CGI Experts to Present at NACIC24: A Global Discussion on Integrated Care

September 19, 2024

We are excited to announce that several members of the Cummings Graduate Institute for Behavioral Health Studies (CGI) community will be presenting at the 2024 North America Conference on Integrated Care (NACIC24). This prestigious conference, co-hosted by the International Foundation for Integrated Care (IFIC), IFIC Canada, the North America Center for Integrated Care, the International Journal of Integrated Care (IJIC), and the Health System Performance Network at the Dalla Lana School of Public Health at the University of Toronto, will take place from October 15-17, 2024, at the Westin Calgary in Canada. With the theme “Creating Health with Integrated Care,” NACIC24 will bring together global leaders, researchers, clinicians, managers, community representatives, patients, and caregivers who are committed to advancing the design and delivery of integrated health care. CGI is proud to join this important conversation, supported by premier partners Health Standards Organization (HSO) and Accreditation Canada.

Introducing the CGI community members presenting at NACIC24:

Dr. Cara English, DBH, CEO and CAO

Oral Presentation: Interprofessional Integrated Care: Addressing the Educational Determinants of Health in the Integrated Care Workforce
October 16, 2:30 PM – 4:00 PM

Description

Background:
Workforce education and training has a direct impact on health outcomes. In this workshop, participants will define educational determinants of health, discuss barriers to professional and community education, identify barriers for different populations, and review strategies that can be used to address disparities, including best practices from integrated care settings. Education and training in integrated care is understood to be a fundamental requirement for teams and systems to navigate the change from siloed care. Definitions for key terms vary from system to system, sometimes within the same country or region, leaving large gaps in the preparation of an integrated care workforce, and by extension, a lack of understanding among the population as a whole as to what integrated care is or could be. At the macro level, professional organizations, licensing boards, and training program curricula continue to operate in antiquated silos, and funding for professional development is often left up to the specific system, hospital, clinic, or individual. At the meso level, we often see practice change mandated without an understanding of the data and evidence, and infrastructure, investment, and good examples are often missing. At the micro level, patients and carers are often left out of the care process entirely while professionals cling to siloed identities and roles without a shared language for team competencies in integrated environments or an environment that fosters learning and supports change. This workshop will present key statistics and share case examples that illustrate strategies that have been used to address educational disparities including community partnerships, patient/community education programs, and advocacy. Small group discussions will be offered for workshop participants to share successful examples and best practices from their local communities, and each discussion group will be invited to share analysis and proposed recommendations and solutions that can be generalized to other communities.

Audience:
This session will be relevant for any stakeholder who is interested in advancing integrated care through education and training of both the workforce and community members.

Approach:
A combination of presentation of data and case examples and small group discussions will be used to provide information and discuss participants’ experiences with barriers and strategies to address barriers in their local settings, and to discuss the generalizability of evidence-based recommendations and strategies from case studies. Approximately half of the workshop will be used for presentation and half will be used for group discussions and reporting back to the large group to generalize learning.

Outcomes:
After group discussions, key takeaways from group discussions will be summarized in the large group, and a question/answer session will be held to provide further clarification and resources. Information and follow up opportunities will be provided in closing remarks and notes on the workshop will be captured and shared with participants. Overall outcomes desired are a greater understanding of the impact of educational determinants of health, as well as strategies that the audience can bring home to address these determinants in their local communities.

Danyelle Lincoln; MA, BCBA, LBA-NV, DBH Student

Oral Presentation: Models of Integrated Care for Specific Populations: Bertolotti’s Syndrome Unveiled: A Systematic Review of Current Research and Clinical Practices
October 16, 2024, 11:30 AM – 1:00 PM

Description

Background:
Bertolotti’s Syndrome is a congenital anomaly of the spine characterized by lumbosacral transitional vertebrae (LSTV) that is associated with lower back pain. For much of the world, back pain has been found to be the leading cause of loss of activity, work restrictions, and absenteeism. This has been associated with enormous economic burdens on a personal level, as well as for the wider economy. However, Bertolotti’s Syndrome is commonly overlooked both in terms of differential diagnosis and the treatment of back pain. Research indicates that 65-80% of people will experience back pain during their lives, and thus far, 4.6%-7% of those occurrences in adults have been associated with LSTV.

