Abstract
The growth of the Primary Care Behavioral Health model (PCBH) nationally has highlighted and created a workforce development challenge given that most mental health professionals are not trained for primary care specialization. This work provides a review of the current efforts to retrain mental health professionals to fulfill roles as Behavioral Health Consultants (BHCs) including certificate programs, technical assistance programs, literature and on-the-job training, as well as detail the future needs of the workforce if the model is to sustainably proliferate. Eight recommendations are offered including: (1) the development of an interprofessional certification body for PCBH training criteria, (2) integration of PCBH model specific curricula in graduate studies, (3) integration of program development skill building in curricula, (4) efforts to develop faculty for PCBH model awareness, (5) intentional efforts to draw students to graduate programs for PCBH model training, (6) a national employment clearinghouse, (7) efforts to coalesce current knowledge around the provision of technical assistance to sites, and (8) workforce specific research efforts.
Similar content being viewed by others
References
Adams, D. P. (1999). American board of family practice: A history. Lexington: American Board of Family Practice.
American Association of University Professors. (n.d.). The status of non-tenure-track faculty. https://www.aaup.org/report/status-non-tenure-track-faculty.
American Psychological Association. (n.d.). APA-accredited programs. http://www.apa.org/ed/accreditation/programs/.
American Psychological Association Education Directorate. (n.d.). Directory of doctoral training programs with training opportunities in primary care psychology. http://www.apa.org/ed/graduate/primary-care-psychology.aspx.
Chaple, M., Sacks, S., Randell, J., & Kang, B. (2016). A technical assistance framework to facilitate the delivery of integrated behavioral health services in Federally Qualified Health Centers. Journal of Substance Abuse Treatment, 60, 62–69.
Council on Social Work Education. (2015). 2014 statistics on social work education in the United States. http://www.cswe.org/CentersInitiatives/DataStatistics/ProgramData/82842.aspx.
Council on Social Work Education. (2016). Social work and integrated behavioral healthcare Project. http://www.cswe.org/institutionalresearch/socialworkandintegratedbehavioralhealthcareproject/.
Corso, K. A., Hunter, C. L., Dahl, O., Kallenberg, G. A., & Manson, L. (2016). Integrating behavioral health into the medical home: A rapid implementation guide. Phoenix, MD: Greenbranch Publishing.
Cubic, B. A., Neumann, C., Kearney, L., McGrath, R., Ruddy, N., Rybarczyk, B., & Zamudio, A. (2011). Report of the primary care training taskforce to the APA board of educational affairs. Washington DC: American Psychological Association.
Daub, S., Levkovich, N., Gallagher, S., & Serrano, N. (2010). Philadelphia primary care behavioral health integration project. Seminar presented at Collaborative Family Healthcare Association 11th Annual Conference, Louisville, KY.
Davis, M. M., Balasubramanian, B. A., Cifuentes, M., Hall, J., Gunn, R., Fernald, D., & Cohen, D. J. (2015). Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care. Journal of the American Board of Family Medicine, 28, S32–S40.
DiLillo, D., DeGue, S., Cohen, L. M., & Morgan, R. D. (2006). The path to licensure for academic psychologists: How tough is the road? Professional Psychology: Research and Practice, 37, 567–586.
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, 3, 207–224.
Hall, J., Cohen, D. J., Davis, M., Gunn, R., Blount, A., Pollack, D. A., & Miller, B. F. (2015). Preparing the workforce for behavioral health and primary care integration. Journal of the American Board of Family Medicine, 28, S41–S51.
Hoge, M. A., Morris, J. A., Laraia, M., Pomerantz, A., & Farley, T. (2014). Core competencies for integrated behavioral health and primary care. Washington, DC: SAMHSA–HRSA Center for Integrated Health Solutions.
Horevitz, E., & Manoleas, P. (2013). Professional competencies and training needs of professional social workers in integrated behavioral health in primary care. Social Work in Health Care, 52, 752–787.
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.
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, DC: Interprofessional Education Collaborative.
Interprofessional Education Collaborative. (2016). Core competencies for interprofessional collaborative practice: 2016 update. Washington, DC: Interprofessional Education Collaborative.
Kinman, C. R., Gilchrist, E. C., Payne-Murphy, J. C., & Miller, B. F. (2015). Provider- and practice-level competencies for integrated behavioral health in primary care: A literature review. Rockville, MD: Agency for Healthcare Research and Quality.
