The authors have no conflicts of interest to disclose. “
“This paper describes the delivery of parent-focused interventions for children with externalizing problems seen in integrated primary care settings. Integrated primary care settings Ku-0059436 manufacturer provide families greater and more cost-efficient access to mental health care services, which creates opportunities to identify and treat child-related problems before these problems become entrenched and before parents grow frustrated and discouraged about possible solutions. Behavioral health consultants (BHCs) who work in primary care settings must be

competent in providing such care if families are to fully capitalize on the improved access to services. Adapting evidence-based interventions to primary care settings is enhanced when practitioners Cyclopamine clinical trial are able to fit robust principles of change to the practice setting and to the populations served. In this paper, we describe efforts to fit the basic principles of parent management training to the families seen in an integrated care Federally Qualified Health Center (FQHC). Children and their caregivers present to their primary care providers for a variety of problems, mostly medical in nature; however, research

indicates that 12% to 16% of children present to their pediatrician with unaddressed emotional or externalizing behavioral concerns (Briggs-Gowan et al., 2003, Costello et al., 1988 and Polaha et al., 2011). One study, conducted in pediatric primary care, surveyed families using the Pediatric Symptom Checklist and found that 16.2% of children met clinical cutoff scores for externalizing problems (Polaha et al., 2011). Another study found that 15.5% of children ages 4 to 8 met diagnostic threshold for externalizing problems aminophylline as assessed by the Parent Diagnostic Interview Schedule for Children, while 9.6% exhibited externalizing symptoms but did not meet threshold (Briggs-Gowan

et al., 2003). Similarly, primary care pediatricians have estimated that approximately 15% of children seen in their practice have diagnosable behavioral health disorders (Williams, Klinepeter, Palmes, Pulley, & Foy, 2004). Primary care may then be an ideal setting for addressing many of these concerns, as estimates suggest as many as 80% of children needing mental health services do not receive them (Kataoka, Zhang, & Wells, 2002). A large portion of pediatric mental health issues are disruptive or externalizing in nature (Bagner, Sheinkopf, Vohr, & Lester, 2010). As many as 20% to 30% of parents report significant behavioral concerns about their toddlers (O’Brien, 1996 and Qi and Kaiser, 2003). Lavigne et al. (1996) conducted a large survey in which they reviewed rates of psychiatric disorders in primary care settings. Childhood disruptive disorders were seen in 16.8% of children 2 to 5 years old, the largest occurrence of diagnosed disorders in that age group.