Audience:
This presentation aims to raise awareness of Bertolotti’s Syndrome among both patients and physicians.

Approach:
A literature review was conducted using a systematic search of academic databases, such as PubMed and NIH, using keywords including “Bertolotti’s Syndrome,” and “transitional vertebrae.” Inclusion criteria focused on peer-reviewed articles published within the last ten years, emphasizing clinical studies, diagnostic methods, and treatment approaches. Landmark studies were included and referenced despite falling outside of the ten-year criteria. Relevant articles were then analyzed and synthesized to provide a comprehensive overview of current understanding and management practices related to Bertolotti’s Syndrome.This presentation was originally designed for a Pathophysiology course at Cummings Institute for Behavioral Health. Elements of this presentation were gathered from collaboration and insight gained from the Facebook group “Bertolotti’s Syndrome Education Group (USA)” – a support and education group for sufferers of this condition.

Results:
Key findings indicate that Bertolotti’s Syndrome is often underdiagnosed due to its overlapping symptoms with other, more common, back pain generating conditions, as well as an erroneous perception amongst physicians that LSTV cannot cause pain. Diagnostic advancements, such as the use of MRI and CT scans, have improved accuracy in identifying LSTV, yet variability in diagnostic criteria persists. Treatment approaches range from conservative management, including physical therapy and pain relief medication, to surgical interventions such as resection of the transitional vertebra or spinal fusion. The review suggests a trend towards individualized treatment plans, however, further studies are necessary to raise awareness of this condition and to develop standardized diagnostic and treatment guidelines.

Implications:
This review highlights the pressing need for increased awareness, as well as standardized diagnostic criteria and treatment protocols. The findings underscore the importance of accurate diagnosis to differentiate Bertolotti’s Syndrome from other pain generators. The audience will gain a deeper understanding of Bertolotti’s Syndrome, including its prevalence, diagnostic challenges, treatment options, and patient frustrations. Bertolotti’s Syndrome is a significant yet often overlooked cause of lower back pain, contributing to the broader issue of back pain that affects a large portion of the population and imposes substantial economic burdens. Despite advancements in imaging techniques, Bertolotti’s Syndrome remains underdiagnosed due to symptom overlap with other conditions and misconceptions among healthcare providers regarding its potential to cause pain. There is a wide range of treatment options, from conservative management to surgical interventions, but the lack of standardized guidelines leads to variability in care. There is a need for increased awareness among healthcare providers about Bertolotti’s Syndrome and its impact. Providers and patients should be updated on recently released literature that redefines how physicians approach this condition.

Kenneth Roberts, MPS, LPCC, LADC, DBH Student

Oral Poster Presentation: Demonstrating Integrated SDoH Impact in Behavioral Health
October 16, 2024, 1:25 PM – 2:25 PM

Description

Background:
Minnesota’s (USA) largest non-profit SUD/MH treatment provider collaborated with a respected local academic institution to conduct voluntary research with patients engaged in co-occurring SUD/MH treatment services on a novel model integrating subsidized recovery housing support with clinical services.

Approach:
Collected longitudinal data during and up to 16 months post treatment to compare outcomes of patients utilizing an integrated recovery residence support resource during the treatment episode with those who did not.

Defined study aims were:

To understand the characteristics of people who choose to live in a recovery residence while receiving intensive outpatient (IOP) treatment compared to those who do not.
To understand the impact of living in a recovery residence during IOP treatment on client retention and outcomes, such as discharge status, substance use, self-care, relationship problems, material resources, life outlook, depression severity, anxiety severity, and sober days.

Results:
Results demonstrated patients utilizing recovery residence support during the treatment episode achieved statistically significant differentials in days abstinent from substance use, length of treatment engagement, successful treatment completion and reduced mental health symptomology.

