The Certificate in Integrated Behavioral Health and Primary Care - Combined Track is designed for clinicians -- such as social workers, nurses, care managers, psychologists, and physicians -- who are interested in the distinct considerations for providing integrated care to both pediatric and adult populations. Participants will gain assessment, intervention, and consultation skills; will learn strategies to apply these skills in the workplace; and will link with a peer distance learning community to practice new skills and discuss ideas.
Introduction to Integrated Behavioral Health and Primary Care
In this module, participants will learn about the nature and implications of integrated care, and will become fluent in the key terms that have come to describe it. Topics will include key public policies affecting the integrated care movement, including the Affordable Care Act; successful models of integrated care; population health management and health disparities; and ethical challenges and opportunities in integrated care. The transition to integrated care will be framed as a paradigm shift from disease-oriented to recovery-oriented service delivery, resulting in new opportunities and challenges, and direct implications for consumers and their families.
Integrated Health Systems and Implementation
In this module, participants will obtain knowledge and skills related to the implementation of integrated care services. Implementation of integrated team-based collaborative care presents challenges and opportunities for providers and managers, with significant implications for access to care and patient satisfaction. Topics include basics of integrated health implementation; telepsychiatric consultation; culturally responsive practice; Patient Centered Medical Home recognition; oral health for collaborative care; and provider mindfulness and self-care.
Foundations of Pediatric Integrated Health Care
Although "pediatrics" describes the age range from birth through 18 years of age, children develop through a number of distinct developmental, psychological, and social stages. The Pediatric track explores how to address the most common issues of these stages using a pediatric integrated health model of care. Topics include an introduction to the model, the role of the pediatric behavioral health consultant, pediatric social determinants of health, and interventions in the medical setting.
As the health care system is transformed from non-integrated to integrated, many services and interventions can be provided directly to the pediatric population as well as their parents in the medical clinic. Although many clinicians know typical child and adolescent diagnoses from a clinical perspective, this module helps participants develop an integrated understanding of typical topics that may present in the medical setting. Topics include ADHD, pediatric asthma, DD-autism, anxiety, depression, trauma, and adverse childhood experiences.
Many adolescents are required to attend at least one physician appointment a year, presenting an annual opportunity to engage them in management of their own health care and in the detection and early intervention of risky behaviors which can have lifelong consequences. Adolescents can be best engaged in self-management when their unique social, developmental, physical and psychological needs are considered. Topics include adolescent-centered medical homes, adolescent sexual health, substance abuse, suicide, eating disorders, and school-based health centers.
Bidirectional Integrated Care
In this module, participants will build upon their knowledge of integrated care implementation in adult healthcare settings. Topics will include the Wagner Chronic Care Model; collaborative care; stepped care; care coordination; and billing in integrated health environments. Participants will learn the "care coordination standard" for integrated primary care and discover new roles in primary care for the behavioral health consultant.
Assessment in Integrated Care
Initial and follow-up assessments play a critical role in effective integrated care. This course addresses free-form interviews such as biopsychosocial-spiritual assessment, structured screening tools such as the PHQ-9 and the AUDIT-C, and mixed assessment and intervention models such as SBIRT. The strengths, weaknesses, benefits, and limitations of common assessment tools in integrated health environments are reviewed.
Behavioral Intervention in Integrated Care
Common elements often form the basis of evidence-based behavioral health interventions. This course teaches and reviews behavioral intervention skills relevant to everyday clinical practice across disciplines and practice settings. Brief interventions around motivational enhancement, psychoeducation, cognitive restructuring, mindfulness, and values-based behavior change can help promote adaptive health behaviors in support of improved wellness. There is a strong emphasis on feasible brief interventions in a fast-paced clinical context and on adapting interventions to each consumer's unique biopsychosocial, socioeconomic, and cultural context.
Biomedical Aspects of Integrated Care
Many presenting medical problems are deeply influenced by health behaviors, and a growing body of evidence suggests that mental health consumers, especially those with serious mental illnesses or substance use disorders, are faced with a broad range of physical health disparities. In this module, participants will deepen their understanding of bidirectional integrated care for medical issues such as diabetes and obesity, and behavioral health issues such as substance use disorders and depression. This courses emphasizes the medical sequelae commonly associated with behavioral health diagnoses and psychotropic medications. There are special sections on primary care psychopharmacology and prescription drug abuse.
- Explain the difference between colocation and integration.
- Compare and contrast interdisciplinary and multidisciplinary teams.
- Identify at least three social determinants of health for adult populations.
- Identify at least five social determinants of health for the pediatric population.
- State the role of warm handoffs in behavioral health consultation.
- Identify and describe an example of the Pediatric Integrated Health Care model.
- Identify requisite skills to serve in the role of behavioral health consultant in pediatric integrated health care.
- Identify 1-3 impacts of trauma on pediatric brain and social/emotional development.
- Apply motivational enhancement in integrated health settings.
- Identify two primary causes of pediatric asthma.
- Identify recommended evidence-based treatment options for ADHD in pediatric primary care.
- Define and apply "reflective listening."
- Define and recognize "change talk."
- Identify the evidence based interventions utilized in Integrated Health Care.
- Identify the five core components of the IMPACT Collaborative Care model and articulate how the model addresses common barriers to behavioral health care.
- Engage in self-assessment in clinical practice.
- Explain how provider mindfulness and self-care relate to workforce challenges such as burnout prevention.
- Develop resources for psychoeducation of pediatric patients.
- Educate parents/caregivers on issues of pediatric obesity causes and interventions.
- Describe the assessment of pain in integrated health settings.
- Identify at least two ethical challenges to integrated health practice.
- Address/resolve common ethical challenges in integrated health practice.
- Identify two financing strategies that can facilitate integrated care.
- Develop skills to hire and train staff in integrated health practice.
- List the 3 most common psychiatric medications prescribed in primary care and their uses, contraindications, and potential side-effects.
- State the demographic health disparities facing people living with serious and persistent mental illness.
- State the role of integrated primary care service delivery in remediating health disparities facing people living with serious and persistent mental illness.
- List the evidence-based components of Screening, Brief Intervention, and Referral to Treatment (SBIRT) for addicted populations.
- Describe the components of the Infant Mental Health model.
- Conduct a biopsychosocial-spiritual interview in a fast-paced integrated care setting.
- List 4 common screening tools and assess their strengths and weaknesses.
- Identify and normalize developmental considerations in adolescent sexual health.
- Use Cognitive-Behavioral Therapy in integrated health settings.
- Define and apply "cognitive restructuring."
- List three features of primary prevention of oral diseases such as dental caries.
- Identify three risk factors for teen suicide.
- Explain 3 factors leading to over-prescription of opioid medications and apply 2 strategies to counteract them.
- Implement an organizational self-assessment for cultural responsiveness.
- Identify symptoms of depression that could present in pediatric primary care.
- Identify appropriate depression medications for the pediatric population.
- List three common anxieties in children and adolescents.
- Apply two prevention and/or intervention strategies for pediatric substance abuse.
- Identify three symptoms of an eating disorder that likely present in healthcare settings.
- Modify a physical environment to become a developmentally-appropriate and engaging adolescent medical home.
- Identify a need for further assessment for developmental disabilities.
- Identify symptoms of autism that are likely to present in pediatric primary care.
- Demonstrate 3 considerations for providing care to the population.
- Identify 1-3 strategies to engage adolescents in health care
- Describe the findings of the ACEs study.
- Describe how trauma may present in integrated health care settings.
- Describe strategies for anti-racist practice in integrated health care settings.