A Conversation with Cori McMahon, PsyD, NCCE: Tridiuum VP for Clinical Services

Behavioral health expert

You may recognize her name from our industry blogs or research, but we’d like you to truly get to know Tridiuum’s resident behavioral healthcare expert, Cori McMahon, PsyD, NCCE.

Dr. McMahon is a licensed clinical health psychologist with over 20 years of experience treating patients in diverse therapeutic and care settings as well as teaching a new generation of behavioral health professionals. Her last 13 years in behavioral medicine have led her to split her time between clinical work and her position as Vice President for Clinical Services here at Tridiuum.

Today, Tridiuum relies on Dr. McMahon’s expertise to enhance our digital behavioral health platform for patient outcomes and provider connections, which has greatly elevated the product in the past five years since she joined the team.

We sat down to chat with Dr. McMahon to learn about her journey as a psychologist, her clinical specialty areas, how she views the evolution of the industry, and why she’s optimistic about the future of behavioral health.

 

Tridiuum: What first inspired your career in psychology? You’ve shared that it’s something you thought about even as a kid.

McMahon: The inspiration for my career was a combination of my own temperament and an accumulation of life experiences. I had an assignment in sixth grade to write an essay about what I wanted to be when I grow up, and I wrote about my plans to become a psychologist! I knew at that point in my life that my personality fit with what I understood as the role of a psychologist—as a helper and a healer.

I was drawn to health psychology and the practice of behavioral medicine after witnessing the effects of chronic diseases like cancer and HIV/AIDS and subsequent death of family members. I learned that physical health and behavioral health are inextricably linked, but healthcare as it was hadn’t yet fully caught up with this profound connection and its implications.

 

Tridiuum: You split your time between clinical work as a health psychologist and lending your expertise to Tridiuum. How did you get connected with Tridiuum? How have you helped shape the product?

McMahon: It’s funny: When I first made the shift from full-time clinical and academic work to working with Tridiuum, colleagues would ask me what it was that drew me to “industry.” I explained that when I’m in the hospital, I make an impact one patient at a time. And there is great value in that work.

At Tridiuum, there’s potential for thousands of patients to be impacted daily. As a clinical health psychologist, I support Tridiuum’s mission from various perspectives as both an internal and an external consultant. I facilitate the product team with patient and provider end-user experience. With the sales team, I bring expertise in building integrated care models, establishing routine behavioral health screenings, and understanding how best to assess different patient populations. I’m also fortunate to act as a liaison between the research team and Tridiuum’s customers so that we can understand how best to use our data and analytics.

 

Tridiuum: Why do you think it’s important to approach health holistically, understanding that physical health affects mental health and vice versa?

McMahon: This is my favorite topic! I think we are finally at a point in healthcare where we are acknowledging the reciprocal relationship between physical health and behavioral health. There is a robust body of literature that supports our understanding here.

From both a clinical and business perspective, we are most successful when we address behavioral health concerns early and often. This allows us to improve overall health and decrease cost of care by keeping patients out of the emergency room or from overutilizing the primary care office. The traditional medical model tries to put out fires once they’re already burning, rather than prevent them in the first place. When we track symptom severity and make changes to the intervention accordingly, we can engage patients in a feedback loop. Then the patient perspective is lifted and engagement is improved, and as a result, so are outcomes.

If we were having this discussion two decades ago, there were few positions available for psychologists to work on medical teams alongside their physician colleagues. Now, positions available in health systems nationally seem to be growing by the minute. Health psychologists are now being sought for very specific work like cancer prevention, tobacco cessation, bariatric and metabolic surgery, trauma service, and others. This is evidence that we’re moving in the right direction.

 

Tridiuum: You specialize in early intervention and chronic disease management. Why are these important and what methods have you employed to address them?

McMahon: I spent almost 10 years working in oncology, and eight in infectious disease focusing primarily on patients with HIV/AIDS in an integrated primary care setting. When we screen for behavioral health and social determinants of health early and routinely, we can intervene in a targeted and efficient way.

For example, when a patient completes a behavioral health assessment, results might determine they need trauma education, substance use counseling, or case management. Using an efficient digital platform allows for all that information to be determined prior to the medical visit and to more quickly connect the patient to the appropriate follow-up care. This saves very valuable discovery time in the medical visit and allows providers the ability to plan intervention immediately.

 

Tridiuum: Along those same lines, can you talk a bit about your experience seeing the effects of comorbidities on your patients?

McMahon: When someone is diagnosed with cancer, it is not uncommon to also experience symptoms of anxiety or depression, or both. If someone experienced anxiety prior to diagnosis, then the diagnosis could exacerbate cognitive symptoms like rumination, physical symptoms like increased heart rate, behavioral symptoms like avoidance of treatment, or a combination of these.

