Fletcherkjer7169

After controlling for general fear of emotion, fear of particular emotion states was associated with some specific PTSD symptoms. CONCLUSION Both general and specific fears of emotion were associated with specific PTSD symptoms in trauma-exposed veterans. Despite this, results support the use of a modified ACS total score, capturing general fear of emotion, rather than the subscale scores, capturing fear of specific emotions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).Referring to provider burn-out as a foe to be conquered is a palatable representation that fits within a familiar medical narrative-combating disease, fighting illness, curing and vanquishing the cancer. Even the words we use to describe our daily work-"on the front lines" or "in the trenches" or "fighting the good fight"-places us on a metaphorical battlefield. Is provider burn-out inflicted by another entity, and if so by whom or by what? Is it, by contrast, a disease or a condition? Is burn-out something that just happens or is it created? The World Health Organization International Classification of Disease (World Health Organization, 2019) added burn-out in 2019, but also made a clear statement that this is an occupational phenomenon and not a medical condition. It defines burn-out as "a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions feelings of energy depletion or exhaustion; increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy. Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life" (WHO, 2019). (PsycInfo Database Record (c) 2020 APA, all rights reserved).Presents a brief story about the drowning death of a two year old child, the grief of the parents, and subsequent organ donation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).Presents a poem about regret, hospice, medical students, and learning. (PsycInfo Database Record (c) 2020 APA, all rights reserved).Presents a poem about reconciling the disconcerting changes of a beloved and aging grandmother. (PsycInfo Database Record (c) 2020 APA, all rights reserved).This collection of 55-Word Stories is inspired by the resilient people experiencing chronic homelessness in downtown Salt Lake City and the dedicated team at Fourth Street Clinic in Utah. (PsycInfo Database Record (c) 2020 APA, all rights reserved).Presents a poem about a mother's response to the death of her premature baby. (PsycInfo Database Record (c) 2020 APA, all rights reserved).The acceptance speech by the recipient of the CFHA 2019 Don Bloch Award is presented. The recipient notes that her work for the last 35 years has focused on increasing access to comprehensive and high quality health care for underresourced and marginalized populations, with a strong emphasis on strengthening systems and clinical practice. Her journey to promote integrated behavioral health began in 2005 and has led to some success in accelerating the adoption and robust expansion of behavioral health integration into primary care in the Philadelphia region. While she has been gratified to create a structure for training, advocacy, and ongoing process improvement to support the talented and dedicated behavioral health providers and clinical teams who do the hard work of caring for our vulnerable patient populations, "everything I know and believe about integrated care I have learned from this association and those affiliated with CFHA." (PsycInfo Database Record (c) 2020 APA, all rights reserved).Don Bloch's legacy is expansive and deep, epitomized by his vision, systemic orientation, innovative work, and a paragon of connecting people. Natalie Levkovich has continued this tradition as past president of the Collaborative Family Healthcare Association (CFHA), Chief Executive Officer of the Health Federation of Philadelphia, and contributor to numerous boards and projects. She is a fervent champion for improving population health by increasing access to high quality care for all, especially the most marginalized. The nomination highlights four central themes to her innovative and remarkable leadership. (PsycInfo Database Record (c) 2020 APA, all rights reserved).At this month's staff meeting of your integrated primary care practice, the medical director makes an announcement Your health system just signed a contract that includes a value-based payment (VBP) arrangement with a local managed care organization (MCO). The medical director suggests that this will lead to big changes in your practice because you will now focus on producing patient outcomes rather than on volume of care delivered. You wonder What is a VBP arrangement? What kinds of patient outcomes? What does this mean for integrated care? and How do I help our organization succeed? Value-based care is the future, and it will impact the way that all of us practice. In value-based arrangements, the delivery of care fundamentally changes because payment for care shifts from our current fee-for-service model, in which provider productivity is key to financial survival, to payment for positive clinical outcomes where quality of care rules. And this change is happening now. In 2015, the U.S. Department of Health and Human Services announced aggressive national VBP targets, with a goal of tying 50% of all Medicare payments to alternative payment models by the end of 2018 (New York State Department of Health, 2015). Since then, many states have adopted similar targets for their Medicaid programs in light of ongoing state budget challenges and unsustainable cost growth trends. As these changes take hold, health care providers are increasingly expected to make fundamental changes to service delivery, financial, and organizational operations. As