Psychologists in Primary Care—Experiences at DoD



The U.S. Department of Defense (DoD) was a pioneer in the integration of behavioral health and primary care and is widely acknowledged as an exemplar. This article by Christopher Hunter, et al. reviews the development of integrated behavioral health care in the DoD primary care clinics. The authors explain the crucial role of psychologists in this process. In addition to successfully promoting integrated care as a core component of the DoD patient-center medical home (PCMH), psychologists played key roles in policy development, the development and implementation of training programs, clinical care, and program evaluation.

The article goes into detail, providing information on the different approaches taken across service branches, the structural and funding issues across the DoD, a description of the shifts made in a clinic implementing the behavioral health in primary care, and the primary care physician perspective. The authors end by saying that, while psychologists played a significant role in the development and implementation of integrated care programs in DoD clinics, there is still a lot to be done and psychologists will continue to have a significant role as the process moves forward in the DoD clinics.

Based on their experience, the authors provide 9 recommendations for psychologists to consider, depending upon the role they play in integrated care. They conclude by stating: 

“As the nation faces significant changes in its health care system, the diverse contributions of psychologists in the DoD, from direct clinical care to policy development, suggest that psychologists are critical for implementing integrated care in systems throughout the United States.”


Hunter CL, Goodie JL, Dobmeyer AC, et al. Tipping points in the Department of Defense’s experience with psychologists in primary care. American Psychologist 2014 May-Jun; 69(4): 388-398. doi: 10.1037/a0035806


NOTE: This article is one of 11 in American Psychologist - Journal of the American Psychological Association, Special Issue: Primary Care and Psychology

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