Rodger Kessler and Dale Stafford This book is intended to foster thinking and dialogue about behavioral health clinicians providing psychological treatments as part of medical practice. Since medical sites evaluate and treat more mental health and substance abuse problems than the specialty behavioral health system and because many acute and chronic medical presentations have significant psychological components, on-site collaboration between medicine and behavioral health is a logical, feasible, and important evolution of medical care. The majority of this book is the presentation of medical cases in which psychological dimensions are important components of the problem, or cases that are primarily mental health diagnoses that were treated in primary care or specialty medical settings. The feature common to each of the cases is that they rep- sent some form of collaborative treatment between medicine and behavioral health. Conversations about the issues raised in this volume will hopefully be held by those who participate in providing health care, who do not often think and talk about these issues together. The intended audience is physicians, psychologists, behavioral health providers, health care administrators, health care financers, and health care policy makers. Each has both a role and an impact on patient care and patient outcomes although each has a different perspective on achieving the goal. Because of new clinical advancements and administrative and cost pressures, the goals of medicine have shifted to achieving the right care for patients.
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Rodger Kessler is a clinical psychologist who has been doing research in the area of integration of primary health care and mental health care for the past 15 years. Dr. Kessler created a five site medical practice where behavioral health clinicians can deliver evidence-based, integrated medical psychological care. Dr. Kessler’s current research focuses on patient compliance with psychological referral in an integrated practice, and the impact of integrated medical psychological care on medical and cost outcomes. He is a Fellow of the American Psychological Association and a Past President of the Vermont Psychological Association.
Collaborative Medicine Case Studies
Evidence in Practice
Edited by Rodger Kessler and Dale Stafford, Berlin Family Health, Montpelier, Vermont and Department of Family Medicine University of Vermont College of Medicine
Just as the mind and body collaborate in maintaining one’s health, collaboration between primary and behavioral health care can bring patients more efficacious treatment and better long-term results, from better compliance with or less dependence on medication to more effective use of health care services.
Collaborative Medicine Case Studies shows physicians and mental health practitioners working together across a variety of settings to assess and treat entrenched illnesses, combined physical and psychological conditions (back pain/panic attacks, diabetes/bipolar disorder), and cases that defy straightforward diagnosis. At the same time, the cases reflect the economic and financial realities of contemporary health care.
The cases discussed generate creative solutions using different levels of collaboration depending on patient need and site variables, but all share important similarities: close communication, careful follow-up by physician and behavioral health collaborators, and patients who would not have been treated as effectively without collaborative care. Blending research evidence, clinical insight, welcome humor, and realistic optimism, these cases demonstrate impressive successes, instructive setbacks, and comparative viewpoints while shedding light on the logistical, financial, and training challenges of integrative practice.
A sampling of the three dozen cases:
Collaborative Medicine Case Studies is a blueprint for a vanguard in care, not only for physicians and psychologists but also for professionals and graduate students in health psychology and health care administration and finance.
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