2011 Education Leadership Conference: Interdisciplinary and interprofessional teaching, research, and practice
The theme of the 10th Annual Education Leadership Conference (ELC)—Interdisciplinary and Interprofessional Teaching, Research, and Practice—is vital to psychology’s future, said Cynthia D. Belar, PhD, executive director of APA’s Education Directorate.
“It’s well accepted that no one discipline has the key to solving major societal problems,” said Belar. “Knowledge in multiple areas is going to need to be amassed, integrated, and applied to successfully address problems in such areas as health, education, the environment, and world peace.”
This year’s conference brought together almost 150 representatives of psychology education and training organizations, psychological membership groups, APA divisions, and APA governance groups. The event took place September 10–13, 2011, in Washington, DC.
Like previous ELCs, the event had three aims: to address issues of mutual concern to psychology education and training groups at all levels, promote a shared identity among psychology’s Educators, and influence public policy regarding education in psychology and psychology in education.
“You were selected by the organizations you represent as leaders of education and training in psychology,” said APA Board of Educational Affairs Chair Margaret E. Madden, PhD. “You also have a critical role in taking back to your organization any lessons learned.”
Belar kicked off the event with an overview of interdisciplinarity in research, practice, and teaching.
Interdisciplinarity, she explained, means integrating the information, perspectives, and tools of two or more disciplines to advance understanding or solve problems whose solutions are beyond the scope of a single discipline. In contrast, multidisciplinarity means different disciplines working independently to address different aspects of a complex problem.
Interdisciplinarity “is working together to create something different, not just a parallel process,” she said.
Interdisciplinary research has a long tradition in psychology, said Belar, noting that the Journal of Psychology: Interdisciplinary and Applied was launched in 1935. And that trend has continued. When Arizona State University’s psychology department asked faculty in 2009 and 2010 what other disciplines they collaborated with on academic or research endeavors, for instance, the answers included the natural sciences, health sciences, fine arts, African American studies, philosophy, and many more. “Psychology really is a hub science for interdisciplinary research,” Belar emphasized.
But interdisciplinary research has grown dramatically in all disciplines over the last few years. Take government funding, for example. The percentage of National Science Foundation (NSF) funding going to multiple investigators jumped from 12% in 1982 to 62% in 2010. The same trend is occurring in medical research, exemplified by the National Institutes of Health (NIH) Roadmap for Medical Research.
Psychology practice is also becoming increasingly interdisciplinary, or “interprofessional” as it’s more commonly called in this arena. Several influential Institute of Medicine reports concluded that improving safety and quality in health care requires drawing on research from aviation, human factors, and other fields and moving away from what Belar called a “lone ranger approach” to a team approach. Health care reform also emphasizes interprofessional practice. The health care law features an expansion of primary care and the development of patient-centered health homes, both of which require increased teamwork.
Training to prepare psychologists to work in such environments still lags behind, said Belar. One important exception is the Graduate Psychology Education (GPE) Program, which has interdisciplinary training at its core. An interdisciplinary focus is important at the undergraduate level, too. “Given psychology’s relevance, an introductory psychology course provides a great opportunity for interdisciplinary learning on campus,” said Belar.
Advancing Science and Challenges to Departments and to Graduate Training in Research
The conference’s first full day began with a look at the increasingly multidisciplinary nature of psychology research.
That trend brings with it “strong centrifugal forces” with the potential to pull psychology apart, warned Linda B. Smith, PhD, chair of the Department of Psychological and Brain Sciences at Indiana University in Bloomington. “We’re in a period of enormous change in our discipline,” she warned. “We ignore it at our own peril.”
Smith outlined the many signs of change. These days, she said, “just about everybody” is doing psychology research, including neurobiologists, computational linguists, experimental philosophers, physicists, even roboticists. “Breakout advances in our topics can come from anywhere,” she said. “The discoveries that advance knowledge will determine the future of psychology, whether or not they are made by a psychology PhD in a psychology department.”
Similarly, said Smith, the most important journals for psychology research are no longer Psychological Review and Psychological Science but the brand-new PloS ONE. The buzzwords used by granting agencies, such as NIH and NSF, also point to an increasingly interdisciplinary future. And more than two thirds of psychology job listings at Research 1 institutions now ask for expertise beyond behavioral experimental research, according to an analysis of the department’s job listserv.
