Behavioral Medicine for Mental Health Professionals
A Training Resource
By Jim Messina, Ph.D., CCMHC, NCC, DCMHS-T
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COPING.US Training Programs Continuing Education Program:
Integrated Behavioral Medicine Approach to Wellness Programming
Description of Program: Behavioral Medicine is the interdisciplinary field concerned with the development and the integration of behavioral, psychosocial, and biomedical science knowledge and techniques relevant to the understanding of health and illness, and the application of this knowledge and these techniques to prevention, diagnosis, treatment and rehabilitation. Wellness Programming focus is on three major goals of Behavioral Medicine: 1. Changes in behavior and lifestyle which can improve health, prevent illness and reduce symptoms of illness. 2. Behavioral changes which can help people to feel better physically and emotionally, improve their health status and increase their self-care skills and improve people’s ability to live with chronic illness. 3. Behavioral interventions which can improve effectiveness of medical interventions, help reduce overutilization of the health care system and reduce the overall costs of care. This program will review SAMHSA’S Eight Dimensions of Wellness program and the Veteran’s Administration’s Whole Health for Life program as well as four programs on www.coping.us: 1. Strategies for Success in Personal Health Management; 2. Balanced Lifestyle; 3. Independent Living Skills and 4. The SEA's Program.
Learning Objectives
1. To learn about how Wellness Programming fits within the concepts of Integrated Primary Care Medicine and Behavioral Medicine to assist patients to improve their overall physical and emotional health.
2. To learn about the specific components of the SAMHSA’s 8 Dimensions of Wellness program and how it can be implemented in the community with the tools showcased in this presentation.
3. To learn about the specific components of the VA’s Whole Health for Life program and how they can be implemented in the community with the tools showcased in this presentation.
4. To learn the specific components and tools of the 4 programs on coping.us 1. Strategies for Success in Personal Health Management; 2. Balanced Lifestyle; 3. Independent Living Skills and 4. The SEA's Program.
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Wellness Programming-A Major Component of Behavioral/Integrated Medicine
Wellness Programming has emerged as a major initiative of SAMHSA and the Veterans Administration and its roots are in the emergence of Integrated Medicine which was also initiated by SAMHSA. What following is a powerpoint which gives an over view of Wellness Program's foundation in Behavioral/Integrated Medicine:
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What Wellness Programming is out there
In this section are offered 1. The SAMHSA 8 Dimensions of Wellness; 2. The VA's Whole Health for Life and COPING.US's four Programs: 1. Strategies for Success in Personal Health Management; 2. Balanced Lifestyle; 3. Independent Living Skills and 4. The SEA's Program. The hope is that the variety of handouts, workbooks and exercises will enable mental health professionals to devise their own wellness programming in their own settings.
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SAMHSA's Wellness Programming: 8 Dimensions of Wellness
SAMHSA's Definition of wellness is being in good physical and mental health
Because mental health and physical health are linked, problems in one area can impact the other so that at the same time, improving your physical health can also benefit your mental health, and vice versa. SAMHSA believwes it is important to make healthy choices for both your physical and mental well-being.and to remember that wellness is not the absence of illness or stress. You can still strive for wellness even if you are experiencing these challenges in your life.
SAMHSA goes on to explain that wellness can improve quality of life and increase years of life, especially for people with behavioral health conditions by reducing health disparities which prevents early deaths and may also lower the nation's healthcare costs. They report that an analysis of medical expenditures published in 2015 by the Agency for Healthcare Research and Quality shows that trauma-related disorders, cancer, mental disorders, heart conditions, and arthritis and other non-traumatic joint disorders are the most costly conditions among American adults ages 18 to 64.
