Preparing psychologists for managed care settings: Enhancing internship training programs.

Do internship programs prepare new professionals for success in today's behavioral health care marketplace? Managed care has quickly affected internship training programs and has dramatically altered the delivery of mental health services. but training programs have been slow to adapt to these changes. For example, instruction in business concepts and training in clinical and professional issues unique to managed care are discernible deficiencies in contemporary internship training programs. This article presents strategies to remedy training deficits in order to produce psychologists who are capable of meeting current market demands. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From the ground up: Building a psychology of women internship track.

Where can a graduate student interested in a specialty track in the psychology of women apply for internship? Until recently, there was no American Psychological Association (APA)-approved internship site in the United States offering such an experience. In addition to the generalist training that typifies APA internships, the internship year also presents an opportunity for specialization. If internship sites are to produce psychologists well equipped to address women's unique mental health needs, then it is vital to create opportunities for trainees to specialize in the psychology of women while on internship. This article describes the development of a Psychology of Women Track as part of a predoctoral internship program, including the context of the track, the specific training experiences included in the track, and a conceptual model of psychology of women training that can be used at other internship sites. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Redesigning internship training programs: A cost-efficient point of view.

Decreased funding for mental health services and training may lead to an increase in unpaid psychology internship positions and a decrease in the total number of positions and sites. An alternative is to view psychology internship training from a cost-efficient point of view and redesign programs to make them financially self-supporting by varying stipend level, hours of direct service/week, and supervision ratio. Programs can emphasize different values of training by varying these parameters. This perspective could be applied to various training sites. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reenvisioning internship training in clinical and counseling psychology: Developments in the Department of Veterans Affairs system.

The Department of Veterans Affairs (VA) system has been a major source of funded, American Psychological Association-accredited psychology internships. The VA system has also been a leader in innovations in internship training. Currently, VA is in the process of redefining the system for allocating funds for psychology internship training, along with funding for all associated health professions. The history and process of that planning are reviewed in this article, along with the current status of plans for the reallocation process. The new system will specifically emphasize training in areas of high clinical priority for VA, particularly primary care, mental health, rehabilitation, and geriatric settings. The new system also will put major emphasis on training in interprofessional settings and training to work effectively as an interprofessional team member. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training in geropsychology: A survey of graduate and internship training programs.

Results of a survey of 76 doctoral training and 97 internship programs in clinical psychology approved by the American Psychological Association indicate that there is little in the way of formal training in geropsychology. Only one program offered it as a subspecialty; no internship programs offered it as a main area of specialization, in contrast with the number of programs that specialized in the mental health needs of children. Results document the growth of training in the psychology of aging on many campuses, but clinical programs remain largely uninvolved. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health and managed care: Training for the 21st century.

Discusses some of the difficulties future clinicians may encounter as they make the transition from graduate training to clinical work, and suggests that many traditional pre-doctoral psychology internships inadequately prepare trainees for the prospective practice of psychology in the era of managed mental health care. Graduate training programs need to integrate clinical work in a managed care setting during internship training utilizing the scientist-practitioner model to (1) more effectively prepare trainees for future work in managed care, (2) expand professional psychology's unique contributions to mental health treatment, and (3) apply the research methodology of psychology to evaluate clinical efficacy and treatment outcomes within the managed care environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cost effectiveness of clinical training in a community mental health center.

The future of professional psychology may well rest on psychology training programs successfully defending their existence in purely monetary terms. This article examines the effectiveness of the training program of an urban mental health center that includes an American Psychological Association-accredited psychology internship. The training program was found to produce net revenues for the facility and to meet the training needs of its participants. Variables related to producing a cost effective psychology training program are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hairdressers and helping: Influencing the behavior of informal caregivers.

Six 30–55 yr old hairdressers who participated in a 10-wk group mental health consultation and training program were compared with 7 control hairdressers on pre- and posttests of an inventory designed to assess helping strategies. Although on the pretest both groups heavily used the strategies of advice giving and presenting alternatives, only program participants showed an increase in the "reflection of feelings" on the posttest. The consultation program included goals such as (a) maximizing helping effectiveness through modeling and (b) education about referrals within the local mental health network. It is suggested that training in interpersonal help giving be offered to other groups of informal caregivers. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Implications of 'Psychological Injuries' for Clinical Psychology Training Programs.

This paper uses the psychological and legal concept of "psychological injury" as an illustration of the evolving market for psychological knowledge and of necessary changes in the graduate and internship training of clinical psychologists. Our current graduate and internship training fails many of our students through neglecting important areas of knowledge and experience. In this paper, I discuss the importance of exposing graduate students to: a) the economics of mental health; b) professional roles involving knowledge dissemination outside traditional academia; c) information needs of direct and indirect consumers of psychological knowledge; and, d) communication skills necessary when interacting with nonpsychologists. Suggestions are made for the improvement of our graduate training programs, including more explicit acknowledgement of the likely career paths of most of our graduates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health consultant to law enforcement: Secret Service development of a Mental Health Liaison Program

The Mental Health Liaison Program developed and used by the Secret Service is presented as a model for comprehensive, multidimensional interactions between law enforcement and mental health systems, with particular focus on assessing and preventing violent behavior. The structure of the program pairs consultants--psychologists and psychiatrists--with Secret Service field offices to provide (a) consultation regarding risk assessment and case management of individuals who threaten or display inappropriate interest in the President or other protectees; (b) training for agents on risk assessment, mental illness, and mental health care issues; and (c) liaison activities between the Secret Service and the mental health community. Practical benefits to the Secret Service are discussed to encourage more systematic use of broad based psychological and psychiatric consultation to law enforcement, with a goal of enhanced intersystem communication and collaboration. The need for program evaluation and outcome research is discussed in the context of applying the model to improve other mental health and law enforcement systems interactions.     