All these changes mean psychology departments have to change, too. Smith offered her own department as a case study. In 2003, the department switched its name from “psychology” to "psychological and brain sciences” to symbolize a new commitment to both cognitive neuroscience and molecular and cellular neuroscience. To facilitate cross-area training and research, the department also reorganized itself to weaken the traditional area structure and make decision making departmentwide. As a result, individuals no longer work in a single area but across areas. In some cases, new hires actually have doctorates in fields other than psychology. And because this kind of work often involves expensive equipment as well as teamwork, the department is moving more toward shared facilities instead of individual labs.
This shift has brought with it serious challenges the department is still grappling with, Smith admitted. The department can’t abandon traditional training areas completely, for example, because that’s how many potential employers define jobs. Another challenge is how to give students a common core of knowledge. But, Smith concluded, the benefits outweigh the risks. There are two possible futures for psychology, she said. In one, psychology acts as a hub integrating various disciplines under one roof.
In the other, psychology gets broken apart and psychology departments no longer exist.
In the question-and-answer period that followed, a participant pointed to a key difference between physicians and psychologists. “Physicians never forget they’re physicians,” he said. “Psychologists often forget they’re psychologists.” Smith agreed. “Everyone knows what a physician is at core,” she said. “But people have lots of opinions about what it means to be a psychologist.”
Core Competencies for Interprofessional Practice
Next, Carol A. Aschenbrener, MD, executive vice president of the Association of American Medical Colleges (AAMC), described one effort to prepare the health care workforce for interprofessional collaborative care.
In 2009, AAMC and five other health care training associations representing nursing, pharmacy, osteopathic medicine, dentistry, and public health came together as the Interprofessional Education Collaborative. “We were all convinced that the care we dream of—accessible, safe, high quality, patient centered, and population focused—can’t be achieved by any one profession,” Aschenbrener explained. “It’s a team sport.”
The collaborative’s goals were to foster a common vision for team-based care, promote efforts to reform health care delivery and financing consonant with that vision, and contribute to the development of leaders and resources for interprofessional learning. The collaborative’s vision is that every medical, nursing, dental, pharmacy, and public health graduate be proficient in core competencies for interprofessional collaborative practice. An expert panel came up with four competency domains:
Values and ethics. The goal in this domain is to work with individuals from other professions to maintain a climate of mutual respect and shared values.
Roles and responsibilities. The goal is to understand your own role and those of other professions and then use that understanding to appropriately assess and address the health care needs of the patients and populations served.
Interprofessional communications. The goal is to communicate with patients, families, communities, and other health professionals in a responsive, responsible manner that supports the team approach not just for treating disease but for maintaining health.
Teams and teamwork. The goal is to apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan and deliver patient- and populationcentered care that’s safe, timely, efficient, effective, and equitable.
Noting that this will be “a culture shift for all the professions involved,” Aschenbrener emphasized that training in these domains must begin early in curricula before professional identities are formed. Interprofessional training also requires repetition and practice in clinically relevant situations, she added.
The collaborative is now working to widen its “circle of engagement” and complete other tasks in its action plan, including collaboration with APA. There’s also a new spinoff group called Interprofessional Partners in Action, an interprofessional public/private partnership comprising representatives from federal agencies, foundations, and the Interprofessional Education Collaborative plus key stakeholders from the education, practice, and policy worlds. Its mission is to ensure that new and current health professionals are proficient in the competencies needed for patient-centered interprofessional collaborative practice. The group will focus on sharing the competencies; preparing faculty to teach the competencies; identifying collaborative practice models that could serve as learning sites; and finding ways to assess individual, team, and program performance.
Update on the Science of Team Science
Bonnie Spring, PhD, professor of preventive medicine, psychology, and psychiatry at Northwestern University, then provided an overview of the evidence base behind team science.
