1. INTEGRATED BEHAVIORAL HEALTH
Behavioral Health Integration Complex Care Initiative
INTEGRATED BEHAVIORAL HEALTH
Elizabeth Morrison LCSW, MAC
Michael Mabanglo LCSW, PhD

2. We are integrated BH clinicians ourselves 

3. What is the core of integrated behavioral health?

4. We can bring our real life into the visit!

5. Under one roof… one team… one plan.

6. Why in primary care?

7. 01 02 03 04 Why in primary care? Patient preference Defacto MH
We are whole people 04
Evidenced- Based

8. Primary care visits driven by psychosocial factors

9. Blending of Cultures Medical Model BH Model Diagnosis Driven
Prescriptive Treatment
Target based on illness
Conclusive communication
BH Model
Client driven
Strength and relationship -based
Target based on patient goals
Explorative communication

10. BH Clinician: Qualities
High level of interpersonal skills
Relationship focused
Cultural humility
Leadership skills

11. BH Clinician: Knowledge & Skills
Deep and broad range of assessment and treatment skills for mental health conditions
Skills to engage in a range of treatment lengths, (single sesion, brief treatment, co- management, cycling courses of therapy…)
At minimum, SUD screening, assessment and OP skills; MAT knowledge
MI and related skills to engage clients in health related behavior changes
Excellent relationship building and maintenance skills (team and patients)

12. BH Clinician: Culture Change Leader
Patient experience the center of our work
Employee experience and wellbeing as a core focus
Privileging empathy, relationships and connection in clinical, operational and administrative decisions
Advancing the importance of evidenced based communication as a fundamental treatment

13. IBH: The defining feature of ICCM
Traditional Complex Care Focus
Medical condition
Medical hospitalizations
Medication management
Behavioral health needs viewed as part of a specialty referral
Integrated Complex Care Focus
Behavioral Health understood as an integral part of whole health
BHC is part of the complex care team
All team members engage client about behavioral health issues

14. Distinction between IBH and BHICCI
All clinic patients 100%
BH Integration 60%
Integrated complex care management (BHICCI): 5-10%

15. Empathy Exercise

16. Empathy Affirmation- noticing strengths
Acknowledgement –repeat feelings
Normalizing – assuring commonality
Non-judgement– articulating directly
This is where you define each of these things. It is necessary to have examples for each for participants to understand what they really mean, so if having some examples in your pocket is important.
Affirm: noticing and articulating someone's strengths. Often starts with ‘I’m impressed with your…’ ‘I’m inspired by your....’,’ I appreciate your....’ (in giving examples, need to finish the sentence)
Acknowledgement: this is acknowledgment of feeling, whetther someone said it or just ‘showed’ it. ‘I hear you are feeling......’ or ‘that sounds really tough’
Normalizing: Letting someone know they are normal ‘Anyone would feel that way’ ‘I’d feel the same’ ‘relapse is so common with this disease’ ‘most of us struggle with our weight...’
Non-judgment: All of the above demonstrate non-judgement, this is a technique where we directly say it ‘I’m not judgeing you’ ‘i don’t have judgments about that, I just wanted to reassure you’

17. PRACTICE!

18. THANK YOU!