http://www.cfha.net/forum_thread.php?t=67Recent posts in Peter Fifield: Mental Health vs. Behavioral Healthhttp://www.cfha.net/forum_thread.php?t=67#post178pSandy Amenphttp://www.cfha.net/forum_thread.php?t=67#post177pI think of behavioral health as being the overarching term for mental health substance abuse and behavioral medicine.nbsp Behavioral medicine is changing the body with words well really they all are but behavioral medicine is health behavior change on one side and the relaxation response approaches on the other relaxation visualization bio-feedback mindfulness hypnosis.nbsp In fact I have no idea how anyone in primary care or anywhere else works without being in all of these areas.ppnbspppI worked with a guy this week.nbsp He is temporarily currently sober from an OTC and prescription pill addiction.nbsp We talked about what he was learning at NA SA and how he stays sober day to day.nbsp We looked at what he thinks and how that can better support his sobriety CBT.nbsp We looked at how he calms himself and uses breating to stay of track RRCBT.nbsp We went into detail about how he got sober before and the times he thought he would fall off the wagon but didnt Solution Focused.nbsp We talked about how his wife has been inducted into the role of monitor for him and how their relationship when it is stuck like that holds on to the old bad boygood gal interaction family systems.nbsp I asked him how much of his identity was taken up with the identy of drug addict now.nbsp He said well over 50.nbsp I asked him what his goal was for the amount of his identity that would be drug addict in the future.nbsp He said 10 0 is not one of the options NA.nbsp We imagined the day when drug addict would be about as much of his identity as fisherman all this is Narrative Therapy a la White and Epston.nbsp I asked him what part of his identity he would hope was taking up more space when we meet again and he said athlete.nbsp He is going to the gym Beh Med.nbsp I asked him to look for times when he and his wife are having an interaction where drug addictmonitor is not in evidence.nbsp What are the roles they like better Family systems solution focused.ppnbspppWhy would you want to work in something as complex as human problems without a full tool boxppnbspppSandy Blountphttp://www.cfha.net/forum_thread.php?t=67#post132pRandall I agree with your generalist approach to mentalbehavioral health treatment in the primary care setting.nbsp Anecdotally speaking that is the jack of all trades approach--addressing behaviors cognition and emotions with a sprinkle of MI is what has proven most effective for most of the practitioners I am familiar with.nbsp Regarding the integration of the whole shabang...mental health and substance abuse treatments--Im not convinced that isolationism is the correct approach here either.nbspnbsp Aside from the PTSD Dx most of the recent literature I have read leans towards co-occurring substance and mental health treatment.nbsp In my opinion separating the two would be a regression regarding the movement towards seeing and treating the person as a whole.nbspphttp://www.cfha.net/forum_thread.php?t=67#post131pDear GuestppnbspppPlease introduce yourself when you use the guest login.nbsp We would love to get to know you better.nbspppnbspppWhile I dont share your dismissive perspective of our brothers and sisters in the substance use field I do think you make some valid points.nbsp Bynbspmoving to one term behavior to describe all of mental health and one title behaviorist we are conflating things that arent exactly the same.nbsp The signifcant and subtle differences can be lost.ppnbspppHowever Primary care physicians are jacks-of-all-trades.nbspMental health clinicians are a better fit in primary care when they reflect this generalist nature.nbsp It is helpful to have a little cognitive behavioral a little systems thinking a little motivational enhancement and yes a little substance use treatment ability.phttp://www.cfha.net/forum_thread.php?t=67#post130pIts an interesting topic for discussion.nbsp Back in the day Albert Ellis was booted from the APA for asserting that the three legged stool can be treated all at once fairly quickly without all the psychoanalytic baloney.nbsp Now everybody does cognitve-behavioral therapy.nbsp Insurance companies want therapists to use cognitive-behavioral techniques but never bother to check what the heck theyre really doing.nbsp Mental health sounds like its for crazy people.nbsp It still scares my mother what I do for a living.nbsp The term behavioral health sounds more user-friendly.nbsp However the term has already been co-opted by the substance abuse megatopolis.nbsp They even have a trade magazine named Behavioral Health.nbspnbspMynbspconcern with changing the name is its helping the addiction treatment folks in their quest to integrate the whole shabang..mental health and substance abuse.nbsp And they are control freaks whose main qualification to treat is they arewere a drunk or addict.nbsp They need to make money like everyone else.nbsp So do their suppliers.nbsp Maybe intorduce legislation to test your hair before giving you a drivers licenseppnbspppnbsp Theyrenbspcurrently workingnbspon the term recovery.nbsp They want to get that word in the mental health lexicon.nbsp Check it out.nbsp Its already happening.nbspphttp://www.cfha.net/forum_thread.php?t=67#post122pPrimary Care pragmatism tells us that we need to use best practice and have measurable outcomes. nbspOut of the trio of cognitions emotions and behaviors the latter of the three seems to be the most measurable.nbsp The question