In the social sciences, said Spring, the proportion of publications authored by teams rather than individuals has more than doubled over the last 50 years. What’s driving team science? “The volume of scientific knowledge has just increased so much it’s no longer really possible to be a Renaissance man,” said Spring. “If we’re going to solve complex problems like global warming, poverty, or cancer, we need to be able to integrate different specialized knowledge bases across areas and to collaborate with people from different specialties.” Spring shared several findings about how teams can function most effectively:
Team composition. The bigger the team—up to a point—the better, the research suggests. Successful teams also tend to have a higher proportion of experts versus newcomers. However,
diversity is essential. “The more you repeat your science with the same collaborators, the lower your impact,” said Spring.
Coordination. Collaboration between universities is increasing, Spring said, adding that publications arising from betweenschool collaborations—especially among the Tier 1 schools—have more of an impact than singleschool or solo-author publications. But the more universities involved in a collaboration, the literature shows, the fewer the publications, patents, and grant awards associated with it. Coordinating activities can mitigate that risk, however. These include a good organizing structure that divvies up responsibilities among groups, project management tools, student exchanges across labs, and in-person meetings.
Common language and constructs. Other disciplines have very different approaches to science, said Spring. “It’s not just words,” she said. “Our methodologies and assumptions about science are religious and tacit; we don’t necessarily know we have these beliefs.”
Institutional support. Cultural norms, funding, and institutional leadership must support team science, Spring said. Tenure and promotion committees in particular must understand that team science looks different than individual efforts.
Spring then described a suite of team science training modules she developed. Available at teamscience. net, these free online learning resources are convenient, interactive, and fun. In addition to a module providing an overview of the science of team science, there are three interactive modules on the team science research process in behavioral science, basic biomedical science, and clinical medical science. The modules are suitable for junior investigators trying to get their first grants, senior investigators developing large collaborative projects for the first time, and research development officers—the matchmakers many universities now use to bring scientists with different expertise together to pursue funding opportunities.
Interdisciplinary Learning in Science, Technology , Engineering, and Mathemat ics (STEM) Disciplines
The focus then shifted to interdisciplinary learning in undergraduate settings. Susan Elrod, PhD, executive director of Project Kaleidoscope at the Association of American Colleges and Universities (AACU), summarized recommendations from AACU’s 2011 report Leadership for Advancing Undergraduate Interdisciplinary Learning in STEM. The project brought together 28 campus teams to think more deeply about their interdisciplinary programs in STEM disciplines, said Elrod, suggesting that “STEM” be amended to “STEM-P” to incorporate psychology.
The report offers five key recommendations for creating successful interdisciplinary programs:
Articulate a shared vision and goals. “There’s more shared vision at the department level,” said Elrod. The higher up you go, survey results revealed, the less shared vision there is. Having institutionlevel conversations is key, said Elrod, because many of the barriers to long-term sustainability of interdisciplinary programs are institutional policies related to infrastructure, budgeting, and governance.
Think about assessment early on. Connect interdisciplinary learning goals with the program’s structure, content, and pedagogy, said Elrod. Sample learning goals include studying problems with multiple causes, finding similarities and differences between disciplines, and developing new insights as a result of considering two or more disciplines together. It’s also important to keep the focus on students as learners who come to the program with diverse backgrounds, Elrod added.
Build a critical mass of faculty. “Often interdisciplinary courses or programs are started by an individual or a couple of folks with common interdisciplinary interests,” said Elrod. That’s fine—until those individuals move on and the program dissolves. To ensure sustainability, bring many faculty, both current and new hires, into the program. Other factors that help maintain momentum include support from high-level leaders, resources, and incentives for faculty involvement.
Think about institutional infrastructure issues. “One of the reasons interdisciplinary programs don’t last a long time is that they run into institutional barriers,” said Elrod. One of the most common is the difficulty of getting interdisciplinary courses approved by administrators “who don’t know how to deal with proposals that come from five different programs,” she said. Making sure interdisciplinary programs have the same rights and accountability as other programs, getting interdisciplinary staff involved in budget and governance meetings, and creating ransparent financial policies can help.
Align interdisciplinary learning with the institution’s vision, mission, identity, and strategic plan. “Campuses where interdisciplinary learning was part of the campus strategic plan had no problems moving their programs forward,” said Elrod. Other campuses had to drop out of the initiative. Barriers they encountered included departmental teaching obligations, a risk-averse culture, a lack of resources, and a lack of incentives and rewards.
