Description 

With the shortage of psychiatrists and other mental health care providers in the United States, primary care collaboration and integrated behavioral health models have become increasingly important as a strategy for bridging the gap and bringing psychiatric care to those in need, particularly underserved populations. Psychiatry is a biopsychosocial discipline, and psychiatrists bring a unique combination of biomedical and psychotherapeutic skills to primary care collaboration, allowing them to provide a deep and holistic view of patients within this care setting. From this perspective, psychiatrists can serve as another kind of bridge, helping connect primary care teams with challenging patients and maximizing the supportive psychotherapy skills that primary care physicians already utilize. In other words, a consulting psychiatrist who integrates biopsychosocial/psychotherapeutic perspectives is able to guide the team in understanding not only what treatments to offer, but also how to offer those treatments in ways that optimize patients’ abilities to make use of that care. In this presentation, we will review the history, theory, and evidence underlying biopsychosocial psychiatric consultation in integrated care. We will demonstrate how an understanding of the dynamics of treatment resistance can support the work of the primary care team with some of the most challenging patients, and will review some common dynamics underlying treatment-resistance. Such consultation can help front-line treaters identify and cope with countertransference, which has a range of benefits, including enhancing the treatment alliance, reducing irrational prescribing, and potentially reducing treater stress and burnout. We will also demonstrate how primary care teams can be educated to provide basic psychotherapeutic interventions that remove resistances to the healthy use of treatment and enhance working alliances with the primary care team.

Format 

Recorded webinar.

This content was recorded during the APA 2023 Annual Meeting.

Learning Objectives 

1. Describe the rationale for a biopsychosocial approach to psychiatric consultation on integrated care teams.
2.  Offer case formulation as a trustworthy foundation on which appropriate and helpful psychiatric interventions can be structured, implemented and maintained.
3. Recognize and help manage countertransference constellations that can interfere with optimal functioning of integrated care teams.
4. Explain and demonstrate at least one brief psychotherapeutic intervention that can be taught to and utilized by primary care clinicians

Target Audience 

Residents/Fellows, Psychiatrists, Psychologists

Estimate Time to Complete 

Estimated Duration: 1.5 hours
Program Start Date: May 1, 2025
Program End Date: May 1, 2028

How to Earn Credit 

Participants who wish to earn AMA PRA Category 1 Credit™ may do so after completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned. 

Continuing Education Credit  

In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

The APA designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Faculty and Planner Disclosures 

The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity. 

Instructors 

• David Mintz, MD, PhD
• Sherry Katz-Bearnot, MD
• Madeleine Lansky, MD
• Elizabeth Greene, MD

Planners  

• Vishal Madaan, MD, Chief of Education and Deputy Medical Director at the American Psychiatric Association.

Accessibility for Participants with Disabilities 

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. Please contact the American Psychiatric Association at 202-559-3900, if you require assistance seven (7) business days prior to the start of a live webinar. 

Technical Requirements 

This internet-based CME activity is best experienced using any of the following: 

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari 
• Internet Explorer 11+ 

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player. 

Optimal System Configuration: 

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version) 
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version) 
• Internet Connection: 1 Mbps or higher 

Minimum Requirements: 

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content 
• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content 

For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance