Health Services and Health Care Economics: The Health Psychology Marketplace.

In an effort toward cost containment, the health care system in the United States has undergone radical changes in the last decade. These changes have influenced the delivery of clinical health psychology services. This article reviews several economic and marketing factors salient to the clinical health psychology marketplace. For example, these economic changes have placed greater emphasis on the need for cost-effectiveness and accountability in the health psychology field. Implications for education and training, collaboration with other health care specialties, new practice initiatives, and public relations are reviewed. Future challenges and opportunities for clinical health psychology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the Special Section on the Future of Health Psychology.

Following 25 years of landmark progress, health psychology faces even greater change in the foreseeable future. Evolving patterns of health and illness and developments in medicine and related fields will shape the future of health psychology. The articles in this special section discuss these future issues in several areas: the biopsychosocial model, changes in demographics, prevention, clinical health psychology interventions, health care financing, and new technologies. In every case, the future holds a variety of important challenges and opportunities in research, practice, training, and policy. (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)     

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)     

Psychology as a Health-Care Profession: Implications for training.

This article places a magnifying glass on psychology's current training realities in the context of global health developments, particularly those of the Canadian health-care system. The authors argue that curriculum review and revision is needed to solidify psychology as a true health care profession; such a review should be proactive and must consider the likely changes in our overall health-care system. In preparing for anticipated changes in health care, it is proposed that curricula modifications be made to better reflect how psychology can contribute (in a broad fashion) to the health of Canadians. Two particular models for psychology's future role are offered for discussion: a) a modified, comprehensive parallel/vertical model that sees psychologists similar to other health-care providers; versus, b) a more innovative horizontal/cross-cutting model in which psychologists provide a unique blend of education, innovation, teaching, system consultation, prevention, as well as direct service provision, to patients with physical and mental health problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meeting U.S. Health Care Needs: A Challenge to Psychology.

Is there really a growing need for primary care psychologists? U.S. population health statistics reveal a great deal of variability in the care Americans receive and in their associated health outcomes. Members of minority groups, the inner-city poor, and rural Americans bear a disproportionate burden of ill health. The decreasing pool of primary care physicians is documented as well as is the growing pool of nonphysician primary care providers. The need to expand the nature of psychological interventions in primary care is examined, and change in the training of professional psychologists is recommended. (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)     

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)     

Training Primary Care Psychologists: A Model for Predoctoral Programs.

This article focuses on blueprints for developing primary care psychology training in graduate psychology programs. The rationale and the foundations for establishing primary care psychology as a generalist model in clinical programs are identified. An outline of a core curriculum for multiprofessional training and an introductory knowledge base for primary care psychology is presented. Finally, a developmental model for primary care practicum training and supervision is described and exemplified. Funding issues, faculty development, and student evaluations of this training are discussed. This article represents the ever-evolving model and lessons learned through 10 years of experience in collaborative programs among Wright State University's School of Professional Psychology, the School of Medicine, the College of Nursing and Health, and a set of urban community health centers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practicing psychology in the era of managed care: Implications for practice and training.

Beginning with the HMO Act of 1973, managed care, a system for controlling health care costs, rapidly expanded and gained influence as the main vehicle for health care delivery in the United States. Implementation of managed care principles in the mental health arena has generated much debate, particularly with respect to issues of quality of care. The authors briefly trace the development of managed care and evaluate its impact on the practice of psychology. The extant literature is reviewed with specific attention to issues of quality of care, confidentiality of patient information, and shifting practice patterns of clinicians. Finally, the future of professional psychology within the context of managed care is examined, and the implications of newly created mental health roles for practitioners, training programs, and organized psychology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A training curriculum for professional psychologists in primary care.

Primary care psychology is a growing field that requires specific training opportunities for successful practice. The knowledge and skills that practitioners need for work in this setting are outlined here in detail. This curriculum integrates literature and experience in family psychology, health psychology, and pediatric psychology; considers multiple levels of education and training; and provides illustrative examples. It is a first attempt in an evolving process of integrating historical and cutting edge literature from many areas of psychology and other disciplines to contribute to comprehensive primary care psychology training. It can be used by programs and individual practitioners alike in designing education and training experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Rural Hawai'i Behavioral Health Program: Increasing access to primary care behavioral health for native Hawaiians in rural settings.

