Collaborative Documentation: New National Council Webinar

If you have read this blog for a while, you are no doubt aware that I am a webinar junkie. There are loads of free webinars available and they provide lots of very useful information. I am especially fond of the webinars presented by The National Council and have written several articles based on their webinars on topics such as Health Information Exchange and behavioral health, integrating behavioral healthcare into the healthcare home, compliance requirements, and the impacts of healthcare reform on behavioral health providers.

These presentations have usually been packed with information, quick-moving, presented by very well informed individuals or panels, and a pleasure to attend. The webinar I attended today was no exception.

Collaborative Documentation Promotes Efficient Services for Children & Youth was presented by Katherine Hirsch, MSW, LCSW, Consultant, MTM Services, LLC. Ms. Hirsch did an excellent job of explaining just what collaborative documentation is, how to do it, how to engage the client in the process, and what the benefits are. She covered an impressive quantity of high quality information in 90 minutes.

If you are looking for ways to more effectively use psychotherapeutic time, improve the accountability of your staff, and assure that records are completed in a timely fashion, you need to see this webinar. In about 48 hours, the recording of the webinar will be available for viewing at the National Council website.

Behavioral healthcare faces many challenges in these rapidly changing times. Finding the time to provide services well and effectively while accurately and carefully documenting those services is a real challenge. Learning how to utilize collaborative documentation can increase your chances of success.

Are you already using this methodology? How is it working for you? for your staff? Please share your experiences in the comments below.


Change in Healthcare is Upon Us…Law or not

In 1992, when Bill Clinton was elected President of the United States for the first time, I was a member of the Committee for the Advancement of Professional Practice (CAPP) of the American Psychological Association. CAPP is charged with general governance oversight of the Practice Directorate, the part of APA responsible for promoting “the practice of psychology and the availability and accessibility of psychological services, providing resources and services to practicing psychologists in all settings and to the public.”

Our first meeting immediately after the election was highly charged. Staff had been studying President Clinton’s healthcare proposals, and the notion of controlling cost through “managed care.”

President Clinton’s healthcare proposals did not fly, but the industry picked up the notion of controlling costs by managing the care provided to consumers, and psychological practice has never been the same. For private practitioners, “managed care” continues to be a primary obstacle to the practice of psychology. Costs might have been suppressed by managing care, but some would argue that the primary effect of the managed care revolution was the creation of a new industry that made money as the middle-men at the cost of providers. Indeed, after a few years of leveling of the costs of care, the rise has been renewed and expanded.

In mid-November, the Supreme Court of the U.S. agreed to hear an appeal of the Affordable Care Act, our nation’s most recent effort to reform our healthcare system.

The Supreme Court agreed to hear appeals from the United States Court of Appeals for the 11th Circuit in Atlanta, which is the only court to have struck down the individual mandate because it overstepped Congressional authority and wasn’t justified by the constitutional power “to regulate commerce” or “to lay and collect taxes.” FierceHealthPayer, November 18, 2011

According to editor Dina Overland of FierceHealthPayer newsletter, even a complete overturn of the law would have little significant impact. She believes that consumers like the changes the law is mandating and there is no stopping this train.

Mercom Capital Group, in their HIT Report of November 21, 2011, says the same thing about the massive changes in the healthcare arena at large. Basing their conclusions on a report by PwC (PricewaterhouseCoopers, LLC), Mercom reports that health organizations will continue to move forward with changes to their health technology and other innovations because the multiple drivers in the marketplace have finally come to a head. No matter the political or the financial uncertainties, PwC believes this movement will continue. These are changes consumers like, and the movement will continue no matter which market forces might change.

In their HIT Report of November 28, 2011, Mercom reports that Harvard and Aetna will ally to work to improve healthcare costs and quality. The two have formed a research collaborative focused on improving the quality and cost of healthcare. They will use bioinformatics, the interface of computer science and information technology with the fields of biology and medicine, to analyze healthcare data in innovative ways. They will focus on outcomes of various treatments considering quality and cost, factors that predict adherence to medical and drug treatments for chronic diseases, examining how claims and clinical data can be best used to predict disease and follow outcomes, as well as other treatments of data that will emerge over time.

Where is your organization in the midst of this dramatic change in how we manage healthcare? How do you see yourself participating in the sea change that is under way? Where does behavioral healthcare fit into this picture?

Just type in your thoughts below. Thanks for commenting.

Creativity: Running out of ideas…

I have been struggling with a topic for this week’s blog. The only thing that has come across my path that feels compelling is the hummingbird who showed up at our coral honeysuckle on Sunday. Unfortunately, integrating that ruby throat into my article does not seem like an easy task.

