Program Curriculum

The Certificate Program requires 20 weeks to complete. It consists of 5 units, each of which is divided into 4 modules that last for one week. Each module includes a video lecture, interaction with the instructor and colleagues through discussion boards, and—where relevant—additional readings. Completion of the entire Program is required to receive continuing education credits. Information about continuing education credit specific to each discipline can be found here.

In addition to required readings and videotapes lectures, students participate in online discussions. All of these activities occur at the convenience of the participant.

Program Outline

Unit 1. Basic Concepts

Module 1. The Integrated Care Perspective
This module reviews the various ways that behavioral health can be integrated into primary care and the literature on efficacy and implementation. The perspective of population-based care, or the systematic management of health conditions in communities, is described. The population-based care approach is used to inform the basis of discussion for all models of integrated care. Integrated care models are contrasted with traditional mental health practice to provide concrete guidelines for successful integration.

Module 2. Basic Concepts in Integrated Care
The following topics are introduced:

• Collaborative care (care manager) models
• Population-based care approaches
• Introduction to outcomes measurement and registry management
• Consulting psychiatry models
• Telehealth

Module 3. Billing
The module describes the use of CPT codes and translation of diagnoses from DSM-IV to ICD systems. Methods for analyzing the financial impact (cost/benefit analyses) of integrated care are introduced.

Module 4. Record Keeping
Best practices in recording patients contacts and storing patient records are reviewed. Common barriers to integrated billing and record-keeping are discussed, including state-by-state variations in regulations and setting-specific issues.

Unit 2. Provider Competencies and Characteristics

Module 1. Functional/Strategic Patient Care
The methods and theoretical bases for patient care in brief interactions are reviewed. Emphasis is placed on the transition from a traditional mental-health perspective to that of a primary care provider. Topics include:

• The step-wise care model/functional diagnostic skill development
• Core components of a primary care behavioral health visit
• The language and pace of primary care
• Cultural, economic, and spiritual factors in treatment and health behavior change

Module 2. Communication with Primary Care Providers
Best practices in communicating effectively with primary care providers and other staff are reviewed. Motivational interviewing is introduced as a tool for improving the effectiveness of mental and behavioral interventions throughout the clinic. Topics include:

• 30-second curbside case presentation
• Motivational interviewing as applied to enhancing medication adherence

Module 3. Adapting Established Interventions to Primary Care
Topics include:

• Motivational interviewing
• Adapting evidence-based cognitive-behavioral interventions
• Implementing acceptance and commitment therapy perspectives

Module 4. Practical Psychopharmacology
Evidence based approaches to medication co-management are reviewed including assisting primary care providers with templates for medication decision-making. The ethics of the participation of non-prescribing mental health professionals in co-managing medication-related issues are discussed. Syndromes discussed include:

• Depression
• Anxiety
• Bipolar disorder
• ADHD
• Dementia
• Schizophrenia

Unit 3. Practice Standards

Module 1. Algorithms for Mental Health Conditions
Algorithms for integrated biopsychosocial treatment of mental disorders are reviewed, with special emphasis on those that are particularly prevalent in community health settings: affective, bipolar, and anxiety disorders. Practical thresholds for referral to specialty mental health care are explored.

Module 2. Behavioral Medicine
This module focuses on the ways in which mental health professionals can help clinics systematize the care of medically-related health issues. Brief overviews of common interventions for the most common of these behavioral health concerns are provided. In addition, the development and use of registries is discussed from simple to complicated systems. Topics include:

• System-based care for chronic diseases, obesity, smoke cessation
• Developing and using registries to improve patient interventions

Module 3. Concepts in Assessment
Topics include:

• Methods of tracking the use of screening tools
• Methods of tracking response to treatment and patient satisfaction
• Tools for tracking screening and response to treatment
• Reporting procedures and data-based goal-setting
• Measuring primary care provider satisfaction

Module 4. Team-Building
Topics include:

• Understanding the primary care culture
• Communication
• Dealing with crisis in the setting

Unit 4. Problem-Based Assessment

Module 1. Affective, Anxiety and Somatic Disorders
The most common mood disorders are reviewed, focusing on utilization of relevant assessment tools. Triage of suicidal, homicidal, and psychotic patients is discussed, including co-management of at-risk patients are reviewed including practical tools for making well-informed patient-centered clinical decisions in adverse situations. Overlap between affective and somatic disorders, high utilization patients, patients with diffuse medical concerns, and patients with formal somatization disorders are reviewed.

Module 2. Pediatric Disorders and Obstetrics
The module focuses on assessment tools for affective/behavioral conditions, symptoms of ADHD, depression, and behavioral disturbances. The most common pediatric behavioral and mental health issues are reviewed, as is the use of brief family-based intervention and consultation with pediatricians and other child care providers in preventative care. The Well Child Check is described. Obstetric screening and care is also discussed, particularly screening for perinatal depression.

Module 3. Geriatic, Cognitive, and Memory Disorders
The most common geriatric disorders are reviewed, focusing on assessment instruments relevant to screening for affective disorders and pseudo-dementia, mental status, activities of daily living, and dementia.

Module 4. Chronic Disease Behavioral complications and causal factors that underlie most chronic diseases are discussed. Examples of disorders reviewed include:

• Diabetes
• Hypertension
• Dyslipidemia
• Cardiovascular Disease
• Asthma

Unit 5. Program Development

Module 1. Systems of Care
Systems of care in the United States are reviewed including the community mental health care system, the community health center system, the public health system, and private systems of care. This module focuses on the ways behavioral health consultants work within each of these systems.

Module 2. Community Relationships
This module focuses on activities of the behavioral health consultant outside the clinical setting. Topics include:

• Accessing resources for AODA and smoke cessation assistance
• Models for collaborating with local community mental health centers and private agencies
• Communicating with the public about the role of the behavioral health consultant

Module 3. Program Development
Common issues related to developing an integrated care program are reviewed including workforce development, hiring strategies, enhancing employee wellness, development of training programs, and intra-organizational barriers.

Module 4. Ethical Issues
Ethical and legal issues unique to the primary care setting are reviewed including differences in standards for sharing information between medical and mental health personnel, informed consent procedures, charting requirements, state-by-state differences in regulation of mental health service delivery, dual relationships with co-workers who are clinic patients, etc. Anticipatory strategies are reviewed to help behavioral health consultants adapt quickly and work concurrently with clinic administration on resolving these issues.