Primary Care Behavioral Health Curriculum

Creating and Managing an Integrated Primary Care Practice Topics

(Module 1) Introduction to Integrated Primary Care

• The health care crisis in the US and the costs and consequences of poor health, particularly behavioral health
• Definitions of Integrated Primary Care (IPC) and Behavioral Health Integration (BHI)
• The role of Primary Care in health care transformation
• Current efforts at health care transformation 
• Major models of Integrated Primary Care 

 (Module 2) Transforming the Organization

•  Outcomes among some integration exemplars
• The role and possible makeup of an integration team
• Information sharing that needs to take place in integrated primary care
• The relationship between Integrated Primary Care and the Patient-Centered Medical Home
• Reasons that workflows may need revision during integration

 (Module 3) Transforming Clinical Practice 

• How to feel comfortable and oriented in a primary care setting
• Methods of building an effective integrated team
• How behavioral health can become an essential part of many primary care cases
• Examples of expertise transfer in an integrated primary care practice

 Bio-Psycho-Social Treatment Topics

(Module 4) Evidence-based Therapies 

• What constitutes valid evidence in scientific literature relevant to your practice
• Types of evidence available for Behavioral Health approaches
• How Cognitive Behavioral Therapy can be applied in a Primary Care setting
• The role of Solution-Focused Interviewing can play in patient and provider change.

 (Module 5) Patient Activation

• The interaction of patient activation and shared decision-making methods in primary care
• Health literacy and patient engagement approaches
• Patient-centered care plans
• The “Share Approach”

 (Module 6) Psychotropic Medication

• The role of a Behavioral Health Provider in psychotropic medication safety monitoring, adherence, and effectiveness
• How to speak comfortably with adult patients and prescribers about psychotropic medications
• The pharmacological properties of common psychotropics

 (Module 7) Caring for Chronic Illnesses

• An evidence-based bio-psycho-social approach for chronic illnesses in primary care
• Symptoms, mechanisms, and treatments of chronic illnesses seen commonly in primary care

 (Module 8) Medically Unexplained Symptoms 

• The usefulness of the terms "Somatization" and "Medically Unexplained Symptoms" (MUS)
• The role of a team approach to MUS
• The role that language plays in engaging the patient
• "Functional" illnesses and Behavioral Health approaches

 Dealing with Substance and Pain in Primary Care Topics

(Module 9)    Substance Abuse in Primary Care 

• Knowledge, skill, and attitudinal needs of providers related to the management of substance use disorders
• Roles of members of multidisciplinary teams for managing substance use disorders in primary care
• Effective interventions for substance use disorders in primary care
• Ways for behavioral health providers and medical providers to collaborate to improve the treatment of substance use disorders in primary care

 (Module 10) Health Behavior Change

• Building the doctor/patient relationship for better health
• The Stages of Change Model
• An introduction to Motivational Interviewing
• A patient's stage of change in relation to a health behavior problem and motivational approaches appropriate to that stage.

 (Module 11) Chronic Pain in Primary Care, Medical Interventions 

• The dilemma of pain, right to treatment vs. danger of abuse
• Pain medications, actions, and indications
• Contracting and monitoring for safety
• Addressing dangerous patterns of use

 (Module 12) Chronic Pain in Primary Care, Behavioral Interventions 

• Current definitions of pain
• Gate Control Theory/Biopsychosocial Model
• The neurology of pain
• Behavioral Health approaches to chronic pain
• Common psychotropic medications for chronic pain

 (Module 13) Relaxation Therapies

• Describe relaxation therapies and their use in Primary Care
• Implement/teach simple relaxation techniques for patients 

 Behavioral Health and Pediatrics Topics

(Module 14) Behavioral Health in the Primary Care of Children

• Engaging parents in promoting health without making them feel judged
• Roles of PCP, BHP, and caregivers in the Primary Care of children
• Major evidence-based screening tools used in pediatric care and how they are used

(Module 15) Behavioral Health Interventions and ADHD in the Primary Care of Children

• Behavioral Health needs in the primary care of children
• The BHP’s role in interviewing the child and caregivers
• Methods of involving and giving help to parents and caregivers
• Speaking with the medical team and caregivers about ADHD: screening, medications and BH interventions

(Module 16) Challenging Populations 

• The needs of common patient populations in the primary care of children 
• Ways in which a Behavioral Health Provider can be of use in the primary care of chronic illnesses in the care of children
• The increased role of behavioral risks with adolescents
• Depression, anxiety, substance abuse, and health behavior needs of adolescents in primary care
• Guiding parents and children struggling with chronic illnesses, and adolescents on behavioral issues in a culturally acceptable and effective manner.

Serious Mental Illness Topics

(Module 17) Integrated Care for People Coping with Serious Mental Illness

• Health needs of people coping with serious mental illness
• Ways in which health and wellness can be fostered through a structured learning program
• How the experience of trauma, mental illness and some come common treatments for mental illness increase health risks and lower the effectiveness of usual medical care for these people
• The possibility of primary care, care management and wellness programs to improve the life experience and health of this group

(Module 18) Serious Mental Illness Health Behavior

• Physical health issues for people with serious mental illness
• Evidence-based lifestyle interventions geared toward people with serious mental illness
• Implementing evidence-based lifestyle interventions within mental health and/or primary care settings

 Population Health in Primary Care Topics

 (Module 19) Screening and Care Management

• The purpose of screening in Primary Care
• Common screening tools used in Primary Care
• Care management for depression in Primary Care
• The pros and cons of implementing care management in Primary Care

 Families, Community and Culture Topics

(Module 20)   Working with Families in Primary Care 

• The family’s role in health
• The importance of a family perspective in addressing problems in health behavior
• Opportunities in regular care (pediatric and adult) to engage family members
• Critical points in care where family involvement is necessary
• Steps in conducting a medical family meeting

 (Module 21) Behavioral Health services in primary care for elderly people

• Describe changes in behavioral approaches necessitated by advancing age
• Discuss the specific needs of a geriatric population
• Identify specific behavioral interventions for older adults

(Module 22) Underserved Populations, Culture and Primary Care

• Working with a culturally diverse population of patients
• The impact of racism, discrimination, immigration, and poverty as well as cultural influences on coping skills
• Narrative questioning skills for discovering important cultural issues and the barriers faced by primary care clinicians in using these techniques