Understanding Health Talk in Behavioral Health Encounters: A Qualitative Analysis
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ORIGINAL ARTICLE
Understanding Health Talk in Behavioral Health Encounters: A Qualitative Analysis Elizabeth B. Matthews1 · Lynden Bond2 · Victoria Stanhope2 Accepted: 15 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Although physical and behavioral health conditions commonly cooccur, best practices making behavioral health treatment responsive to clients’ health needs are limited. Particularly little is known about how physical health is addressed by clinicians within routine therapeutic treatment. This study describes the frequency and type of health talk occurring within integrated behavioral health sessions, and explores how this talk functions within ongoing therapeutic work. Participants in this study included 51 dyads of clinical social workers (n = 13) and clients (n = 51) receiving therapy within an integrated community health and behavioral health center. Therapy sessions were recorded and transcribed verbatim. Content analysis determined the frequency and content of health talk in sessions. Thematic analysis was used to understand the function of health talk within these visits. Health talk occurred in 92% (n = 47) of sessions. Clients initiated the majority of discussions. Talk about sleep (40%, n = 19), diet/exercise (35%, n = 16), and chronic health conditions (28%, n = 13) were most common. Health talk either complimented or conflicted with therapeutic work, depending on the topic discussed and when it occurred during session. Health talk changed the scope of therapeutic work by integrating care coordination into routine practice. Health talk was pervasive and was frequently initiated by clients, signaling its relevance to clients’ recovery. Providers leveraged heath talk to complement their therapeutic work, but these strategies were not universally applied. Care coordination activities were a part of routine therapy. Practice and policy changes that support a more interdisciplinary approach to clinical work are needed. Keywords Health promotion · Behavioral health services · Integrated care · Health literacy
Background The inextricable link between physical and psychological health has been well established. Current evidence suggests that as many as 68% of adults with a mental disorder suffer from a comorbid medical condition, while nearly one third of individuals with a medical condition may concurrently experience a mental disorder (Druss and Walker 2011). This has led to alarmingly high mortality rates for individuals with behavioral health disorders, with those suffering from severe and persistent conditions dying, an average of 25 years earlier than the general population. Often, these deaths are due to preventable health conditions, such as * Elizabeth B. Matthews [email protected] 1
Graduate School of Social Service, Fordham University, 113 W 60th St, New York, NY 10023, USA
New York University Silver School of Social Work, 1 Washington Plaza, New York, NY 10003, USA
2
obesity, hypertension, and diabetes (Cohon and Mandersc
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