Behavioral Medicine, Part II
Why is it effective?
A growing body of research has documented the benefits of behavioral medicine in the treatment of acute and chronic illnesses. The interventions of behavioral medicine include behavioral or psychological strategies, which directly influence physiological states. The methods are best implemented using individual interventions with concomitant daily practice. Clinical experience indicates that patients who use behavioral self-help strategies have better medical outcomes and improved self-efficacy in managing symptoms than those who rely on medical intervention alone.
Outcomes research indicates that patients have improved prognoses and feel more cared for when behavioral medical interventions are integrated into their treatment plans. In addition, behavioral medical consultation-as opposed to psychiatric or psychological evaluation-circumvents patient concerns about being labeled as having a mental health issue or psychiatric diagnosis.
Improved outcomes appear to be based on patients' active participation in treatment, decreased feelings of passivity in response to their illness or injury, and improved perceptions about the probability of recovery of function or quality of life, regardless of actual recovery potential. Family members, who are often included in behavioral medical approaches, find greater comfort with the care received by patients and are aided in their own adjustment to the challenges faced by their loved ones. It has been documented that patients and families often experience a sense of "false despair" that negatively impacts their prognosis when they believe they are powerless to influence health care outcomes.
Who else benefits?
The addition of a behavioral medical professional to the health care team provides several benefits in addition to those experienced by the patient. Physicians and nursing staff find patients are more cooperative and in better compliance with their treatment regimen when behavioral medicine strategies are integrated into the treatment plan.
The facility benefits as there is promising research that behavioral medical interventions may result in shorter lengths of stay, allowing the organization to realize significant savings in prospective payment system reimbursement.
An appropriate use of the model would be to offer a behavioral medical consultation to all new patients as soon as possible after admission so an appropriate set of therapeutic interventions can be identified and implemented.
The challenge of living with a serious illness mandates that health care providers explore all options available to their patients. There is a great deal that can be done to help patients help themselves manage symptoms, improve their quality of life, and promote their well-being. Behavioral medicine can make a significant contribution to a comprehensive treatment approach.