Dual interviews: Moving Beyond Didactics to Train Primary Care Providers in the

Biopsychosocial Model

James Anderson, PhDFellow in Primary Care Psychology

University of Massachusetts Medical School

Stephanie Carter-Henry, MD, MSAssistant Professor of Family Medicine and Community Health

University of Massachusetts Medical School

Juan C. Ramos, PsyD Fellow in Primary Care Psychology

University of Massachusetts Medical SchoolCollaborative Family Healthcare Association 13th Annual Conference

October 27-29, 2011 Philadelphia, Pennsylvania U.S.A.

Session # I3 - TapasOctober 28, 20113:30 PM

Faculty Disclosure

We have no relevant financial relationships to disclose.

Background and Importance

Include literature

Objectives

• Describe the use of dual interviews as a training and skill development experience for mental health and medical providers

• Establish and conduct a conjoint behavioral and medical provider encounter in a manner that embodies collaborative care and is consistent with the stated goals of the PCMH movement

• Identify the challenges, skills needed and learning experiences developed in a dual interview

• Discuss the impact of the dual interview in the patient care and patient interaction with the healthcare system

Expected Outcome

•Participants will understand the definitions and value of a dual interview in a collaborative care model

•Participants will observe an example of a dual interview as it applies in a primary care setting

•Participants will become familiar with the different type, structure, and scheduling of a dual interview

Definition of A Dual Interview• Meetings between the patient or family, a Primary

Care Provider (PCP), and a Behavioral Health Provider (BHP)

• During this collaborative process, both the PCP and

BHP are expected to add value to the encounter while functioning as a team, with shared treatment goals, using a patient centered approach, and enriching the patient care using the biopsychosocial model

Blount, De Girolamo & Mariani (2006). Training the Collaborative Care Practitioners of the Future.

Families, Systems and Health, 24 (1), 111-119.

Types of Dual Interviews• Health Behavior Change

– Smoking cessation

– Exercise

– Eating behavior• Psychosocial Complaints

– Psychological disorder

– Stress reduction

– Relaxation techniques• Learning and teaching

– Difficult patient encounters

– Improvement in interviewing skills• Care coordination

– Referral to specialty mental health

– Management of multiple comorbility, psychiatric and medical.

Purposes of A Dual Interview• Patient-Centered Medical Home (PCMH)

– Representation of Engel’s biopsychosocial model in primary care; Collaborative care is at the core of the PCMH

– Unique opportunity for developing the necessary competencies to work in PCMHs.

• Teaching and Learning– Development of skills and competencies in collaborative practice for both

behavioral health and medical providers. – The PCP learns how to identify patients for whom the addition of a behavioral

health perspective could improve the patient care.– Offers a replicable strategy and opportunity to move beyond didactic training

in collaborative care towards experiential learning and competency.• Patient Benefit

– Improve care for patients, especially those with complex medical and psychosocial needs.

– Address the mental health needs that rely on their primary care providers to receive treatment

Scheduling A Dual InterviewSame Day “on the run”:• BHP is available• BHP is accessible• BHP shares space

Schedule in advance:• The PCP plan includes the dual interview in the future patient treatment plan• The BHP and the PCP include the dual interview in advance in their respective

schedules

Rounds with the providers:• The BHP and the PCP round together• The BHP shadows the PCP during a clinical session and sees all the PCP patients during

that time

Session Evaluation

Please complete and return theevaluation form to the classroom monitor

before leaving this session.

Thank you!