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Therapies

behavioral health practitioner

What Is It?
How Does It Work? 
Health Benefits
How To Choose a Practitioner
References  

Evidence Based Rating Scale
 

What Is It?

A behavioral health practitioner is a counselor, therapist, or other mental health professional who is specially trained to offer support for emotional distress and skills for better living. The aim is to promote wellness by motivating people to adopt healthier habits, make peace with difficult life changes, and regain a sense of balance and control.

The behavioral health practitioner can be invaluable for helping someone who is depressed or anxious about work, family, illness, or other stressful life events. More recently, behavioral health practitioners are being integrated into conventional medical care to help assist medical doctors with the underlying psychological and behavioral elements of disease. As a vital member of a health-care team, the practitioner is able to give continual support in implementing changes. Research has shown that this support often leads to improved long-term compliance outcomes and can be a very cost effective method of instilling change. A therapist may, for example, work with a person to meet the challenges of rehabilitation after a stroke, quitting smoking or losing weight, coping with disabling pain or infertility, or overcoming stubborn insomnia. Some behavioral practitioners have been likened to coaches, preparing patients mentally for challenges that lie ahead.

How Does It Work?

If you have never visited a behavioral health practitioner you may be uneasy about the experience, because you are not sure what to expect. First and foremost, do not be apprehensive that anything you say to these clinicians will be used to judge you. The fact that many behavioral health modalities involve talking about the problem intimidates many people who may not be familiar with the behavioral health construct. These professionals are trained to listen, take notes and assist you in reaching your goals. They will need details on your condition to help formulate a treatment plan, and will not use the information provided during therapy outside of the therapy session.

After taking a history of the issue at hand, the therapist will construct an individualized treatment plan. Since behavioral health practitioners are often trained in many modalities, these plans may include homework, guidance in active practices such as imagery or relaxation training, or other health behaviors. Whatever the plan, your participation in the process is key. Because this therapy focuses on implementing long-term change, it requires that you be an active participant in your care. You must make a commitment to yourself in order to achieve optimal benefit.

Health Benefits

Behavioral health practitioners work both independently and part of larger collaborative medical teams to promote healthy behaviors and thought patterns. Your condition will influence the specific type of care you receive. Specifically, behavioral therapy may help to:  

·         Treat insomnia. Recent National Institutes of Health consensus statements and the American Academy of Sleep Medicine's Practice Parameters recommend that cognitive-behavioral therapy for insomnia be considered the first line treatment for chronic insomnia (1, 2). Chronic insomnia plagues 1 in 10 adults. This condition is implicated in causing accidents, decreasing quality of life, negatively impacting productivity at work and increased rates of depression and diabetes. If you suffer from this debilitating condition a behavioral health practitioner may be able to help you regain your health and vitality.

·          Relieve some forms of depression. Depression either alone or in concert with another medical condition can often seem overwhelming when approached alone. Behavioral health practitioners can help you discover more effective ways of dealing with life stress, and are often called in by medical doctors to help treat conditions that also cause high levels of anxiety or depression. A study conducted by the University of Washington on 1,801 older adults suffering from diabetes and depression showed that the treatment group treated with behavioral health approaches in addition to conventional care experienced 115 more depression free days than did their conventional care only counterparts (2). It has also been shown to help women suffering from postpartum depression (3). Behavioral Health treatments for depression may also reduce the chance of relapse even after the treatment ends (4).

·         Break the cycle of eating disorders. Eating disorders inflict serious psychological and physical trauma on not only the people suffering from the disorder but the larger family unit as well. Both anorexia nervosa and binge eating have shown favorable responses to treatment with cognitive behavioral therapies (5, 6). Small trials have also shown guided self-help to be of benefit (7).