Interdisciplinary Teaching Practices: Opportunities and Challenges
Mary J.S. Roth, PhD, associate provost for academic operations at Lafayette College, then shared one Project Kaleidoscope participant’s experience launching an interdisciplinary program. Lafayette College is a 2,300-student liberal arts college with an emphasis on engineering. In 2008, it approved a strategic plan that included a call to create an interdisciplinary program in health and life science that could capitalize on Lafayette’s unique strengths.
The first step was mobilization, a process that began with building a team. Over 2 years, administrators and faculty from key disciplines came together to discuss the possibilities. Students participated via focus groups. To develop a common vocabulary, a “learning community” spent a few months reading and discussing How People Learn: Brain, Mind, Experience and School. The team also held a day-long retreat. The result was a mission statement for the new health and life sciences program.
Once the “what” was settled, said Roth, the next step was to focus on the “how.” The college took an inventory of faculty interests and held faculty conversations for 2 years, bringing together groups to talk about a given subject, such as food, in an interdisciplinary way. “When students start hearing someone from theater talk about food, they just light up,” said Roth. “It gave the community a lot of confidence that we could do this.” The college also looked at best practices at other schools.
The next step was implementation, a process that began by determining student learning outcomes and working backward. Lafayette has very strong departments, or silos, said Roth. “We want to respect those silos, because as a community we believe in the importance of disciplinespecific expertise for students,” she said. As a result, the program—which is a minor—encourages students to become experts in their disciplines while thinking about the connections between disciplines. A capstone course allows them to bring that interdisciplinary perspective to bear on a specific problem. Students come together at a one-day retreat to make presentations on their capstone experiences. Faculty then use a rubric to assess whether the students are achieving the learning outcomes.
The final step was institutionalization. Once the program was approved, it had a budget. And curriculum approval was not that difficult, said Roth. One of the biggest barriers was persuading new and existing faculty that participating in the program wouldn’t hurt their future promotion and tenure prospects. The solution was to develop memoranda of understanding that outline the expectations and responsibilities of all parties, including teaching loads, scholarship expectations, and the like.
Creating Collaborative Partnerships and Projects
Debra Rowe, PhD, president of the U.S. Partnership for Education for Sustainable Development, then shifted the conversation to environmental sustainability. Why is educating for sustainability such a high priority? Many people don’t know that today’s human population is already exceeding the planet’s carrying capacity, said Rowe, and that solutions exist that can reduce suffering and planetary degradation while building stronger economies. What’s needed is a rapid shift within education, from doing analyses to taking action. “We’ve gotten very good at graduating armchair pontificators; they get As in their classes but don’t know how to be effective change agents,” said Rowe. “Education to action is the key.”
Rowe then described a few efforts to do just that. One is the Higher Education Associations Sustainability Consortium, a network of associations committed to advancing sustainability within their constituencies and higher education itself. Another effort is the Disciplinary Associations Network for Sustainability, which Rowe founded and facilitates. This network, which includes APA, is working to infuse sustainability into curricula, promotion and tenure, accreditation, and professional identity. Take textbooks, for example. “We don’t have to add more pages in textbooks, just make them more relevant,” said Rowe. The network also works to inform legislators, policymakers, and the public.
Rowe invited participants to volunteer for several projects, including developing a common language for use in position papers or journal articles; gathering and disseminating resources on teaching sustainability; holding interdisciplinary, problem-based professional development workshops; developing public policy recommendations; sharing the message with faculty and students; and developing textbook content.
“You’re in a unique role,” Rowe told the audience. “You can change what’s going on in your classroom, your institution, and the national scene.”
Leading in the Era of Team Science and Collaboration
The day’s last presentation focused on how to overcome common pitfalls in collaborations. “Repeatedly attempting to work with people to resolve conflicts is not satisfying,” began NIH Ombudsman Howard Gadlin, PhD, citing the repetitive nature of those problems. “We began moving away from running a repair shop to thinking about steps to anticipate possible conflicts and reduce their likelihood or, if they do occur, providing collaborating scientists with tools for addressing the issues.”
