Mental illness and psychological distress is associated with higher rates of medical service usage and treatment of these issues results in more appropriate medical utilization rates. Little research has been conducted in an integrated care clinic, wherein health psychologists or behavioral health specialists work together with physicians to provide patient care. The current study examines the effects of brief behavioral and mental health interventions on patient medical utilization in this setting with care delivered by medical residents and doctoral psychology trainees. Access to the health system’s electronic billing records allowed for objective measures of annual healthcare utilization in terms of inpatient, outpatient, and emergency department use. A quasi-control group was constructed using propensity score matching in order to compare patients who had received a primary care psychology intervention to those who had not. Rates of inpatient utilization decreased significantly among treated patients overall as well as among treated patients identified as frequent attenders; there was no change in inpatient utilization among patients in the control group overall nor among frequent attenders in the control group, indicating that there is likely an effect of behavioral and mental health treatment on rates of inpatient visits. Rates of emergency department use and specialty outpatient visits were comparable between treated and control group patients, suggesting the lack of a treatment effect in these areas. Strengths, limitations, possible mechanisms, and implications for future research are discussed.

The cost of health care continues to increase. Based on the biopsychosocial model of heath care, it has been shown that the treatment of psychological and social problems can have a cost offset effect on the cost of medical care. While this offset effect has been shown in an MFT population, there are no known studies that have looked at predictors of the change in medical use by those that receive marital and family therapy. This study looked at psychological and social measures of individuals who received marital and family therapy. These measures were evaluated based on the change from intake to one year post intake using best subsets multiple regression. The model for males showed variables that could be affected using a cognitive or cognitive-behavioral model of therapy. The model for females showed variables that could be affected using the emotionally focused model of therapy. The implications of this study are that a therapist could be the most effective in conjoint therapy if they apply concepts from both cognitive and emotionally focused therapeutic models.