This anxiety can become a barrier to engaging in treatment. At times I’ve helped patients with exposure to treatment by walking with them into a radiation room, providing education about the process so the patient could establish expectations, and even sitting alongside them during chemo infusion.

I recall a patient who was diagnosed with HIV and needed to begin a regimen of antiretroviral therapy. Due to a severe trauma history, she was mistrustful of others and had difficulty with medical exams. She had strongly held beliefs based in HIV stigma about the danger of taking such medications. Active substance use created challenges in her ability to make it to scheduled appointments—in general and while sober. Anxiety exacerbated all of this. It took some time in treatment with behavioral medicine and addictions counseling to support her in taking her meds and remaining engaged in her overall healthcare. The impact of care is profound here: It’s the difference between deteriorating toward AIDS status or maintaining an undetectable viral load and living a life where HIV is not of primary concern.

 

Tridiuum: Tridiuum’s platform also measures therapeutic alliance. How do you go about laying that foundation and why is it important for patients to find a therapist or clinician who is the right “fit”?

McMahon: There are so many factors that impact therapeutic alliance. Things like being on time for an appointment and calling the patient by their preferred name and/or pronouns are essential. It sends the message that you have respect for that person and their time. In an initial session with a patient, it is important to balance between active and reflective listening with curiosity to hear the patient’s story, along with education and socialization to the therapeutic process.

To maintain therapeutic alliance, asking for patient feedback goes a long way. It’s important to regularly look at progress toward treatment goals and to engage the patient in that conversation. We want them to be active participants in their care, working collaboratively toward their goals, as opposed to simply being passive recipients of the provider’s care.

Semantics are important, too. At the end of a session I will say, “Tell me what questions come up for you? Usually, people have different questions at this point.”  I want to normalize and give permission for my patients to ask questions and not feel that they are a burden.  If I ask, “Do you have any questions?”,  the answer will inevitably be “no.”

 

Tridiuum: You are also passionate about outreach to underserved communities. How are these communities uniquely affected by behavioral health issues?

McMahon: In the HIV/LGBTQIA+ population, it’s common for there to be multiple health comorbidities along with complex psychosocial stressors or social determinants of health. For those who are under or uninsured, access to behavioral health care is even more challenging than it is for those with financial resources. These patients’ access to care is also challenged by concrete barriers like transportation, active substance use, or trauma history. Approximately 40 percent of the population screens positive for PTSD, over 40 percent for depression, and about a third for substance use, according to screenings I see in clinical practice. It’s so important to meet patients where they are, both literally and figuratively, with trauma-informed care. The Cooper University Hospital Comprehensive EIP Extended Care program where I practice is fortunate to have an outreach team who is regularly presenting information in local churches, community centers, and schools.

 

Tridiuum: What are the biggest challenges that the behavioral health industry is currently facing, and what is next for Tridiuum?

McMahon: General access to care is a significant challenge since provider schedules are full, and demand has increased with the COVID-19 pandemic. I recall a statistic that phone calls to national suicide hotlines are up by 300 percent in some areas, and that the majority of new patients have not previously engaged in behavioral healthcare or had a mental health diagnosis.

When someone calls the number on the back of their insurance card, they are generally met with a wide list of providers in their geographic area who may not have availability or fit their needs. As a result, mental health apps have become popular as people are taking it upon themselves to seek care, especially younger people.

At Tridiuum, we find ourselves in a unique and valuable position to act as the connective tissue between organizations that support improved access to quality care. We’re just scratching the surface by having payers use a brief form of the assessment to understand level of acuity, then connect patients with a provider who is both available and a good fit. We’ve also expanded focus across our platform to support measurement-based care and making connections between payers, providers, and patients. We call it the “network effect.”

 

Tridiuum: What is your advice for fellow therapists and clinicians for treating their behavioral health patients?

McMahon: One bit of advice I like to share with my trainees is to remain a good scientist and take in all communication, verbal and non-verbal, with curiosity. Remember that the person in front of you is not a representative of their entire race or ethnicity, religion, gender identity, town, etc. They are an individual with unique life experience. Be very mindful of implicit bias and of what the patient may be experiencing when they first see you. Appreciate the courage it takes to engage in care.

For my behavioral health and physician colleagues, I’ll reiterate my prior statement about self-compassion. Our profession is focused on serving others and we need to remain mindful that the ship needs regular tending as well if it is to continue to carry the load successfully.

 

Tridiuum: What’s your favorite thing to do outside of your work at Tridiuum or your clinical work?

McMahon: I have a 10-year-old son who’s my favorite person in the world. Most of my time outside work is spent supporting his busy social life, which I love and am very happy to do. With children, you’re forced into mindfulness.

I can immediately shut down work when necessary. In my spare time I also love and need to read. I always have one or two books I’m reading or listening to. My husband and I also just took up mixed martial arts—taekwondo and hapkido. I’m now an orange belt! When I’m done I feel amazing and exhausted, but it’s great for my mental health.