Gadlin’s goal is not to resolve conflicts, he emphasizes. “Science depends on disagreement,” he explained. “The last thing scientists want to hear is that you’re going to take away what gives energy to their work.” Instead, he wants to help collaborators create an environment in which professional disagreement can flourish and personal conflict can be contained.
Several factors, including lack of trust, squabbles over sharing credit, and the like, can keep collaborators focused on interpersonal problems rather than on their their science, said L. Michelle Bennett, PhD, deputy scientific director of the National Heart, Lung, and Blood Institute at NIH. She and Gadlin offered several suggestions to collaboration leaders:
Recognize the stages of team development. To give collaborators a shared vocabulary, Bennett recommends a model of team development created in the 1960s and 70s. The first phase is forming, or bringing team members together. The next stage is storming. “This is when the big elbows come out,” said Bennett, explaining that team members are figuring out their roles and engaging in turf battles. Giving teams a word for the phenomenon helps them remember it’s a normal stage of development, said Bennett. The next stages are norming, when everyone starts settling in, and performing, when people are working together seamlessly. The final stages are adjourning, if the collaboration has fulfilled its objective, or transforming, if they want to tackle a new goal.
Develop a shared vision. Leaders must articulate a vision for the group as a whole, and participants must understand both the larger vision and their own role within it.
Set expectations. Good leaders establish clear expectations about authorship, research conduct, evaluation criteria, and other issues. “Doing so can provide a scaffold for building greater trust,” said Bennett.
Build trust. Although scientists are often reluctant to talk about trust, said Gadlin, lack of trust is one of the most common problems teams experience. A strong leader trusted by all participants can help others overcome their distrust. Shared experiences like weekly data meetings and “prenuptial” agreements for scientists are also helpful. “The time to talk about how to handle disagreement and conflict is when you’re getting along,” Gadlin emphasized.
Harness diversity. Diversity is an asset in collaborations, but it can also be a source of misunderstanding, said Gadlin. Examples include clinicians’ need for immediate action versus scientists’ need to avoid rushing to judgment. Even dress—suits and ties versus jeans and T-shirts—can be problematic.
Minimize risks. Collaboration can be risky, especially for junior investigators who have yet to make a mark on their own. Leaders should work to minimize the potential downsides, said Gadlin, and ensure that individual participants have ways to incorporate their own passions into the team’s work.
Conference participants spent their first afternoon together in small groups devoted to discussing specific topics and developing questions to explore with the larger group. Chaired by Margaret Madden, PhD, the next day’s interactive session focused on the following seven areas:
Training for Team Science
“We were very barrier-focused,” said APA staffer Gregory Greenwood, PhD, of his group’s discussion. The audience as a whole agreed that there are many barriers to training students in team science, with the faculty themselves as the primary obstacle. Some participants disagreed. Blaming faculty isn’t fair, said one participant, explaining that shifting to a team science orientation should be a multiyear process rather than something faculty are told they have to embrace by next semester. University culture and institutional barriers play a big part in faculty’s reluctance, another participant added. Tenure and promotion policies that don’t reward interdisciplinary work are one example. While administrators may say they support interdisciplinary work, the participant pointed out, “at the end of the day, it’s your individual widgets that are being assessed.” Such barriers can be overcome, said another participant. “When I accepted my job, I asked for my contract letter to state that the college valued interdisciplinary work and that publications in journals outside of psychology would count,” she said. “You can build little things in along the way.”
The discussion then shifted to barriers to encouraging and supporting new and junior investigators in team science research. Participants overwhelmingly agreed that the biggest barrier was that promotion and tenure committees don’t understand team science and don’t evaluate it fairly.
Training for Primary Care
Led by Nancy Ruddy, PhD, this group began by asking what differentiates integrated primary care psychology. The audience overwhelmingly chose the correct answer: Psychologists are involved with all patients seen by a clinic. “We have a long tradition of interdisciplinary work in psychology, but integrative primary care in psychology is going one notch further: being part of a team and having a behavioral health aspect as part of the care of every patient,” said Celiane Rey Casserly, PhD, of APA’s Board of Educational Affairs.
