The Downward Spiral

To illustrate this point, read through the following two examples:

• “Mary” has pain related to fibromyalgia, she reduces her level of activity including amount of exercise. This inactivity leads to weight gain, a feeling of isolation, decreased social support, and boredom. She initially copes with the stress of her situation by eating junk food, drinking more alcohol, smoking cigarettes, and gambling on the internet. So now Mary is dealing with fibromyalgia, obesity and diabetes. She’s prescribed more medications, which cost more money and come with a list of unpleasant side effects. Then, Mary’s spouse and other family members begin to experience more frustration, anger and resentment—rather than concern and support, which creates even more stress and more physical pain. To top it all off, this escalating list of factors has now resulted in Mary having to cope with performance issues at work, increased absenteeism, higher healthcare costs for insurance, marital stress, unhealthy addictive behaviors, irritable/depressed mood, less positive self-image, and a loss of self-confidence.
  
  
• “Bob” experiences a heart attack and must then undergo heart surgery. He’s angry and frustrated with how long his recovery is taking, hates to attend the now frequent medical appointments, and often ignores the advice of others to take his medication and cut down on fatty foods. In addition, since Bob is a man who likes to have a lot of control over events in his life, he’s (secretly) feeling quite worried and at times feels powerless and scared. At his next medical appointment, Bob’s doctor reports his blood pressure is too high and prescribes another medication. Since this medication has an effect on Bob’s sexual intimacy with his wife, he now feels even more alone and less inclined to follow his doctor’s advice. Additionally, all this stress has interfered with Bob’s ability to get a good night’s sleep—which results in him feeling sluggish and irritable, weakens his body’s ability to recover, and interferes with his ability to concentrate and think clearly (which causes Bob to erroneously worry that he might be developing Alzheimer's).

These two examples demonstrate how easily one problem with your physical health can very rapidly spiral into what feels like a “living nightmare” and have a profound effect on all aspects of your life. To assist you in managing physical health issues in the healthiest manner you can, we’ve developed a set of Health & Behavior Interventions for a number of common health issues, which we then tailor to meet your specific needs and lifestyle.

Health & Behavior Assessments and Intervention

Our H & B Services focus on the impact of biopsychosocial (cognitive, emotional, social, or behavioral) factors that relate to your physical health status and treatment of a medical diagnosis— these services are not psychiatric services. Instead, these interventions are designed to improve your health and well-being by reducing or eliminating issues that affect prevention, treatment, management, or recovery from acute or chronic physical health problems.

• H & B Assessment (Individual or Family) — consists of a health-focused clinical interview that examines your emotional, social and medical history, as well as your ability to manage problems related to your specific health issue, hospitalizations and treatments. The assessment also includes behavioral observations, psychophysiological monitoring, and health-oriented questionnaires. We then develop a treatment plan, taking into account your particular health stressors, coping skills, and lifestyle.
  
  
• H & B Intervention (Individual, Family, or Group) — typically consists of weekly sessions designed to improve your physical health status. Interventions might include education and skills training in any of the following areas: awareness of the disease process; knowledge of health risks; strengthening health-promoting behaviors; reducing health-related risk-taking behaviors; realistic goal-setting; improving adjustment to physical illness; developing self-monitoring techniques; coping skills strengthening; social skills strengthening; the positive impact of social support; the role of spirituality in health behavior; effective communication with your family and physician; conflict resolution skills; assertiveness training; relapse prevention; adherence to medical treatment; symptom management; and improving healthy lifestyle habits related to diet and exercise. A variety of techniques, such as cognitive-behavioral, relaxation response training, guided visualization, mindfulness meditation, behavior modeling, and problem-solving techniques are used to assist your doctor in helping you achieve your treatment goals. Family members may also participate in several sessions in order to learn how to clarify their roles and responsibilities related to your physical health issue.

Medicare and your secondary insurance typically cover most of the cost for these services, which come out of funding for medical rather than psychiatric services. Additionally, many private third-party insurance plans cover a sizeable portion of the cost and, like Medicare, tend to classify these services under the physical illness benefits of your health plan. In most cases, this alleviates the possibility of higher co-payments or behavioral health "carve out" provisions. We’re happy to call your insurance company for you to obtain coverage information of these services.