Fostering Cognitive Complexity in Behavioral Health Providers: Perspectives From Supervisors in Integrated Primary Care

The integration of behavioral health into primary care settings, known as Integrated Primary Care (IPC), offers a holistic approach to addressing both physical and mental health needs (Ramanuj et al., 2019). Efforts to expand access to mental healthcare have contributed to the growing presence of IPC settings (Martin 2017), with mental health providers, such as mental health counselors, joining these teams as Behavioral Health Providers (BHPs; Blount, 2017). However, the unique complexities of IPC often leave BHPs feeling underprepared, largely due to the traditional training frameworks emphasized in many graduate counseling programs. The need for BHPs to adapt to the fast-paced, population-based, and team-oriented nature of IPC (Reiter et al., 2017) underscores the importance of developing cognitive complexity (CC), a key capacity for effective clinical decision-making in these settings. This study employed a mixed-methods approach using Concept Mapping (Trochim, 1989) to explore how clinical site supervisors collectively define, organize, and prioritize supervisory practices most critical to fostering CC among BHPs in IPC. The study resulted in 143 generated statements organized into 16 clusters across four overarching regions. The findings offer valuable implications for clinical supervisors in IPC, mental health counseling BHPs, and counselor educators seeking to better support supervisees in integrated care environments.