·         Control panic and anxiety attacks. An estimated 40 million American adults suffer from anxiety disorders (8). These conditions can range from a racing heart and shallow breathing to the need for extreme order of compulsive obsessive disorder (ODC). All of the conditions share one unifying theme; they disrupt the daily functioning of those who are afflicted. Conventional treatments work in these cases, but not as well as when they are used in conjunction with cognitive behavioral therapies (CBT) (9). University of Washington researchers showed that of 232 patients suffering from panic disorder, those treated with CBT had 60 more anxiety-free days over the course of a year than did the study participants that were treated with medication alone (10). The study also examined the cost of combined care and found that the addition of CBT to conventional pharmacologic treatment was well within the cost range of other conventional medically accepted treatments.

·         Encourage long term weight management. Obesity is one of the most costly conditions affecting Americans today. Science has shown direct links between carrying extra weight and increased susceptibility to conditions such as cancer, diabetes and heart disease. However, for many people, losing weight isn’t as simple as just cutting out snack foods and sweets. For many, emotional triggers turn even the best-laid diets astray. Behavioral health practitioners can help your chances of achieving weight loss goals through personal coaching and behavior modification (11, 12).

·         Relieve chronic low back pain. A review of 21 studies on the use of behavioral modification therapies for the treatment of chronic low back pain showed that relaxation and cognitive training did offer some relief from measure of pain and disability in the short-term (13). More research is needed to determine how long these benefits last and which particular therapies from the myriad of behavioral health interventions confer the most benefit. 

How to Choose a Practitioner  

Finding a good behavioral health practitioner means finding someone you enjoy working with who can help you meet your treatment goals. There are many types of therapists using a variety of techniques, from talk therapy to relaxation training. Some meet one-on-one with you. Others conduct sessions that include partners or other family members. Still others lead support groups, and some specialize in working with older adults or with children. Certain practitioners provide telephone help-lines for initial consultation or follow-up.

 

As with finding any type of practitioner, word of mouth is a good way to start. Friends and family, your primary-care physician, and other health practitioners are all good sources for referral. In addition, many community hospitals and health-care plans offer a network of professionals trained in behavioral techniques. Don't be afraid to ask questions about the types of treatment available, the practitioner's background, and how long therapy might last.

 There are other points to consider as well: 

·    Does the practitioner’s treatment style mesh well with your personal style? Behavioral health specialists have different personal styles and use varying methods. Choose somebody you feel comfortable with. The therapist should also be able to work well with your doctor and other members of your health-care team, if necessary.

·    Does the therapist have a degree?
In some states, just about anyone can be called a "therapist." Look for someone who has a master's or doctoral degree in a behavioral science or mental health field, such as social work, health education, family or marital counseling, psychology, or psychiatry.

·    Is the therapist licensed?
The practitioner should hold a valid license to practice in your state. State licenses vary in terms of requirements, but all help to assure that practitioners meet strict standards relating to professional ethics, education, experience and training.

·    Does the therapist belong to any professional organizations?
You may want to consider asking the therapist if they belong to any professional organizations or groups. These bodies usually offer additional training and course seminars to keep their members abreast of the latest discoveries in their field.

Note: The different degrees that follow these therapists’ names might be confusing. A Master Social Worker who becomes licensed in one state, for example, may go by a hodgepodge of initials, depending on the state and the person's level of experience and training. Examples include M.S.W. (Master Social Worker), L.S.W. (Licensed Social Worker), L.I.S.W. (Licensed Independent Social Worker), L.C.S.W. (Licensed Clinical Social Worker), and L.I.C.S.W. (Licensed Independent Clinical Social Worker).

 For more information or help in locating a therapist, contact one of the following organizations. 

·  Society of Behavioral Medicine, Middleton, WI. Call (608) 827-7267.

·  Association for Advancement of Behavior Therapy, New York, NY. Call (800) 685-AABT.

·  National Institute of Mental Health, Bethesda, MD. Call (301) 443-4513.

·  National Mental Health Association, Alexandria, VA. Call (703) 684-7722.

·  American Psychiatric Association, Washington, DC. Call (888) 357-7924.

·  American Psychological Association, Washington, DC. Call (800) 374-2721.

·  American Institute for Cognitive Therapy, New York, NY. Call (212) 308-2440.

