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Greater than 20% of children and adolescents meet diagnostic criteria for at least one behavioral health (BH) disorder, and greater than 40% experience clinically significant impairment because of subclinical presentations [...], Introduction: Integrating behavioral health providers into pediatric primary care to provide behavioral health (BH) services is both effective and efficient; however, the impact of pediatric integrated services on the operational and financial outcomes of primary care provider (PCP) visits has not been thoroughly investigated. The present study examined whether length of practice integration predicts the relationship between BH content addressed in a PCP visit, visit length, and revenue generation. Method: A total of 1,209 pediatric encounters with 25 PCPs across 7 primary care offices in a predominantly rural health system were abstracted for the presence or absence of BH content, visit length, duration of integration, and revenue. [x.sup.2] analyses and the generalized linear model framework were used to address the study objectives. Results: Integration was associated with more PCP visits with a BH topic discussed at 6-11 months of integration but not at 14-24 months. Visits with a BH topic were longer than medical-only visits and shorter when a practice was integrated for 6-11 months but not at 14-24 months of integration. Public insurance and integration were associated with lower revenue generation per minute. Visit content was not associated with PCP revenue. Discussion: Results suggest a relationship between integration and the operational and financial outcomes of PCP visits. This study shows that initial efficiencies or improvements (e.g., time, cost, content) associated with integrating BH may be lost over time. Future studies should evaluate sustainability in relation to program impact. Keywords: behavioral health, primary care, integrated care, pediatric

This study evaluated a cognitive behavioral group treatment with bulimics. All 13 participants met the DSM-III-R criteria for bulimia nervosa. A multiple baseline design was used with three groups that received the same treatment. The duration of baseline varied for each group: 2, 6, and 10 weeks. The two primary dependent variables were daily self-reports of binging and purging. Five additional outcome measures were used to provide corroboration and to assess broader psychopathology and cognitive changes. Significant reductions in binging and purging occurred between baseline and the end of treatment and between baseline and three weeks post discharge. When data from one outlier were eliminated, those reductions were also maintained at three months post discharge. The five additional variables also showed consistent and meaningful clinical improvements. The results support the value of using a cognitive behavioral approach in group treatment with bulimics.

Partial hospitalization has developed as an important treatment modality for adults and recently for adolescents. Although several articles have described adolescent partial hospitalization programs, very few have any research supporting their effectiveness. An adolescent partial hospitalization program is described and evaluated using four outcome measures obtained both at admission and discharge from the program. Significant improvement occurred for all variables: the Child and Adolescent Behavior Problem Checklist completed (a) by patients and (b) by parents, (c) the Assessment of Current Functioning Scale (therapist ratings), and (d) Goal Attainment Scaling. These preliminary data support adolescent partial hospitalization as a treatment modality worthy of further application and research. [ABSTRACT FROM AUTHOR]