Degree In Sight

This time last year, Annette Herron and Donald Ranallo were in a dreaded place: They both were internshipless after Match Day.

What happened next should help this year's matchless students take heart. By summer's end, Herron and Ranallo both placed in an internship that fits their needs. Along with two other students, they landed neuropsychology and rehabilitation internships at the University of Missouri-Columbia through the Association of Psychology Postdoctoral and Internship Centers (APPIC) Clearinghouse, which links unmatched students with sites that still have slots to fill.

"After not matching I had pretty much given up on finding an internship," recalls Herron. "So when I saw the announcement of four internships in health psychology-my area-it was fortuitous."

The internship's director, George "Brick" Johnstone, PhD, had been hard at work getting the slots funded, since managed-care billing restrictions had stopped the program for three years. The slots' salvation came through the Bureau of Health Professions-administered Graduate Psychology Education (GPE) program, created by Congress and APA to train interns to work with underserved populations such as children and the elderly.

GPE granted Johnstone's internship program $462,567 over three years not only to prepare interns for work with the underserved, particularly in rural areas, but also to train more minority interns. The funding came at the right time for Herron, who's using it to hone her skills in geriatric testing, and for Ranallo, who's using it to learn how to improve rehab for patients with disabilities.


BETTER REHAB

The internship's rehab focus appealed to Ranallo because he'd himself undergone four months of rehab after a serious rodeo accident-he was steer-wrestling-more than 15 years ago.

The accident severely injured his spinal cord, and doctors expected him to be paralyzed from the neck down. But he regained use of his arms-and he gives much of the credit to the rehab staff.

"They were helpful and supportive at the same time that they pushed me to the limits of my ability," he says. "Their hard work early on helped me get more functioning back. And now I want to do the same for others in that position."

His internship work with patients with brain and spinal cord injuries and deficits at Missouri's Rusk Rehabilitation Center, he says, is enlightening him about the balance between motivation and reality.

"You want to keep treatment expectations for patients high and keep them motivated," he explains. "But the expectations and recommendations need to be appropriate. You don't want them so high the patient can't achieve success or so low that they won't push themselves enough."

Ranallo is also working to help patients and caregivers outfit their homes and mentally prepare for rehab patients' posthospital life.

"It's important to educate the patient and family not just on the injury itself, but on expected long-term care and outcomes," he says.


MORE ACCESS

Better caregiving is also important to another Missouri intern, Annette Herron. But Herron's major focus is a different underserved group: the elderly. She's opted to do her neuropsychology rotation with geriatric patients, especially those with Alzheimer's disease and other forms of cognitive decline. Like Ranallo, she's motivated by personal experience.

"I was raised by my grandmother, and throughout my years I've had a strong rapport with older people," she says. "So I've noticed that as much as this population has grown, it's been neglected as far as clinical services."

To help fill that gap, Herron is honing her skills in neuropsychological testing to link elderly patients with the services they need. And she's providing psychotherapy to support them and their caregivers.

Another underserved group targeted by the internship-rural residents-receives neuropsychological and rehab services through another rotation at the Missouri Rehabilitation Center. Located deep in rural southern Missouri, the center provides mostly inpatient rehab because patients drive such long distances to reach it. The staff caters to people who are underemployed and otherwise lack community support for their neurological disabilities-a rural focus that appealed to former intern Vicky Tsinnijinnie Lomay, PhD.

A Navajo who grew up on a reservation in northern Arizona, Lomay wants to bring neuropsychological services to other Native Americans scattered across the wide expanses of the state's reservations.

"They really need qualified professionals and people who understand their culture," says Lomay, currently completing a postdoc in clinical neuropsychology at the Phoenix Barrow Neurological Institute at St. Joseph's Hospital and Medical Center in Phoenix. "That's where I plan to help."

In director Johnstone's view, Lomay, Ranallo and Herron are proof positive that the internship is helping future psychologists meet the needs of the underserved.

"There's a definite need for rehabilitation and neuropsychology skills in rural areas and with minority populations, and our grants are enabling both those goals," he says.

In fact, GPE is funding another four slots at Missouri for both 2005-2006 and 2006-2007. The funding is already secured, so this and next year's interns won't have to wait until summer to land their perfect internship.