Training Psychology Interns in Primary Behavioral Health Care.

Abstract

This article describes a training program for primary behavioral health care (PBHC) for clinical psychology interns. The authors discuss the rationale for integrating mental health into primary care and the need for additional training programs at the predoctoral internship level. A review of relevant literature suggests that effective functioning in primary care requires competence in (a) generalist psychology, (b) health psychology, (c) interdisciplinary team functioning, and (d) skills specific to primary care. The authors advocate for a relatively intensive training program to address these areas. Common intern training difficulties observed during 3 years of program implementation are discussed. Practical, lessons-learned recommendations that address these problem areas provide guidance for others seeking to develop a PBHC training program.A growing body of literature recognizes the potential value of integrating behavioral health services into the primary care arena. Researchers have found that approximately 60% of primary care visits involve some behavioral health need (Cummings, Cummings, & Johnson, 1997). Furthermore, epidemiological research suggests that although 28% of Americans in any given year meet diagnostic criteria for a mental disorder, half of these individuals do not receive any form of treatment. Of those who are treated, approximately half receive specialized mental health treatment, whereas the remaining half receive services solely through their general medical providers (Narrow, Regier, Rae, Manderscheid, & Locke, 1993;Regier et al., 1993). Thus, the existing mental health system provides specialized, intensive services to a minority of individuals with behavioral health problems. The rest receive treatment solely from their physician or receive no behavioral health services whatsoever.Traditional models of mental health care cannot adequately provide services to the large numbers of individuals presenting to primary care clinics with a host of biopsychosocial problems. Consequently, innovative service delivery models capable of providing more comprehensive behavioral health interventions to primary care populations have been developed (

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