Implications:
The ongoing study outcomes highlight the impact and need for innovative, integrated strategies to recognize and address the impact of social determinants of health (SDoH) as a component of effective whole-person care.

Destinee Rodriguez, ABA, DBH Student

Oral Presentation: Models of Integrated Care for Specific Populations: Closing the Gaps for Families: Assessing What Matters Most to Families
October 16, 2024, 11:30 AM – 1:00 PM

Description

Background:
Autism Spectrum Disorder (ASD) is classified as a neurological brain-based disorder impacting an individual’s ability to communicate, socialize, and manage behavioral symptoms to varying degrees. The science of behaviorism is rooted in three branches of experimental analysis of behavior, behavior analysis, and applied behavior analysis (ABA). In emerging years, ABA services have been recommended as a form of treatment for individuals with ASD. Utilizing a scientific approach to research the relationship between behavior and the environment, through the manipulation of environmental variables paired with concepts of conditioning and reinforcement, ABA is recommended to aid individuals through challenges that may negatively impact their daily life while also supporting the improvement of socially significant behaviors.MethodsIn any event ABA services are recommended, families are expected to adhere to a recommended number of treatment service hours. Historically, it is believed treatment services hours are needed to occur at an intensive rate in order to produce any significant improvements. However all too commonly, treatment service hours are recommended with little to no consideration for what types of social determinants may affect a family’s ability to adhere to a full treatment service hour recommendation. In time, the gap between recommended versus accepted treatment service hours frequently leaves families in question as to if their efforts will ever produce any significant improvements for their child and family. For this reason, clinicians are urged to assess evidence-based outcomes versus perceived outcomes to support families in closing the gap in question, developing a service outcome that is equally meaningful and significant to their child and family.

Approach:
Before clinicians continue to advocate for full treatment adherence to produce meaningful outcomes, it is recommended clinicians consider the assessment of evidence-based outcomes compared to perceived outcomes of treatment adherence, attendance and desired outcomes. The three domains of treatment adherence, attendance, and desired outcomes are the most influential factors in measuring a family’s ability to accept a full recommendation of treatment service. While evidence-based outcomes are concrete, comparing what measures are most important to the families will more largely reveal underlying social determinants within or beyond a family’s control, reflective of their ability to accept a recommended treatment service.

Results:
The assessment and diagnosis of ASD is changing, and more recent studies recommend further consideration of social determinants including the functioning of family systems, impact of stress, and family perspectives on care needs are critical in determining what a “successful intervention” may look like. To better understand family perception of the three domains while also assessing social determinants, clinicians should discuss whether data collection is reflective of families’ desired outcomes. In these consultations, clinicians may prepare to lead larger conversations of what treatment outcomes are most meaningful, desirable, and preferred for the families and their children.

Implications:
Upon receiving an ASD diagnosis, ABA services will likely be recommended to families. Commonly, families are not familiar with the time investment needed to participate in a full recommendation of services. When families do not accept a full recommendation of services, they are often left to wonder if the efforts they can realistically make will produce significant improvements for their child and family. To support families in making these difficult decisions, clinicians are encouraged to explore evidence-based outcomes compared to perceived outcomes with the family while embracing a service outcome that is meaningful, desirable, and preferred. Ultimately, supporting families in receiving a service that is most meaningful and desirable to their child and family should be a critical goal for ABA Clinicians.

To explore the full NACIC24 program, packed with a range of workshops, oral paper and oral poster sessions as well as a wide range of networking activities, click here.

