A primary mental health care model for advanced practicum training in a university health clinic.

Abstract

University health centers provide an opportune setting in which psychology graduate students can obtain training in integrated primary care (IPC). The purpose of this article is to describe an advanced practicum experience for psychology doctoral students, who serve as integrated behavioral health providers (BHPs) in a university primary care clinic. First, we describe aspects of our IPC practicum, including planning and development; the theoretical model; implementation of behavioral health screening; structure of patient visits; use of evidence-based practice; management of risky patients; communication with specialty mental health and primary care providers (PCPs); issues related to practicum eligibility, training, and supervision; evaluations; and program maintenance. Then we report on characteristics of 347 patients seen by BHPs over 3 semesters; the most common reasons for referral were sleep, depression, and anxiety. Lastly, we surveyed 7 graduate students who completed the practicum to obtain their views on aspects of the training experience; students reported that they developed new skills and would recommend the practicum to others. Our experience suggests that an IPC practicum in a university health center has the potential to benefit psychology graduate students, primary care providers (PCPs), and patients.

Preparing the Workforce for Behavioral Health and Primary Care Integration

“…3,11,22 Moreover, BHCs and PCCs are infrequently trained in collaboration or practicing in interprofessional settings. 6,17 Although increasing numbers of programs are emerging offering integrated care training for students, 6,11,[23][24][25][26] medical residents, 6,11,24,27,28 or postdoctoral trainees, 3 insufficient training capacity and practical experience opportunities continue to be major barriers to supplying the workforce needed for effective behavioral health and primary care integration. As practices and payers increasingly recognize the benefits of integrated care, the need and demand for competent clinicians to work in these integrated settings will grow.…”

The experience of doctoral students at program-affiliated practicum training clinics.

“…Despite challenges related to competent supervision, cultural competency, and adequate resources, PTCs show substantial potential to effectively prepare trainees to be future health service providers. PTC sites have the potential to demonstrate the integration of science and practice across assessment, intervention, and other aspects of psychologist training (Borkovec, 2004), and to provide opportunities to develop new skills, such as learning how to conduct brief assessments and culturally competent interventions (Funderburk & Fielder, 2013). Moreover, students in PTCs may observe and learn to utilize empirically supported therapies effectively (Cukrowicz et al, 2011), and address ethical dilemmas with the support and supervision of licensed practitioners and clinic staff.…”

Barriers to integrated primary care and specialty mental health services: Perspectives from Latinx and non-Latinx White primary care patients.

“…IPC service utilization is associated with improvement of functioning and symptoms of diverse patients who present to primary care with mental health problems (Bridges et al, 2015; Bryan et al, 2012; Ray-Sannerud et al, 2012). IPC patients, including Latinx patients, report high levels of satisfaction with services and therapeutic alliance (Corso et al, 2012; Funderburk & Fielder, 2013; Villalobos et al, 2016). IPC increases efficiency administratively and in patient care, resulting in cost savings for the clinic (Robinson & Reiter, 2016).…”