[PC-BH-Integration] Primary Care Behavioral Health training

[Blount, Alexander]

Please forward this to anyone you think might be interested in a
training program in 
Primary Care Behavioral Health.

We still have 4 places at the Worcester site for the training program
that starts September 14.

There are also places at sites in Lewiston, ME; Pittsburgh, PA;
Asheville, NC; Lethridge, Alberta; Calgary, Alberta, and Portland, OR.

Registrations will be taken until the date of the first class or until
slots are full.

To obtain further information, email blounta at ummhc.org 

Didactic Program

9/14/07   Workshop 1: Primary Care Culture & Needs  
Faculty: Ronald Adler, MD & Alexander Blount, EdD

Culture and Language of Primary Medical Care (2 hours)
-     Primary care's role in health system
-     Primary care vs. specialty medical care
-     Content and sequence of the basic medical interview
-     Recommended preventative care expected of primary care physicians
-     Role play primary care interview with associated decision-making 
Goal: Feels comfortable and oriented in a primary care setting.

Behavioral Health Needs in Primary Care (1 hour)
	-     Mental health and substance abuse rates
	-     Behavioral health needs
	-     Chronic illness mental and behavioral health needs
	-     "Ambiguous" illnesses
	-     Cultural impact on illness presentations
	-     A typical morning in practice
	-     Example of common "complex" cases
Goal:  Conceptualizes how a behavioral health professional can help in a
wide variety of primary care cases.
Consulting with MDs (3 hours)
	-     Common physician perceptions of role of a BHP
	-     Ways of impacting those perceptions
	-     How physicians want to be approached
	-     Determining what input from BHP is useful to the PCP
	-     Terms for types of collaborative care
	-     Co-located patterns of care
	-     Integrated patterns of care
	-     Practice dual interview
	-     Practice talking in front of the patient for a hand off
Goals: Effectively uses the curb-side consultation model to communicate
with a physician.  Can speak sensitively and with clarity about a
patient's situation with a physician in front of the patient.
 
10/19/07  Workshop 2: Evidence-based Therapies and Substance Abuse in
Primary Care.    Faculty:  Jeffery Baxter, MD, and Alexander Blount, EdD
 
Substance Abuse in Primary Care (3 hours)
-	Chronic illness vs. failure of will
-	Role of SA in common illnesses and health behaviors
-	The CAGE and other quick screens
-	Physician training in identifying and treating substance abuse
-	Chronic pain and the dilemmas of pain medication.
-	What a Behavioral Health Provider can add to the care in each
case. 
-	Evidence based approaches to substance abuse in primary care.
Goals: Can identify substance abuse problems of patients presenting
medical complaints.  Can work collaboratively to help patients with SA
problems

Evidence-based Therapies (3 hours)
	-    Role of "evidence" in making treatments credible
	-    Types of evidence available for approaches we use
	-    CBT and the therapies of patient activation
      -    Family and other multi-person approaches in primary care
	-    The role of solution focused interviewing in patient and
provider change
      -     Role plays to practice
	-    Working in brief visits and brief treatments
Goal: Able to briefly assess, engage and intervene with adults with
behavioral health needs in primary care, using methods supported by
evidence. Able to briefly assess, engage and intervene with children
with behavior problems using methods supported by evidence.

11/16/07   Workshop 3: Behavioral Health Care for Chronic Illnesses
Across the Lifespan and Child Development and Collaborative Pediatric
Practice 
Faculty:  Alexander Blount, EdD, & Kathleen Braden, MD
       
Child Development (1 hour) 
-    The role of "milestones" in organizing pediatric decision making
-    Early developmental milestones and the office assessment of them
-    Interaction of experience and biology in developmental problems 
-    Common developmental disorders
Goal: Able to screen children for developmental problems

Collaborative Pediatric Practice (2 hours)
-	The unique nature of pediatrics: doctor/patient relationship is
(at least) a triangle.
-	Engaging parents in promoting health without making them feel
judged
-	Difficult situations in normal care: bedtime, toileting,
feeding, interface with school and learning.
-	Learning problems and ADHD
-    Special roles for Behavioral Health in pediatric practice
Goal:  Able to guide parents on behavioral issues in a culturally
acceptable and effective manner.

