One of the reasons mental health counselor Lisa Corbin, PhD, LPC, NCC, chose to work at PCOM was because of the institution’s osteopathic focus on holistic care.
“Our mental health affects our emotional health and affects our physical health,” she explained. Looking at the whole picture, Corbin emphasized, provides ways to improve the quality of care—and the quality of life—for patients.
Corbin, in her role as a professor and director of the Mental Health Counseling program at PCOM, trains students to work with primary care physicians and other healthcare providers in order to strengthen a patient’s ability to improve their health and overall well-being.
Corbin, along with PCOM graduate Nic Schmoyer-Edmiston, PhD, NCC, MS '21, recently explored how mental health counseling programs incorporate this concept of integrated behavioral health (IBH) into counselor education. The resulting article—"Integrated Behavioral Health Training in Counselor Education: A Call to Action"—was recently published in The Journal of Integrated Primary Care.
Integrated behavioral health is a collaboration between mental health providers and other health professionals designed to provide the best level of care for the client.
“In today’s healthcare environment, this most often occurs within primary care,” Schmoyer-Edmiston said. This includes clinical mental health counselors, clinical social workers, clinical psychologists, or marriage and family therapists working directly with primary care physicians and other primary care staff.
“It's also not uncommon for this to occur in specialty care settings like OB-GYN clinics, cardiology, and oncology as well as general hospital settings,” he added.
Corbin recounted an experience with a patient who was facing multiple surgeries and a long recovery time. The patient, she said, was severely depressed and struggling to cope.
“She was on an antidepressant but her primary care physician realized she needed more than just the medication,” Corbin explained.
By utilizing cognitive behavioral therapy, Corbin was able to help the patient deal with her thoughts and emotions within a few weeks time.
“Now the client is actually doing a bit better because her mental health is better and she's able to better deal with the negative physical health,” Corbin said.
This collaborative health approach not only improves the patient’s health and well-being but can also reduce cost making it an attractive approach for providers and insurers alike.
Integrated behavioral health should ideally reduce the overall cost burden of care while enhancing patient outcomes, Schmoyer-Edmiston said.
“In healthcare, there's this aspirational principle called the quadruple aim, which talks about four goals that all health care should strive towards,” he explained.
These four goals are:
IBH, Schmoyer-Edmiston explained, can help achieve all of these goals. And while all are important, Schmoyer-Edmiston believes integrated behavioral health can be of particular benefit to providers.
“Primary care physician and mental health therapist burnout is especially high right now, and suicide rates among PCPs are among the highest of any other profession,” he said. By distributing patient care responsibilities, IBH could potentially reduce provider stress and burnout.
“The responsibility isn't just on one person. It's on the healthcare team as a whole,” he explained.
According to Corbin and Schmoyer-Edmiston, many counseling programs do not specifically train counselors to work in integrated care settings.
“What we do see very consistently is that when new clinicians from mental health counseling—and sometimes psychology and social work backgrounds—integrate into these settings, they have to learn how to do these things on their own,” Schmoyer-Edmiston said.
At PCOM, however, students in the MS in Mental Health Counseling program receive IBH training beginning in their first year of studies.
“One of the interprofessional educational experiences that MS counseling students get exposed to is having DO (doctor of osteopathic medicine) students come into their counseling skills class. And the DOs are able to watch some of our students perform basic counseling skills,” Corbin said. “Our hope is that the DO students will pick up some basic counseling skills in an informal way. Sometimes DO students will step in and pretend to be a client which I think also helps them develop empathy and understanding.”
These interprofessional experiences continue throughout the program with DO students observing classes in cognitive behavioral therapy, counseling students observing classes in osteopathic manipulative medicine, and students from both programs working together in other collaborative exercises.
These experiences provide answers to several questions, Corbin explained.
“[We] come together in these small groups where we can say, ‘What does this really look like? What do you as the health care provider need to know from us as clinicians?’,” she said. “How can we support each other as we come together for this client in their long-term care?”
PCOM, Corbin added, is one of the few counseling programs that provides students with hands-on learning experiences in integrated behavioral health.
“Very few schools are doing this,” she said. “It really can set you apart.”
Schmoyer-Edmiston agreed.
“As an alumni and as an incoming faculty, I think the fact that PCOM prepares you to do various tasks associated with collaborative health care through targeted, intentional training sets PCOM apart from other institutions,” he said. “These are the things that are going to be happening as we move forward as a profession. This is what you're going to need to know. We're anticipating it here. We hand you integrated care training on a silver platter.”
The fact that the program is housed within a medical school provides a unique advantage, he added.
“With a healthcare system that is evolving more towards integrated care and interprofessional collaboration, the fact that PCOM is housed in a collaborative space is huge from my perspective,” Schmoyer-Edmiston said. “I definitely don't think I would have been as prepared for doctoral studies and for clinical practice, if I had gone somewhere else.”
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