K. A., Polizzi, N. C., & Earles, J. E. (2016). Primary care behavioral health provider training: Systematic development and implementation in a large medical system. Journal of Clinical Psychology in Medical Settings.
- Funderburk, J. S., Dobmeyer, A. C., Hunter, C. L., Walsh, C. O., & Maisto, S. A. (2013). Provider practices in the primary care behavioral health model: An initial examination in the Veterans Health Administration and the United States Air Force. Families, Systems, and Health, 31, 341–353.
- Hunter, C. L., Goodie, J. L., Dobmeyer, A. C., & Dorrance, K. (2014). Tipping points in the Department of Defense's experience with psychologists in primary care. American Psychologist, 69, 388–398.
- Hunter, C. L., Goodie, J. L., Oordt, M. S., & Dobmeyer, A. C. (2017). Integrated behavioral health in primary care: Step-by-step guidance for assessment and intervention (2nd ed). Washington, DC: American Psychological Association.
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Suzanne M. Miller
- Cardiac Psychology
- Chronic Illness
- Counseling Cancer Patients
Ellen A. Dornelas
- Helping Children Manage Diabetes
Alan M. Delamater
- Smoking Cessation
Bonnie J. Spring
- Weight Loss and Control
Ann Mary Kearney-Cooke
- Chronic Health-Related Disorders in Children: Collaborative Medical and Psychoeducational Interventions
Edited by LeAdelle Phelps
- Clinical Health Psychology in Medical Settings: A Practitioner's Guidebook, Second Edition
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- Primary Care Psychology
Edited by Robert G. Frank, Susan H. McDaniel, James H. Bray, and Margaret Heldring
- Psychological Treatment of Chronic Illness: A Biopsychosocial Therapy Approach
- Psychological Treatment of Medical Patients in Integrated Primary Care
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