Role of behavioral health professionals in a collaborative stepped care treatment model for depression in primary care: Project IMPACT

Mark T. Hegel, Jennifer Imming, Margaret Cyr-Provost, Polly Hitchcock Noel, Patricia A. Arean, Jurgen Unutzer

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

We describe a new collaborative stepped care treatment model for depression in primary care that was recently tested in Project IMPACT, a multi-site, randomized, controlled study with older adults (Unutzer, Katon, Williams, Callahan, Harpole, Hunkeler, Hoffing, Arean, Hegel, Schoenbaum, Oishi, & Langston, 2001). We present in particular detail the role of the central figure in this model, the Depression Clinical Specialist, a behavioral health professional (a psychologist or psychiatric nurse) trained to coordinate the delivery of a flexible, multicomponent intervention that includes antidepressant medications and brief psychotherapy (Problem-Solving Treatment for Primary Care). We describe the training program for these specialists and present two patient case studies demonstrating the stepped care model in practice. Finally, we discuss the issues involved in implementing this model and review recent changes in training and reimbursement practices for behavioral health professionals, suggesting the viability of the model for the future.

Original languageEnglish (US)
Pages (from-to)265-277
Number of pages13
JournalFamilies, Systems and Health
Volume20
Issue number3
DOIs
StatePublished - 2002

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

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