There was nothing particularly remarkable about that day. It wasn’t sunny. It didn’t rain. The clouds offered no movement, no promises of new shapes with hidden messages. It was just a gray day, like so many others. And yet, it became a day I would remember. It all started with a call about a patient […]
Integrated Psychiatry in Pediatric Primary Care: A PCBH-Informed Approach
For these practices, an Integrated Psychiatry approach—directly informed by the Primary Care Behavioral Health (PCBH) model—provides a flexible, population‑focused alternative. PCBH emphasizes rapid access, same‑day consultation, brief interventions, and team‑based care embedded directly within primary care workflows. Applying these principles, Integrated Psychiatry brings psychiatric expertise into the pediatric medical home, enhancing access, reducing stigma, strengthening […]
Psychologists in Primary Care Behavioral Health
Over time, I’ve noticed more PCBH job postings recruit only for LISW/LPCC/LMFT (or equivalent). From my experience, many psychologists would love to work in PCBH, but they never get the chance. Many job postings don’t even list psychologists as an option, and when contacted, organizations often can’t offer pay that fits the level of training […]
A Third Edition: Why Now and What’s It About?
Our book has six parts. The first is an update on the evidence for making this huge change to the scope and delivery of primary care services. We speak directly to leaders, with a hope of preparing them for a successful launch and scale-up. In the second and third sections, we provide information on specific […]
Slot Utilization Is Not a Metric for Integrated Care
Nearly every time we work with consulting clients working on implementing integrated care the complaint is the same. There’s a healthcare administrator breathing down their neck about how many scheduling slots are going unutilized. It’s as if the golden hammer of healthcare optimization is managing slots. It’s time we call this what it is – […]
Not Enough Money For Integrated Care & Other Lies We Tell Ourselves
By Neftali Serrano, PsyD Far too often, I hear the same weary refrain from healthcare professionals championing integrated care: “My leaders tell me that my integrated care program is just not making us enough money.” Let’s be clear—this isn’t a financial question. It’s a philosophical one dressed up in a spreadsheet. Because when a leadership […]
We Need A Federal Director of Integrated Care
Why We Need Dedicated Integrated Care Directors — At Every Level of the Health System If you’ve spent any time in the integrated care space, you know the pattern: A grant funds a pilot. A bold health plan tries something innovative. A state rolls out a value-based model. Then people move on, funding dries up, […]
Title: Charting New Territory: Bion and the Behavioral Health Revolution
Bion’s Relevance in Modern Healthcare The psychoanalytic perspectives of Bion, especially his concepts of container-contained thinking, thinking under pressure, and emotional truth, appear conceptually distant from the practical and fast-paced demands of integrated healthcare. Yet it is precisely in this setting, where clinicians must think quickly while holding complex emotions, that Bion becomes indispensable. According […]
Searching for Pearls of Integration
The Value of a Pearls Gathering At the end of the first pandemic year, BHCs from multiple sites at the Pediatric Physicians’ Organization at Children’s (PPOC) convened to reflect on what we called the “Pearls of 2020 – Staying Integrated During the Pandemic.” The Pearls initiative identified six key elements of integration, each of which […]
GATHER for Integrated Care
A few months ago, I was experiencing some significant stress in multiple microsystems of my life and was implementing many of my tried-and-true strategies to ground myself in my values and practice self-compassion. One night at dinner, my children were asking about differences I had in schools. It is important to know that, as the […]
Community as Resistance: US Healthcare Teams Need Strengthening In Turbulent Political Times
I’m going to make an argument here that the antidote to political uncertainty and rapid change in the healthcare landscape is community, particularly local community. And in so doing I’m also tying us to a promise that this community, the Collaborative Family Healthcare Association (CFHA), will be a nexus of moral strength and innovation for […]
It’s Going To Take More Work: A Call to the Integrated Care Community in 2025
If you are a clinician you know the feeling. It’s that moment in a care process with a patient where you could do more or choose to do less. You battle internally to decide what to do and ultimately you know you can’t live with yourself if you choose to do less. That’s our moment as […]
Mea Culpa: What My Generation Of Integrated Care Leaders Ignored
5 Minute Read. As a seasoned professional in integrated care, I’ve been part of a pioneering generation that sought to blend medical and behavioral health services to improve patient outcomes, particularly with the advent of the Primary Care Behavioral Health service delivery model (PCBH). Reflecting on this journey, it’s clear that while we’ve made significant […]
The #1 Reason Why Integrated Health Care Teams Lose Mental Health Clinicians To Online Therapy Companies
By Neftali Serrano, PsyD, 2 Minute Read In recent years, the struggle to retain and recruit behavioral health providers has intensified within primary care. A closer examination of this trend reveals a significant underlying cause: the selection bias rooted in the mental health provider training process. This bias not only shapes the career preferences of […]
Advancing Success in PCBH: A Framework for the Adoption of Measurement-Based Care
4 minute read In our first blog post on March 3rd, 2023, we reported on efforts by the Primary Care Behavioral Health Special Interest Group (PCBH SIG) to advance the understanding of screening and outcome measurement in demonstrating the value of the integrated model of service delivery. Since that time a Measurement-Based Care (MBC) workgroup […]
Health Federation of Philadelphia Announces Historic Director Position: How Partnership and Persistence Paid Off
5 minute read On July 13, 2023, Health Federation of Philadelphia (HFP) announced a new investment in integrated care by the Philadelphia Department of Behavioral Health and Intellectual Disability Services (DBHIDS), which will allow HFP to hire a Director of Behavioral Health Integration position. The new Director will be responsible for leading all training and […]
Measuring Success in PCBH: Results from a Workgroup on Behavioral Health Screening
3 minute read In spring 2022, CFHA CEO Neftali Serrano approached the Primary Care Behavioral Health Special Interest Group (PCBH SIG) to begin the work of catalyzing standardized outcomes for measuring success in a PCBH environment. This invitation was warmly received as the role of the PCBH SIG is to grow interest and enthusiasm, provide […]
Can I Still Do This? Returning to Primary Care Behavioral Health
3 minute read. Original post available here Returning to the PCBH (Primary Care Behavioral Health) world after a week off is always an exciting, yet frightening experience. My mind always worries when returning to clinical work. “Will I still be able to do this?” “Do I still got what it takes?” And, then, all that doubt […]


















