Basic science training in psychopharmacology: How much is enough?

Training psychologists to administer psychotropic medication will require acquisition of a unique knowledge base and set of skills that are generally not components of graduate education in psychology. Nevertheless, the current level of basic science training in graduate education in psychology is substantial and should, with minor modification, allow adequate preparation for students to enter into specialized training to prescribe. The direct provision of psychopharmacology requires psychologists to demonstrate competencies in addition to those required in the general provision of psychological services. Such competencies are perhaps best taught at the postdoctoral level. The authors argue that all curricula training professional psychologists should be able to train psychologists capable of practicing as independent, full-fledged health care providers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care psychology and graduate education.

Contends that health care (HC) psychology should be more strongly emphasized in graduate clinical psychology training programs so that clinical psychologists can better meet demands for services that come from society, the HC field, clinical psychology itself, practicing clinical psychologists, and clinical psychology graduate students. The relationship of clinical psychology to HC psychology and the efficacy of training in HC psychology to meet those sources of demand are described. Various means of implementing graduate programs that stress or include HC psychology are discussed. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Crisis in training pediatric psychologists.

Examines the shortage in the US of personnel who are trained in child mental health care that results in underservice to children, youth, and families. Doctoral programs offering specialty training are in short supply, as are pediatric psychology training programs. In addition, many clinical psychology programs are ill-equipped to offer curriculae for the development of skills and knowledge bases required by child psychologists. It is concluded that a training conference is needed to communicate the issues involved in this mental health provider crisis if children are to have access to psychological services. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postdoctoral training in primary care health psychology: Duties, observations, and recommendations.

The need for postdoctoral training in health psychology has taken on added importance following transformations of the U.S. health care delivery system toward primary care models of delivery. This transformation provides psychologists with the opportunity to work as primary care practitioners, educators, and researchers, and it suggests the need for postdoctoral training that prepares students for those opportunities. The author addresses issues relevant to postdoctoral training from the perspective of a former participant in a postdoctoral fellowship training program in primary care health psychology. The duties and contributions of a primary care health psychologist are described. These include the provision of graduate medical education and clinical services tailored to primary care. The author also offers recommendations regarding postdoctoral health psychology training in order to enhance psychologists' ability to collaborate with medical professionals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Primary Care Psychology Training on Campus: Collaboration Within a Student Health Center.

Applied psychological services are being implemented into the primary care treatment milieu to improve patient treatment and reduce health care costs. Unfortunately, few psychologists have training specifically oriented to working in this setting. A predoctoral training program wherein psychology graduate students may obtain practicum experience working in a student health center on a university campus is described. The theoretical underpinnings of this training are based on the integrated primary care models of K. Strosahl (1997) and K. Strosahl, N. Baker, M. Braddick, M. Stuart, and M. Handley (1997), which emphasize integration of psychological and medical treatment, brief intervention, consultation, and expedited referral for longer term cases. Though many issues remain, integrated primary care offers promise for improved health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological consultation with primary care physicians: Obstacles and opportunities in the medical setting.

This article discusses the relationship between psychologists and primary care physicians and describes the training and practice of physicians in the areas of mental and behavioral health care. Issues affecting the relationship between psychologists and primary care physicians are then reviewed. Different models of psychological consultation are discussed, and an integrated behavioral systems model of psychological consultation is presented as a potentially effective model for consultation with primary care physicians. This model provides a framework for psychologists to function as coproviders of primary health care services. Practical strategies to enhance collaboration between psychologists and primary care physicians in private practice are discussed. The need for more research on primary care and for the inclusion of psychologists in managed care and health care reform are also highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managed Care: Implications for School Psychology. Comment.

Comments on the article by Sanchez and Turner (see record 2003-03405-005) examining the implications for practice and training in psychology in the era of managed care. The current author states that Sanchez and Turner should be commended. Their article amplifies and clarifies critical issues psychologists must consider while practicing within an era increasingly shaped by health insurance policies and practices. Nevertheless, the author feels that several intriguing facets of managed care were not highlighted. Discussion focuses on the impact that reimbursement and managed care is having on school (and clinical) psychologists. The author points out that it is unknown to what extent managed care may (and has) altered psychological services delivered by school psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology in the Veterans Administration: A storied history, a vital future.

