Dialectical Behavioral Therapy (DBT), originally developed by Dr. Marsha Linehan to treat individuals with borderline personality disorder and chronic suicidal ideation, has evolved into a powerful, evidence-based approach for a wide range of mental health challenges. Today, DBT is effectively used to treat conditions such as depression, bulimia, binge-eating disorder, bipolar disorder, PTSD, and substance use disorders in both adolescents and adults.

In the face of rising pediatric mental health needs, Novant Health Twin City Pediatrics found itself at a crossroads. As adolescent mental health concerns such as depression and anxiety became more prevalent, clinicians found themselves increasingly fielding complex and time-consuming questions. These mild to moderate conditions required consistent follow-up and oversight, yet the surge in demand for mental health services made it difficult for patients to access timely care, particularly from providers who accepted their insurance. Many adolescents went without necessary treatment. 

Thanks to a powerful partnership with Northwest AHEC and the guidance of Lara Dickerson, MHA, Senior Quality Improvement Specialist, the practice chose a different path—one of innovation, collaboration, and compassion.

Adair Stewart, Dr. Elizabeth Allen, Dr. Gretchen Hoyle, Lara Dickerson, Jennifer Cleland Green, Lauren Stokes

The Challenge

Primary care pediatricians face a dilemma. Mental health visits are longer, emotionally taxing, and historically under-reimbursed. Yet the need is undeniable. Twin City Pediatrics chose to lean in—embracing the challenge rather than deflecting it.

The question became: Can mental health care in pediatrics be both impactful and financially viable? The answer, it turns out, is yes.

The Solution: Collaborative Care Model (CoCM)

With coaching from Lara Dickerson and guidance from AHEC Practice Support Services, Twin City Pediatrics implemented the Collaborative Care Model (CoCM).  A practice which emphasizes collaboration between primary care physicians, care managers, and psychiatric consultants to improve access, outcomes, and patient satisfaction within the pediatric medical home. 

Key components of the model include:

• A Behavioral Health Care Manager (BHCM) providing core services like parent coaching, brief therapeutic interventions, and referral coordination.
• A Psychiatric Consultant offering oversight and subspecialty advice..
• A Primary Care Provider trained in pediatric physical health.
• Validated clinical tools (PHQ-9, GAD-7, Vanderbilt, etc.) for measurement-based care.
• Customized EHR workflows and a patient registry to track progress and enable billing for behavioral health services within the primary care practice.

Practice Support Team Impact

The journey began with a conversation at the 2023 NC Pediatric Society Meeting, leading to a partnership with Northwest AHEC. Practice coach Lara Dickerson became a key ally, meeting monthly with the team for two years. Her support included:

• Coordinated with internal Novant departments (HR, billing, IT, compliance).
• Billing guidance and documentation templates.
• Consultation with NC Medicaid on psychiatric consultant roles.
• Staff training modules.
• Troubleshooting billing issues.
• Setting BHCM workload benchmarks.
• Secured a $50,000 Capacity Building Fund grant from Community Care of NC to support BHCM staffing.

Thanks to this comprehensive support, the program not only launched - it thrived.

The Results

By June 2025, the program became revenue-positive, six months ahead of schedule. With monthly BHCM costs of $5,400 and over $13,000 billed in June alone, the practice expects $6,500 in revenue—exceeding expenses by more than $1,100 per month. Today, the program includes a growing number of enrolled patients - many with complex needs - and is delivering tangible improvements in the lives of children and their families.

“The Psychiatric Collaborative Care Model has empowered our practice to provide meaningful, evidence-based mental health care for our pediatric patients. Our success is replicable, sustainable, and deeply impactful.”
— Gretchen S. Hoyle, MD - Twin City Pediatrics

“It was amazing to see how this model enables primary care practices to spend adequate time with each patient on physical and mental health concerns, developing treatment plans collaboratively with specialists and making a significant difference for kids in our community.”
— Christopher Jones, DrPH, MHA - Northwest AHEC

From Patients & Families

“I’m so glad he’s finally going to get the help he needs.”
“I’ve felt so alone for so long. Having someone to talk to means everything.”
“She is so much better. I can’t thank you enough.”

Read the full Report from Twin City Pediatrics & Gretchen S. Hoyle, MD

This program offers a comprehensive overview of the essential assessments needed to ensure that behavioral health clients are receiving appropriate treatment. It will cover the clinical assessment requirements and the various screening tools used to determine the right level of care and make appropriate referrals. Additionally, the training will explore the different levels of care and available services for children, adolescents, and adults within the current behavioral health system.

Presented by Northwest AHEC & Wake Forest University School of Medicine

This fall, Northwest AHEC is offering a dynamic lineup of behavioral health webinars designed to equip professionals with the latest tools, strategies, and insights to support mental wellness across diverse populations. Whether you're a clinician, counselor, social worker, or behavioral health advocate, these sessions offer valuable continuing education and practical knowledge.

