Year of Award


Document Type


Degree Type

Doctor of Philosophy (PhD)

Degree Name

Clinical Psychology

Department or School/College

Department of Psychology

Committee Chair

Duncan G. Campbell

Commitee Members

Jennifer Bell, Bryan N. Cochran, Christine Fiore, Holly Schleicher


Health Care Provider, Integrated Behavioral Health, Integrated primary care, Primary Care Behavioral Health, Provider Burnout, Provider Job Satisfaction


University of Montana

Subject Categories

Clinical Psychology


Most research to date on integrated behavioral health (IBH) or integrated primary care (IPC) practices has examined primary care settings nested within academic medical centers or clinics within the U.S. Department of Veterans Affairs. This leaves clinics in rural and/or underserved communities without much representation in the literature. Likewise, provider job satisfaction and burnout have rarely been linked to the IPC model. Through an online cross-sectional survey of medical and behavioral health care providers in various primary care-based health care settings throughout Montana, this cross-sectional study demonstrates that degree of behavioral health integration significantly predicts greater job satisfaction and lower burnout among Montana health care providers, while controlling for covariates. Multiple linear regressions and descriptive statistics were used to analyze results among 147 participants. Higher level of IPC significantly predicted job satisfaction above and beyond covariates (B = 0.123, p < .05). Likewise, lower level of IPC demonstrated significant prediction of burnout (B = -0.036, p < .01). The IPC Practice Integration Profile (PIP) subscales that demonstrated the most significant prediction of burnout, patient engagement and workflow, involve engaging patients in behavioral health services (B = -0.368, p < .001) and having systems in place to treat and refer behavioral health concerns (B = -0.259, p < .001). Importantly, most providers (72.7%) believe that greater level of IPC will result in greater job satisfaction, and providers from clinics with more integration are more satisfied with the provision of behavioral health services than those from clinics with less integration (54.2% versus 25.0%, p < .001). Unsurprisingly, COVID-19 has affected health care providers in myriad ways, with this study capturing the following relevant takeaways: Almost three-quarters of providers report that their overall (72.7%) and work-life (71.3%) stress have worsened, relative to before the pandemic, and the vast majority of respondents (83.1%) believe that their patients’ mental health concerns have worsened as well. That higher degree of IPC is associated with greater job satisfaction and less burnout among Montana health care providers provides additional evidence for using IPC models to deliver care. Given that burnout and low job satisfaction are associated with poor provider retention and health, poor patient satisfaction and outcomes, and cost inefficiencies, these findings have potential to shape policy-level discussions and planning regarding the use of IPC models in Montana and potentially other rural mountain west states. Future directions for research are discussed.



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