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Psychiatric Services Special Projects

Montana is at the epicenter of the US mental health crisis. Barriers to accessing mental health care include a shortage of mental health care providers and difficulty accessing care in very rural or remote settings. Given our severe challenges, Billings Clinic's Psychiatric Services team is working hard to introduce evidence-based, best practices across the spectrum of care.

Project ECHO

Image of Dr. Arzubi during an ECHO videoconferenceThe ECHO (Extension for Community Healthcare Outcomes) model™ is a medical education and care management collaborative that empowers clinicians in remote settings to deliver better care to more people locally. By putting local clinicians together with specialist teams at larger medical centers in weekly virtual clinics or teleECHO™ clinics, Project ECHO shares knowledge, expands treatment capacity and offers peer support to otherwise regionally isolated clinicians.

Project ECHO Billings Clinic uses this research-validated method to establish an addictions and behavioral health collaborative and peer support for addictions and behavioral health clinicians working within the Department of Corrections to care for offenders who are incarcerated or transitioning back into the community.

As the most comprehensive psychiatric and behavioral health medical practice in Montana, Billings Clinic is leading this initiative, bringing together a psychiatrist, pharmacist, nurse, and social worker. Rimrock Foundation and the Department of Corrections will also supply professional personnel to complete this multidisciplinary team hub.

Project ECHO Billings Clinic will offer weekly educational support and 60 minutes of collaborative case review provided by mental health clinicians from the Montana State Prison and Passages. The multidisciplinary team will collectively share strategies, best-practices, and appropriate testing or pharmacy recommendations to best serve the patient.

Equine-assisted Psychotherapy Program

Billings Clinic's equine-assisted psychotherapy (EAP) program is used to treat a variety of mental health and human development needs. EAP incorporates horses, a mental health professional, a horse specialist, and patients in a joint effort to facilitate emotional growth and learning.

Equine Assisted Psychotherapy

Trauma Informed Care

A large proportion of our patients have been exposed to adverse childhood experiences (ACEs). The CDC’s ACEs Study demonstrated that chronic exposure to different forms of abuse, neglect, and family dysfunction represents a significant risk factor for developing mental health and medical problems along the lifespan.

Our staff is being trained in proven approaches to assess and treat patients who have been exposed to ACEs. The Neurosequential Model of Therapeutics (NMT) from the Child Trauma Academy and Attachment, Self-Regulation, and Competency (ARC) from the Juvenile Resource Institute are two models currently being introduced to our practice.

Billings Clinic collaborates on trauma-informed care awareness and education as a member of Healthy By Design, Yellowstone County’s community health improvement coalition.
Go to to learn about:

  • free training in trauma-informed care for community-based organizations
  • Yellowstone County Mental Health Workgroup
  • Mindfulness Classes for providers and caregivers
  • ACE Study and Assessment.

Triple Chronotherapy

The challenges of managing acute depression and suicidality in the adolescent population in Montana have led a collaborative team of psychiatric nurses and adolescent psychiatrists to trial an innovative non-pharmacological procedure called triple Chronotherapy.

This procedure employs sleep deprivation, sleep phase advancement, and bright light therapy, which is implemented around-the-clock by psychiatric nursing staff.

Combining triple chronotherapy with medications can sometimes speed up the benefits of medications by boosting mood, improving sleep, and reducing suicidal thoughts in a matter of days.

Billings Clinic is the first organization in the U.S. to make this intervention available to adolescents.

View this TED talk video: How a Light Box & a Dream Team Changed one Hopeless Teen's Life


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