Impact of behavioral health consultant interventions on patient symptoms and functioning in an integrated family medicine clinic.

Patterns of symptomatic and functional change associated with behavioral health consultant (BHC) intervention in an integrated family medicine clinic were investigated among 338 primary care patients under routine conditions without exclusion. Patients were referred to the BHC by primary care providers (PCPs) and participated in one to four brief, behaviorally oriented appointments in primary care. The Behavioral Health Measure-20 (BHM) was completed at each appointment. Results indicated that higher levels of distress at baseline were associated with more follow-up appointments, and that patients demonstrated simultaneous, clinically meaningful improvement in well-being, symptoms, and functioning in as few as two to three BHC appointments. Patterns of clinical improvement support the effectiveness of BHC interventions, but contradict the phase model of psychotherapy (Howard, Lueger, Maling, & Martinovich, 1993).