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Assumptions and PCBH

I was going through recent PCBH Corners (check em out here https://www.youtube.com/playlist?list=PLvLh_YdubBs5P-dw9IrSH7-TwTqM8fkqo) and came across one of the first ones Bridge and I did and it was with Kirk Strosahl. Side note, a reminder to us all to reach out often to those in the field who inspire us and even when our mind is telling us, “yeah, don’t do that, because who are you to reach out to them,” still reach out. I can remember attending a workshop at the Association for Contextual Behavioral Sciences with Kirk and Patti during grad school, was probably in 2012 or somewhere around there. I remember sitting in the back (another side note, sit in the front 😊), and thinking, “these two (i.e., Patti and Kirk), I want to be like them.” Fast forward five or so years, and here I was sitting in an exam room with Kirk getting to ask him questions for PCBH Corners. Again, reach out to those in the field who prompt curiosity and inspire you.


Okay, onto the real point of this, the one PCBH Corner we did with Kirk is on suggestions for students or providers new to PCBH. You can find the video here, https://www.youtube.com/watch?v=HRqA5C7oV1s&list=PLvLh_YdubBs5P-dw9IrSH7-TwTqM8fkqo&index=80. My mind assumes I have watched this video a number of times and for whatever reason, could be complete randomness, my mind was struck by Kirk’s quote, “Assumptions can be magnificently instructive and useful; and, (assumptions) can be magnificently destructive and un-useful.” Oh, buddy and third side note already, if you get a chance, TALK TO KIRK and ask him questions. I often quip, “he is just a different human,” meaning, he sees things differently and able to use the English language in a way that amplifies his insights that is unrivaled. So, again, if you get the chance, corner Kirk at a conference and ask him some questions and tell him I said to!


Again, moving on, the quote, “Assumptions can be magnificently instructive and useful; and, (assumptions) can be magnificently destructive and un-useful,” what an incredible perspective prompting message. As we have been talking with the trainees regularly this year, we hope that PCBH does not look the same in five years as it does now. It can’t, as if it looked the same, it shows we aren’t iterating, we are not evolving, we are not challenging our assumptions of what can be done in primary care. Kirk has another quote related to this, “I think most of the time, the thing that gets in our way, is our own assumptions and our own self-imposed limitations.” Knowing Kirk and his life’s work, he is referencing the areas of MH care that have proved to stunt access and evolvement in our field. How much time is needed for an intervention to work, how many visits does this individual need, who will respond to what, where do people go for care, etc. etc. Beautifully, Kirk summarizes, “(we have to) keep experimenting, and don’t a priori think we can’t do magical things in these non-traditional settings.” Hell, bucking, yes…


Now that I am writing this, my mind is connecting (rightly or wrongly, we don’t really ever know, do we?) why this PCBH Corner is sticking out so much to me. Not only due to the conversations we are having with trainees about 1) being willing to step outside of their comfort zone and challenge their assumptions about what can be done in PCBH visits and 2) challenging us, as training programs, to continue to iterate the model and how we provide behavioral health care in primary care (fourth and final side note, gratitude for one of our trainees being inquisitive about the impact that BHCs wearing scrubs could have on patient care. You know what, let’s find out 😊), and maybe more due to reading/listening to Scott Sonenshein’s Stretch that discusses, amongst many things, how expertise, while functional and useful, can limit perspective and “thinking outside the box;” doesn’t that sound like the first quote from Kirk above?


In writing this, my mind is excited and PUMPED about the future of PCBH and healthcare, as a whole. Having mentors and figures in the field, like Kirk, who encourage us to “do better than me,” evolve, iterate, etc., is such an exciting experience. Then, to pair with having such inspiring and engaged trainees that we are fortunate to have at CHCW and the NPTC Cascades Region each year, Kirk’s prompt of challenging assumptions is being realized. Truly, what will PCBH look like in five years, 10 years, 20 years, my mind wonders? What will our interventions look like? And, while there is a pull to the future in hopes of getting a glimpse of what it will be, my mind is also very content on sitting in this moment of what it is and the excitement, innovation, and iterations that are happening regularly. My gratitude to this community and all the people and organizations doing the work of PCBH. And, I must also say, I am so freaking pumped for Boise in October to get to iterate and innovate in person. Gratitude for the work we get to do and the moment we share now…


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