Interview Questions (and Desired Answers) for BHC Position Applicants

What are your thoughts on the current state of mental healthcare in general?

Look for someone who sees problems with the specialty model of care and wants to try something different, though they may only have a vague idea of what that might involve. Candidates who say they want to see more patients or extend services to a greater percentage of the population or point to the importance of improving access to care through same-day visits are on the right track. On the other hand, candidates who complain about not getting satisfactory reimbursement or about restrictions from managed care might not possess the vision that makes a successful BHC.

Describe your ideal work situation, including the room and area of a building where you would like to work.

MH providers are usually trained to maintain private and quiet offices, so don’t be surprised to hear this as an answer. However, the ideal candidate will say she likes to be in the middle of the action and thinks that that’s the best way to become a part of a team.

What types of patients are you most eager to see?

Be skeptical of candidates inclined toward a narrow specialty practice and/or the pursuit of non-clinical activities regarding select groups of patients (e.g., research, administration). Also, avoid candidates who may avoid or refuse to treat certain problems. All providers have a comfort zone clinically, but those with the widest zone and a willingness to expand it will work best as a BHC.

If you only had 15 minutes to spend with a patient experiencing insomnia and marital problems, what would you do?

Most interviewees will express surprise and perhaps uncertainty when asked to describe a 15-minute intervention, but nonetheless some answers are better than others. Look for answers that stick to the problems at hand and that end up with a reasonably clear self-management plan. A favorable candidate may suggest screening for common causes of insomnia, such as problematic work schedules or poor sleep hygiene habits, and then developing an intervention that addresses factors that may be triggering the insomnia. The candidate may also suggest exploring marital problems as a potential catalyst to the patient’s issues with sleep and suggest a future check-in with the patient via a brief follow-up. Simply suggesting a referral for outside counseling is an insufficient answer.

If you were asked to consult with a PCP about an 8-year-old child with attention and behavior problems at school, what would you do?

Many MH providers have led a fairly specialized existence, so those who have worked primarily with adults might express unease when asked about working with children. However, strong candidates will be open to working with new populations and problems, and have at least a basic idea of how to help. For example, the applicant may identify ways he can help the PCP (e.g., contacting the child’s teachers, recommending brief standardized assessment tools, meeting with parents, etc.), demonstrate an awareness of diagnostic criteria for child behavior problems, and/or show some familiarity with behavior modification techniques. A good follow-up question could be to ask the applicant what he would say to a PCP about a child that possibly had Attention Deficit Hyperactivity Disorder, Combined Type. Look for a familiarity with basic behavior change techniques and that ideally demonstrate an awareness of the time limitations in PC. Simply suggesting a referral for counseling or more evaluation is, again, an insufficient answer.

If you were asked to consult with a PCP about an obese, adult patient with diabetes who is non-compliant with treatment, what would you do?

As with previous questions, many candidates will issue a disclaimer that obesity and diabetes have not been mainstays of their past work, yet they should show some basic familiarity with both and a willingness to engage with the patient. Ideal answers will mention approaches such as motivational interviewing or psychological acceptance of chronic disease, or may reference collaborative goal-setting approaches. Exploration of the patient’s mood (e.g., to assess for depression) would also be a reasonable part of the plan. Detailed understanding of the medical aspects of obesity and diabetes should not be expected.

If the clinic manager came to you and asked you to be the lead for the clinic in developing a clinical pathway for chronic pain, what would you do?

Relatively few candidates will be familiar with the term “clinical pathway”, which means that the one who is may be a strong candidate (though one who isn’t might still be a good candidate). If unfamiliar with the concept, a candidate should at least express an interest in learning about it. An impressive answer would include the importance of focusing on quality of life and functioning (in addition to pain intensity) as an outcome, and/or an awareness of the potential pitfalls of narcotic analgesics. Applicants who express an interest in or knowledge of novel interventions such as group visits will also likely be keepers. At a minimum, candidates should recognize chronic pain as something they can help with and be willing to work on issues at the systems-level. Candidates who say they would not feel able to take on such a task should lose favor.

Describe a project you initiated and then developed. It could be large or small, recent or from your past, and could be a work, school or volunteer project.

This question can help identify the self-starters among the applicants. This is an especially important trait for the BHC who is hired to develop a new service, since that requires the ability to form a clear vision for the service, the ability to work with others to develop it, and the persistence to stick with the plan despite any number of obstacles. However, BHCs hired into an existing service also benefit from this trait. Often there is only one BHC on the PC team, or only a small number of BHCs spread across a large medical staff, either of which can feel isolating at times. To succeed in such a situation, one needs to have self-starter qualities. Thus, individuals who can readily list work, school, or volunteer project(s) they have initiated and developed throughout their adult life might be good candidates to consider; those who struggle to think of any examples might not be. (With kind permission from Springer Science+Business Media: Recruiting and Training a Behavioral Health Consultant, January 1, 2016; Author, Patricia J. Robinson and Jeffrey T. Reiter.)

Excerpted from Integrating Behavioral Health Into The Medical Home: A Rapid Implementation Guide by Kent A. Corso, PsyD, BCBA-D; Christopher L. Hunter, PhD, ABPP; Owen Dahl, MBA, FACHE, LSSMBB; Gene A. Kallenberg, MD; Lesley Manson, PsyD.