With over 300 abstracts submitted and a diverse range of workshops, oral sessions, and networking activities, NACIC24 is set to be a unique opportunity to explore all aspects of integrated health and care. Bringing together 500 delegates from across North America and around the world, the conference will foster collaboration among professionals, patients, caregivers, and community members. There’s still time to register and attend NACIC24. To learn more, visit: http://www.integratedcarefoundation.org/NACIC24

Testimonials

“As a member of the AAPI community, I’m very familiar with the barriers to mental health services and the need to break through the glass wall of cultural stigma that prevents many from receiving potentially life–saving treatment. I was the only Asian American person in my master’s cohort, the only Asian American person in many of my clinical work settings, the only Asian American person to walk into many of the professional settings that I pushed myself to show up to. In my current practice, I’m constantly reminded by my patients of how difficult it is to find an Asian American mental health provider, though this reminder constantly informs me that more needs to be done for my community. Day after day, I read stories of Asian American people who die by suicide as a consequence of our culture’s avoidance of mental health topics. As a DBH, my biggest goal is to use my expertise in whole–person care to amplify the conversation around mental health and help my community understand that mental healthcare is not a privilege that we are not entitled to, it is a crucial part of our healthcare that will manifest differently in us than what many Western psychology or psychiatry textbooks will describe, and that our unique experience of mental health issues are valid, important, and is time to be part of the larger conversation.”
Willam Chum, LMHCDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - September 16, 2022

“The DBH represents something that I've always embraced in my professional career. And that's collaboration and working across a lot of different disciplines to make sure you’re delivering the best care for the patient. Everything is about being patient centered about finding innovative ways and creative ways to collaborate with other professionals.”
CDR Sean K. Bennett, LCSW, MSWAC, BCDDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - October 10, 2023

“This program will change how you present to the world, not just as a professional but as an individual. Understand this is work but the work is worth it and the journey is undeniably transformative. If you are seeking a doctorate for the title, this is not the program for you. If you are seeking a doctorate to interrupt and disrupt the course of healthcare, then this is the program for you. You won’t find a more supportive program with professors who are dedicated to your success and your education. This program is not about the regurgitation of information. It is about the appropriate applied application of knowledge and information to push forward and become an advocate for equitable and quality care for all.”
Brandy K. Biglow LMHC, CCTP, QSDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - February 5, 2024

“The Doctor of Behavioral Health (DBH) program has definitely transformed my understanding of behavioral health. Understanding the links between physical and mental health has taught how to make better treatment decisions. The DBH program has also given me insights that otherwise would not be possible and allows me to view individuals through a lens that I was previously ignorant of. This program has helped me grow into a more confident individual, provider, and parent.”
Cory H. Cannady, BCBA, LBADBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - March 13, 2024

“The DBH program has been a pivotal turning point in my understanding and application of behavioral health principles. Recently, the concept of ‘whole person health’ has gained widespread attention in healthcare circles, becoming somewhat of a buzzword. Like many others, I embraced this term, believing in my capacity to deliver comprehensive care.

Prior to my engagement with the program, my approach, albeit well-intentioned, lacked an appreciation for the intricate interplay between physical and mental health. More importantly, the role of unmet social needs as a catalyst for health disparities was a dimension I had not fully integrated into my practice. The DBH program illuminated these connections, offering me a robust framework to understand and address the multifaceted needs of individuals, especially within marginalized communities.

Additionally, the confidence I have gained through the DBH program extends beyond theoretical knowledge. My role as a connector and advocate for these individuals has become more pronounced, driven by a deep-seated commitment to fostering accessibility, equity, and comprehensiveness in care.”
Michelle Stroebel MA, NCC, LCMHC, NADD-CCDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - June 12, 2024

“I have worked in behavioral health for the entirety of my professional career starting with college internships up to my current role as Deputy Executive Commissioner of Behavioral Health for the Texas Health and Human Services Commission. While I have years of experience in the field, the DBH program at Cummings has framed my perspective as leveraging therapy as a first line of intervention. As a public servant, much of the work I do is usually in the aftermath of crises or when the system is being forced to respond to a service gap. However, the DBH program takes a much more proactive and integrative approach to health. This perspective/approach has the potential to positively shape policy in Texas in my role as a public servant charged with addressing the safety net needs of the most vulnerable constituents in Texas.”
Trina K. Ita, MA, LPCDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - July 10, 2024

