Infants rely on relationships with caregivers for survival. The relationship between an infant or young child and their caregiver(s) is one of the most critical factors influencing health and development for the rest of a person’s life.
“Dyadic” approaches to health and wellness integrate the science of relationships into pediatric healthcare by centering significant relationships into assessment, intervention, and referrals as part of the pediatric patient’s care plan.
Why Dyadic Care is Important
By supporting the well-being of a child’s caregiver, the caregiver will be better resourced to promote healthy development for their child.
Infant and early childhood practitioners recognize the inextricable link between a young child and their caregiver and caregiving environment, making the relationship between the child and their caregiver and environment the target of interventions. Thus, infant and early childhood mental health inherently includes a “dyadic,” “triadic,” or family-centered focus.
What This Means for Pediatric Primary Care
Dyadic care in pediatric primary care means expanding the focus of pediatric visits to include screening and support for caregivers, families, and other environmental factors that will inevitably impact child health. Typically, dyadic care is provided by another member of the healthcare team, such as a licensed behavioral health provider or a community health worker, who works alongside a pediatric healthcare provider.
In this integrated care model, pediatric mental health professionals are available to address developmental and behavioral health concerns as soon as they are identified, bypassing the many obstacles families face when referred to offsite behavioral health services. Furthermore, in this model, health care for the child is delivered in the context of the caregiver and family (i.e. “dyadic health care services”) so that families are screened for behavioral health problems, interpersonal safety, tobacco and substance misuse and social determinants of health such as food insecurity and housing instability. Families who are given referrals receive follow-up to make sure they received the services.
The California Department of Health Care Services allows reimbursement for behavioral health promotion and prevention using evidence-based services. Many relationship-based models have strong evidence supporting their effectiveness in promoting positive child and family level outcomes. These are examples of relationship-based models we recommend that were specifically designed for pediatric primary care or have evidence of adaptations for implementation in primary care. Do you know about a model you would like to share with us? Please send us a message.
Learn about the evidence for dyadic care and how it can promote child, caregiver, and family well-being.
Learn about the case for dyadic Medi-Cal billing, how California’s benefits originated, and the essential details of billing and reimbursement.
For the first time ever, children and their caregivers will be able to receive family therapy support with no prerequisite mental health diagnosis, and will have access to comprehensive, prevention-oriented, pediatric primary care services during a child’s most critical years of life (ages 0 - 3 years). The California Department of Health Care Services (DHCS) is providing an opportunity to reform our Medicaid delivery system to advance children's social and emotional health. This is a unique moment in history where we have the opportunity to transform how early intervention services are implemented with young children and their families. Providers will be able to offer dyadic team-based care services through health promoting and preventive, short-term behavioral health interventions, and care coordination.
Join us in transforming care and optimizing dyadic health and well-being!