Medical provider satisfaction with integrated care in a pediatric gastroenterology clinic.

INTRODUCTION: Benefits of behavioral health (BH) integrated care (IC) in pediatric primary care have been demonstrated (Asarnow et al., 2015). Pediatric subspecialty care treats patients with high levels of medical and psychosocial vulnerability and complexity (Samsel et al., 2017), underscoring the need for increased IC. Medical provider satisfaction (MPS) with IC is highly relevant for the utilization and expansion of these services. The purpose of this preliminary study was to examine MPS related to BH IC services in a pediatric gastroenterology clinic. METHOD: Eight pediatric gastroenterology providers working in an outpatient clinic completed a 32-item survey (adapted from Corso et al., 2016) assessing their satisfaction with integrated BH care services. Descriptive statistics were utilized to examine and summarize provider satisfaction data. RESULTS: Pediatric gastroenterology medical providers reported high levels of satisfaction with existing IC services and a preference for embedded versus colocated IC. They perceived provider-related and clinical benefits of IC, felt that addressing BH issues is important, and believed IC is a valued service. Medical providers expressed that they wanted expanded IC services, including an embedded psychologist at more locations, BH screenings for younger patients, and an electronic psychosocial screening process. DISCUSSION: The results of this study align with research findings regarding high medical provider satisfaction with IC in primary care and a preference for embedded BH services (Asarnow et al., 2015). While this preliminary study is small in scale, it is an important initial step to better understand MPS with IC in pediatric subspecialty care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Video review of family medicine resident clinical encounters: a tool for building emotional intelligence.

Video Review (VR) is a well established educational tool for developing the practice of patient-centered care in family medicine residents. There are a number of behaviorally-based checklists that can be use in both live observation as well as VR of clinical encounters to identify and promote behaviors associated with patient-centered care, most of which also overlap with behaviors associated with Emotional Intelligence (EI). We propose a VR that is structured less on a seek-and-find of clinician behaviors and more as a self-reflective exercise of how the clinician presents in the room alongside how they were feeling during that encounter. We believe that this exercise promotes the first two skills of EI (self-awareness and self-management) and then provides a foundation on which to build the second pair of skills (social awareness and relationship management). This perspective paper offers guidance, including stepwise instruction, on how to facilitate such a VR curriculum.

Commentary on Integration of primary care and behavioral health services in Midwestern community health centers: A mixed methods study.

Comments on the original article by Staab et al. (see record 2022-14598-001) regarding the integration of primary care and behavioral health services in Midwestern community health centers. As a clinician, the author identifies with many of the findings in Staab et al.'s paper. Limited resources related to patient access were cited as a barrier to integration. In the academic medical center and the larger community, we have experienced too few behavioral health providers (BHPs) to meet the increasing demand for behavioral health (BH) services. There are long waitlists for BH care, and patients report difficulty accessing appropriate BH resources. A lack of funding within the health care system has been a barrier to hiring an adequate BH workforce to meet the demand of internal and external BH referrals. Integrated care requires a specific set of skills and training experiences to competently provide brief interventions and work as part of an interdisciplinary medical team in a fast-paced medical setting. The pool of qualified applicants for integrated care positions is limited, challenging recruitment efforts. Another factor reducing access within the integrated care setting is difficulty adhering to a short-term treatment model with patients who have severe mental health issues and long-term therapy needs, given their difficulty obtaining longer-term services. Unlike the majority of community health centers (CHCs) in this study, we have insufficient social work support to adequately meet all patients' care management needs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An Exploratory Feasibility Study of Incorporating Volunteering Into Treatment for Adolescent Depression and Anxiety.

Community volunteering is an under-utilized, at least under-researched, strategy to supplement existing treatment for affective disorders. We present findings from a feasibility study incorporating community volunteering into clinical treatment for depression and anxiety among adolescents and young adults. This exploratory pilot study had four aims: to investigate recruitment feasibility; to describe participants' experiences with volunteering; to explore psychosocial assets by which volunteering might decrease depressive and anxiety symptoms; and to document preliminary changes in mental health outcomes before and after the volunteering intervention. Interviews and surveys were employed with participants (N = 9; ages 14-20, Mage = 16 years old; eight women and one man) newly diagnosed with: mild to moderate depression (single episode), mild to moderate anxiety, or adjustment disorder. Recruitment was feasible overall, successes and challenges are discussed. Experiences with volunteering were very positive. Qualitative findings revealed perceived positive effects of volunteering on mood and well-being such as helping with social anxiety and being a positive distraction. Qualitative findings revealed several psychosocial assets that improved related to volunteering (e.g., sense of purpose/meaning and sense of community). On average, participants reported a 19% decrease in depressive symptoms from the pre-survey (before volunteering) to the post-survey (after volunteering). Although more research is warranted, the implication of this study for practicing psychologists treating adolescents and young adults for mild to moderate depression and/or anxiety is that they may wish to consider incorporating community volunteer activities into treatment. Volunteering was a desirable activity for interested participants in treatment for affective disorders.