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Person-centered treatment planning is a process and a product. The treatment planning process relies on collaboration and shared decision-making with clients to: (1) synthesize information from the assessment to identify specific problems to be solved; (2) set goals and objectives; (3) select interventions; and (4) monitor progress toward goals through documentation and periodic review. The product is a written plan of action that guides treatment. The treatment plan is derived from the case conceptualization of client strengths, problems, and access to resources developed from information in the assessment. The plan drives the selection of service interventions that can include psychotherapeutic approaches, skill development, rehabilitation, advocacy, self-help, and the acquisition of resources through case management. The specific areas of person-centered treatment planning covered in this chapter include: (1) developing a case conceptualization that synthesizes information from the psychosocial assessment to design a person-centered care plan; (2) developing goals and objectives that are specific, measurable, actionable, achievable, relevant, recovery-oriented, and time limited; (3) selecting interventions from a shared decision-making perspective; and (4) reviewing progress notes and documentation formats. The chapter concludes with a continuation of the case of Mr. Clarence Smith from Chap. 10.1007/978-3-030-59659-0_4.

Experiencing interpersonal violence has serious consequences for short- and long-term health. This makes it imperative that behavioral health professionals incorporate trauma-informed screening, education, and intervention processes and procedures as a routine part of their day-to-day activities. In this chapter, I explore screening, assessment, and intervention strategies for two types of interpersonal violence commonly seen in integrated behavioral health settings: intimate partner violence (IPV) and community-based violence (CBV). First, data on the prevalence and health impacts of interpersonal violence across multiple populations will be provided. Second, trauma-informed approaches to universal screening, education, and support for patients in regard to IPV will be outlined. Third, programmatic components of hospital-based violence intervention programs will be reviewed, and the importance of these programs as integrated behavioral health practices designed to reduce morbidity and mortality will be discussed.

The experience of trauma and toxic stress is common and can profoundly impact the health and behavioral health of survivors long after exposure. Survivors of trauma are at risk for a range of co-occurring conditions that can lead to high morbidity and premature mortality, making screening, assessment, and treatment of trauma in routine health and behavioral health settings a priority. In this chapter, I explore the impact of trauma and adverse childhood events (ACEs) on health and well-being. This chapter includes epidemiological data on the prevalence of trauma and post-traumatic stress disorder (PTSD), and how the experiences of ACEs impact health. A definition and overview of trauma-informed care (TIC) practices, policies, and procedures will be provided, and a range of common screening and assessment instruments will be reviewed. The signs and symptoms of post-traumatic stress disorder (PTSD), and an outline of trauma-informed and evidence-based strategies for assessing and treating trauma-impacted clients will also be provided that include prolonged exposure therapy, cognitive processing therapy (CPT), eye movement desensitization and reprocessing therapy (EMDR), and trauma-informed cognitive behavioral therapy (TF-CBT).

Medical and behavioral health disorders commonly co-occur. This comorbidity has devastating effects on health in the form of increased illness, disability, and early mortality. It also has increased economic costs in health care and other spending. The integration of behavioral health and primary care services carries vast potential in the prevention, early intervention, and effective management of chronic diseases for patients with co-occurring behavioral and physical health problems. In this chapter, I review the epidemiology of behavioral health disorders in the United States for different groups and provide information on the comorbidity of these disorders with other health conditions. I then use an ecological systems lens to review common biological, psychological, and social factors found to be important determinates of risk and resilience for common behavioral health disorders at individual, familial, institutional, and societal levels. Finally, I review common social determinants of health and behavioral health and provide a rationale for effectively addressing these determinants through integrated care models.

Health care in the United States continues to remain fragmented, inefficient, inequitable, and ineffective. These factors, combined with long histories of inequities in access to social determinants of health and wealth, have contributed to health disparities for individuals who identify as Black, Indigenous and People of Color (BIPOC), disparities that have been exposed by the COVID-19 pandemic. Integrating health and behavioral health services can address system fragmentation and inequitable access to resources. In this chapter, I define integrated behavioral health practice (IBHP) and provide an overview of the various factors that have led to the rise of integrated behavioral health care (IBHC) in the United States over the last two decades. These inter-related and overlapping factors include service fragmentation, health disparities, the realization of the role of trauma in health outcomes, and the recognition of the co-occurring and bidirectional nature of mental illnesses, addiction, trauma, and physical illnesses. I also identify the barriers to full integration of behavioral health care in health settings and explore potential solutions by highlighting specific models of integrated behavioral health care and the competencies associated with effective integrated behavioral health practice.

