Healthcare is now practiced in a different financial and delivery system than it was two decades ago. Currently managed care defines what is treated, how, by whom and for what reimbursement. Mental health professionals have been greatly impacted by these changes to their practice, and yet, there is little understanding of exactly what it is and where it is going. The present volume explores these issues, prospects and opportunities from the vantage of mental health /medical professionals and managed care executives who are in the very process of implementing changes to the existing system of managed care. Behavioral healthcare will be integrated into medical practice in the future for sound clinical and economic reasons. The present volume, edited by four prominent mental health professionals provides a roadmap of the emerging directions integrated behavioral healthcare is taking and lays out the steps the mental health professional needs to take--in training, and modifying her/his clinical practice--to adapt to the new system of healthcare.
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Nicholas A. Cummings, Ph.D., Sc.D. is the President of the Foundation for Behavioral Health and Chairman of the Nicholas & Dorothy Cummings Foundation, Inc. He was the founding CEO of American Biodyne (MedCo/Merck, then Merit, now Magellan Behavioral Care). He is also the former President of the American Psychological Association. Dr. Cummings was the founder of the four campuses of the California School of Professional Psychology, the National Academies of Practice, the American Managed Behavioral Healthcare Association, and the National Council of Professional Schools of Psychology. He was also the Chief Psychologist (Retired) at Kaiser Permanente. He was the former Executive Director of the Mental Research Institute. Currently, Dr. Cummings is a Distinguished Professor at the University of Nevada, Reno.
Janet L. Cummings, PsyD., is President of the Nicholas & Dorothy Cummings Foudation, Inc., and former staff psychologist at American Biodyne (MedCo, now Merit Behavorial Care). She earned her Doctorate at the School of Professional Psychology, Wright State University, 1992.
There exists a conceptual and practical division between professionals that help people with physical/medical problems and those that help people with mental/behavioral problems. In this dualism, individuals with physical problems, like a broken bone, go to a medical doctor and individuals with behavioral problems, like a broken marriage, go to a mental health professional.
If all medical problems were due to physical causes and all mental problems were due to psychosocial causes, then diagnosis and treatment would be clear. However, this is not the case. Broken bones are caused by behavioral problems (e.g., marital abuse, alcoholism, poor diet). Medical problems are treated by behavioral changes (diet, exercise, and other lifestyle changes). And most medical treatments require, and can be defeated, by behavioral compliance problems with the prescribed regimen (pill taking, showing up for the scheduled procedures, etc.). Moreover, mental health problems can be caused and treated by physiological factors (neuron-chemical imbalances, endocrine problems, and psychotropic drugs). Thus, fragmenting the treatment of the mental and physical problems into two distinct realms makes little conceptual or practical sense.
Integrated Behavioral Healthcare describes the promise of integrating behavioral and medical care in the primary care setting - a move that recently has been gaining momentum. It provides a roadmap of the emerging directions integrated behavioral healthcare is taking and lays out the steps the mental health professional needs to take, in training and in modifying their clinical practice, to adapt to the new system of healthcare.
|There exists a conceptual and practical division between professionals that help people with physical/medical problems and those that help people with mental/behavioral problems. In this dualism, individuals with physical problems, like a broken bone, go to a medical doctor and individuals with behavioral problems, like a broken marriage, go to a mental health professional.
If all medical problems were due to physical causes and all mental problems were due to psychosocial causes, then diagnosis and treatment would be clear. However, this is not the case. Broken bones are caused by behavioral problems (e.g., marital abuse, alcoholism, poor diet). Medical problems are treated by behavioral changes (diet, exercise, and other lifestyle changes). And most medical treatments require, and can be defeated, by behavioral compliance problems with the prescribed regimen (pill taking, showing up for the scheduled procedures, etc.). Moreover, mental health problems can be caused and treated by physiological factors (neuron-chemical imbalances, endocrine problems, and psychotropic drugs). Thus, fragmenting the treatment of the mental and physical problems into two distinct realms makes little conceptual or practical sense.
Integrated Behavioral Healthcare describes the promise of integrating behavioral and medical care in the primary care setting - a move that recently has been gaining momentum. It provides a roadmap of the emerging directions integrated behavioral healthcare is taking and lays out the steps the mental health professional needs to take, in training and in modifying their clinical practice, to adapt to the new system of healthcare.
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