Training Psychology Interns in Primary Behavioral Health Care.

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Academic and Internship Directors' Perspectives on Practicum Experiences: Implications.

Academic and internship training directors (TDs) were surveyed regarding practicum training. The most frequently endorsed definition was that a variety of specific activities at a practicum site constituted a legitimate part of a practicum hour, including supervised clinical assessment, clinical intervention, and community consultation, advocacy, or training. Academic and internship TDs differed in their views regarding the minimum number of practicum hours necessary and whether the number of hours should be capped. Implications for points of agreement and disagreement are discussed, and applications of these data to future education and training initiatives are proposed. Suggestions for turning the focus toward competencies rather than hours obtained are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Geropsychology training in Canada: A survey of doctoral and internship programs.

The Canadian Psychological Association emphasises the importance of diversity training for doctoral and internship programs, and age is an important aspect of diversity. Yet, little is known about training capacity in clinical geropsychology in Canada. To address this issue, the authors surveyed directors of clinical training in all accredited clinical and counselling psychology doctoral and internship programs in Canada. Responses from 92% (n = 43) of these programs indicated that there are no doctoral programs in Canada with a formal concentration in geropsychology; however, 40% of internships offer a major rotation in geropsychology and a further 48% offer a minor rotation. Training activities are largely focused on the diagnosis and assessment of mental health problems, with relatively less attention to therapeutic interventions. Data are presented on the availability of geropsychology resources (e.g., faculty/clinical supervisors, courses, practicum, research opportunities) and the perceived need for geropsychology training. Recommendations for enhancing geropsychology training capacity in Canada are reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Crisis intervention training at a predoctoral internship in professional psychology.

Describes the model for crisis intervention at the internship level at a university counseling center. The program is organized around 3 components: orientation and didactic training in crisis intervention; crisis team membership in a local community mental health agency; and supervision of crisis intervention experiences. Data on the evaluation of the program are presented. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School psychologists as consultants: Issues in training, practice, and accountability.

From contemporary research and theory in mental health consultation, implications are drawn for the development of an indirect service role for school psychologists. Attention is given to the need for training school psychologists in consultation skills, to the obstacles encountered in the initiation of consultative relationships, and to methods for assessing efficiency and effectiveness of a variety of consultative activities. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health consultation in the pediatric intensive care unit.

The need for psychosocial intervention to be integrated with medical care on intensive care units is high, but too often mental health professionals are ill-equipped by traditional training programs for such work. Medical crisis counseling provides a conceptual framework useful in developing the skills needed to effectively intervene in such settings. The pediatric intensive care unit ( PICU ) is arguably one of the most emotionally demanding and high-stress areas where mental health clinicians may be asked to consult. This article describes medical crisis consultation in the PICU setting, suggests survival strategies for the mental health consultant to the PICU, and provides illustrative case examples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multiple functions for psychologists in community consultation.

"Psychologists are assuming a wider range of responsibilities in community program administration and community consultation: in mental health, corrections, education, and anti-poverty." A program for training consultants was developed in New Mexico during a 4-yr demonstration project. Selection criteria include: (1) sound graduate training including the PhD for psychologists, (2) substantial clinical skills in diagnosis and therapy, (3) experience in consultation and administration, and (4) experience in community work. A 2-mo., full-time orientation program was conducted for the consultants hired. The project stimulated development of various new resources in local communities including, among others, a day school for retarded children, a family casework agency, a day center for emotionally disturbed children, a training and consultation service to an orphanage, and an alcoholism treatment and rehabilitation program. (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)     

La consultation: Un r?le professionnel à mieux définir.

There are currently increasing requests for psychologists to provide “consultation” services to their peers, other professionals (ex., physicians, social workers, school teachers) or community services (ex., school, community agencies, mental health services, mass-medias). However, so far, there are few empirical works systematically aiming at defining the character of that professional activity and consultation may still be confused with the competency of intervention in the field of clinical psychology. This article aims at defining “consultation” as a specific professional activity, presenting the models of consultation and exploring clinical examples of consultation. Then, practical, ethical and training considerations related to “consultation” activities are discussed and some recommendations are provided, based on available literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consultation and training with school-based crisis teams.

Schools often bring outside mental health consultants to provide postcrisis counseling after a suicide or another tragedy. This article describes a different role for consultants who specialize in this type of work: training school personnel to provide this valuable service themselves. It is argued that training school-based personnel to provide postcrisis counseling results in greater value to a school system than does direct service provision by an outside consultant. The author's experience as mental health consultant to a large urban/suburban school district's crisis team is used to illustrate various training techniques that can be used and benefits that can be derived from this type of consultation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)