The group then discussed under what circumstances a psychologist should communicate with a primary care provider about their patient. The group agreed that psychologists should always communicate with primary care providers, with permission. “The most important thing to remember is that you have to follow the culture of medicine, not the culture of psychology,” said one participant, citing as an example the need to train students to create two-paragraph reports to physicians instead of 10-pagers. “They’re not going to change for us; we have to change to accommodate them.”
Interdisciplinary Research Careers
Led by APA President-Elect Suzanne Bennett Johnson, PhD, this group examined professional development issues for careers in interdisciplinary research. In the report-out session, APA Board member Susan Wilson, MS, asked the audience when concepts of interdisciplinary science should be introduced to students, and a large percentage of the audience thought elementary school was the right time. “This was kind of a trick question, because we were thinking these ideas should be introduced at all levels,” said Wilson. “But certainly we need to start early.” Interdisciplinary learning is already the norm in elementary school, one participant pointed out, citing as an example projects that incorporate what students are learning in history in their English classes. By middle school, however, that integration starts to disappear. By high school, classes are very focused on subject area.
The discussion then shifted to whom psychologists should be prepared to argue that psychology is a science. The audience agreed that other psychologists, other scientists, policymakers, and the general public all need to hear the message that psychology is indeed a science. Psychologists themselves often place themselves in a different category than other scientists, one participant said. “Even those in our group made a distinction between other scientists and psychologists,” the participant noted. “It shows the pervasive thinking in psychology that we’re somehow different and separate from other scientists.”
Policymakers often don’t recognize psychology’s contributions, because psychologists visiting Capitol Hill tend to identify themselves as neuroscientists, human factors specialists, and the like, another participant pointed out. “Physicians don’t do that,” he said. “They’re always physicians, whatever subspecialty they’re in.”
Academic Administration Issues
“How well do you think your department is doing in relation to implementing interdisciplinary perspectives into the curriculum and research activities?” asked Michael Roberts, PhD, of APA’s Board of Educational Affairs. For most of the audience, the answer was not too well. That minimal level of implementation is tied to such barriers as recalcitrant faculty and administrators, inadequate resources and time, and lack of interaction, said Roberts. Administrators are the most serious obstacle to implementing interdisciplinary science and training, most participants agreed; faculty colleagues are another obstacle.
Mary Roth, PhD, of Lafayette College asked the group what APA should do to facilitate interdisciplinary teaching. Recommendations included ramping up the public education initiative about the importance of psychology in everyday life to include psychology’s contributions to solving societal problems; creating a task force to identify how psychology contributes to solutions to societal problems, including through textbooks and other venues; creating professional development for educators to learn how to do interdisciplinary teaching, share other disciplines’ perspectives within an atmosphere of mutual respect, and learn how to weave together interdisciplinary perspectives to identify gaps and build better solutions to societal problems; and connecting with other disciplinary societies to share structures, strategies, and considerations regarding exploring and implementing interdisciplinary learning in a systemic way.
Debra Rowe, PhD, then asked whether participants knew about and used APA’s Principles for Quality Undergraduate Education in Psychology, which includes principles for interdisciplinary teaching. Many knew about the principles but hadn’t used them. Several admitted they didn’t know about the principles. A representative from APA’s Division 2 (Society for the Teaching of Psychology) was troubled by those findings. “It’s enlightening that 20% of us aren’t familiar with the quality principles for undergraduate education,” the participant said, calling for graduate-level educators to familiarize themselves with what’s happening at the undergraduate level.
Technology for Collaboration
Sue Frantz, MA, of Highline Community College offered an overview of tools that can facilitate collaboration. Dropbox, for example, is a cloud computing tool that allows users to create a virtual shared drive. Users can access files from any Internet connection, and any changes to saved documents automatically trigger updates that go to everyone who shares that file. Other useful services include a scheduling tool called Doodle, a tool called TitanPad that Frantz described as “like having a pad of paper out in a public space” that multiple people can work on simultaneously, and backchan.nl, a tool that lets audience members suggest questions during presentations. “I’d like to see backchann.nl used at psychology conferences,” said Frantz. “There are a bunch of people who have good ideas but don’t feel comfortable speaking up.”
Frantz asked the audience what technology-related issues they thought were most important to keep in mind in the context of interdisciplinary collaboration. The top two responses were technology’s impact on access to information and privacy and sensitivity to differences in access to and skill level with technology. Privacy concerns are especially relevant when it comes to medical records, the audience agreed.
Promoting Productive Disagreement While Containing Conflict in Teams
Frank C. Worrell, PhD, of APA’s Board of Educational Affairs asked the group how they thought APA could best facilitate the development of interpersonal and interdisciplinary work. Many participants called for APA to systematically review APA policies and procedures around publishing in APA journals, accreditation, and conference hours and change them to support interdisciplinary work and collaboration. Most APA journals require contributors to say whether the data they’re using have been used before, one participant pointed out, explaining that interdisciplinary teams typically use the same data for multiple projects. That rule puts interdisciplinary teams at a disadvantage, the person said, even when their projects are using the same data for completely different projects.
Making it easier for interdisciplinary teams to publish and present their work in APA venues would also make team science more acceptable at the departmental level, said another participant, noting that doing so would “make departments more able to defend new collaborations as being consistent with the norms of the field.”
Worrell then asked how universities and psychology programs can best promote collaborative and interdisciplinary work. Giving seed grants for interdisciplinary work related to promotion and tenure was the number-one response. Promotion and tenure committees often question candidates’ contributions to group projects, said one participant. Some faculty members even recommend that junior faculty wait until they’re tenured before joining teams. “That’s a huge impediment to team science,” she said. Worrell offered one solution: carving out individual projects for junior team members from a collaboration’s very beginning. “It’s part of the contract we establish with them,” he said, “so they’re protected in the process.”
Education Advocacy Awards Luncheon
The awards luncheon is a highlight of every ELC. The awards recognize psychologists who have worked hard to gain federal support for psychology education and training through their advocacy activities and support. This year, four individuals were honored for their outstanding efforts and were presented awards by BEA Chair Margaret Madden, PhD, and APA President Melba Vasquez, PhD, ABPP.
Education Advocacy APA Member-at-Large Distinguished Service Award
For the first time, two individuals received this award. The first award recognized Linda Campbell, PhD, of the APA Federal Education Advocacy Coordinator (FEDAC) grassroots network. Describing Campbell as a long-time supporter, Madden noted Campbell’s 15 years promoting education advocacy as a member of APA governance. “Still wanting to do all she can to get federal support, she most recently became a grassroots leader for FEDAC,” said Madden.
Madden presented the second award to Steve Pfeiffer, PhD, of the Association for the Advancement of Psychology/Psychologists for Legislative Action Now. “What you may not know is that he’s been instrumental in advancing the education advocacy agenda since its inception,” said Madden, calling Pfeiffer an ardent and tenacious supporter of advocacy. “Ever since the government relations office was established, he has consistently encouraged the psychology education and training community to actively support legislative initiatives and advocacy activities.”
Education Advocacy Grassroots Distinguished Service Award
Madden presented this award to Wendy Paszkiewicz, PsyD, who attended the meeting as a FEDAC representative. “Despite significant professional and personal demands, earlier this year she agreed to serve as a grassroots leader,” said Madden. “And even though she was a FEDEC freshman, she immediately began helping to expand the FEDEC network by recruiting new campus training representatives in her region and recruited so many, she won the recruiting challenge.” Accepting the award, Paszkiewicz acknowledged the assistance of Sharon Berry, PhD, her co-coordinator for the region.
Friends of Psychology Distinguished Service Award
The award recognizes the essential role that congressional staff members play in education advocacy. This year’s award went to Kate Mevis, a key aide to Sen. Jack Reed (D-RI). The award acknowledged her role in developing legislation to reauthorize and expand the Garrett Lee Smith Memorial Act, which includes most of the Campus Care and Counseling Act. “Congressional staff members are often unsung heroes, working long hours behind the scenes,” said Madden. “Kate Mevis exemplifies that tradition.”