“CGI feels like a community of long-lost cousins that finally met as adults and we realized that we share the same goals. The support from the faculty and classmates have been nothing short of amazing. I can reach out to my advisor at any given time to discuss course work, career endeavors, or to just vent about life. There is a feeling of closeness and belongingness at CGI that is just unmatched. I am very happy to be a member of the family and will continue to spread the word of how great this DBH program is.”
Michelle Francis, LCSW/LICSW-QSDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - September 10, 2024

“The DBH program’s mission, purpose, and objective say it all: We strive for intentional care outcome improvement practices that exemplify whole person-centered integrated healthcare advanced competency. The program of study drives insights and awareness of the ever-changing patient population and multidisciplinary practice environments to change how the world experiences healthcare. This is further reinforced by the pillars of medical literacy, integrated behavioral health intervention, and entrepreneurship skills and expertise. Development growth is needed to prepare the aspiring DBH for the future of the shifting healthcare marketplace through international networking in a growing community of disruptive innovators and an evolving movement toward systemic healthcare change. I feel that I will be positioned alongside a fellowship of like-minded professionals trying to improve the quality of healthcare service delivery value and outcome sustainability.”
Jose Mathew, LCSW, LAC, ACS, EMDR-T, CCTP-IIDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - October 8, 2024

“The DBH program has reinforced my vision of viewing behavioral health (BH) as an integrated component of the healthcare system rather than a siloed service. As a practitioner in the focused BH realm of substance use disorder (SUD) treatment, I observe on a regular basis how identifying and serving SUD patients is often missed, ignored and stigmatized in primary healthcare, despite the fact that early intervention at these check-points often has the potential to intervene earlier and lessen the negative SUD outcomes frequently seen by the time a patient reaches specialty SUD services. Reinforcement received in my DBH program has motivated me to promote integration as a leader in my workplace and is a primary factor in considering the long-term trajectory of my individual career path.”
Kenneth L. Roberts, MPS, LPCC, LADCDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - November 5, 2024

“By becoming a DBH, I have found that I am able to have different conversations with different people. Before having my doctorate degree, I was able to speak to certain items in behavioral health, but was only seen as a licensed therapist where as a doctor, I am able to speak to the changemakers and policy makers in a more collaborative manner which then allows us as a group to enhance the services we are providing. I also found that as a DBH, my confidence in the treatment room has improved immensely and cases that may have been more difficult for me before are no longer as difficult due to the training I have received in the program.”
Dr. Allison Earl, DBH, LPC-SDBH Alumna, Cummings Graduate Institute for Behavioral Health Studies - November 13, 2024

“I think the DBH is quite groundbreaking, it allows you to study from anywhere in the world. The support is fantastic, and you can make out of the DBH what you want. Unlike standard professional doctorates, the DBH was trying to break new ground, not trying to go over just old ground. It greatly encourages its students to be those people who break new ground.

As a person who actually has a disability, I found CGI staff to be very supportive, very accommodating. If I need extensions, they are always there. In fact the staff will reach out and check on you, if they haven’t heard from you in a very short period of time. Which I have never had from any other university.

I find the community of fellow DBH students absolutely wonderful, we reach out across numerous social media platforms, we email each other. Doesn’t matter where I am in the world or where they are in the world, everyone is supportive. Its support, support and encouragement with the DBH.”
Jason P. Sargent, B Policing, GDip Psych, MSW, JPDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - December 10, 2024

“Graduating from the DBH program has influenced and enhanced my approach to addressing behavioral health challenges and making a difference in the field by preparing me to become a serious business owner. Through the DBH program, I understand now that becoming a business owner not only assists me in reaping the financial benefits of working for myself, but the program also offers me a sense of freedom to make a difference in an individual’s life.”
Dr. Rebecca K. Wright, DBH, LBA, BCBA, QBADBH Alumna, Cummings Graduate Institute for Behavioral Health Studies - December 18, 2024

