Common behavioral and cognitive interventions in primary care: Moving out of the specialty mental health clinic

(from the chapter) The window of opportunity for intervening in primary care settings is much narrower than that in specialty mental health clinics. In specialty mental health, providers often have the luxury of over a dozen 50-minute sessions. In primary care, interventions must be selected that will have the desired effect in one to four 30-minute appointments in a typical case. In this chapter, we describe nine such interventions that we consider the behavioral health consultant's (BHCs) basic toolkit for practicing in primary care. These interventions were selected on the basis of empirical evidence and their compatibility with a self-management model of care, and we have found that they have been effective for addressing a wide variety of symptoms and functional impairments seen in primary care. The interventions are: (a) relaxation training, (b) goal setting, (c) cognitive disputation, (d) motivational interviewing (MI) strategies, (e) problem solving, (f) self-monitoring, (g) behavioral self-analysis, (h) stimulus control, and (i) assertive communication. In this chapter, we first describe the intervention and how it fits into the 5A's model (i.e., assess, advise, agree, assist, arrange). Within the structure of the 5A's, we describe how to present the intervention to a patient in plain, understandable language. For several of the interventions, handouts and worksheets are included at the end of the chapter. We do not focus on applying these interventions to specific patient problems in this chapter as this is the focus of the chapters in Part II of this volume. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (chapter)