Special ethical considerations for behavioral health consultants in the primary care setting

Hayley C. Fivecoat*, Travis A. Cos, Kyle Possemato

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


The growing movement of integrating behavioral health services in medical settings aims to increase ease of access to behavioral health services. Behavioral health consultants (BHCs), who are embedded within primary care clinics, provide a variety of psychological services (screening, brief interventions, and referral to specialized treatment settings) in a novel manner relative to traditional outpatient behavioral health treatment. These alterations in service delivery present unique ethical challenges to effective patient care in primary care behavioral health (PCBH) practice. This article discusses potential ethical dilemmas and challenges that are faced in PCBH. Confidentiality, privacy and informed consent are discussed, given the complex level of communication within primary care clinics. The potential for having multiple relationships with coworkers is reviewed. The need for BHC's to provide sufficient clinical intervention and assessment, and how these may be limited in scope in BHC practice, is discussed. Finally, the complexity of obtaining competence for practice in primary care is explored. We discuss how ethical guidelines apply to this work, and also aim to address where further clarity is needed and context-based ethical decision-making is warranted. Case studies are provided to help illustrate the novel challenges faced by BHCs in integrated medical settings.

Original languageEnglish (US)
Pages (from-to)335-342
Number of pages8
JournalProfessional Psychology: Research and Practice
Issue number5
StatePublished - Oct 2017
Externally publishedYes


  • Confidentiality
  • Ethics
  • Informed consent
  • Multiple relationships
  • Primary care behavioral health

ASJC Scopus subject areas

  • Psychology(all)


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