and Jeffrey T. Reiter2
(1)
Mountainview Consulting Group, Inc., Zillah, WA, USA
(2)
HealthPoint, Seattle, WA, USA
Electronic supplementary material:
The online version of this chapter (doi:10.1007/978-3-319-13954-8_3) contains supplementary material, which is available to authorized users.
Keywords
Behavioral health consultantBehavioral health assistantCore competency trainingBehavioristPrimary care psychologistJob descriptionInterview questionsMentoringJob performance evaluation“The beginning is the most important part of the work.”
Plato, The Republic
The mission of the Primary Care Behavioral Health (PCBH) model is to improve the effectiveness and efficiency of the Primary Care (PC) system in helping patients of all ages, with any preventive, acute, or chronic behavioral issue. Pursuit of this mission requires changes in many elements of the clinic and medical staff, but perhaps the most important is to have a well-trained BHC. Unfortunately, finding such a person is not as easy as it might sound. The work of a BHC involves a set of skills and knowledge base that few MH graduate training programs teach. A BHC must know how to deliver brief, evidence-based interventions to a large volume of patients using a consultant model; to be a generalist, addressing any and all behavioral needs of patients from birth to death; to be a team player, comfortable with being easily accessed and working collaboratively on treatment needs; and to be a “systems thinker” who understands PC’s role within the healthcare system and sees the big picture of what the clinic and the healthcare system need.
The good news is that training programs across the United States (and other countries) are updating curricula to better prepare behavioral health providers for this role. Yet a robust BHC workforce remains a long way off. Thus, in this chapter, we provide guidance for hiring, training, supervising, and evaluating a BHC. In a nutshell, this chapter provides everything a clinic needs to know for filling the all-important role of their newest team member, the behavioral health consultant (BHC).
Hiring a BHC
The first step in adding a BHC is, of course, to find the right person. In this section, we provide guidance regarding each step of the process, from advertising the position to interviewing candidates to selecting the best candidate.
Job Description
One of the first steps toward hiring a new BHC is crafting a job description. As noted earlier, we believe the title behavioral health consultant (BHC) fits this position best, as it distinguishes the role from that of a therapist. However, some behavioral health providers working in PC use other titles, such as primary care psychologist or primary care behaviorist or simply behaviorist. Of course, the devil is always in the details, so regardless of title, the most important part is developing a job description that clearly details the consultant role. Below is a sample job summary that will work for most organizations:
The Behavioral Health Consultant (BHC) position requires an independent license to practice in a health care setting, such as a PhD/PsyD in psychology, a Masters in social work, or a Masters in counseling. The BHC works in the primary care clinic as a regular team member and delivers brief, consultation-based services to patients and primary care providers (PCP). The BHC works with individuals, groups and families, providing evidence-based behavioral interventions for both mental and physical health conditions in patients of all ages. The individual in this position must be comfortable with a flexible schedule, able to complete at least ten patient visits per day, and adept in working closely with PCPs and other team members. Other required skills and duties are outlined below.
The job summary is usually followed by a list of bullet points detailing additional requirements for the position. Specific points may vary, depending on the organization, but at a minimum these should include items similar to those provided in Table 3.1.
Table 3.1
Additional BHC job requirements
Knowledge and skills | Basic, nontechnical knowledge of psychotropic and other relevant medications |
Basic understanding of primary care | |
Excellent computer skills, able to work in an electronic health record | |
Ability to work with a diverse patient and staff population, often using an interpreter in visits | |
Duties and responsibilities | Attendance at all provider, relevant staff, and quality improvement meetings |
Regular evaluation of the BHC service | |
Assist with care coordination and access to outside resources for patients, as needed | |
Design and implement critical pathways for select populations |
As a general rule, avoid requirements that applicants have experience in PC, because very few will. Focus instead on applicants with either the skills listed in Table 3.1 or who demonstrate a strong interest in learning them. In addition, Freeman (2011) recommends looking for individuals with the following personality traits: flexible, high energy level, team player, and strong interest in health and fitness. We agree with those recommendations and would add the following: extroverted, self-starter, and have an interest in larger systems issues in addition to individual patient care. Specific core competencies for a BHC are detailed in Chapter 5 and are also helpful to keep in mind when hiring a BHC.
Clinics often have questions about what type of professional degree makes for the best BHC. They may wonder if they can get the same services from a master’s-level provider and pay less for the BHC’s salary. In our experience, the success of the BHC depends more on skills and personality than on the degree. That being said, doctoral-level providers typically have training in areas that master’s-level providers do not, including program development and evaluation, research, and some clinical areas. For this reason, organizations sometimes prefer a doctoral-level provider if there will be only one BHC; or they select a doctoral-level provider to lead a BHC service that is otherwise staffed with master’s-level providers. If a BHC will be expected to provide training, program evaluation, and supervision, this should be included in the job description.
Suggestions for Recruiting and Interviewing
For recruiting purposes the following job posting is recommended as a starting point (other pertinent details, specific to the organization, can be added). The below description provides enough detail to attract the most viable candidates, without placing too many requirements:
Behavioral Health Consultant (BHC): Exciting new position as a primary care team member providing brief 15- to 30-minute interventions for a wide variety of behavioral issues in patients of all ages. The BHC will work closely with primary care providers and staff to develop and implement treatment plans. Applicants should have an interest in and/or experience with brief interventions, team-based care, a wide variety of psychiatric, substance abuse and behavioral medicine problems, and diverse populations. Must have a PhD in psychology, a Masters of Social Work, or a master’s in a related counseling field, and be licensed or license-eligible in X state.Related posts:
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