Argues that in the face of the Balanced Budget and Emergency Deficit Control Act of 1985 (Public Law 99-177 [the Gramm-Rudman-Hollings law]), the Veterans Administration (VA) system is worthy of wholehearted support from psychologists, regardless of whether they are working in the VA. A history of psychology in the VA is reviewed to illustrate the VA's significant contributions to the field, especially to clinical and counseling psychology. One of the accomplishments of VA psychological research in the 1st decade of clinical psychology was the launching of large-scale cooperative programs, with participants from many disciplines and across many hospitals. Although training and research are both important activities for VA psychologists, the main reason for the presence of psychologists in the Department of Medicine and Surgery is direct patient care. It is stressed that a significant reduction or elimination in the level or quality of VA health care would represent an abrogation of the national commitment to provide care to veterans with disabilities incurred during their services. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Survey of Hospital Psychology in Canada.

Despite the major advances in health psychology over the past decade and the changes that have taken place in the Canadian health sector, there remains a paucity of information available about the structure of psychological services in Canadian health-care settings. The most current information about psychology in Canada's hospitals was gathered in 1982 - almost 20 years ago (Arnett, Martin, Steiner, & Goodman, 1987). This article updates the previous information, as it presents the results of a survey that was sent to 975 acute, psychiatric and continuing care health facilities with a minimum patient bed count of 100. Detailed information about the number of psychologists and administrative organizations of psychological services in Canada are reported. The range of services provided by psychologists in health-care settings has expanded, and professional autonomy, as shown by the existence of independent departments of psychology, has changed. The implications of these results for the organization and delivery of psychological services in Canadian healthcare, and for advocacy on the part of psychology, are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between psychology and organized labor: Past, present, and future.

Discusses factors that have affected and recently improved the tenuous and often hostile relationship between psychologists and unions, including an increase in published studies illustrating the applicability of psychological knowledge to labor concerns, activities within organized psychology, and increased interest in behavioral issues on the part of organized labor. In an effort to explore and ultimately improve the perception and utilization of psychologists by unionists, the authors present an overview of the literature on unionists and psychologists, offer contextual information to explain the relationship problems, and describe a number of projects conducted by an American Psychological Association task force on unions. Findings from a survey sent to 150 national, international, and independent unions that assessed current and past problems between psychologists and unions, unionist perceptions of psychologists, and the need for services that could be delivered by psychologists are presented. The need for further work, such as the identification of prolabor psychologists in the field and demonstrations to unions and their members of the efficacy of services provided by health care and organizational psychologists, is discussed. (68 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investing in our future: Unrealized opportunities for funding graduate psychology training.

Purpose: Changes in the health care environment have brought challenges and opportunities to the field of psychology. Practitioners have been successful in modifying service models to absorb losses of financial support for behavioral health care, due to managed care and public policy changes, while simultaneously managing the growing need for these services. However, in this reactive mode of responding to evolutions in the health care system, the field of psychology has at times lost sight of the long-term vision required to promote psychology's inclusion in the health care system of the future. In particular, a focus on training psychologists and ensuring the availability of funding to support these activities must be a priority in planning for the future. This article provides an overview of federal programs that currently offer funding for psychology training, as well as other opportunities for federal funding that have been unrealized. Details regarding advocacy efforts that were required to secure available sources of funding are given, followed by consideration of strategies for taking advantage of existing resources and prioritizing advocacy for additional funding. Conclusion: Funding for psychology training provides an avenue for increasing the number of well-trained psychologists who can serve patients' mental and behavioral health needs and thereby improve health outcomes. Moreover, capitalizing on available funding opportunities for psychology training and promoting efforts to expand these opportunities will help ensure that the field of psychology is positioned to remain an important contributor to the health care system of the future. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clarification and elaboration on evidence-based practice in psychology.

Responds to comments by D. C. Wendt and B. D. Slife (see record 2007-13085-019), P. H. Hunsberger (see record 2007-13085-020), and R. B. Stuart and S. O. Lilienfeld (see record 2007-13085-021) regarding the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in psychology. The goal of the task force was to create a scheme that would suggest how evidence should be used to design and offer services that will benefit patients and to assure the public and the health care system that psychologists are providing evidence-based services. There were and will continue to be many scientific and philosophical issues inherent in any such enterprise, and agreement by all psychologists with every aspect of EBPP may not be possible. Nevertheless, the APA's EBPP policy and the report that accompanied it are remarkably inclusive of various perspectives while remaining unambiguous about the need to use evidence in a way that leads to effective services. What is needed at this point are clinically relevant evidence and investigations of how such evidence can be used to best benefit those served by psychological interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

U.S. mental health policy: Proactive evolution in the midst of health care reform.

