Speaking of Education

The 2009 Presidential Summit on the Future of Psychology Practice highlighted numerous opportunities to apply psychological science and serve societal needs (see "A new day for practice"). But the summit's special focus on psychology's role in our nation's health system and the health-care reform process was particularly noteworthy. Throughout the weekend, summit speakers and participants repeatedly underscored the importance of psychology's involvement in integrated care, including primary care.

That was particularly rewarding for me, as it became clear that the practices many psychologists have devoted their careers to developing are now being recognized as mainstream by organized psychology. Indeed, it has been through the integration of science and practice in many academic health centers that the knowledge base that has fostered this expansion of practice has developed over the years. Summit participants also underscored the importance of our education and training systems to be relevant to 21st century health care and our commitment to lifelong learning if we are to maximize our potential for contribution.

It was over 30 years ago that I first addressed what is transportable from traditional clinical psychology training—what needs to be added and what needs to be subtracted in order to prepare psychologists for broader roles in health (Professional Psychology, 1980). Later, after I gained considerable experience in developing integrated care services and related training programs, I wrote about implications for graduate education and training (Professional Psychology, 1989) and challenges for psychology in collaborative models (Professional Psychology, 1995). Many of the issues raised then are as relevant today—and I was certainly not alone in raising them. In fact more than 10 years ago APA published the report "Interprofessional Health Care Services in Primary Care Settings: Implications for the Education and Training of Psychologists".

We currently have multiple examples of psychology education and training in integrated care, including primary care, at the doctoral, internship and postdoctoral levels. Some have been made possible through funding by the Graduate Psychology Education program in the Bureau of Health Professions—a program APA initiated in 2002 to support interdisciplinary training of health service psychologists. But we do not have enough of these programs to meet national needs. Nor do we have a sufficient number of practicing psychologists in community health centers to help create the needed training opportunities in those settings. Just as psychology's involvement in academic health centers is integral to our future in health research and practice (see Monitor, Academic health centers: preparing our health work force), psychology's full participation in community health centers is integral to our role in this nation's developing primary-care system.

These issues are ones of at the core of psychology's identity as a health discipline and profession. We've been through a period where some programs have perhaps focused more on the training of psychotherapists than on the education and training of broad-based expertise in cognition, emotion and behavior in their sociocultural context. The risk here is that those programs will produce technicians who may be quickly outdated. One point I have consistently made is that psychology is a discipline known for "giving away" techniques that it has developed, which is a problem only if our marketing is premature or if we cease to develop these techniques. Psychology education and training have distinctive features that include the measurement of behavior and research skills. I still believe our future in health care is very dependent upon our skills in program development, evaluation of services and quality improvement efforts.

Now it's time to revisit our education and training to make sure it includes core scientific psychology, its application to health and the attention to advocacy that will ensure psychology's role in the nation's health-care system. I look forward to our upcoming Education Leadership Conference on Preparing Tomorrow's Health Workforce.

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