Collaborative Medicine Case Studies

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Collaborative Medicine Case Studies Evidence in Practice Edited by Rodger Kessler and Dale Stafford, Berlin Family Health, Montpelier, Vermont and Department of Family Medicine University of Vermont College of Medicine   Just as the mind and body collaborate in maintaining one’s health, collaboration between primary and behavioral health care can bring patients more efficacious treatment and better long-term results, from better compliance with or less dependence on medication to more effective use of health care services. Collaborative Medicine Case Studies shows physicians and mental health practitioners working together across a variety of settings to assess and treat entrenched illnesses, combined physical and psychological conditions (back pain/panic attacks, diabetes/bipolar disorder), and cases that defy straightforward diagnosis. At the same time, the cases reflect the economic and financial realities of contemporary health care. The cases discussed generate creative solutions using different levels of collaboration depending on patient need and site variables, but all share important similarities: close communication, careful follow-up by physician and behavioral health collaborators, and patients who would not have been treated as effectively without collaborative care. Blending research evidence, clinical insight, welcome humor, and realistic optimism, these cases demonstrate impressive successes, instructive setbacks, and comparative viewpoints while shedding light on the logistical, financial, and training challenges of integrative practice. A sampling of the three dozen cases: The head and the brain: migraines, orofacial pain, tinnitus. Comorbid PTSD and persistent pain. Individuals and couples with complex medical/emotional problems. Chronicillnesses: obesity, spina bifida, cardiovascular disease. A Hmong woman’s post-immigration depression. A physician with anorexia Burn patients who keep coming back without treatment success. Collaborative Medicine Case Studies is a blueprint for a vanguard in care, not only for physicians and psychologists but also for professionals and graduate students in health psychology and health care administration and finance.

This timely and important work looks at the collaborative health care model for the delivery of mental health care in a primary care setting. This has become the ideal model for the treatment of comorbid medical and psychiatric or psychological disorders. There is also an increased awareness that pharmacological intervention, the most frequently delivered intervention for psychological disorders, is often of limited effectiveness without concurrent specific psychological intervention. Further, Kessler shows that most psychological care these days is delivered through primary care—patients prefer to receive psychological care in that setting, and if they are referred elsewhere, it becomes less likely that they will follow through. In sum, moving mental health care into primary care has been shown to improve both the medical and psychological outcomes. The book includes more than two dozen case studies, co-written by clinical psychologists and primary care physicians. It is essential reading for any psychology practitioner in a clinical setting, as well as for health care administrators.

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Rodger Kessler

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Collaborative health care model Comorbid medical disorder treatment Diabetes Evidence-based clinical interventions Medicine case studies Rehabilitation assessment patients primary care

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