Education Leadership Conference
The Standing Rock psychology internship program in Fort Yates, N.D., isn't your ordinary training opportunity. For one thing, interns are required to participate in community development projects alongside the Native Americans they serve. For one recent intern, that meant helping to establish a women's "talking circle," a kind of Native American support group.
Innovations like that one are were made possible by the Graduate Psychology Education (GPE) initiative, a U.S. Health Resources and Services Administration initiative that's the only federal program dedicated exclusively to psychology education. The program was the focus of a session during APA's 2009 Education Leadership Conference.
APA has been a strong advocate for GPE since its founding in 2002. GPE-funded internships, doctoral programs and postdocs emphasize interdisciplinary training and service to underserved populations. This year's $2 million appropriation funds 18 grants.
The Standing Rock program has its roots in a training model that training director Tami DeCoteau, PhD, of the Indian Health Service developed with GPE funding in South Dakota in 2003. The goals are to increase the psychology work force in rural and reservation communities, improve Native Americans' access to mental health care and prepare trainees for culturally sensitive practice, said DeCoteau.
To achieve those goals, interns not only participate in a community development project. They also learn about the unique issues involved in working on a reservation. Jurisdictional issues, for example, can be tricky, since tribal, county, state and off-reservation providers may all be involved in patients' care.
"Since the program began in 2008, we've been able to increase our patient load almost threefold," said DeCoteau. "With the assistance of our interns, we've been able to serve five outreach communities within the 2.3 million acres of reservation land." That expanded service is especially important given the reservation's suicide rate—three times the national average.
GPE funding is also improving access to care and training in urban areas. A program run by Gilbert Newman, PhD, of the Wright Institute in Berkeley, Calif., for example, trains students on "key problem triage": In each patient encounter, students run through 14 questions to identify the most significant or most treatable problem. Each question leads users to an additional set of questions students can use to gain a deeper understanding of the problem.
The training program is also developing an innovative online pedagogical tool that allows students and faculty to post information on mental health disorders, then download it to a handheld device as an immediate reference in health psychology settings.
In Philadelphia, the GPE program at The Children's Hospital of Philadelphia addresses the health-care needs of urban children, says Paul Robins, PhD, director of pediatric psychology and co-director of the psychology internship program. Interns move through different rotations, gaining experience in such areas as adolescent HIV, primary care, attention-deficit hyperactivity disorder, developmental delays among children in the child welfare system and aggressive behavior among elementary school girls. Thanks to GPE funding, said Robins, the program has served 300 children a year who would otherwise not have received services.
Barbara Cubic, PhD, an associate professor of psychiatry and behavioral sciences and family and community medicine at Eastern Virginia Medical School, described a GPE-funded initiative that jointly trains clinical psychology interns and family medicine residents. This program prepares students to work in health-care settings that integrate psychological and physical care. The fast pace takes some getting used to, said Cubic. "They have to learn to do in 15 minutes what they used to do in an hour."
The session also included an overview of activities within HRSA's Bureau of Health Professions.
Ronald H. Rozensky, PhD, professor and associate dean for international programs in the University of Florida's College of Public Health and Health Professions, described his role as chair of the Advisory Committee on Interdisciplinary Community-based Linkages in HRSA's Bureau of Health Professions. The committee, which provides advice to Congress on health-care work force-related issues, will focus next year on preparing an interprofessional work force to address health behaviors.
Rozensky and other leaders from all four of the bureau's advisory committees sent a joint letter to Congress emphasizing the need for interprofessional team care. One specific suggestion was to open the Graduate Medical Education program to professions in addition to physicians.
"That would restructure funding streams to eliminate barriers to training all health-care professionals—medical, nursing and all other health personnel—together," said Rozensky.
"It's extraordinary that we have a psychologist on the committee, let alone the chair of the committee," said Nina G. Levitt, EdD, associate executive director for government relations in APA's Education Directorate. "And to have the four advisory committees come together on any one issue and write a joint letter has never happened in history."
Rebecca A. Clay is a writer in Washington, D.C.
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