Poster 19 – Development & Implementation of Integrated Behavioral Health Programs in Tertiary Care: Clinical, Operational, Financial, & Educational Considerations

Summary

Spinal cord injuries (SCI), strokes, and traumatic brain injuries (TBI) are just some of the major illnesses and injuries that land patients in tertiary care settings (e.g., inpatient rehabilitation). Unfortunately, these patients and their families have unique emotional, instrumental, and professional support needs that are often left unmet (Kreutzer et al., 2018). The realization of new disabilities and ambiguous loss can make the road to recovery and development of a new normal immensely challenging for both patients and families (Kreutzer et al., 2016). In a recent accreditation survey report, The Commission for Accreditation for Rehab Facilities (CARF) identified the need for increased family and psychosocial services for physical illness and injuries within a tertiary care setting (2015). Recommendations included an increase of biological, behavioral, cognitive, psychological, and sexual services for brain injury specialty programs, ongoing assessment of depression and emotional adjustment to spinal cord injury, and improvement in the addressment of depression, sexuality, and intimacy for stroke patients. CARF suggested these improvements would benefit the person served, caregivers, and staff. The integration of behavioral health into tertiary care has demonstrated such improvements. For example, it has been shown to help meet the unique support needs of caregivers of patients with traumatic brain injuries within inpatient rehabilitation (Niemeier et al., 2019). Additional support for caregivers has also proven beneficial in the care of patients with TBI and SCI (Baker et al., 2017). In order to fulfill the needs addressed in the CARF report, the Director of Admissions, Performance Improvement and Practice began the development of an integrated behavioral healthcare program to provide family-centered care within the inpatient rehabilitation center. Given knowledge of family therapists’ ability to provide such services within healthcare contexts (American Association for Marriage and Family Therapy, 2018), and in alignment with the organization’s mission as a teaching hospital, the medical family therapy rehab program was created. The establishment of this program provides clinical, operational, financial, and educational insights into the successful development of such programs. This presentation intends to introduce the beginning stages of an integrated behavioral health program within tertiary care through the lens of the four-world view (Peek, 2008). Participants will gain understanding of the unique aspects of tertiary care, how to initiate the development of similar programs, and learn strategies for integrating into pre-existing interdisciplinary teams.