Determining whether a case is appropriate for PMT-based strategies is an important clinical task, but procedures for conducting this type of assessment are outside the scope of the current paper. Finally, we assume that behavioral health clinicians will have prior experience with and knowledge of working in integrated care settings. Our paper does not directly address the challenges of working within an interprofessional health-care
team in a primary care setting (e.g., fast pace, relatively short appointment times), but only serves to provide some examples for adapting PMT-based strategies for integrated care. For more information regarding general challenges faced when working in an interprofessional health-care team, see Robinson and Reiter (2007), Shaw, de Lusignan, and Rowlands (2005), and Xyrichis and Lowton (2008). Armed with knowledge about traditional PMT principles and accustomed to the rapid pace and flow of integrated CB-839 nmr care, the BHC is ready to translate her skills and knowledge to fit with the IBHC model. Therefore, we turn to a description selleck of how to accomplish such a task and begin answering the question: What actually happens when the BHC walks into a room with a patient
and the patient’s family? Following medical provider referral for an externalizing behavior problem and initial acceptance of the case by the BHC, the BHC determines the extent to which the problem behavior can be addressed by the IBHC model. As described in our Assumptions section previously, the brief and
time-limited nature of primary care practice requires a quick triage decision by the BHC regarding the patient’s degree of difficulty. Problems that the BHC deems long-standing Fludarabine (particularly those that have been unsuccessfully addressed by prior treatment efforts) or behavior that has become excessively violent (where weekly or more frequent sessions are indicated) are likely best managed in traditional outpatient settings. Although we do not provide comprehensive suggestions for completing the triage process, nor do we implement a systematic or structured triage interview, some helpful triage questions may include: In what situations does the problem behavior occur? How frequently does it occur? How severe is the behavior? What have been some of the results or outcomes of the behavior (e.g., serious injuries, destruction of property)? Readers interested in additional information about the triage process may consider consulting Brunelle and Porter (2013) or the Center for Integrated Healthcare’s Operations Manual for Primary Care-Mental Health Integration Co-Located, Collaborative Care ( Dundon, Dollar, Schohn, & Lantinga, 2011). Once the BHC has completed the triage process, the second task often involves assessment, usually in the form of a functional analysis of the problem behavior. This will typically occur in the same behavioral health session as the triage phase.