Using subscales of the Adult Needs and Strengths Assessment (ANSA) and an author created Crisis Event measure, holistic client functioning was assessed for persons diagnosed with comorbid serious mental illness (SMI) and primary healthcare diseases. An ex post facto, quasi-experimental, pre- and post-test design was selected to compare the effectiveness of an integrated behavioral and primary healthcare (IBPH) treatment approach to a treatment-as-usual (TAU) approach, across a 12-month treatment period.

Study participants consisted of 196 persons diagnosed with SMI and primary or non-primary healthcare diseases who lived in rural communities located in the southern region of the United States. Using a profile analysis, mean difference scores obtained from four subscales of the (ANSA; i.e., risk behaviors, behavioral health needs, life domain functioning, strengths) and a Crisis Event Measure were analyzed across three null hypotheses (i.e., level, parallelism, flatness).

A statistically significant difference was observed across all null hypotheses, each indicating a moderate, approaching large degree of practical significance. Persons receiving primary healthcare services in coordination with mental health treatment experienced on average a 24-times greater improvement in their holistic client functioning across a 12-month treatment period. Holistic client functioning for persons in the TAU condition appeared stable throughout the 12-month treatment period.

Findings from this study offer promising insight into the effectiveness of an IBPH treatment approach for person diagnosed with comorbid SMI and primary healthcare diseases. To read more about this study, see Schmit, Watson, and Fernandez’s (2018) article titled, Examining the Effectiveness of Integrated Behavioral and Primary Healthcare Treatment”  found in the Journal of Counseling & Development[1]


[1] Schmit, M. K., Watson, J. C., & Fernandez, M. A. (2018). Examining the effectiveness of integrated behavioral and primary healthcare treatment. Journal of Counseling & Development, 96, 3-14. doi:10.1002/jcad.12173
Michael K. Schmit, PhD, LPC, is an assistant professor at the University of North Texas. He earned a PhD in Counselor Education from Texas A&M University-Corpus Christi and a master’s degree in substance abusing counseling from the University of Louisiana at Monroe. His research agenda focuses on counseling outcome research, integrated care treatment, and simplifying research methods and statistics in counseling. Michael’s clinical background encompasses working with persons across the lifespan addressing issues related to holistic functioning, serious mental illness, and substance use. Prior to his appointment at UNT, he was a counselor and program administrator at a regional community mental health agency.
To learn more about Dr. Schmit’s work, respond in the comments below or reach out directly! Email:
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3 Responses

  1. I’m not a medical person (does that term make sense?) but I understand logic…integrated healthcare, continuity, cooperative treatment across specialties – it has to lead to a positive outcome. Thanks for sharing!

  2. It is very exciting to see the CANS used to research different modalities and approaches in the real world. TCOM data is most powerful in action, and seeing researchers assess the effectiveness of practice with the data, is really what it’s all about. I am excited to read this article, and hope that more research like this is highlighted in the TCOM blog!

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