Impact of Behavioral Health Consultant Interventions on Patient Symptoms and Functioning in an Integrated Family Medicine Clinic

被引:53
作者
Bryan, Craig J. [1 ]
Morrow, Chad [1 ]
Appolonio, Kathryn Kanzler [1 ]
机构
[1] Wilford Hall USAF Med Ctr, Lackland AFB, TX 78236 USA
关键词
primary care; treatment outcomes; phase model; psychotherapy process; PRIMARY-CARE PATIENTS; COLLABORATIVE CARE; SUDDEN GAINS; COST-EFFECTIVENESS; COGNITIVE THERAPY; DEPRESSION; PSYCHOTHERAPY; PROGRAM;
D O I
10.1002/jclp.20539
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Patterns of symptomatic and functional change associated with behavioral health consultant (BHC) intervention in an integrated family medicine clinic were investigated among 338 primary care patients under routine conditions without exclusion. Patients were referred to the BHC by primary care providers (PCPs) and participated in one to four brief, behaviorally oriented appointments in primary care. The Behavioral Health Measure-20 (BHM) was completed at each appointment. Results indicated that higher levels of distress at baseline were associated with more follow-up appointments, and that patients demonstrated simultaneous, clinically meaningful improvement in well-being, symptoms, and functioning in as few as two to three BHC appointments. Patterns of clinical improvement support the effectiveness of BHC interventions, but contradict the phase model of psychotherapy (Howard, Lueger, Maling, & Martinovich, 1993). (C) 2009 Wiley Periodicals, Inc. J Clin Psychol 65:281-293, 2009.
引用
收藏
页码:281 / 293
页数:13
相关论文
共 30 条
[1]   Effectiveness of a quality improvement intervention for adolescent depression in primary care clinics - A randomized controlled trial [J].
Asarnow, JR ;
Jaycox, LH ;
Duan, N ;
LaBorde, AP ;
Rea, MM ;
Murray, P ;
Anderson, M ;
Landon, C ;
Tang, LQ ;
Wells, KB .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 293 (03) :311-319
[2]  
Blount A, 1998, INTEGRATED PRIMARY CARE, P1
[3]   Evaluation of a collaborative mental health program in primary care: effects on patient distress and health care utilization [J].
Cigrang, Jeffrey A. ;
Dobmeyer, Anne C. ;
Becknell, Milton E. ;
Roa-Navarrete, Ruth A. ;
Yerian, Stephen R. .
PRIMARY CARE & COMMUNITY PSYCHIATRY, 2006, 11 (03) :121-127
[4]  
Department of Health and Human Services (USA), 2000, HLTH PEOPL 2010 UND
[5]   RCT of a care manager intervention for major depression in primary care: 2-Year costs for patients with physical vs psychological complaints [J].
Dickinson, LM ;
Rost, K ;
Nutting, PA ;
Elliott, CE ;
Keeley, RD ;
Pincus, H .
ANNALS OF FAMILY MEDICINE, 2005, 3 (01) :15-22
[6]  
Gatchel R.J., 2003, CLIN HLTH PSYCHOL PR
[7]   Psychotherapy practice and research - Repairing a strained alliance [J].
Goldfried, MR ;
Wolfe, BE .
AMERICAN PSYCHOLOGIST, 1996, 51 (10) :1007-1016
[8]   Sudden gains in cognitive therapy for depression: A replication and extension [J].
Hardy, GE ;
Cahill, J ;
Stiles, WB ;
Ispan, C ;
Macaskill, N ;
Barkham, M .
JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY, 2005, 73 (01) :59-67
[9]   THE DOSE-EFFECT RELATIONSHIP IN PSYCHOTHERAPY [J].
HOWARD, KI ;
KOPTA, SM ;
KRAUSE, MS ;
ORLINSKY, DE .
AMERICAN PSYCHOLOGIST, 1986, 41 (02) :159-164
[10]  
HOWARD KI, 1993, J CONSULT CLIN PSYCH, V51, P1059