“I have always wanted to pursue a higher degree but never found a program that met my needs. When I investigated the DBH program, I can honestly say I was excited. It was a program that would expand my knowledge in behavioral health but also how it relates to physical health. The philosophy of treating the whole person was exactly what I was looking for.”
Elizabeth Nekoloff, M.Ed., LPCC-S, NCCDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - January 16, 2025

“Prior to obtaining my DBH, I practiced behavioral health within the boundaries of behavior analysis. The DBH degree has given me the ability to broaden my scope of competence allowing me to provide a higher quality of care to my clients through a person-centered approach, while still staying within my scope of practice. I was in the beginning stages of opening my business when I enrolled in the DBH program which set my trajectory towards being a stronger leader. The program equipped me with essential healthcare leadership and entrepreneurial skills, allowing me to ensure high-quality services for my clients and foster a supportive work environment for our staff. It has also given me the confidence to expand my business and pursue other healthcare ventures, reaching a broader range of patients in need.”
Dr. Pauline Tolentino Pablo, DBH, BCBA, IBADBH Alumna, Cummings Graduate Institute for Behavioral Health Studies - January 21, 2025

“Although I have worked with many patients who have mental health diagnoses, or behaviors which make managing their medical diagnoses and day to day life difficult, the DBH program at CGI is broadening that knowledge and providing a deeper understanding of behavioral health and how best to help these individuals manage their health and improve their quality of life. This will allow me to provide and advocate for more meaningful and seamless integrated care, providing new tools for my intervention toolbox, and the confidence and skills to collaborate within and lead whole person focused interdisciplinary teams. I also anticipate building upon my knowledge as a nurse case manager and long time caregiver, as well as my personal passions and professional vision, learning about processes and operations, to be in position to start up and lead my own company one day, offering the services and care I know every person should have access to.”
Hollie Wilson, MSN, RN, CCMDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - February 11, 2025

“The Doctor in Behavioral Health (DBH) program has changed my understanding of the subject and career path. Before this academic journey, my knowledge of behavioral health was primarily theoretical, including essential ideas and methods. However, the DBH curriculum combined intense academic research with practical application, helping me understand behavioral health from multiple angles. Recognizing mental health as part of total health changed my perspective. The biopsychosocial model, which showed how biological, psychological, and social variables affect mental health, was stressed in the DBH curriculum. This comprehensive approach made me realize how complex human behavior is and how important it is to address mental health issues. Effective interventions must target the individual’s surroundings, relationships, and life experiences, not just symptoms. The curriculum also gave me enhanced evidence-based practice training to execute successful solutions. Studies methods and data analysis classes improved my critical thinking and allowed me to evaluate and apply behavioral health studies. This gave me the confidence to contribute to the field’s knowledge base through practice and research.”
Dr. Rhea Hill, DBH, LPCDBH Alumna, Cummings Graduate Institute for Behavioral Health Studies - February 17, 2025

“The DBH program will open opportunities for me to contribute to healthcare system innovation, particularly through trauma-informed care and integrated behavioral health settings. I will be better positioned to advocate for and implement holistic care models that improve health outcomes for underserved populations. Ultimately, this program will help me transition into higher-level roles, such as a director or consultant in behavioral health, where I can influence broader system changes and contribute to the future of healthcare delivery.”
DeKyn Rashad Peters, MPH-CHES,BSW/BA,APCDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - March 4, 2025

“The DBH program has been integral in preparing me for leadership roles by providing a solid foundation in both the theoretical and practical aspects of leadership within the behavioral health sector. Through coursework, case studies, and hands-on experiences, I have learned to lead with empathy, data-driven decision-making, and strategic planning. The program has also honed my skills in organizational development, communication, and policy advocacy, equipping me to effectively lead teams, drive impactful change, and foster environments that promote positive behavioral health outcomes. With this training, I am confident in my ability to lead initiatives that address systemic barriers and improve care delivery.”
Dr. Jerrika Henderson, DBH, CMHCDBH Alumna, Cummings Graduate Institute for Behavioral Health Studies - March 18, 2025