Article Figures & Data
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Domain Measures Age-Group Demographics Age; race; ethnicity; gender; location of primary care clinic Child and adult Mental health and substance abuse categories Alcohol-related disorder; anxiety; bipolar disorder; impulse-control and conduct disorders; depression; feeding and eating disorder; neurodevelopmental disorders; personality disorder; schizophrenia; somatic disorder; other substance disorder; suicide attempts; tobacco use; ADHD; trauma Child and adult Other medical categories Neoplasms; endocrine, nutritional, and metabolic diseases; diseases of the nervous system; nervous system pain and pain syndrome; diseases of the circulatory system; diseases of the respiratory system; diseases of the digestive system; diseases of the musculoskeletal system; pregnancy, childbirth, and the puerperium; congenital malformations, deformations, and chromosomal abnormalities Child and adult Psychotherapy program summary IBH clinician; program status; psychotherapy principles used; mental health services used, recommended, and accepted; inactivation reason; consultation-only reason; referral to outside clinician; duration of care episode Child and adult Questionnaire results PHQ-9; PHQ-2; GAD-7; MDQ; AUDIT
PSC-17; PHQ-9M; MDQ-A; CRAFFT; SCAS; Vanderbilt Teacher; Vanderbilt ParentAdult only
Child onlyADHD = attention deficit hyperactivity disorder; AUDIT = Alcohol Use Disorders Identification Test; CRAFFT = Car, Relax, Alone, Forget, Friends, Trouble; GAD-7 = Generalized Anxiety Disorder 7-item scale; IBH = integrated behavioral health; MDQ = Mood Disorder Questionnaire; MDQ-A = Mood Disorder Questionnaire–Adolescent Version; PHQ-2 = 2-item Patient Health Questionnaire; PHQ-9 = 9-item Patient Health Questionnaire; PHQ-9M = 9-item Patient Health Questionnaire modified for teens; PSC-17 = 17-item Pediatric Symptoms Checklist; SCAS = Spence Children’s Anxiety Scale.
Note: The database captures specific International Classification of Diseases, Tenth Revision conditions (eg, panic disorder) that are subsumed into broader diagnostic categories (eg, anxiety) for ease of reporting.
Domain Application Example Clinical Using MBC to regularly track patient symptoms in the database across psychotherapy sessions allows IBH clinicians to easily evaluate the ongoing impact of brief interventions, collaboratively discuss adjustments to treatment plans with patients, and communicate patient progress with interdisciplinary clinicians. If a patient’s self-reported depressive symptoms on the PHQ-9 are not improving substantially across psychotherapy sessions, a measurement-based approach can help guide discussions about treatment planning with the patient and primary care clinician. Educational Clinical supervisors can use the tracking database to examine the most common psychological interventions being applied by IBH clinicians for specific presenting concerns. This strategy allows supervisors to evaluate fidelity to evidence-based care across the practice and to identify opportunities for additional trainings, case consultations, or cotherapy to promote continued learning and growth in the delivery of specific evidence-based interventions. If data from the database indicate that clinicians are routinely engaging in cognitive restructuring for patients with depression but are rarely focusing on behavioral activation goals, supervisors may choose to focus ongoing trainings and case consultations on the application of behavioral activation in IBH. Research Interdisciplinary team members can use the large tracking database to collaborate on research projects and contribute to the literature examining psychotherapy processes and outcomes in primary care. Engaging in interdisciplinary, clinically focused research can also promote academic advancement for IBH team members. The database allows for exploration of potential moderators of treatment outcomes (eg, age, race), an area of the primary care literature that is still limited. Administrative Data and metrics from the tracking database are incredibly helpful when reporting on practice-level outcomes to departmental and institutional leadership. Tracking data on duration of care and number of therapy sessions per patient can assist with ensuring fidelity to the model and promoting access to IBH services. The data from the database can help to demonstrate IBH’s positive impact on the primary care patient population, which can offer specific support when advocating for program-level changes such as the need to recruit additional IBH clinicians. IBH = integrated behavioral health; MBC = measurement-based care; PHQ-9 = 9-item Patient Health Questionnaire.
