Few behavioral health clinicians are trained in graduate school to work in primary care, so they need assistance in making the huge transitions in practice style and making the adjustment to the culture and pace of primary care. To help with this transition, I developed a state of the art core competency training system over 20 years ago that is still being used by PCBH consultants and trainers today.
This system involves an intensive “immersion” course in the PCBH model (often 3-5 days long), in which the new behavioral health consultant learns everything that will become important to the success of the program. Often, physicians and other PCPs will attend parts of this immersion course that are relevant to their role as “partners” in the integrated care approach. Click Here to see an example of an intensive immersion training curriculum
Often, a significant portion of the immersion course experience involves training both behavioral health and primary care providers in the basic principles and processes of Focused Acceptance and Commitment Therapy. FACT is an approach that can be used by both primary care and behavioral health providers, and can be applied to the wide range of medical and psychosocial issues that are seen in primary care practices.
The next phase of core competency training involves going into the hallways of the clinic and shadowing the new behavioral health consultant at all points of the consulting process. The core competency framework I developed identifies six core areas of skill that mush be mastered if the behavioral clinician is to succeed in the new role of team-based consultant. This includes how the consultant relates to members of the health care team, how the consultant conducts patient interviews, manages time, and comes up with intervention recommendations, how the consultant talks with medical team colleagues about those recommendations, and how the consultant documents the visit. This often involves shadowing the consultant for 3-5 days of regular work in the clinic. At the end of shadowing experience, I complete a core competency assessment tool and go over each of the six skill domains, with the goal of setting forward looking learning objectives for the consultant as part of the process. Click Here to see an example of the Core Competency Assessment Tool for the Behavioral Health Consultant (BHC)
During on site shadowing, I also observe the practices of the primary care providers who will be “feeding” the practice of the embedded behavioral health consultant. Many systems overlook the importance of training doctors, physician’s assistants, nurse practitioners and ancillary medical staff in how to change their practice patterns to facilitate moving more patients into embedded behavioral health services. Thus, an important component of any on site competency training is to educate the medical providers about how to subtly shift their traditional way of practicing medicine to support the transition to integrated, team-based care.
Click the links below to see examples of Primary Care Provider Training Support Tools:
