Career Development for Integrated Primary Care: Trainee Perspective on an Innovative New Curriculum

Mark A. Stillman, PhD, Mercer University; Olivia Gupton, MS, Mercer University; Natasha DePasa, MS, University of Central Florida; and Keri Dotson, MS, University of Central Florida

Across virtually every area of specialized expertise and interest within SBM, those who desire to improve population health in medical settings could benefit from clearly understanding how integrated primary care (IPC) training can help them to meet their goals. In congruence with the timely emphasis that SBM President James F. Sallis, PhD, placed upon translating science to policy and practice, this article highlights the importance of graduate training in order to better prepare for all areas of applied behavioral medicine. On a more pragmatic level, it is also essential that graduate education and training programs respond to growing workforce demands for psychologists to function as full members of IPC health teams.

As the demand for population health increases, so does the need to effectively train psychologists in the competencies that are necessary to work within integrated care settings (Cubic et al., 2011).  The American Psychological Association (APA) Division 38 developed a freely available introductory curriculum as a resource for graduate training programs and affiliated clinical training sites. Feedback has been positive and promising, and strongly suggests that exposure to the IPC curriculum fosters interest among students and promotes an awareness of psychology’s role in the changing healthcare field.

The APA Society for Health Psychology’s Committee on IPC has developed a freely available course, Integrated Primary Care Psychology: An Introductory Curriculum (Gunn et al., 2016), to be used as a resource by any graduate program or training site with the goal of enhancing psychologists’ roles in the transforming health care system. Mercer University’s Clinical Medical Psychology Doctoral program was the first national pilot of the APA’s entire curriculum (August – December, 2015). We reflect on this experience below.

Curriculum Development

The Primary Care Psychology Introductory Curriculum (see Table 1) was developed by psychologists with extensive clinical and training experience in primary care. It presently includes four 120-minute Foundation Modules (each with 90-minute versions), and eleven 90-minute Topic Modules, with additional modules becoming available over the next few years.

Table 1. Integrated Primary Care Psychology (IPC) Curriculum Description

Foundational Modules
Module 1	Introduction to IPC	Defines field, integration and traditional vs. integrated role of the psychologist
Module 2	Across the Continuum: Psychology’s Role in IPC	Discusses range of primary care patient needs
Module 3	Primary Care Patients: Who are They and How Can Psychologists Be Helpful	Describes primary care patients’ common behavioral health concerns
Module 4	IPC Interventions	Identifies clinical skills for primary care intervention
Additional Topics
Anxiety     ADHD     Chronic Disease Management     Chronic Pain     Depression     Health Promotion/Disease Prevention         Motivational Interviewing Research & Quality Improvement Substance Misuse     Training Trajectory     Working with Older Adults

The curriculum will be accessible on the Division 38 website beginning in June 2016.

Trainee Perspectives

Olivia Gupton, MS, Mercer University doctoral student:

As a student in the inaugural cohort for the IPC course, I gained a working comprehension of the Behavioral Health Consultant’s role related to IPC Competencies as defined by McDaniel et al. (2014). Multimodal teaching techniques were used, including interactive presentations, student exercises, references, case materials, illustrative videos, and resources. The skills and knowledge I learned from this course prepared me for my practicum in an Atlanta area adult outpatient clinic where I collaborated closely with medical doctors, nurses, social workers, psychologists, and psychiatrists to treat patients with comorbid medical and psychiatric diagnoses.

Natasha DePesa, MS, University of Central Florida doctoral student, incoming intern at Tampa VA:

Training in IPC is highly desired by graduate students. Within our clinical psychology graduate program, a small group of IPC-committed students advocated for clinical experiences in integrated health to enrich our generalist training. Our extensive efforts in developing an integrated primary care externship site provided unique and invaluable learning experiences. Initially, significant time and money were invested to ensure appropriate training and guidance. Currently, we are adapting the training model to be more sustainable and to meet the varied needs of students within our program. The new IPC curriculum is an excellent tool for generalist programs like ours.

Keri Dotson, MS, University of Central Florida doctoral student, presently applying for clinical internship:

IPC training is an invaluable experience for students, even those not planning a career in IPC or a medical setting. Training in IPC has enhanced my understanding of the biopsychosocial model by emphasizing increased awareness and consideration of medical factors in case conceptualization, treatment planning and implementation, and care coordination. Such training experiences also foster development of a shared vernacular among various healthcare professionals. Personally, this experience has allowed me to further establish my professional identity as a health service provider and develop as a clinician, leader, and young professional.

Summary

In response to the general shift towards delivering all manner of evidence-based behavioral interventions to broad populations in primary care settings, psychologists can benefit from IPC training that focuses on collaboration, treatment implementation, and brief interventions. The construction of the IPC curriculum by APA’s Division 38 was aimed to address and meet the needs of our field. The response from students who have undergone specialized IPC training has been highly positive and promising.

 

References

Cubic B., Neumann, C., Kearney, L., McGrath, R., Ruddy, N., Rybarczyk, B., Zamudio, A. (2011). Report of the Primary Care Training Task Force to the APA Board of Educational Affairs.  American Psychological Association.

Gunn, W. B., Ward-Zimmerman, B., Ruddy, N., Cubic, B. A., Kearney, L. K., Neumann, C., Vogel, M. E., Stillman, M. A., Wells, S. (2016). Integrated Primary Care Psychology:  An Introductory Curriculum. American Psychological Association; Society for Health Psychology.

McDaniel, S. H., Grus, C. L., Cubic, B. A., Hunter, C. L., Kearney, L. K., Schuman, C. C., . . . Johnson, S. B. (2014). Competencies for psychology in practice in primary care. American Psychologist, 69(4), 409-429.