Evidence-Based Practice in Integrated Pediatric Primary Care

Pediatric behavioral health (BH) services are an increasing necessity due to rising mental health concerns, especially among impoverished communities, and insufficient resources resulting in long-term negative consequences. Primary care providers are often the initial identifiers of behavioral health concerns and are currently the first line of defense for mental health care. However, many pediatricians report inadequate training and insufficient time and structural support to effectively address these concerns, highlighting the dire need for behavioral health specialists within the primary care setting. The presence of behavioral health providers (BHPs) in the pediatric primary care setting increases access to behavioral health services, mitigates emerging problems, and reduces the burden on the medical system. Nevertheless, multiple barriers continue to limit the integration of behavioral health providers in primary care settings including administrative constraints, training needs, and differential insurance coverage of behavioral health care. In particular, the patient volume represents an ongoing burden and highlights the need for comprehensive and time-efficient assessments that provide diagnostic clarity and help tailor treatment as well as short-term, evidenced-based, and solution-focused interventions that target a clearly defined problem. Brief, transdiagnostic interventions offer efficient delivery in a time-constrained environment and provide easily digestible material to parents who often manage the implementation and solidification of skills to address ongoing symptom management. Due to the complex, fast-paced nature of primary care, students must seek specialized training in the administration of assessment and brief behavioral treatment within this environment. As it is not a current component of psychology graduate training programs, trainees will need to expend additional effort in seeking out these unique experiences.