The utilization of integrative care/collaborative care models has significantly increased in recent decades, both within private and public sectors of health care (Kelly & Coons, 2012). But what are integrative health care models? Integrative health care models refer to the collaboration between health professionals, which endeavor to administer whole treatments in an effort to enhance the overall well-being of patients. One of the leading movements is integrating behavioral health into primary care settings. Numerous studies have revealed that this sort of merging of services can enhance access to mental health assistance, improve quality of care, lower the costs of health care, better overall health in patients, lessen the burdens on PCP’s, and enhance and better the ability for PCP’s to attend to the mental health needs of their patients (Auxier, Farley, & Seifert, 2011). Health care teams can achieve therapeutic goals for individual clients through open, honest, and respectful collaboration among professionals from diverse fields of practice, as well as through open, honest, and respectful communication with the patient. This supports health literacy by ensuring that health professionals are communicating adequately, that health services are accessible to the patient, and that the patient understands and is able to act upon health information and services in a fashion that improves their quality of care and general health and well-being.
Some primary factors that might lead to the failure of the CC/IC delivery model is professionals not communicating with one another, information not getting passed along properly, lack of understanding for the scope of practice for each individual practitioner, or putting more emphasis and importance on their own field of practice and methods of treatment, that it results in a power struggle within the integrative relationship. Ways to improve such issues could be setting up more face-to-face meetings and/or virtual televideo conferences. Group emails are also another way to combat these issues, ensuring that everyone is on the same page and providing a mode of communication to work out any differences or clear up any misunderstandings between practitioners. Additionally, communication through patient charts, when charts are electronically-based and information is systematically organized is another way to alleviate these issues (Soklaridis, Kelner, Love, & Cassidy, 2009).
I think a primary method to help educate PCP’s about the scope of other practitioners’ practice could be onsite training with a mixture of technology specific training. This would be especially beneficial when merging behavioral health services with primary care services. PCP’s could learn to assess better for behavioral health, substance abuse, and other disorders, which could lead to early detection and prevention.
The APA Ethical Code of Conduct can be used to guide decisions in a number of ways. First, a few standards that seem most applicable in this situation include: 2.01 - Boundaries of Competence, 2.03 – Maintaining Competence, 3.04 – Avoiding Harm, 3.10 – Informed Consent, and 4.05 – Disclosures. When working within am integrative relationship, all professionals must maintain a level of competence within their own practice, but must also strive to become educated in the practices of the other practitioners’ professions. You cannot effectively and ethically treat a patient using methods from other fields of practice without training and education. To do so could violate the standard and principle of do no harm. The client comes first and their health and well-being is paramount. Informed consent must still be obtained from all parties, wherein the patient is agreeing to the integrative treatment that will likely be provided from a number of clinicians. This brings up the issue of disclosure, it should be established at the outset between the integrative team and the patient what is allowed to be disclosed among professionals and that which is to stay between individual clinician and patient.
Potential work settings where the CC/IC model might be found include: primary care settings, rehabilitation units, long-term care settings, and community-based health centers. Such a model might improve job satisfaction in the sense that it reduces the burden of having one clinician come up with treatment options for a patient that harnesses a whole slew of issues, some of which may be outside of their area of expertise. It will help in being able to treat the whole person, and not just certain aspects of the patient’s presenting problems.
References:
American Psychological Association. (2010). Ethical principles of psychologists and code of conduct: Including 2010 amendments. (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site. Retrieved from http://www.apa.org/ethics/code/index.aspx
Auxier, A., Farley, T., & Seifert, K. (2011). Establishing an integrated care practice in a community health center. Professional Psychology: Research and Practice, 42(5), 391–397. doi:10.1037/a0024982
Kelly, J. F., & Coons, H. L. (2012). Integrated health care and professional psychology: Is the setting right for you? Professional Psychology: Research and Practice, 43(6), 586–595. Retrieved from https://library.ashford.edu/ezproxy.aspx?url=http%3A//search.ebscohost.com/login.aspx?
Soklaridis, S., Kelner, M., Love, R., & Cassidy, D.J. (2009). Integrative health care in a hospital setting: Communication patterns between CAM and biomedical practitioners. Journal of Interprofessional Care, 23(6), 655–667. Retrieved from https://library.ashford.edu/ezproxy.aspx?url=http%3A//search.ebscohost.com/login.aspx?direct=true%2526AuthType=ip,cpid%2526custid=s8856897%2526db=a9h%2526AN=44746564%2526site=ehost-live
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