Integrating Behavioral Health Services Into Pediatric Gastroenterology: A Model of an Integrated Health Care Program

Integration of behavioral health services into pediatric health care is critical to optimal patient care, but logistic and financial barriers often prevent integration. We describe an integrated clinical, research, and training program bringing pediatric psychologists into a hospital-based pediatric gastroenterology clinic. Almost 300 pediatric patients with gastroenterology problems were seen by pediatric psychologists over the first 31 months. The 3 most common gastroenterology presentations included encopresis, abdominal pain, and irritable bowel syndrome. One third of the patients followed by psychologists were in therapy for less than 1 month and an additional third were seen for between 1 and 4 months, supporting a short-term model of care. Financial arrangements, clinical service reimbursement data, and research and training integration are described. Demonstrations of feasibility and acceptance of psychology services integrated into pediatric care are crucial for new models of health care delivery that more closely align with our biopsychosocial models of health.