Health care access issues present significant challenges for rural populations and health providers. Psychology can support improved access and quality of rural health services through the development of integrated behavior health programs within primary care settings. This article reviews a clinical training and service delivery program, the Rural Hawai'i Behavioral Health Program, which has evolved in response to the pressing health needs of Native Hawaiians in rural communities. Native Hawaiian cultural factors and components of the primary care model that have supported the development of this program will be reviewed. Program expansion, sustainability, and treatment efficacy research will be discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Abstracts: Selected symposia/paper/poster presentations: APA annual convention.

Presents a collection of abstracts of selected symposia, papers and posters presented at the annual convention of the American Psychological Association (APA). These include symposia on rehabilitation psychologist training; culture and the rehabiltation process; the effects of physical trauma on distress and observer bias; geriatric rehabilitation; disability assessment; intervention of substance abuse after traumatic brain injury; and health care reform and pediatric rehabilitation. Paper sessions focused broadly on family issues in health and disability, and self and affect as correlates of disabling conditions; and, poster sessions addressed new directions in rehabilitation psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The future of psychology practice and science.

This article reviews the 2009 APA President's initiatives and recommendations for the future of psychology practice and science. The future of psychology practice requires that we expand the focus of traditional practice; become health care providers, not just mental health providers; use evidence-based practice, assessment, and outcome measures; incorporate technology into our practices, including electronic health records; and change training and focus to meet the needs of our diverse society. The future of psychological science requires that we train and work in multidisciplinary teams, employ different methods and approaches, and shift our focus to translational science. The future of our profession requires substantial changes in graduate education to prepare our students for science and practice in the 21st century. In light of advances in science and practice that reveal the critical importance of psychosocial and behavioral factors in health and disease, I call for the creation of a department of behavioral health within the federal government. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The integration of psychology into primary care: Personal perspectives and lessons learned.

The purpose of this article is to discuss the integration of psychology into a Veterans Affairs Medical Center Primary Care clinic, as experienced by the authors. There has been an evolving need for psychology's presence in primary care, due in part to the increasing number of primary care patients who present with complex physical and psychological issues, as well as institutional procedures for first-line treatment of more common mental health concerns (e.g., depression). Concurrent with the expansion of Medical Center services and patient population, an increasing demand has been placed upon psychology in primary care. To better accommodate the workload, a consultation-oriented model of treatment has been implemented. Within this integrated model, primary care providers and psychologists collaborate to provide multidisciplinary care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Veterans Administration psychology: Six decades of public service (1946-2006).

Psychologists in the Veterans Administration (VA), now the Department of Veterans Affairs, have contributed 60 years of public service to the treatment of our nation's veterans, enhanced by their involvement in clinical research supporting that care. From the development of new mental health care programs following World War II to their role in today's polytrauma centers caring for severely wounded veterans, VA psychologists have not only provided distinguished service to veterans but also provided insights for the entire profession in the care of veterans. This article highlights some of their contributions to practice and research as VA psychology and its training program celebrate their 60th anniversary. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Professional psychology training in the era of a thousand flowers: Dilemmas and challenges for the future.

As revealed in discussion at the 2009 Presidential Summit on the Future of Psychology Practice, professional psychology training today is involved in a series of choices for its future. This paper outlines some of those major dilemmas and while acknowledging the difficulties inherent in resolving some of these issues, proposes areas of common ground and a series of next steps, which emphasize the importance of research and assessment as identifying marks of the professional psychologist, the requirements for accountability and standards in training, the need to develop behavioral medicine and neuropsychology as the field increases its partnership with health care, the importance of collaboration with school psychologists and international psychologists, the need to emphasize public sector service, and the imperative to develop these goals in a thoughtful way with new technology. (PsycINFO Database Record (c) 2011 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)     

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)     

Challenges to Professional Psychology Education in the 21st Century: Response to Peterson.

Professional psychology education faces many critical challenges brought about by the major changes occurring in the health care arena. This article shows that professional schools and programs have a good record of responding to these challenges and of taking proactive steps sponding to prepare their graduates for new health care roles and delivery systems. Data on admissions to psychology doctoral training programs demonstrate little support for the toral concerns raised by Donald R. Peterson (2003, this issue) about the preparation of students for graduate training in professional programs. Although quality concerns are important to investigate, such examination best resides with portant the American Psychological Association's Committee on Accreditation, which has the promotion of quality and excellence in professional psychology education and training as its major goal and responsibility. (PsycINFO Database Record (c) 2010 APA, all rights reserved)