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Integrated Care: Maturing the Relationship Between Psychology and Primary Care

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Mark E. Vogel at Michigan State University
Mark E. Vogel
Heather Kirkpatrick at Michigan State University
Heather Kirkpatrick
Amy S. Collings
Amy S. Collings
Amy S. Collings
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Crystal L. Cederna-Meko
Crystal L. Cederna-Meko
Crystal L. Cederna-Meko
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Abstract

Integrated primary care (IPC) is an evolving model that describes the provision of behavioral health services within a primary care setting. IPC calls for professional psychologists to adopt an integrated and collaborative approach to care, while delivering a broad range of services at a faster pace, using a limited number of sessions of shorter duration, and more team interactions to address a variety of behavioral health issues. Successful implementation of IPC entails professional developmental growth through predictable stages. By tracing the development of one postdoctoral fellowship training program from colocated to fully integrated, providing case examples, and discussing lessons learned along the way, this article highlights best practices and common barriers to implementing an IPC model for others seeking to develop an IPC approach to training and/or practice.
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Integrated Care: Maturing the Relationship Between Psychology and
Primary Care
Mark E. Vogel, Heather A. Kirkpatrick, and
Amy S. Collings
Genesys Regional Medical Center, Grand Blanc, Michigan
Crystal L. Cederna-Meko
Hurley Medical Center, Flint, Michigan
Melissa J. Grey
Genesys Regional Medical Center, Grand Blanc, Michigan
Integrated primary care (IPC) is an evolving model that describes the provision of behavioral health
services within a primary care setting. IPC calls for professional psychologists to adopt an integrated and
collaborative approach to care, while delivering a broad range of services at a faster pace, using a limited
number of sessions of shorter duration, and more team interactions to address a variety of behavioral
health issues. Successful implementation of IPC entails professional developmental growth through
predictable stages. By tracing the development of one postdoctoral fellowship training program from
colocated to fully integrated, providing case examples, and discussing lessons learned along the way, this
article highlights best practices and common barriers to implementing an IPC model for others seeking
to develop an IPC approach to training and/or practice.
Keywords: primary health care, integrated services, collaboration, health care psychology, postgraduate
training
As the Patient Centered Medical Home (PCMH) continues to
evolve, the call for mental health treatment inclusion in primary
care has increased. Considerable evidence suggests that mental
health problems are common in primary care (Fries et al., 1993;
Gatchel & Oordt, 2003) yet often go under recognized and/or
inadequately treated (Pirl, Beck, Safren, & Kim, 2001; Wang,
Demler, & Kessler, 2002). In addition to traditional mental health
issues, behavioral issues (e.g., patient engagement, lifestyle
change, etc.) that surround chronic diseases often complicate treat-
ment adherence and adversely impact health (Mokdad, Marks,
Stroup, & Gerberding, 2004). In response, Integrated Primary Care
(IPC) has been proposed as a model that normalizes mental and
behavioral health issues in primary care with the goal of improved
health outcomes. This model is consistent with health policy and
reform efforts in the United States (e.g., Patient Protection and
Affordable Care Act; Public Law. No. 111–148, March 23, 2010)
which promote opportunities for psychologists to work as part of
integrated health care teams. This model is also consistent with the
2011 American Psychological Association (APA) strategic plan
that includes an initiative to forge alliances with health care
organizations to increase the number of psychologists working in
integrated health care settings (Farberman, 2011). Many psychol-
ogists are in a unique position to aid in the development and
implementation of IPC yet may be unfamiliar with how to adopt
this model. The article describes best practices and common bar-
riers to implementing an IPC model within medical specialty
MARK E. VOGEL received his PhD degree in clinical psychology from
California School of Professional Psychology – Los Angeles. He is asso-
ciate professor in the department of Family Medicine at Michigan State
University, College of Human Medicine, Director of Behavioral Science
and Psychology at Genesys Regional Medical Center, and chief psychol-
ogist at the Consortium for Advanced Psychology Training. His areas of
professional interests include integrated primary care, interprofessional
medical education, patient-centered medical home, and safety and quality
improvement in healthcare.
HEATHER A. KIRKPATRICK received her PhD degree in counseling psychol-
ogy from University of Illinois at Urbana-Champaign. She is director of
Behavioral Science for Internal Medicine at Genesys Regional Medical
Center. Her areas of research and practice include primary care psychol-
ogy, medical and psychological postdoctoral fellowship education, psycho-
pharmacology, and physician wellness.
AMY S. COLLINGS received her PhD in clinical psychology from Eastern
Michigan University. She was a health psychology fellow through
Michigan State University’s Consortium of Advanced Psychology
Training at Genesys Regional Medical Center and currently is working
as a health behavior psychologist at the Ann Arbor Veterans Adminis-
tration. Her areas of research and practice are integrated primary care
and health psychology.
CRYSTAL L. CEDERNA-MEKO received her PsyD in clinical psychology from
the University of Indianapolis. She coordinates the developmental-behavioral
pediatrics rotation for pediatrics residents at Hurley Medical Center, supervises
clinical health psychology postdoctoral fellows through the Consortium for
Advanced Psychology Training, and provides a variety of pediatric psychol-
ogy services on an inpatient and outpatient basis. Her areas of professional
interest include anxiety disorders, behavior management, health promotion,
behavior change, and coping with chronic medical conditions.
MELISSA J. GREY received her PhD in clinical psychology from Eastern
Michigan University. She is Assistant Professor of Psychology at
Monroe County Community College and adjunct clinical supervisor at
Eastern Michigan University. Her areas of professional interest include
multicultural practice, prejudice and discrimination, public policy, and
training.
CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Mark
E. Vogel, Genesys Regional Medical Center, One Genesys Parkway,
Grand Blanc, MI 48509. E-mail: vogel1@msu.edu
Professional Psychology: Research and Practice © 2012 American Psychological Association
2012, Vol. 43, No. 4, 271–280 0735-7028/12/$12.00 DOI: 10.1037/a0029204
271
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