Our Services
Behavioral Health Intervention (BHI)
Behavioral health intervention, or “BHI,” refers to a brief course of mental health care focused on addressing psychosocial barriers that do not necessarily preclude a return to work, but may lengthen the timeframe for successful reintegration into the workforce. A course of BHI typically consists of 16 sessions of behaviorally-oriented counseling sessions. The following are examples of the psychosocial barriers that are the focus of BHI:
1. Low recovery expectations
2. Activity avoidance and unreasonable fear of worsening
3. Catastrophic thinking
4. Fear-avoidance behavior
5. Perceived injustice
6. Loss of vocational connection
7. Family/ support system issues
8. Inadequate understanding or expectations of diagnostic and treatment options
9. Inadequate understanding or expectations about the industrial insurance process.
Sometimes, a worker may develop mental symptoms in response to a physical injury. However, this doesn’t necessarily mean that the worker has a mental disorder. Common reactions —such as mild or moderate depression, or mild or moderate anxiety— can be addressed as psychosocial barriers impeding the worker’s ability to return to work.
Workers don’t need a psychological evaluation, psychological diagnosis, or authorization from their claim manager to qualify for BHI. BHI is covered for all injured workers to support their recovery. No authorization is required and there is no cost to the worker if they have an active claim. The diagnosis used for BHI is the physical injury diagnosis of the accepted condition.
Psychological Consultation
If a worker is suspected to have a mental disorder, they should be referred for a psychological consultation to ascertain whether there is a diagnosable mental condition that complicates their ability to return to work within a reasonable timeframe. Typically, a psychological consultation includes a diagnostic interview, review of available medical records, and psychometric testing. It requires authorization from the worker’s claim manager.
Psychological consultations are fundamental in guiding psychological treatment. They also help to clarify whether a worker has a mental disorder that is caused or aggravated by a work-related injury or illness, or whether there is a pre-existing or unrelated mental condition that is delaying recovery from work-related injury or illness.
120-Day Psychological Evaluation
Just like the psychological consultation, the 120-day psychological evaluation includes a diagnostic interview, review of available medical records, and psychometric testing. However, unlike the psychological consultation, the 120-day evaluation includes a determination of whether treatment (BHI or therapy) is deemed to be "curative" based on whether there is clinically meaningful improvement. It also includes recommendations to optimize treatment. An analysis of subjective and objective treatment outcomes is conducted (including a statistical analysis of objective outcome data) to ascertain whether there has been clinically meaningful improvement. The 120-day psychological evaluation requires authorization from the worker’s claim manager.
Psychotherapy
BHI is not appropriate for workers with a diagnosed mental disorder. In such cases, workers should attend psychotherapy, also called "mental health treatment" in the L&I environment.
Workplace accidents can have a significant psychological impact on workers and their families. Psychotherapy can help workers overcome emotional problems that can arise after a work accident or its sequelae, learn pain management strategies, and rebuild their self-esteem.
A course of psychotherapy can last up to 90 days. Reauthorization for ongoing treatment may be sought if documentation shows that the psychotherapy has resulted in clinically meaningful improvement.
If a mental health condition is accepted on the claim, a referral must be made by the injured worker's treating provider. Contact us to make a referral.