A Mixed Methods Evaluation of an Integrated Primary and Behavioral Health Training Program for Counseling Students

Abstract

Behavioral health provider shortages continue to grow in the United States, with the need for related services increasing as the SARS-COVID-19 pandemic persists. The implementation of integrated primary and behavioral healthcare (IPBH) practices represents one viable approach to leverage existing resources and maximize the potential for client outcomes; however, best practices for counselors within an IPBH paradigm remain unclear. We report the findings of a mixed method evaluation of an IPBH training program with 45 (36 females; 9 males; M_age = 31.65) professional counseling students who predominately identified with ethnic minority identities (55%), urban residences (66%), and disadvantaged backgrounds (44%). We detected statistically and practically significant changes in self-efficacy (p = .01, d = .55) and interprofessional valuing and socialization (p < .01, d = .76), but mixed findings for variables associated with multicultural competence. Stakeholder interviews and document analysis identified four key facilitators (Financial Support; Facilitated Engagement; Witnessing Collaboration; Holistic Representation of Clients and Client Care) and four barriers (Awareness Raising and Recruitment; Logistics and Coordination; Inconsistent Culture of IPBH; Momentum Maintenance) to program success.

Keywords:

• Counselors
• integrated primary behavioral healthcare
• self-efficacy
• interprofessional collaboration
• multicultural competence

Conclusion

As behavioral health provider shortages continue to become pronounced along with magnified community needs, it is imperative to identify and implement treatment approaches that maximize resources and client outcomes. The implementation of IPBH represents a pathway for counselors to be a part of the solution; however, best practices for training have not been defined. This program evaluation demonstrates outcomes with one group of participants and the associated facilitators and barriers to program effectiveness. While some of our findings are auspicious, others merit consideration for quality improvements that may promote additional participant growth and development gains.

Notes on Contributors

A. Stephen Lenz, PhD, LPC, is a Professor of Counselor Education and Chair in the Department of Counseling, Health and Kinesiology at Texas A&M University-San Antonio.

Joshua C. Watson, PhD, is a Professor of Counselor Education and Chair in the Department of Counseling and Educational Psychology at Texas A&M University-Corpus Christi.

Additional information

Funding

This work was supported by Health Resources and Services Administration’s Behavioral Health Workforce Education and Training Program for Professionals.