SAMHSA goes on to report that many factors play a role in these disparities that impact people with serious mental and/or substance use disorders, including:
- Higher rates of cardiovascular disease, diabetes, respiratory disease, and infectious disease (including HIV)
- Elevated risk factors due to high rates of smoking, substance misuse, obesity, and unsafe sexual practices
- Increased vulnerability due to poverty, social isolation, trauma and violence, and incarceration
- Lack of coordination between mental and primary healthcare providers
- Prejudice and discrimination
- Side effects from psychotropic medications
- Overall lack of access to health care, particularly preventive care
SAMHSA goes on to introduce the 8 dimensions of health by stating that wellness means overall well-being
- It includes the mental, emotional, physical, occupational, intellectual, and spiritual aspects of a person’s life
- Incorporating aspects of the Eight Dimensions of Wellness, such as choosing healthy foods, forming strong relationships, and exercising often, into everyday habits can help people live longer and improve quality of life
- The Eight Dimensions of Wellness may also help people better manage their condition and experience recovery.
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SAMHSA’s Eight Dimensions of Wellness are:
- Emotional—Coping effectively with life and creating satisfying relationships
- Environmental—Good health by occupying pleasant, stimulating environments that support well-being
- Financial—Satisfaction with current and future financial situations
- Intellectual—Recognizing creative abilities and finding ways to expand knowledge and skills
- Occupational—Personal satisfaction and enrichment from one’s work
- Physical—Recognizing the need for physical activity, healthy foods, and sleep
- Social—Developing a sense of connection, belonging, and a well-developed support system
- Spiritual—Expanding a sense of purpose and meaning in life
You can read more about SAMSHA's strategies for wellness at: https://www.samhsa.gov/wellness/strategies
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Tools from SAMHSA to Promote Wellness
SAMHSA provides us with some tools for promoting wellness:
- Tools for Emotional Health: Emotional health according to SAMHSA refers to a positive self-concept which includes dealth with feelings constructively and developing positive qualities such as optimism, trust, self-confidence and determination. They provide Wellness Worksheets which provide more than 100 self-evaluating tools for emotional well being which are available at: http://www.integration.samhsa.gov/health-wellness/wellness-strategies/wellness.pdf
- A SAMHSA Handbook called: Creating a Healthier Life-Step by Step Guide to Wellness Takes you through 8 specific steps to include the 8 Dimensions of Health into your life. You can download this Handbook at:
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The SAMHSA's 8 Dimensions of Wellnes can be utilized in a variety of settings and below is a 8 Dimensions of Wellness Goal Setting Sheet:
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The VA's Whole Health for Life Program
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The Veterans' Administration has implemented a program entitled Whole Health for Life.Have a look at: www.va.gov/patientcenteredcare. The program focuses on 8 components which contribute to wellness and health. The areas of focus are:
- Working your Body
- Power of the Mind'
- Spirit and Soul
- Family Friends and Co-workers
- Recharge
- Food and Drink
- Personal Development
- Surroundings
The Puget Sound VA developed a 9 week program for veterans called: Whole Health: A Guide to Proactive Living and Well-Being. You can download the workbook by clicking here:
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The VA has also developed a Self-Inventory for their Whole Health for Life Program which you can get here:
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Lastly the VA has prepared an extensive brochure on their Whole Health for Life program which you can get here:
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The VA's program of Whole Health for Life can be adapted for civilian populations and below is a Goal Setting for Your Whole Health which can be used with civilians.
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COPING.US Group Wellness Programming in Primary Medical Care, Mental Health and Substance Abuse Treatment Settings
On Coping.us are four distinct support group programs which involved a combination of emotional healing, psychoeducation and creating a network of supports for clients and patients.
2. Tools for a Balanced Lifestyle: A Support Program for a Guilt Free System of Healthy Living: This program was developed for patients who needed to turn their lifestyles around to lose weight, eat well, implement an exercise program and deal effectively with the irrational drivers involved in their weight management. This program has a number of powerpoints which were included in the next program to be discussed. You can get directly to the Balanced Lifestyle Support Group Model at: http://www.coping.us/balancedlifestyle/strategiesforsuccess.html
4. The SEA's Program: The Self-Esteem Seeker's (SEA's) Program is a support group modeled after the 12 Steps of AA. However it is addressed at the emotional growth of its participants who suffer from a whole array of mental health and substance use disorders. The online manual contains instructions on how to conduct the program for patients, a 12 Step Workbook for patients, SEA's Tools for Recovery, and the SEA's Lifestyle Skills Handbook. It is available at: http://www.coping.us/seasmanual.html
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