Integration of Behavioral Health in Community Health Centers
The conference’s final plenary session focused on psychology’s role in community health centers.
Dennis Freeman, PhD, chief executive officer of Cherokee Health Systems in eastern Tennessee, kicked off the session with a look at how community mental health centers have changed over the last few decades. When he began his career in 1969, such centers were more than just a way to get psychological services to areas that had never seen a mental health professional before. "Community health centers were also a key training ground for psychologists in those days,” said Freeman, who described working in tandem with primary care doctors.
That’s no longer the case. As a result of policy changes, budget reductions, and other factors, said Freeman, those roles are fading. Fortunately, federally qualified health centers (FQHCs) are picking up the slack when it comes to providing behavioral health services to the underserved. But while 71% of FQHCs provide behavioral health services, only 112 out of 1,000-plus centers employ psychologists, and only 46 train psychologists. “For those of us interested in the future of the profession, ... we may be missing a rich opportunity if we don’t link with FQHCs,” said Freeman. “For those of us committed to the underserved, FQHCs seem to be the place to be for psychologists.”
Cherokee has taken advantage of that opportunity. While it began as a mental health center, it is now an FQHC as well and serves as what Freeman calls a “hybrid safety net organization.” Psychologists and other behavioral health consultants are full-time members of primary care teams, providing brief, targeted interventions to address behavioral health aspects of care. “And training future psychologists to serve underserved populations has always been a core part of our mission,” he said, citing a GPE-funded internship program and postdoctoral training as examples.
Gilbert Newman, PhD, director of clinical training at the Wright Institute, then described his efforts to train students in primary care psychology. These initiatives have an important dual function, he said. “We have an opportunity here not only to address the internship shortage but to really repopulate the public health system with psychologists,” he said.
But FQHCs aren’t well-informed about psychologists, Newman said. At one APA event, for example, the head of a large FQHC noted that he had 20 psychologists working for him. “He actually had one,” said Newman. “The rest were social workers.” Many psychologists working in primary care settings today had to learn “by the seat of their pants,” said Newman. “They feel they haven’t been trained sufficiently to do the work they’re doing.”
Convinced that training for primary care work should begin much earlier in psychologists’ careers, Newman launched a primary care training initiative in 2004. A grant from the GPE Program helped him expand the program, as did a state program that provides funding for mental health and services to the homeless. The training focuses on consultation skills rather than psychotherapy. Students must learn to quickly assess and provide brief interventions to help improve patients’ health, said Newman. Leadership and advocacy skills are also key parts of the training. “We have to really be able to show the added value of hiring psychologists,” said Newman.
Seiji Hayashi, MD, MPH, chief medical officer at the Bureau of Primary Health Care at the U.S. Health Resources and Services Administration (HRSA), ended the session by sharing the federal perspective. In what he called an “FQHC 101,” Hayashi explained that there are three kinds of FQHCs: those funded by HRSA, those not funded by HRSA, and those funded by the Indian Health Service. What they all have in common is enhanced reimbursement above and beyond regular Medicaid and Medicare reimbursement, he explained.
Including a psychologist in FQHCs—especially in small, rural clinics—can be challenging, said Hayashi. And there are factors that add to the difficulty, such as workforce issues and a rule that only one provider can be paid when a patient comes in for a primary care visit. But integrating behavioral health and primary care would be transformative, Hayashi emphasized, using the story of one of his own patients as an example. After 2 years, he and the patient still hadn’t managed to get her diabetes under control. One day it occurred to him to ask if she was hearing voices. It turned out she was. She was seeing a psychologist and psychiatrist at a community mental health clinic. While Hayashi hadn’t known about them, they hadn’t known about him either or the many medications he was prescribing for the woman’s diabetes, hypertension, and hepatitis C. “It was an ‘Aha!’ moment,” said Hayashi.
On the conference’s final day, participants headed to Capitol Hill to visit their congressional representatives and advocate for psychology’s educational priorities. Participants made more than 178 visits to the offices of their members of Congress to advocate for the GPE Program, and they all returned feeling energized by their experience—especially the many first-timers who expressed feeling empowered by their training and Hill visit and enthusiastic about continuing to actively participate in advocacy for their profession.