Mental Health Professionals in Medical Settings: A Primer

American Journal of Clinical Hypnosis,  Apr 2003  by Weisberg, Mark B

• E-mail
• Print
• Link

Another problem relates to recommendations about the appropriate scope of services. The authors focus only on the brief psychotherapeutic services needed in these settings. But, in my experience, there are many other skills needed to be an effective mental health consultant in a medical or primary care setting. Other requisite skills include the ability to do a quick assessment of a patient's mental status, psychological and psychophysiological functioning; discern and clarify the "real" referral question; quickly and concisely interview the patient, family, nursing staff, referring physician, etc. to ascertain contributing factors; be an effective systems analyst on multiple levels, including the clinic, family, and hospital; be well informed on relevant physical diagnoses and treatments, medications, and dosages (particularly psychotropics) and be able to speak to the relative and complimentary contributions of psychotropics versus psychotherapy. They must be able to assess quickly and effectively problems of compliance with treatments, and to understand (and be able to convey in simple language) the myriad ways in which a "somatizing patient" may represent a complex combination of neurophysiologic pathways intensified by excessive autonomic arousal and vigilance.

I believe that the inexperienced mental health professional in a medical setting requires the development of a different sense of professional role identity than that suggested in this text. Given that this book is described as a "primer", it attended very little to the elaboration of essential training and skills necessary for the clinician to learn about effective functioning.

The authors should be commended on their desires to contribute to the integration of mental and physical health services. If a clinician wants to learn about financial accountability or administrative startup issues in collaborative care, this book might be a useful resource. However, for novice professionals just learning about consultation in medical settings, I would recommend other texts (e.g., Johnson, Perry & Rozensky, 2002) that do a better job of describing some of the tasks, underlying skills, and conceptual underpinnings required.

References

Barrett, J.E., Barrett, J.A., Oxman, T.E., & Gerber, P.D. (1988). The prevalence of psychiatric disorders in a primary care practice. Archives of General Psychiatry, 45,1100-1106.

Johnson, S.B., Perry, N.W. & Rozensky, R.H. (Eds.), Handbook of clinical health psychology: Medical disorders and behavioral applications. Washington, DC: American Psychological Association Press.

Strain, J. (1982). Collaborative efforts in liaison psychiatry. In T. Millon, C. Green, & R. Meagher (Eds.) Handbook of clinical health psychology. New York: Plenum.

Strosahl, K. (1998). Integrating behavioral health and primary care services: The primary mental health model. In A. Blount (Ed.), Integrated primary care: The future of medical and mental health collaboration (pp. 139-166). New York: W.W. Norton.