Behavioral Health Assessments and Interventions of Residents and Psychology Trainees During Dual Interviewing: A Descriptive Study

摘要

There is a strong case to be made for physicians and behavioral health providers working collaboratively in primary care settings.1,2 Behavioral health problems are common in primary care, often go unrecognized by health care providers, can compromise the treatment of physical problems, are related to physical health status, and can be treated in a cost-effective manner in primary care.3 The development of collaborative, multidisciplinary teams is essential for improving patient care4,5 and for the success of the patient-centered medical home (PCMH).6Increasingly, family medicine residencies include psychology trainees (predoctoral/postdoctoral) to provide behavioral health assessments, testing, brief interventions, and to train residents in collaborative skills within the PCMH.7 Dual interviewing8 (the practice of medical residents and psychology trainees collaboratively interviewing clinic patients) is one of the most important of these skills. Much has been written about how such collaboration might occur,9 but little is known, however, about how residents and psychology trainees actually interact during dual interviews. Therefore, we attempted to address this vital shortcoming in the literature by describing the frequency of medical residents and psychology trainees completing behavioral health assessments (defined broadly as the assessment of DSM-IV disorders as well as the frequency of health-related behaviors such as diet and exercise) and interventions. Additionally, we will compare the frequency of behavioral health assessments and interventions between residents and psychology trainees in single visits as well as repeat encounters (ie, follow-up visits with the same resident/trainee dyad). To our knowledge, this is the first study to present such data that are critical to understanding how medical residents and psychology trainees collaborate during dual interviews.Methods