Behavioral Health Consultation

counselingBehavioral Health Consultants (BHC’s) are increasingly finding that patients they are treating for psychological disorders, have chronic medical conditions as well. According to the National Centers for Chronic Illness Prevention and Health Promotion (2007), chronic medical conditions such as Cardiovascular Disease, Diabetes, COPD, and Cancer are the leading causes of death and disability in the United States. They cause major limitations in daily living for one out of 10 Americans or approximately 25 million patients. The studies show that the rates of chronic medical conditions are more than three times higher than the rate of all mental disorders. Based on these reported high rates, behavioral health providers will encounter patients with chronic medical conditions even if these patients present primarily with psychological issues.

Behavioral Health Consultants working with patients with chronic conditions can be challenging for the BHC provider. A strong emphasis is placed on the BHC provider to utilize behavioral health consultation and/or brief psychotherapeutic interventions within the primary care setting. It requires the BHC provider to: 1) engage and develop a working relationship with the medical provider; 2) conduct quick assessment; 3) conceptualize the problem, and 4) develop and implement a mini-treatment plan that has been initiated by the primary care provider (PCP) and co-created with the BHC provider.

A combination of medical and psychological knowledge, specialized competencies, and psychotherapeutic skills are needed as a base competency. Additional training is needed relevant to an understanding of a patient’s acute and/or chronic medical condition representations and treatment expectations. Necessary skills are needed to perform and negotiate these medical condition representations that require a targeted focus on the patients illness related therapeutic tasks, and a knowledge of the kinds of interventions most likely to be effective in clinical practice in the context of treating the medical illness. The BHC provider must have a basic understanding of the patient’s specific medical condition and must be able to integrate what is known about the patient and the medical condition to plan and implement effective  treatment interventions.