Chronic Illnesses Across the Lifespan (3 hours) 
	-     Symptoms, mechanisms and treatments of:
		Asthma
		Diabetes
		Heart disease
		Irritable bowel syndrome
	-     Behavioral health needs and mental health co-morbidities
for each illness
	-     Behavioral treatments in evidence based protocols for
chronic illnesses
	-     Group medical visits
Goal:  Able to describe an evidence-based biopsychosocial approach for
chronic illnesses in primary care.

12/7/07     Workshop 4: The Toolbox 
Faculty:  Alexander Blount, EdD, Kathleen Braden, MD, & Ron Adler, MD

Screening Instruments for Primary Care and Methods of Care Management (3
hours)
	-     Screening vs. diagnosis vs. outcome
-     Pediatrics:  The Vanderbilt, the Connors, Pediatric Symptom
Checklist.
	-     Communicating with parents and physicians about screening
results
	-     Adults:  The chronic illness care movement
	-     Organizing a care management program
	-     Multi-illness screens, informal screens, PHQ-9, QIDS, SF -
12 & 36, the Duke
	-     Decision-tree for determining next steps after screening
Goal:  To be knowledgeable about one child and one adult screening
instrument and able to discuss its use with physicians and patients.	

Psychotropic Medication Overview (3 hours)
-     Getting past the either-or of meds vs therapy
-     Pediatrics:  When you might suggest considering medication
-     Speaking to parents and children about medication
-     Common medications given to children, indications, actions and
side effects
-     BHP role in assessing side effects and communicating with
prescriber
-     Talking with adults about medication
-     Common medications used in adult primary care, indications,
actions and side effects
-     The necessary role of psychiatry in primary care: consultation and
treatment
Goal:  To knowledgeably discuss common psychotropic medications with a
patient, including indications, effects and side effects.  Able to
appropriately recommend initiating medication to a primary care
physician.

1/11/08    Workshop 5: Behavioral Medicine Techniques 
 Faculty:  Alexander Blount, EdD, & Ronald Adler, MD

	Health Behavioral Change Strategies (2 hours)
	-     Building the doctor/patient relationship for better health
	-     Stages of Change model
-     Motivational interviewing
	-     Matching approaches to stages of change
	-     Health behavior change interviewing practice for smoking
and obesity 
Goal:  Able to conceptualize the stage of change of a patient in
relation to a health behavior problem and to match motivational
approaches to that stage.

Treating the Somatizing Patient (1 hour)
-	Is the concept of somatization useful?
-	Teamwork in providing care
-	Language that engages the patient
-	The use of uncertainty in uncertain situations
Goal:  Able to discuss bodily symptoms that have no medical findings
with patients in a way that promotes curiosity and coping in relation to
the illness.


Behavioral Medicine Skills (3 hours)
-     Role of relaxation response therapies
	-     Sleep promotion skills
	-     Progressing relaxation and autogenics
	-     Hypnotic methods without trance
	-     Biofeedback
	Goal:  Able to teach patients techniques to calm their bodies'
reactivity.

2/8/08  Workshop 6: Specific Populations within Primary Care Faculty:
Alexander Blount, EdD, Warren Ferguson, MD and Tamara Armstrong, PsyD 

Underserved Populations, Culture and Primary Care (2 hours)
-	Impact of culture on health practices and health beliefs
-	Particular health problems of underserved populations
-	Looking for a way to improve cultural "fit" when problems arise
-	Promoting cultural curiosity and appreciation
-	Using interpreters
-	Examples from the Worcester Rainbow: multiple Latino groups,
Vietnamese, Albanian, Ghanaian
Goal:  Able to adapt the approach to specific patients based on
knowledge of cultural factors.

Working with Families in Primary Care (3 hours)
-	The family's role in health
-	The importance of a family perspective in addressing problems in
health behavior
-	Opportunities in regular care (pediatric and adult) to engage
family members
-	Critical points in care where family involvement is necessary
-	Steps in conducting a medical family meeting
Goal:  Able to effectively and sensitively conduct a family medical
meeting.

	Summary (1 hour)
-	Questions about implementation and finance
-	Other questions and discussion

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