McDaniel, S. H., Grus, C. L., Cubic, B. A., Hunter, C. L., Kearney, L. K., Schuman, C. C., … Johnson, S. B. (2014). Competencies for psychology practice in primary care. American Psychologist, 69, 409–429.
Miller, B. F., Glichrist, E. C., Ross, K. M., Wong, S.L., Blount, A., & Peek, C. J. (2016). Core competencies for behavioral health providers working in primary care. Prepared from the Colorado Consensus Conference. http://farleyhealthpolicycenter.org/wp-content/uploads/2016/02/Core-Competencies-for-Behavioral-Health-Providers-Working-in-Primary-Care.pdf.
Miller, B. F., Mendenhall, T. J., & Malik, A. D. (2009). Integrated primary care: An inclusive three-world view through process metrics and empirical discrimination. Journal of Clinical Psychology in Medical Settings, 16, 21–30.
Mitchell, A. M., Hagle, H., Puskar, K., Kane, I., Lindsay, D., Talcott, K., … Goplerud, E. (2015). Alcohol and other drug use screenings by nurse practitioners: Clinical issues and costs. Journal for Nurse Practitioners, 11, 347–351.
NCQA. (2016). PCMH PRIME certification: For Massachusetts practices that demonstrate the ability to address behavioral health in primary care. Massachusetts, USA: NCQA.
O’Donohue, W. T., Cummings, N. A., & Cummings, J. L. (2009). The unmet educational agenda in integrated care. Journal of Clinical Psychology in Medical Settings, 16, 94–100.
Peek, C. J. (2008). Planning care in the clinical, operational, and financial worlds. In R. Kessler & D. Stafford (Eds.), Collaborative medicine case studies: Evidence in practice (pp. 25–38). New York, NY: Springer.
Ratzliff, A., Norfleet, K., Chan, Y. F., Raney, L., & Unützer, J. (2015). Perceived educational needs of the integrated care psychiatric consultant. Academic Psychiatry, 39, 448–456.
Reiter, J. T., Dobmeyer, A. C., & Hunter, C. L. (2017). The primary care behavioral health (PCBH) model: An overview and operational definition. Journal of Clinical Psychology in Medical Settings, 24(4), this issue.
Robinson, P. J., & Strosahl, K. D. (2009). Behavioral health consultation and primary care: Lessons learned. Journal of Clinical Psychology in Medical Settings, 16, 58–71.
Robinson, P.J., & Reiter, J. (2015). Behavioral consultation and primary care: A guide to integrating services (2nd Ed). New York, NY: Springer.
Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational interviewing in health care: Helping patients change behavior. New York, NY: Guilford Press.
Serrano, N. (Ed.). (2014). The implementer’s guide to primary care behavioral health. Madison, WI: Access Community Health Center.
Serrano, N., Daub, S., Reiter, J., & Cos, T. (2015). Using standardized patients for competency assessment and training of BHCs—Part 2. Seminar presented at Collaborative Family Healthcare Association 17th Annual Conference, Portland, OR.
Society of Health Psychology, Curriculum Development Sub-Committee, Committee on Integrated Primary Care. (2016). Integrated primary care psychology: An introductory curriculum.
Strosahl, K. (2005). Training behavioral health and primary care providers for integrated care: A core competence approach. In W. T. O’Donohue, M. R. Byrd, N. A. Cummings & D. A. Henderson (Eds.), Behavioral integrative care (pp. 15–52). New York: Routledge.
Wagner, E. H. (2010). Academia, chronic care, and the future of primary care. Journal of General Internal Medicine, 25(Suppl 4), 636–638.
Zink, B. J. (2006). Anyone, anything, anytime: A history of emergency medicine. Philadelphia, PA: Elsevier Health Sciences.
Funding
No external funding was used to support creation of this work.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors Neftali Serrano, Colleen Cordes, Barbara Cubic and Suzanne Daub declare that they do not have any conflicts of interest.
Results Involving Human and Animal Participants
This article does not contain any studies with human participants performed by any of the authors.
Rights and permissions
About this article
Cite this article
Serrano, N., Cordes, C., Cubic, B. et al. The State and Future of the Primary Care Behavioral Health Model of Service Delivery Workforce. J Clin Psychol Med Settings 25, 157–168 (2018). https://doi.org/10.1007/s10880-017-9491-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10880-017-9491-1