The Department of Defense (DoD) was one of the original adopters of the Primary Care Behavioral Health (PCBH) model. Over 20 years ago, the United States Air Force (USAF) piloted its “Behavioral Health Optimization Program” or BHOP at a single Air Force Base. Since 1997, the program has expanded across 72 Air Force facilities and […]
Taking the Hamster off the Wheel: How My BFEF Experience Helped Me Get My Feet Back on the Ground
At the beginning of my year in the Behavioral Science/Family Systems’ Educator Fellowship (BFEF), I had a gut feeling that I was “hitting the wall.” The burnout week had arrived. This occurred both in my personal and professional life. When I started my job 4 years ago, I hit the ground running and tried to […]
The Pre-Rehab Checklist: How to Get the Most Out of Your Recovery
In the United States right now, there are over 14,500 rehabilitation centers for people recovering from drugs and alcohol. These centers offer a range of treatment options, including detox and inpatient or outpatient rehab. With outpatient rehab, addiction specialists and nurse practitioners visit people in their homes, allowing them to continue with their normal routine […]
Complex Patients: Positioning Teams for Best Outcomes
Patients living today with both complex medical and behavioral health problems are expected to die 25 years earlier than the general population.1 These patients have more medical problems than the general population and a disease burden that increases as behavioral health problems increase. Most patients with behavioral health problems are seen in non-psychiatric medical […]
Financing the Primary Care Behavioral Health Model: Q&A with Dennis Freeman
It’s no secret that the US health care system is expensive and under significant change these days. One part of the system that is receiving a lot of attention in primary care. The evidence suggests that primary care is an excellent investment for payers who want better health outcomes; however, recent data shows that payers […]
Cultural Considerations for Behavioral Health Providers in Primary Care
Healthy People 2020 is a multi-year, multi-stakeholder effort by the US government to address social determinants of health and disparities. This vision for a healthier country includes specific actions that the United States must take to achieve better health by the year 2020. Some of the goals include: Attain high-quality, longer lives free of preventable […]
4 Things Your Supervisee Wants to Hear from You
For the tiny town of Cottonwood, Idaho – population 900 people and 1800 cattle – sports were something to rally around. My senior year in high school, we made it to the football state championships. When we took to the field for the championship game, it was breathtaking to see half the town in the […]
The Warm Handoff: Turn up the research heat
As I replay my experiences from the recent CFHA Conference in Houston, two primary themes emerged as key take-home messages. The first, voiced by Executive Director Neftali Serrano in his eloquent plenary address, highlighted the central role of relationships and connections to the organization as exemplified by the mantra (paraphrasing) ‘don’t be afraid to gently […]
Health care records on your iPhone?
Yup, Apple is making the foray into health care. One of the biggest companies on the planet wants to give you access to your medical records using the popular iPhone. This feature will be available once the iOS 11.3 update rolls out later this year. Check out the article link above for details on how […]

The Unspoken Role of the Behavioral Health Consultant: 6 Tips for Navigating Colleague Mental Health Needs
This post was inspired by a recent CFHA listserv discussion. If you are reading this and not a CFHA member, the listerv is one of the many amazing benefits of CFHA membership! It usually looks something like this: A face I know well pops into my office door—another staff member in the clinic where I […]
Addressing Fidelity in Primary Care Behavioral Health with the PPAQ: Measurement Matters
(Brief History) My colleagues and I at the VA Center for Integrated Healthcare (CIH) first developed the Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) to address a fundamental question: What do PCBH providers do every day? We all know that variation in clinical practice is common. In short, clinicians don’t perfectly follow conceptual models […]

Assume Trauma Until Proven Otherwise
I decided to write a piece in response to the CFHA listserv discussion on detecting and addressing trauma in primary care. As I watched the messages from my colleagues trickle in about how to address medical providers’ unease discussing trauma with their patients I paused and knew my contribution would be forthcoming. I have done […]
Current State of Integrated Care: Collaborative Care in Kentucky
Kentucky has a long history of healthcare innovation. In May of 1993, it submitted its first 1115 waiver (under section 1115 of the Social Security Act, the federal government may grant the state flexibility to experiment with projects that are likely to promote the same objectives as the federal program – for more information, see […]
Current state of integrated care: An opportunity in England
A recent article in Context, the house magazine of the Association of Family Therapy (AFT), raises questions about the future of family therapy as an accredited profession in the UK. A variety of threats to the profession are described, which include a lack of clarity about what the family therapists do and with which client groups. […]
New Editors at Families, Systems, & Health
Congratulations to the new incoming editors at Families, Systems, and Health: Drs. Jodi Polaha and Nadiya Sunderji. We are looking forward to some great work! This signals an end to the productive and expansive era of the former editors, Colleen T. Fogarty and Larry Mauksch. CFHA would like to thank Colleen and Larry for their visionary leadership. […]
Current state of integrated care: Interview with a family physician in South Korea
In 2007, my education in marriage and family therapy (MFT) in the US began. After a year of course work, my clinical experience as a MFT intern started at the University of California San Diego Family Medicine Residency, which had well-established integrated care. For me, it was a novel and exciting experience working as a […]
Collaborative Medication Management: Tips for Working with Pharmacists
A day-in-the-life The day: Wednesday. The time: 8:50 am. I (KV) just received a handoff from a provider, the 9 am patient has arrived, and I am in the middle of a coordination of care phone call with a school nurse who is attempting to help facilitate proper dosing of a stimulant for a 15 […]
Friday Plenary Session
If you missed the Friday morning plenary session at the 2017 CFHA Annual Conference in Houston, you missed a fantastic presentation by Len Nichols, PhD, Professor of Health Policy at George Mason University. Dr. Nichols described how we got to the current state of affairs in healthcare and what reform may look like in the […]