Hello, colleagues.
I am putting my feet on U.S. soil for the first time in a month today. My trip to Europe included visits with colleagues in Spain, Sweden, Denmark, and attending the Association for Contextual Behavioral Science (ACBS) World Conference IX in Parma, Italy. The presentations at ACBS were there were fantastic, and now seems the perfect time to tell you about a new book. Real Behavior Change in Primary Care: Strategies and Tools for Improving Patient Outcomes and Increasing Provider Satisfaction is now available from New Harbinger, and you may want to take a look at a variety of free downloadable materials from the book.
In addition to describing my book, I want to tell you a little about myself and my co-authors. I am a researcher, writer, and trainer in behavioral health integration and application of behavior change techniques in primary care. I began working with Steve Hayes and Kirk Strosahl in the 1980’s. In 1998, I formed Mountainview Consulting Group with Kirk Strosahl. Our company’s website (behavioral-health-integration.com) has many free downloadable materials for behavioral health providers who work in primary care. Current clients include the United States Air Force Medical Operations Division and the San Francisco Department of Public Health.
My co-authors include Debra A. Gould, MD, MPH, and Kirk Strosahl, PhD. Deb is a practicing physician, researcher, and University of Washington Family Practice residency faculty member (at the Central Washington Family Medicine Clinic in Yakima). Her many areas of expertise include assessing, preventing, and intervening with medical provider burnout. Kirk is a co-founder of Acceptance and Commitment Therapy and a pioneer in the movement to bring behavioral health services into primary care clinics. He is currently working with Deb at the Central Washington Clinic, where he is having a great time training residents and providing behavioral health consultation services.
Now for a brief description of Real Behavior Change in Primary Care, beginning with why we wrote it. Many patients have historically sought help with behavior problems in the primary care setting, and, with current economic problems, the number is growing. An American Psychological Association poll in September 2010 suggested that 80 percent of the public reported experience of stress related to the economy, up from 66 percent in April 2010. The National Sleep Foundation recently found that 27 percent of people surveyed last fall have sleeplessness because of economic anxiety. Calls to the National Suicide Prevention Lifeline have increased from 39,465 in 2008 to 50,158 in 2009. These are troubling times, and providers of primary care are working diligently to address behavioral and emotional health problems, along with medical problems.
We can no longer allow the historical separation of mental health and medical treatment. Separation has a negative impact on heath outcomes—particularly for more vulnerable patient populations. A number of activities are coming together to change this situation. First, the Medical Home model is now promoting integration of behavioral health services into routine primary care. Secondly, evidence for behavioral treatments in primary care is growing, and mindfulness training for physicians, behavioral health providers, and patients is increasingly available in a variety of venues. However, one gap that needs to be addressed is the lack of access that most primary care providers have to current, empirically supported behavior change techniques that emphasize mindful, values-based behavior change. That’s why Deb, Kirk, and I wrote Real Behavior Change in Primary Care.
Real Behavior Change in Primary Care has two main goals. The book provides health care providers with (1) engaging and effective tools for working with both routine and challenging patients, and (2) tools to treat their own frustrations (that may put them at risk for burnout and / or leaving the field of medicine). The book offers a template for providers to use to apply principles of contextual behavioral science (in particular, Acceptance and Commitment Therapy or ACT) and a pocket guide to assist with quick identification of brief techniques tailored to fit the typically short visits that nurses, mid-levels, and physicians have with patients.
This is a small book with three sections: Part one provides an overview of the contextual behavior change model, part two provides case examples that illustrate application of the model and related clinical practice tools to patients with chronic disease, substance abuse, depression, anxiety, chronic pain, and trauma, and part three introduces a primary care stress checklist and illustrates use of techniques for primary care providers (and residents and medical students) to use to create meaningful and workable medical careers. As a supplement to the book, there are two online bonus chapters and copies of all clinical practice tools used in the book. These materials are free downloads. The bonus chapter topics are “Angry Patients . . . and Soft Eyes: Connecting with the Help Rejecting Patient”, and “I’m Okay. But, You Won’t Be for Long: Addressing Health Risk Behaviors”. To help you get a quick overview of the book, take a look at the book’s table of contents.
If you are new to the movement to take behavioral health services into primary care, you may want to consider reading a book I wrote with my colleague, Jeffrey T. Reiter, several years ago. Behavioral Consultation and Primary Care: A Guide for Integrating Services (2007) by Robinson & Reiter describes a model for launching delivery of behavioral health services in primary care settings. It is a practical book that is an ideal first-read for behavioral health providers wanting to expand into the primary care treatment venue and for primary care providers who want to recruit a behavioral health provider into their clinic. It includes clinical chapters that present numerous case examples illustrating ACT treatments for children, adults, and older adults, as well as chapters on group services, ethical issues, and program evaluation. Behavioral Consultation and Primary Care is available from Springer Science and Media, as well as on Amazon.com and other on-line bookstores.
Before ending this very long post, I want to thank New Harbinger for making a “bold move” and publishing their first book for physicians, nurse practitioners, physician assistants, and nurses.
Finally, you may want to check the following two websites for updates on Real Behavior Change in Primary Care workshops, materials development, etc.:
Very Respectfully,
Patti Robinson