health care providers, VBP will require us and our health centers to develop new skills, capacities, and systems for managing clinical, financial, and operational performance and risk. We must all make sure we understand and are ready to play our part in the transition to VBP. (PsycInfo Database Record (c) 2020 APA, all rights reserved).INTRODUCTION A novel couple-based intervention was created to address the individual and interpersonal needs of people with chronic pain and their romantic partners, as research has shown that pain negatively impacts both partners. A pilot study revealed positive outcomes in both partners, though the extent to which improved relationship functioning contributed to these outcomes is unknown. The purpose of this study was to examine couples' experience of the treatment to determine whether addressing relational flexibility was appraised by couples as playing an important role in this novel intervention. METHOD Fourteen couples who completed the treatment participated in interviews and gave feedback about the intervention. Interviews were analyzed using a multiphase thematic analysis to provide information about the treatment effects and mechanisms of change from the couples' perspectives. RESULTS Couples described the intervention as essential in rebuilding their relationships, which had been negatively impacted by the effects of chronic pain. DISCUSSION The presence of chronic pain had contributed to feelings of isolation, helplessness, and resentment within relationships. Participants valued this dyadic treatment because it enhanced their communication, connection, and intimacy. Their reports reinforce the importance of targeting both partners in pain treatment when relationship distress is present, as the improvements made in individual treatment are unlikely to be maintained if patients return to environments that are unsupportive and distressed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).Comments on an article by Richman, Lombardi, and Zerden (see record 2020-20111-003). The analysis provides important baseline data that identifies where behavioral health and primary care colocation is currently occurring in the United States. It builds on an earlier analysis from 2008 (Miller et al., 2014), which found that colocation of primary care providers (PCPs) with behavioral health providers is more common in urban settings than rural. As person-centered care becomes more of an expectation for consumers, policymakers and payers will continue to feel pressure to address the highly fragmented and expensive care delivered today. Providing incentives for behavioral health integration, including primary care and behavioral health colocation, is vital to achieving that goal. Knowing where and which types of practices are colocated will help target interventions to where they are most needed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).INTRODUCTION Evidence supports that integrated behavioral health care improves patient outcomes. Colocation, where health and behavioral health providers work in the same physical space, is a key element of integration, but national rates of colocation are unknown. We established national colocation rates and analyzed variation by primary care provider (PCP) type, practice size, rural/urban setting, Health and Human Services region, and state. METHOD Data were from the Centers for Medicare & Medicaid Services' 2018 National Plan and Provider Enumeration System data set. Practice addresses of PCPs (family medicine, general practitioners, internal medicine, pediatrics, and obstetrician/gynecologists), social workers, and psychologists were geocoded to latitude and longitude coordinates. Distances were calculated; those 44% were colocated with a behavioral health provider. PCPs in urban settings were significantly more likely to be colocated than rural providers (46% vs. 26%). Family medicine and general practitioners were least likely to be colocated. Only 12% of PCPs who were the sole PCP at an address were colocated compared with 48% at medium-size practices (11-25 PCPs). DISCUSSION Although colocation is modestly expanding in the United States, it is most often occurring in large urban health centers. Efforts to expand integrated behavioral health care should focus on rural and smaller practices, which may require greater assistance achieving integration. Increased colocation can improve access to behavioral health care for rural, underserved populations. This work provides a baseline to assist policymakers and practices reach behavioral health integration. (PsycInfo Database Record (c) 2020 APA, all rights reserved).INTRODUCTION Greater understanding of the impact of low intensity psychosocial interventions delivered by behavioral health clinicians (BHCs) working in an integrated care program (ICP) may promote better depression care. METHOD In a randomized controlled trial, 153 participants identified as depressed by their primary care provider (PCP) were assigned to ICP or usual care (UC, management by PCP, including specialty referral). In the ICP condition, BHCs worked collaboratively with PCPs and liaison psychiatrists. RESULTS ICP participants with lower and higher severity symptoms reported significantly greater use of coping strategies than UC participants at the 1-month follow up (lower p = .002; higher p = .016). ICP participants with lower severity continued to report significantly greater use of coping strategies than UC participants at the 4-month (p = .024), and 7-month (p = .012) follow ups. ICP participants were more likely to be following relapse preventions plans at the 4-month follow up (lower 89.5% vs.