Sometimes, I feel like I have run out of ideas. When that happens, I am reminded of feelings I experienced as a child and young adult. I knew I was not an artist and felt myself also to be not creative.

It took many years before I learned that my creativity takes forms different than that of artistic individuals. At some point in the process of doing psychotherapy with some very difficult clients, I realized that most of my creativity takes the form of what I will call creative alternativism. Generating possibilities…especially possibilities for different types of behavior and different kinds of thinking…was the primary manifestation of that creativity. Helping my clients find different ways to be in the world in order to overcome their pain and problems was the most important way I expressed that creative urge.

I have since realized that I often apply that process to myself as well. Since I can be a pretty rigid person when it comes to my own thinking and behavior, I have found that I need to make systematic efforts to implement the alternatives I generate for myself. I may well come up with many ideas about how to change my behavior, but I need structure to implement those changes.

Three years ago, I knew that adding yoga into my fitness efforts would benefit my arthritic joints and relieve some of my stress. Signing up for a yoga class was the structure that allowed me to make that a regular part of my activities. After three years, I have found other structures to help me extend that one class to two and now into a daily practice. I need and use structure to implement the possible changes I creatively generate for myself.

I had an email this week from a colleague I have not seen in years. I was delighted to learn that for the past year, she has been painting! At age 60, she took a pastels class at her local community college. She was hooked on the medium and has found a new outlet for her creativity. In my experience, she has always been creative. She has been a psychologist and psychotherapist for her entire professional life. She has researched and written and published…an aspect of her professional creativity; and now, she paints!

I am delighted to know that a new aspect of creative expression can manifest itself at any age, as long as we are open to it.

How do you express your creativity? Do you manage to do this within your professional life? Does the place you work benefit from your creative endeavors, or is it just for you?

Please share your thoughts about creativity, regenerating it, and keeping our lives…and blog topics…fresh.

Prevention and Pain: A major way to save money

This morning I read an editorial (An ounce of prevention could heal a pound of pain) by Dina Overland of the FierceHealthPayer newsletter. She decided to use her platform as the editor of a newsletter that is aimed at insurance payers to directly address those payers about prevention of healthcare problems and diminishing future costs. She focused on an area that behavioral health and substance abuse professionals work in often . . . pain.

Ms. Overland’s review of the Institute of Medicine’s (IOM) report on pain and prevention cited some facts I had not heard.

Chronic pain affects 116 million Americans–that’s more people than affected by heart disease, cancer, and diabetes combined–and costs the United States
$635 billion each year. That’s what the Institute of Medicine (IOM) found in its report, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research.

If that’s not jarring enough, here are some more staggering facts: The United States spends $2 trillion on healthcare, but only 4 cents of every dollar goes to prevention and public health, despite being among the best tools to reduce spending. For every $1 invested in prevention, we save $6 in projected healthcare costs, says Sen. Tom Harkin (D-Iowa), who participated in the Department of Health and Human Services (HHS)’s announcement
of its guidelines to incorporating prevention throughout the healthcare industry.



I could not help but think about the number of people who would never have become substance abusers if their chronic pain had been addressed and treated at an early stage. How many behavioral health clients have you treated for depression after years of experiencing intractable pain?

The IOM and HHS see the coordination of care among primary care providers and specialists as the best way to address early intervention and prevention of pain. What role should mental health and substance abuse providers play in this coordination? How many of your patients also experience chronic pain? Where do behavioral health providers fit in?

Please share your thoughts and comments below. What role do you want to play in diminishing healthcare costs? Who should we see when it hurts?


APA and Public Education in Behavioral Health

In a previous life, when I was actively involved in the American Psychological Association (APA), I was for three years a member of and one year the chair of the Public Information Committee of the APA. Prior to that, I hosted a live, call-in television show for two years. Frankly Speaking with Dr. Kathy Peres was entirely focused on educating the public about psychological matters. I believe that public education about how mental health issues affect our day-to-day lives is a significant responsibility of all professionals and organizations that provide services in the behavioral health arena.

Given that belief, I was very pleased today to receive an email from the APA announcing a new series of videos and podcasts by APA CEO, Norman B. Anderson, Ph.D. You can view the introduction and the first two installations in the series This is Psychology, one on bullying and another on children’s mental health.

APA invites you to place these links on your own professional web sites and to share them and the information they contain as broadly as possible.

Last week, I wrote about potential problems with use of social media in your organization. Public education of this sort. . .including sharing of the information created on Twitter and FaceBook is one arena in which I think social media has the potential for more power than in any other area of our professional lives.

How does your organization participate in education of the public about behavioral health issues? Please share your initiatives and activities here so others can communicate them more broadly for you.