1. Assessments and Levels of Care: Guiding Clients to the Right Treatment

📅 Date: September 26, 2025
🕘 Time: 9:00 AM – 11:00 AM
📍 Format: Live Webinar
👩‍🏫 Speaker: Erica K. Smith, MSW, LCSW

This session provides a comprehensive overview of clinical assessments and screening tools used to determine appropriate levels of care for children, adolescents, and adults. Learn how to make informed referrals and navigate the behavioral health system effectively.

🔗 Register Here
📄 Download Brochure

2. Advanced Application of DBT Skills

📅 Date: October 10, 2025
🕘 Time: 9:00 AM – 3:30 PM
📍 Format: Live Webinar
👩‍🏫 Speaker: Rebecca Edwards-Powell, MSW, LCSW

Designed for professionals familiar with DBT, this workshop focuses on strengthening clinical application through skills training groups, behavioral strategies, and role-play techniques. 

🔗 Register Here
📄 Download Brochure

3. Identifying and Addressing Anxiety and Trauma-Related Disorders in Adolescents

📅 Date: October 15, 2025
🕘 Time: 9:00AM-12:15PM
📍 Format: Live Webinar
👩‍🏫 Speaker: Sarah E (Betsy) E. 'Betsy' Bledsoe , PhD, MPhil, MSW

This program is designed to help practitioners become more familiar with identifying the signs and symptoms of anxiety and trauma related disorders in adolescents.

🔗 Register Here
📄 Download Brochure

4. Experienced SUD Professionals Panel: Sharing Their Expertise, Wisdom, and Hope

📅 Date: October 22, 2025
🕘 Time: 1:00PM-3:00PM
📍 Format: Live Webinar

👩‍🏫 Speakers: 
Jesse Battle, MSMHC, LCMHC, LCAS, CCS
Tuesday Feral, LCMCHA (they, them)
Leslie D. McCrory, Retired Counselor
Geraldine A. 'Geri' Miller , PhD, LP, LCAS, CCS
Paul D. Nagy, LCAS, LCMHC, MS
Daniel H. Wilemon, M.Ed., LCMHCS, LCAS, CCS

Join a panel of seasoned substance use disorder professionals as they share insights, lessons learned, and hopeful perspectives on recovery and treatment. This interactive session is perfect for those seeking inspiration and practical guidance.

🔗 Register Here
📄 Download Brochure

🎓 Continuing Education Credits

Each session offers CE hours for psychologists, social workers, counselors, and other behavioral health professionals. Details are available on each registration page.

On the most recent episode of the Northwest AHEC Healthcare Insights podcast, host Andrew Brewer speaks with Dr. Gretchen Hoyle. And, you can now earn 1 hour of CE credit after listening!

Dr. Hoyle returns to provide a post-launch update of implementing a collaborative care management model (CoCM) in primary care practice in a large health system. The model provides continuity of care for chronic conditions such as ADHD, anxiety, and depression. Learn how CoCM operates and insights on transforming care practices with a behavioral care manager, data registry, EHR workflows, and billing.

According to Dr. Hoyle, "This model allows us as pediatricians to use a team based approach for pediatric patients with mental health issues." Members of the CoCM team include the primary care provider who makes a diagnosis and referral, a psychiatric consultant who provides subspecialist level expertise and advice, and the behavioral health care manager (BHCM) who interacts most closely with the patient and their family. Dr. Hoyle finds it is the BHCM that is the "hero" of the CoCM team!

Learning Objectives:

• Describe the functions of each member of the Psychiatric Collaborative Care Team.
• Describe how mental health symptoms are measured and tracked in the Psychiatric Collaborative Care Model.

Register for CE Credit here: https://northwestahec.wakehealth.edu/t3/courses-and-events/75184

View a complete list of current episodes in the Podcast CE Learning series here: https://go.northwestahec.wakehealth.edu/podcastCE

Check out the latest episode of NW AHEC Healthcare Insights podcast!

When disaster strikes communities close to us, human service professionals often feel a familiar calling for a meaningful way to utilize their mental health skills in a challenging and rewarding manner that makes a real difference.

This training will prepare licensed mental health professionals for volunteer or paid roles in disaster response, contributing significantly to the psychological recovery of both disaster survivors and disaster workers. Having more mental health professionals trained and ready to respond in times of a disaster will be an invaluable asset to the people of our state, nation, and world.

Developed for licensed mental health professionals who are assumed to have a base of clinical knowledge, this training will give participants familiarity with characteristics, stages, and responses to disaster. Basic intervention strategies, including psychological first aid and empowerment of coping skills will be presented, along with the important topics of self-care and ethical issues in disaster response.