Argues that it is vital that psychological and behavioral health care perspectives be explicitly recognized during the coming reform of the US health care system. Mental health policy should not be treated as a mere extension of physical health policy; to do so extends all the flaws of the physical health system into the psychological care arena, resulting in a mismatch with the actual health care needs of the nation. Furthermore, organized psychology must remind policymakers that psychologists provide health services in areas of health care beyond mental health. The challenge to psychology is to ensure the continuation of adequate and timely access to appropriate psychological and behavioral health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rightsizing the workforce of psychologist in health care: Trends from licensing boards, training programs, and managed care.

The psychology workforce continues to expand despite changes within health care, such as managed care, that appear to reduce the demand for psychologists' services. Data from doctoral training and internship training are reviewed. Estimates of the psychology workforce are provided, including the authors' survey of psychology boards for 1995, which estimated there were 89,514 licensed psychologists in the United States. Growth in the field between 1988 and 1995 is estimated at 44%. Workforce estimates are applied to 3 HMO staffing models and population estimates, projecting a surplus of psychologists in many states. The authors provide suggestions for reducing the workforce, including improved monitoring of workforce size and reducing current training levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health services and the emerging role of psychology in Greece.

Notes that, of the few mental health services available in Greece, those resources that do exist are centralized in large cities and few psychologists are involved. The majority of persons requesting help receive pharmaceutical treatments; psychotherapy and counseling are rare. The present authors discuss how recently psychology is rapidly emerging as a science/profession in Greece. Licensure now is required of most academic psychologists, who are expected to practice as well as teach and do research. Although all Greek psychologists must be trained abroad, this multicultural education provides opportunity for broader theoretical perspectives; however, this same multicultural orientation may also pose difficulties in establishing standards for practice. Current increasing demand for psychological services may result in needed support for training programs within Greece. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physician domination in the health care industry: The pursuit of antitrust redress.

Argues that the exclusion of qualified practitioners from the medical staffs of hospitals and the exclusion of psychological services from federal and commercial health care programs threaten the independent and autonomous practice of psychology in any national health insurance program. If psychological services are to be made available to consumers through such a program, psychologists must act now to preserve their status as independent professionals. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The cost-effective delivery of rehabilitation psychology services: The responsible utilization of paraprofessionals.

The new and rapidly changing health care environment necessitates innovation on the part of rehabilitation psychology to achieve cost-effectiveness. This innovation could take the form of rehabilitation psychologists' responsibly using bachelor's-level technicians, or paraprofessionals, in the delivery of clinical services. This article proposes a pyramid model of rehabilitation psychology service delivery using paraprofessionals and psychology trainees. Specific clinical activities appropriate for paraprofessionals are outlined. Controversies regarding use of bachelor's-level paraprofessionals and the inflationary process of over-credentialing doctoral-level psychologists are discussed. It is proposed that psychology interns and residents be cross-trained in allied health skills so that psychology trainees can provide clinical support to other health care disciplines, thereby improving the cost-effectiveness of, and preserving, hospital-based psychology training programs. The article emphasizes the need for doctoral-level rehabilitation psychologists to adopt administrative roles in medical settings in order to implement innovative service models. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology can be indispensable to health care reform and the patient-centered medical home.

The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March 2010, making health care reform a reality. Perhaps the most well-developed model of primary care that aligns with the PPACA's agenda is the patient-centered medical home (PCMH). Integrated care, as defined by collaborative care between mental health and primary care providers and systems, will undoubtedly play a critical role in the success of the PCMH. The role of psychology and integrated care in the PCMH as well as training implications for psychologists are discussed. This article is intended to challenge our discipline to embrace psychology as a health care profession that must prepare for and solidify its added value in the health care delivery models of the future. Requisite skill sets for primary care psychologists and existing training opportunities are presented. Finally, possible mechanisms for training psychologists in integrated care and the professional roles primary care psychologists can expect to fill are proposed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Professional associations' strategies for revitalizing professional psychology.

The professional associations of psychologists are working to revitalize professional psychology. In response to recent challenges, these associations have attempted to (a) remove barriers to quality services within the mental care health delivery system; (b) help psychologists become better integrated within the overall health care system, as opposed to being narrowly defined as mental health professionals; and (c) help more psychologists move into services outside of the health care delivery system. These 3 strategies are motivated by a vision of psychology as a broad problem-solving discipline that can contribute to human welfare in a varied range of domains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)