Integrated Behavioral Healthcare: Positioning Mental Health Practice With Medical/Surgical Practice

365 Pages·2007·17.943 MB·English

by  Cummings, Nicholas A.

Integrated Behavioral
Healthcare
Positioning Mental Health Practice
with MedicaVSurgical Practice
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Integrated Behavioral Healthcare
Positioning Mental Health Practice
with Medical/Surgical Practice
Nicholas Cummings, Ph.D., Sc.D.,
William O'Donohue, Ph.D.
S teven C. Hayes, Ph.D.
Victoria Follette, Ph.D.
University of Nevada, Reno
Academic Press
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Copyright(cid:14)9 2001 by A CADEMIC PRESS
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Foreword
Healthcare is now practiced in a radically different financial and delivery
system than it was two decades ago. Behavioral healthcare has been trasnformed
from a cottage craft into an industry. Once industrialization occurs it is never
reversed. Thus, we will not go back to the solo practice funded by indemnity
insurance no matter how much this is pined for by individual practitioners
or their guild organizations. Organized behavioral healthcare has defined
and will continue to define who is treatedfor what kinds of problems, how, by
whom, and for what reimbursement. Moreover, the situation is still not stable:
after recent mergers many of the large behavioral healthcare companies are
facing serious financial difficulties.
Mental health professionals have been greatly impacted by these devel-
opments and yet there is little understanding of exactly what has happeneG
what has caused these events, what are the resultant strengths and weak-
nesses, what the behavioral healthcare professional should do in response to
these, and what the future will look like. This book is edited by four mental
health care professionals, including the "father" of behavioral managed care,
Nicholas Cummings, and attempts to provide some answers to these key
questions.
This book is an outgrowth of a conference held in Reno, Nevada in
January, 1999. We would like to thanks the presenters as well as Vice President
for Research Ken Hunter and Dean Robert Mead for their support of that
conference. We would also like to thank Erin Northouse for her assistance in
all phases of this project.
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Contents
.............................................
Preface xi
Chapter 1
The History of Behavioral Healthcare: A Perspective
from aLifetimeo f Involvement
Nicholas A. Curnmings ............................................ 1
Chapter 2
ANew Vision of Healthcare for America
Nicholas A. Ctlmmings ............................................ 19
Chapter 2 Discussion
Medical Health Care and Mental Health Care:
Integration and/or Partnership
Alan E. Fruzzetti.. ............................................... 39
Chapter 3
The Integration of Primary Care and Behavioral Health
Type I1 Changes in the Era of Managed Care
Kirk Strosahl .................................................... 45
Chapter 3 Discussion
Take Me to Your Leader!
Linda Hayes ..................................................... 71
vii
viii Contents
, ,
Chapter 4
Programmatic Approaches to Care and Outcomes:
The Medical Co-Management Group Appointment
Jaylene Kent and Malcolm Gordon .................................. 77
Chapter 4 Discussion
Reinventing the Team Model: Can Quality
and Lower Cost go Hand in Hand?
Greg Hayes ...................................................... 91
Chapter 5
Organizing a Collaborative Healthcare System
in a Medical Setting
James D. Slay, Jr., Caroline Mcleod, and John N. Johnson .............. 95
Chapter 5 Discussion
A Review of the Collaborative Care Project
Martin Gutride .................................................. 121
Chapter6
Behavioral Technologiesin Disease Management:
ANew Service Model for Working with Physicians
123
Robert Dyer ...... ...............................................
Chapter 6 Discussion
Persuasion Criteria in the Business of Disease
Management and Behavioral Health
Barbara Kohlenberg .............................................. 143
Chapter 7
Accountability for Quality in the Real World: From 30,000
Feet to Ground Level and Back Up
Tom Trabin ...................................................... 149
Chapter 7 Discussion
The Best and Worst of Times for Behavioral
Mental Health Practice
Steven Thorp, Jennifer Gregg, Reville Niccolls, and
William O'Donohue .............................................. 183
Chapter 8
Managed Care: Cost and Effectiveness
Ian A Shaffer. .................................................... 187
Contents ix
Chapter 8 Discussion
Effectiveness and Cost in Managed Care
Ole Thienhaus ................................................... 207
Chapter9
Practice Guidelines and the Industrialization
of Behavioral Healthcare Delivery
Steve C. Hayes and Jennifer Gregg ................................... 211
Chapter 9 Discussion
Comments on Practice Guidelines
Duane Varble ..................................................... 251
Chapter 10
Financial Risk and Structural Issues
Stephen P. Melek .................................................. 257
Chapter 10 Discussion
Integrated Care: Potential Disaster or Golden Opportunity?
Jeanne Wendel .................................................... 273
Chapter 11
Program Restructuring and Curricular Enhancement for
Accountable Training
Warwick G. Troy .................................................. 283
Chapter 11 Discussion
Continuing Education: Opportunites for Enhanced Family Relations
Victoria Follette ................................................... 309
Chapter 12
Managed Care: Implications for Clinical Training
Michael S. Pallak ................................................. 313
Chapter 12 Discussion
Clinical Psychology Curriculum and the Industrialization
of Behavioral Healthcare
Jane E. Fisher, ]effrey Buchanan, and Jacob E. Hadden .................. 331
Index ............................................... 337