Implementation Tool: Resident Training

Psychiatry Residency Training: Making Recommendations and Treatment to Target

This module reviews principles of goal setting and the development of care plans for common primary care presentations. Developing a treatment plan includes making medication recommendations to primary care providers, supporting the care coordinator’s use of appropriate brief behavioral and psychotherapeutic interventions (Behavioral Activation Distress Tolerance, Problem Solving Therapy, Motivational Interviewing; Health Behavior Change: Exercise, Tobacco, Diet ), working with difficult patients, and assessing patient for appropriate level of care. Other topics include enhancing medication compliance, supporting clinic development of safety protocols (to address suicidal thinking and violence) and utilizing community resources. Part of the Psychiatry Residency Training in Collaborative Care.

Resources
Module 5: Making Recommendations and Treatment to Target Slide Handouts
Module 5: Making Recommendations and Treatment to Target Overview

Psychiatry Resident Training in Collaborative Care

Integrated behavioral health is a rapidly growing field in mental health and to date there are limited training resources on this topic. The AIMS Center has developed a clinical rotation curriculum that introduces a senior resident to the role of the Psychiatric Consultant in a Collaborative Care team.

STRUCTURE OF THE CLINICAL ROTATION

Collaborative Care teams consists of a care manager embedded in a primary care setting (usually MSW or other Behavioral Health Care Manager), the primary care provider (both the source of referrals and the prescriber of any medications), and a Psychiatric Consultant (provides weekly case load supervision and individual case reviews of four to six patients weekly). During this clinical rotation, the resident works directly with a Psychiatric Consultant to participate in a one-to-two-hour consultation with a Behavioral Health Care Manager, receives a one-to-two-hour supervision with the attending, and may participate in interdisciplinary care team meetings.

EDUCATIONAL CONTENT

To support the clinical rotation, we have designed a set of six modules to cover the fundamentals necessary to assume the role of a Psychiatric Consultant on a Collaborative Care team. This content trains a psychiatrist to function in any role at the interface of primary care and mental health and may be useful in programs even where a Collaborative Care setting isn’t available.

MATERIALS

OVERVIEW OF ENTIRE SERIES: Collaborative Care Consultation Psychiatry: A Clinical Rotation Curriculum for Psychiatry Residents

Module 1: Psychiatry Resident Training: Introduction to Collaborative Care

Module 2: Psychiatry Resident Training: Introduction to MHIP

Module 3: Psychiatry Resident Training: Collaborative Care Teams

Module 4: Psychiatry Resident Training: Case Finding, Differential Diagnosis and Case Formulation

Module 5: Psychiatry Resident Training: Making Recommendations and Treating to Target

Module 6: Psychiatry Resident Training: Team Building, Workflows, and Quality Improvement

Medicaid and Collaborative Care for SUD: Read a white paper outlining CoCM’s potential to improve substance use disorder outcomes, and the benefits of widespread Medicaid coverage. Medicaid & Collaborative Care for Substance Use Disorder & Mental Health

Teaching Psychiatry Residents to Work at the Interface of Mental Health and Primary Care

There is now a variety of well-established educational experiences in integrated care within psychiatry residencies. This article proposes core competencies to be taught and highlight rotations and educational methods in five different programs, which provide experience in different models of integrated care, as a psychiatric consultant, overseeing population-based mental health care, and delivering medical care for psychiatric patients. The authors present examples of programs educating psychiatry residents to work in integrated healthcare settings.