7 TPC Digest 7 TPC Digest Alexander M. Fields, Cara M. Thompson, Kara M. Schneider, Lucas M. Perez, Kaitlyn Reaves, Kathryn Linich, Dodie Limberg The State of Integrated Primary and Behavioral Health Care Research in Counselor Education: A Review of Counseling Journals I n the evolving health care landscape, there has been a documented need to increase mental health services. The integration of primary and behavioral health care services, often referred to as integrated care (IC), has emerged as a strategy to increase access to trained mental health providers. An IC modality bridges primary care and mental health treatment and creates a multidisciplinary, one-stop-shop approach to providing holistic care for individuals. Literature for IC emerged in the 1970s when Department of Veterans Affairs (VA) centers noted a significant number of veterans with co-occurring mental and physical health conditions. Early IC scholars described a need to challenge traditional health care services occurring in silos (e.g., providers at separate locations) to simultaneously treat the physical and mental health of veterans returning from war. The IC approach then moved beyond VA centers, and the literature has steadily increased over the last few decades across multiple disciplines. The increase in IC representation may be the direct result of the noted benefits. In addition to increasing access to providers, settings that adopt an IC approach have reported an increase in mental health service utilization, medication adherence rates, healthy behaviors, and prevention services. Furthermore, IC literature has consistently demonstrated a decrease in mental and physical health symptoms, health care appointment cancellations, and time between health care appointments. Despite the positive reports for IC, there is still a relative dearth of IC literature in counseling journals. However, this does not mean that counselors are not engaging in IC practice. In fact, the Health Resources and Services Administration (HRSA) has reported that over 1,300 counselors have been trained to practice in IC modalities through their Behavioral Health Workforce Education Training (BHWET) programs. The lack of IC literature in counseling journals poses a threat to the sustainability of including counselors in IC settings, as there is limited documentation of the counselor’s training, role, and benefit. This article aims to synthesize the existing IC literature in counseling journals to identify publishing trends and also synthesize existing IC literature on client outcomes, counselor-level outcomes (e.g., competency development), and implications for future research. Specifically, this article is organized through a scoping review of 27 articles across 2004–2023 in 10 counseling journals. To be included, the article must have been in a counseling or counselor educator journal housed within a national, regional, or state organization. The articles were organized according to their format and were described as either conceptual, empirical, or meta-analyses and systematic reviews. Of the 27 articles, 11 articles were classified as conceptual, 13 as empirical, and three as meta-analyses or systematic reviews. Implications for counselors-in-training (CITs), counselors, counselor educators, and clients were represented across each classification. Overall, IC implications from each article were positive for training and practice perceptions for CITs and counselors, as well as clinical outcomes for clients. Moving forward, the authors encourage counselor educators and counseling scholars to continue studying IC. Future scholarship would benefit from a deeper understanding of client-level implications, with an emphasis on how IC can benefit marginalized communities. Alexander M. Fields, PhD, is an assistant professor at the University of Nebraska at Omaha. Cara M. Thompson, PhD, is an assistant professor at the University of North Carolina at Pembroke. Kara M. Schneider, MS, is a doctoral candidate at the University of South Carolina. Lucas M. Perez, MA, is a doctoral candidate at the University of South Carolina. Kaitlyn Reaves, BS, is a doctoral student at Adler University. Kathryn Linich, PhD, is a clinical assistant professor at Duquesne University. Dodie Limberg, PhD, is an associate professor at the University of South Carolina. Correspondence may be addressed to Alexander M. Fields, University of Nebraska at Omaha, College of Education, Health, and Human Services, Department of Counseling, Omaha, NE 68182, alexanderfields@unomaha.edu.
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