Integrating Psychosocial Interventions with Patients with Gastrointestinal Disorders in Primary Care and Specialty Care Services

Jennifer K Paternostro, Erica V Rozbruch, Robert D Friedberg


Emphasis on integrated physical and behavioral health care skyrocketed in recent years partially as a result of the Federal Health Care initiatives described in the Affordable Care Act, emergence of the biopsychosocial model, and the ongoing collaboration between medical providers and pediatric psychologists. Integrated models of care demonstrate significant advantages to patients as well as medical providers. Behavioral health problems arise in approximately 50 percent of well-child and pediatric outpatient visits and consume physician time that should be spent addressing medical concerns. Additionally, families who present with behavioral health concerns in primary care settings often utilize greater health care resources than those families that do not present with a behavioral health problem. Thus, integrated behavioral health care allows for better allocation of physician time and resources.

The current article aims to provide a framework for behavioral health integration in primary and specialty clinics, with specific emphasis on treating pediatric patients with gastrointestinal conditions. Chronic conditions such as Crohn’s disease and Ulcerative Colitis are generally managed by a Gastroenterology Specialty Clinic. Patients with chronic medical conditions, like Inflammatory Bowel Disease, are at greater risk of disease distress and psychosocial challenges that would benefit from behavioral health consultation. Further, functional gastrointestinal disorders are believed to largely result from psychosocial distress, and typically respond to behavioral intervention. Pediatric psychologists are well-equipped to support primary and specialty clinics in managing psychosocial challenges that often present in patients with gastrointestinal distress. The current article describes the foundation of integrated care practices and how pediatric psychologists should be utilized in pediatric medical settings.



Integrated pediatric primary care, gastrointestinal, behavioral health

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