Orientation to Disaster Mental Health Intervention

Live Webinar / June 7, 2025 9 AM - 11 AM

Check out all the details and register now to reserve your spot.

For 16 years, the NC “One Community in Recovery” Conference has served as a powerful gathering of individuals dedicated to fostering recovery, resilience, and advocacy in mental health and substance use. Planned by a statewide committee of behavioral health providers and advocates—many with lived experience—this annual event continues to be a beacon of hope and progress.

This year, from March 5-7, 2025, over 200 participants came together under the theme “Healing Together: Building Stronger Communities.” The conference provided a platform for insightful discussions, innovative strategies, and shared experiences that continue to shape the future of recovery in North Carolina.

Conference Highlights

One of the standout sessions was “Addressing the Connection of Brain Injury, Public Health, and the Legal System in North Carolina” presented by Desireé Gorbea-Finalet of Disability Rights NC. This thought-provoking discussion shed light on how brain injuries intersect with public health and justice systems, emphasizing the need for comprehensive support and policy changes.

The pre-conference session also sparked important dialogue with a panel discussion on “Exploring Alternatives to Involuntary Commitment in North Carolina.” Featuring a diverse group of stakeholders, this session explored real-world challenges and potential solutions to ensure a more person-centered approach in crisis response.

Attendees also had the opportunity to engage in 16 breakout sessions, covering a wide range of recovery-focused topics, and hear from two inspiring keynote speakers:

• Jeff Walker of Wilkes Recovery Revolution, a peer-run Recovery Community Organization in Wilkes County, NC.
• Vesper Moore, an Indigenous activist and mental health rights leader, who spoke on recovery, advocacy, and the importance of elevating lived experiences in policy and practice.

Northwest AHEC invites you to our upcoming Spring Behavioral Health Webinars! Whether you're looking to enhance your clinical practice, support recovery, or deepen your understanding of trauma-informed care, we have valuable sessions for you. Click below for more information on each.

• Microaggression as an Ethical Issue in Clinical Practice - April 1, 2025 from 9AM- 12:15PM - Microaggressions are subtle, often unintentional exchanges that convey negative messages based on race, gender, sexual orientation, age, or disability. While clinicians aim to provide culturally sensitive care, unknowingly committing microaggressions can harm communication, erode trust, and disrupt the therapeutic process. Ethical guidelines call for minimizing these occurrences to support effective client relationships. This program explores the impact of microaggressions, their role in clinical practice, and strategies for reducing them. Note: This course may count toward ethics requirements for license renewal. Register Here
  
  
• Practical Suggestions for Facilitating SUD Recovery - April 9, 2025 from 1PM - 3PM - Health professionals often encounter clients or patients with substance use disorders (SUDs). Understanding how to effectively address these complex challenges is critical for providing optimal care. This workshop is designed to offer a comprehensive overview of practical approaches and evidence-based interventions for working with individuals affected by SUDs. Register Here
  
  
• Safety First: Trauma-Informed Care with People Experiencing Substance Use Disorders - May 16, 2025 from 9AM - 12:15PM - Widely demonstrated in the literature on substance use disorders, trauma experienced by the person is a common and primary part of the sequelae leading to addiction. Traumatic life experiences can unfortunately also be a part of a person’s time as a substance user.
  This training will present a brief overview of what constitutes single incident or developmental traumas; what it means to be a trauma-informed practitioner; awareness of vicarious or secondary traumatization and related social worker self-care. Participants will learn how to consider trauma in their approach to working with clients and in their ability to thrive as a practitioner.  Register Here
  
  
• Race-Based Traumatic Stress: Broadening Your Toolkit to Support Diverse Individuals - June 20, 2025 from 9AM - 12:15PM - This session explores race-based traumatic stress and its impact on clients of color. We’ll review the theoretical framework, trauma responses, and resilience strategies while identifying risk and protective factors. Clinicians will enhance cultural competence through interactive learning, self-reflection, and practical skills for sensitive, effective care. Register Here

In response to a need expressed by several practices in our region, Practice Support (Lara Dickerson, MHA, BA and Leslie McDowell, DNP, ANP-BC, RN at Northwest AHEC) created an on-demand learning module entitled, “Managing Difficult Patient Situations”. The learning module offers 1 credit hour and registration is FREE.

The module has garnered 511 registered learners since its release in January of 2024, from all corners of North Carolina and beyond! The diverse crowd represents ten different states (AK, CA, GA, MI, MN, OH, OR, SC, TX, VA) and included representation from 96 counties in NC.

This learning module was also incorporated into a Workplace Safety Toolkit produced by the American Academy of Ambulatory Care Nurses for its membership in June, and now reaches a national audience of nurse leaders and educators.
 

16th Annual “One Community in Recovery” Conference Healing Together: Building Stronger Communities