is how do we take out one of the legs on this three legged stool with out tipping it over.nbsp Or do we not have tonbsp I think most would agree that it is almost impossible to separate these concepts.nbsp Maybe we just attend to the body in a holistic manner--combining the three when needed but come up with an entire new name for the process.ppnbspppBehavioral health appears too isolative regarding human emactionsem and tends to disregard at least in its title the other two legs of the stool. nbspAlthough mental Health has the most fitting title it does have a marred reputation. It tends to carry a considerable stigma it may imply that medications are necessitated for successful outcomes it may imply that a severe and persistent issue is at hand and it leaves patients thinking long term psychotherapy is necessary. nbspWhat if we call it something so ambiguous no one knows what it means nbspHow about Health Stratification Treatmentnbspphttp://www.cfha.net/forum_thread.php?t=67#post121pHmm... I have always seen these two as seperate areas under psychology.nbsp Mental Health consisting of psychopatholgy. Behavioral Health concerns issuess that can have annbspactual outcomes by changing behavior such as addictions.nbsp You cant really change your outcome if you have something likenbspschizophrenia by changing your behavior you can only control it with medication.nbsp Thats just how I see itphttp://www.cfha.net/forum_thread.php?t=67#post119pa nameOLELINK1apnbsppp classMsoNormala nameOLELINK1appp classMsoNormalPetepp classMsoNormalnbsppp classMsoNormalYou ask great questions.nbsp In my perspective preference for the term mental health behavioral health or Irsquoll add emotional health have historically come down to onersquos training and bias.nbsp If psychology is considered a 3-legged stool made up of emotions cognitions and behaviors then each leg has its own branch.nbsp Perhaps due to the early dominance of psychoanalysis the term mental health has long been the preferred term in our field.pp classMsoNormalnbsppp classMsoNormalPsychologists and other mental health professionals chafed against behaviorism due to the perception that it reduced humans to rats and reduced clinicians to Skinner box drivers.nbsp I believe this perception was not shared by the medical field because they were early adopters of rigorous science and animal studies.nbsp They have a low tolerance for the immeasurable and behavior is the most outwardly measurable aspect of psychology.pp classMsoNormalnbsppp classMsoNormalIt would seem behaviorism is winning the day reference the proliferation of Bs in NCCBH PCBH IBH etc and many community mental health centers are changing their names to replace mental health with behavior health.nbsp I support this change for a number of reasonspp classMsoNormalnbsppp classMsoNormalnbsppp classMsoNormal stylepadding-left 30pxIt is a more broad term that easily encompasses psychopathology addiction and coachingpp classMsoNormal stylepadding-left 30pxnbsppp classMsoNormal stylepadding-left 30pxIt is a better description for the lifestyle interventions that primary care clinicians offer for people with diabetes heart disease tobacco addiction etcpp classMsoNormal stylepadding-left 30pxnbsppp classMsoNormal stylepadding-left 30pxIt helps move beyond the stigma identified with mental health.phttp://www.cfha.net/forum_thread.php?t=67#post118p classMsoNormalIn a a titleRandall R Blog hrefforumthread.phpt49past CBC blog athere was a brief discussion around thedifference between ldquoCollaborate and Integraterdquo.nbsp Although to some it mayonly appear to be an issue of semantics to others there is a need to createconsistent definitions in our profession.nbsp A reliable discourse within our profession could facilitate the relay ofideas concerning policy process and practice.pp classMsoNormalnbsppp classMsoNormalAs the conceptsof Integrated Care become more and more familiar within the medical landscape thereis a potential need for a universal discourse.nbsp On occasion I interactwithin our local and state-wide communities here in New Hampshire spreading the word ofintegrated medicine and collaborative care.nbsp Naturally two phrases thatare often used during conversations are ldquoIntegrated Carerdquo and ldquoBehavioralHealthrdquo.nbsp Shortly after these words leave my mouth a look ofinquisitiveness often arrives on the faces of anyone lending an ear.pp classMsoNormalnbsppp classMsoNormalDr. Ben Millerasked an important question in a a titleBen M Mental Health hrefforumthread.phpt59prior bloganbsp ldquoWhere is MentalHealthrdquonbsp As I read the blog I thought that before we can identify emwhereem ldquoitrdquo is we actually need to know emwhatem ldquoitrdquo is.nbsp I have a request ofyou all.nbsp Please post your opinionrelated to the difference between Mental Health and Behavioral Health.nbsp Ihave my own operational definition but quite often I find myself attempting todiscern between them and Irsquom sure my resultant answer is rarely the same.nbspQuestions I find myself asking are nbspldquoIsit more than just a way to euphemize a service being sold to an unwittingpatientrdquo ldquoIs there a core practical difference between the two or is itmerely a philosophical differencerdquo ldquoDoes behavioral health only occur in amedical setting and mental health in a specialty clinicrdquo and ldquoDoes anyonereally care about the difference aside from the MedicaidMedicare billingdepartmentsrdquo.nbsp I hope that there are some Behaviorists Gestaltists andPsychoanalysts out there from a range of professions ready to respond to thistopic.nbspp