Working with complexity in integrated behavioral health settings

Macaran A Baird, Charles J Peek, William B. Gunn, Andrew Valeras

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations


This chapter provides a practical approach for understanding and dealing with patient “complexity” in a health care context. Complexity is defined as the interaction of patient, provider, and care delivery variables, which intermingle to create situations where usual treatments are not working-or not working as well as patients and clinicians are expecting. These situations can only be understood by looking at the complex interaction of those variables and adopting new models of understanding and implementing new care-giving strategies. The chapter begins with a review of different approaches to dealing with complexity within the USA and in Europe. A particular method and clinical checklist is described in detail. A “real world” application, the Complex Continuity Clinic, using this and other methods of engaging patients in complex situations, is outlined, with clinical examples. Finally, the important implications of a complexity approach to emerging health care reform is described, shedding light on how effective approaches that embrace complex biopsychosocial health issues can result in greater quality and reduced costs.

Original languageEnglish (US)
Title of host publicationIntegrated Behavioral Health in Primary Care
Subtitle of host publicationEvaluating the Evidence, Identifying the Essentials
PublisherSpringer New York
Number of pages26
ISBN (Electronic)9781461468899
ISBN (Print)9781461468882
StatePublished - Jan 1 2013


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