In 1990 the Pew Health Professions Commission was created by The Pew Charitable Trusts as a program to be administered by the University of California Center for Health Professions, University of California, San Francisco, for the purpose of assisting educational institutions and workforce policy makers in meeting the changing needs of the American health care system (see http://futurehealth.ucsf.edu/pewcomm.html).
One of the Commission's several publications to date was Critical Challenges: Revitalizing the Health Professions for the Twenty-First Century, published in December 1995 by the UCSF Center for the Health Professions. The report makes clear the need for more accessible, affordable, and accountable health care for American citizens through new integrated systems of primary, specialty, and hospital services. The report calls especially for major expansion of the nation's primary health care services in ambulatory and community settings. This mandate calls for different models of education and training in the health professions every bit as much as it does for a revision of health care service systems.
One year later in 1996, the National Academy Press published Primary Care: America's Health in a New Era, based on work of the Institute of Medicine Committee on the Future of Primary Care. Although the publication, edited by M.S. Donaldson, K.D. Yordy, K.N. Lohr, and N.A. Vanselow, is focused primarily on needs for change in the medical profession, it makes clear the importance of the behavioral and social sciences in the management of primary health care in family and community systems. The need for behavioral health care as an integral part of primary health care services was reinforced in FY 1997 by Congressional recommendation that the Secretary of Health and Human Services (DHHS) support the development of standards and models of education and training that prepare behavioral health professionals to work in managed care systems and interprofessional primary health care settings.
Such is the context for this report, supported by contract with the (DHHS) Substance Abuse and Mental Health Administration (SAMHSA) and the Health Resources and Services Administration (HRSA). Psychology as a health profession clearly has a vital role in primary health care services; but psychologists must be properly prepared for such roles through pre-service and in-service training. It is the purpose of this report to provide information and to serve as a stimulus for professional psychology training programs in their efforts to prepare doctoral students, interns or residents, or practicing psychologists engaged in continuing professional education for the challenges and opportunities afforded in primary health care systems. For additional information about Federal initiatives in primary care, including possible grants information for health services research or training, you might inquire of HRSA or SAMHSA.
A major component of this report is the bibliographical information. Any bibliography, of course, is out of date once published. Thus, journal articles or other substantial publications of the past year may not be included. It is possible also that some published work that should have been included was not. For those instances, the author and project working group apologize.
The same caveat applies to the section of this report that lists examples of professional training programs in psychology in which the role of psychologists in primary care settings is given major consideration. A case in point is the list of psychology training programs in Veterans Affairs Medical Centers. The VA has placed major emphasis on primary health care services over the past several years in refocusing its health services. Thus, more VA medical centers than those listed afford primary health care training opportunities for psychology interns and residents. The ones listed are simply for example and, as noted in the report, had self-identified with such training in the (1997-98) APPIC Directory. Thus, if you are a doctoral student seeking an internship or a faculty advisor for such a student, and primary health care training is part of what you want in your internship experience, do not depend entirely on the listings of internship programs cited by example in this report.
In keeping with the intent that this report facilitate discussion and other forms of exchange among the students and faculty of professional education and training programs in psychology, or among those already engaged in professional practice, please let us know if you have information additional to that provided in this report that could be helpful or perhaps have a program or know of one that should be added to the list cited by way of example in this report. In turn, we will try to maintain an update of such information for others through this cite. You may contact us by email at: APA Education Directorate.
To view the report in its entirety, click here to view the Adobe Acrobat form. (If your system does not already have Adobe reader installed, you can download a copy for free from the Adobe site at http://www.adobe.com/)From information received since the report has come out, an addendum to the list of Internship Programs found at the end of the report can be seen by clicking here.