This chapter will focus on stage-based interventions for substance use disorders. Clients with substance use disorders may be in various stages of change in regard to their motivation and intention for changing their substance use behaviors. Tailoring treatment approaches to a client’s particular stage of change can help them reduce the harms associated with substance use, increase their motivation for change, and learn skills designed to help them reduce or eliminate their use and prevent relapse. This chapter will organize three general sets of interventions found to be effective for substance use disorders according to the transtheoretical model of change: (1) harm reduction approaches for persons in the precontemplation stage; (2) motivational interviewing for clients in contemplation and preparation stages; and (3) brief cognitive behavioral treatments for clients in the action and maintenance stages of change. The principles, philosophies, theoretical orientations, and practices for each approach will be reviewed in detail and illustrated using case vignettes.

The purpose of this chapter is to help providers understand the factors that influence change, recovery, and well-being so that they can (re)create contexts that empower clients and promote health. In this chapter I review theories that can help providers understand how to respond to clients who engage in unhealthy behaviors and how to create the contexts that lead to change, recovery, and well-being. In the first part of this chapter, I review three major theories of recovery and well-being that include: (1) the model of mental health recovery, (2) The model of subjective well-being, and (3) the model of psychological well-being. In the second part of this chapter, I review three theories related to understanding how people change health-related behaviors, such as substance use and other risk behaviors. Three major theories are reviewed that include: (1) the transtheoretical model of change, (2) the health beliefs model, and (3) the theory of reasoned action. I also identify general treatment approaches that enhance recovery and well-being and discuss how to efficiently and effectively deploy these approaches in ways that maximize behavior change in clients.

Behavioral health screening and assessment is an ongoing process of gathering and synthesizing important information across a range of domains including mental health, substance use, interpersonal relationships, and social determinants of health (SDOH) in order to inform treatment planning. This chapter will provide an overview screening and assessment practices vital to integrated behavioral health practice. The assessment process described in this chapter will be rooted in the ecological systems perspective discussed in Chap. 10.1007/978-3-030-59659-0_2 and will be person centered, strength based, holistic, and recovery oriented. The purpose of assessment is to inform the development of a robust clinical formulation and treatment plan (described in Chap. 10.1007/978-3-030-59659-0_5) designed to address the intersectional issues that clients face from a bio-psycho-social perspective. This chapter will focus on assessment and documentation areas that include: (1) screening for common behavioral health issues such as depression, anxiety, stress, trauma, suicide, and substance use; (2) assessing personal strengths and capacities that lead to health; (3) past and current problems in the functional domains of health, mental health, substance use, interpersonal relationships, employment, and daily living; and (4) assessing social determinants of health. The chapter will conclude with an illustrative case study highlighting important areas and considerations of the assessment process.

Additional file 4. Representative example of a final, summative wiki assessment submission.

Additional file 5. Summative Pharmacology MCQ Item Statistics.

Additional file 2. Example small group wiki assignment.

Additional file 3. Small group pharmacology wiki grading rubric.

Additional file 6. Percentage of students who failed formative small group wiki assignments and the percentage of failures due to timeliness, quality or authorship/citations/respect for M1 students 2014–2018.

Additional file 1. Distribution of online pharmacology modules in relation to first year teaching blocks, elements of the conceptual framework being introduced, and over-the-counter drug context.

Supplemental material, Supplemental_Material_Stossi_Resubmission for Single-Cell Distribution Analysis of AR Levels by High-Throughput Microscopy in Cell Models: Application for Testing Endocrine-Disrupting Chemicals by Fabio Stossi, Ragini M. Mistry, Pankaj K. Singh, Hannah L. Johnson, Maureen G. Mancini, Adam T. Szafran and Michael A. Mancini in SLAS Discovery

Szafran_Mancini_ARER_Supplemental_2_0 for A Mechanistic High-Content Analysis Assay Using a Chimeric Androgen Receptor That Rapidly Characterizes Androgenic Chemicals by Adam T. Szafran, Michael J. Bolt, Caroline E. Obkirchner, Maureen G. Mancini, Christine Helsen, Frank Claessens, Fabio Stossi and Michael A. Mancini in SLAS Discovery

Steroid hormones are pivotal modulators of pathophysiological processes in many organs, where they interact with nuclear receptors to regulate gene transcription. However, our understanding of hormone action at the single cell level remains incomplete. Here, we focused on estrogen stimulation of the well-characterized GREB1 and MYC target genes that revealed large differences in cell-by-cell responses, and, more interestingly, between alleles within the same cell, both over time and hormone concentration. We specifically analyzed the role of receptor level and activity state during allele-by-allele regulation and found that neither receptor level nor activation status are the determinant of maximal hormonal response, indicating that additional pathways are potentially in place to modulate cell- and allele-specific responses. Interestingly, we found that a small molecule inhibitor of the arginine methyltransferases CARM1 and PRMT6 was able to increase, in a gene specific manner, the number of active alleles/cell before and after hormonal stimulation, suggesting that mechanisms do indeed exist to modulate hormone receptor responses at the single cell and allele level.