·  National Association of Social Workers, Washington, DC. Call (202) 408-8600.

·  American Psychiatric Nurses Association, Arlington, VA. Call (703) 243-2443.

 

References

 

  1. Smith MT, Perlis ML. Who is a candidate for cognitive-behavioral therapy for insomnia? Health Psychol. 2006 Jan;25(1):15-9.
  2. Edinger JD, Wohlgemuth WK, Krystal AD, Rice JR. Behavioral insomnia therapy for fibromyalgia patients: a randomized clinical trial. Arch Intern Med. 2005 Nov 28;165(21):2527-35.
  3. Katon W, Unutzer J, Fan MY, Williams JW Jr, Schoenbaum M, Lin EH, Hunkeler EM. Cost-effectiveness and net benefit of enhanced treatment of depression for older adults with diabetes and depression. Diabetes Care. 2006 Feb;29(2):265-70.
  4. Milgrom J, Negri LM, Gemmill AW, McNeil M, Martin PR. Milgrom J, Negri LM, Gemmill AW, McNeil M, Martin PR. A randomized controlled trial of psychological interventions for postnatal depression. Br J Clin Psychol. 2005 Nov;44(Pt 4):529-42.
  5. Molinari E, Baruffi M, Croci M, Marchi S, Petroni ML. Binge eating disorder in obesity: comparison of different therapeutic strategies. Eat Weight Disord. 2005 Sep;10(3):154-61.
  6. Kotler LA, Boudreau GS, Devlin MJ. Emerging psychotherapies for eating disorders. J Psychiatr Pract. 2003 Nov;9(6):431-41.
  7. Banasiak SJ, Paxton SJ, Hay P. Guided self-help for bulimia nervosa in primary care: a randomized controlled trial. Psychol Med. 2005 Sep;35(9):1283-94.
  8. Hollon SD, Stewart MO, Strunk D. Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety. Annu Rev Psychol. 2006;57:285-315.
  9. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of Gen Psychiatry, 2005 Jun;62(6):617-27.
  10. Katon W, Russo J, Sherbourne C, B Stein M, Craske M, Fan MY, Roy-Byrne P. Incremental cost-effectiveness of a collaborative care intervention for panic disorder. Psychol Med. 2006 Jan 10;:1-11.
  11. Lang A, Froelicher ES. Management of overweight and obesity in adults:Behavioral intervention for long-term weight loss and maintenance. Eur J Cardiovasc Nurs. 2006 Jan 5.
  12. Evangelista LS, Miller PS. Overweight and obesity in the context of heart failure: implications for practice and future research. J Cardiovasc Nurs. 2006 Jan-Feb;21(1):27-33.
  13. RWJG Ostelo, MW van Tulder, JWS Vlaeyen, SJ Linton, SJ Morley, WJJ Assendelft. Behavioural treatment for chronic low-back pain. The Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD002014. DOI: 10.1002/14651858.CD002014.pub2.
  14. McNaughton-Cassill ME, Bostwick JM, Arthur NJ, et al. Efficacy of brief couples support groups developed to manage the stress of in vitro fertilization treatment. Mayo Clin Proc. 2002 Oct;77(10):1060-6.
  15. Tuschen-Caffier B, Florin I, Krause W, Pook M. Cognitive-behavioral therapy for idiopathic infertile couples. Psychother Psychosom. 1999;68(1):15-21.

Evidence Based Rating Scale  

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies with what our clinical advisors have found to be efficacious in their personal practice. This tool is meant to simplify which supplements and therapies demonstrate promise in the treatment of certain conditions. This scale does not take into account any possible interactions with any medication/ condition/ or therapy which you may be currently undertaking. It is therefore advisable to ask your doctor before starting any new treatment regimen.

Condition

Rating

Explanation

 

Anxiety & Panic

 

 

 

 

Some large trials indicate efficacy, especially in conjunction with conventional treatments. (25, 26)

 

 

 

 

 

 

 

Back pain

 


Date Published: 04/19/2005
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