Education Leadership Conference
When Debbie Gomez first saw the 3-year-old boy, he was in bad shape. His drug-abusing parents had neglected and abused him so badly that child welfare workers finally placed him in the care of his great aunt and uncle. When the boy's pediatrician at the Community Clinic at St. Francis House noticed behavioral problems, he referred the family down the hall to Gomez, a clinical psychology doctoral student at the University of Arkansas.
In their first session together, Gomez taught the boy's great aunt and uncle how to effectively reinforce good behavior. In a second session, they addressed the boy's sleep problems. The results were dramatic. "The aunt had tears in her eyes, and said, ‘He looks like a completely different child,'" Gomez told participants at APA's Education Leadership Conference in September. "They were so much in love, they were actually going to adopt him."
For Gomez, that story illustrates how the Graduate Psychology Education (GPE) program helps bring psychological services to previously underserved populations. The GPE program — the only federal program specifically devoted to funding education and training for professional psychologists — is also designed to train psychology students to work in integrated health-care settings.
A GPE grant has allowed the University of Arkansas to expand didactic training to include sections on integrated care, diversity and program evaluation; provide opportunities for students to reach out to the community; create a weeklong immersion program in partnership with a medical school in Puerto Rico; and help students engage in advocacy at the state and national levels. The GPE program's capstone, however, is a 10-month practicum at the Community Clinic, said Ana J. Bridges, PhD, GPE program director and an assistant professor of psychological science at the University of Arkansas.
Working at this federally qualified health center gives students a chance to put into practice the GPE program's public health perspective, said Bridges.
"In traditional psychology, the emphasis is on effective treatment," she said. "The public health perspective is looking at impact, so effectiveness is one but not the only part of the equation." Taking into account how many people can access a treatment, how much it costs to deliver it and how long the effects last, a public health approach might mean choosing a less effective treatment that can be more broadly disseminated.
The outcomes have been impressive, Bridges said. For one, GPE trainees feel more competent to work in integrated settings, be culturally sensitive, consult effectively with medical providers and practice evidence-based care. Patients are also benefiting, Bridges said, citing research that found a marked reduction in distress among patients despite an average of just one-and-a-half visits per person.
"What I tell Congress and state representatives when I meet them is that we get 75 percent of the therapeutic effect of a 20-visit treatment in one-and-a-half visits," she said.
The GPE is also helping community health centers meet the challenges the Affordable Care Act will bring, said Kathy Grisham, the clinic's executive director. For instance, the GPE program helps prepare psychologists and others for the new emphasis on team-based care, said Grisham. Even more important, GPE will help the clinic and other federally qualified health centers meet expanded demand as the act increases access to care for more people.
"We have been able to gain very positive, measurable outcomes, which is what everybody is looking for today," said Grisham.
—Rebecca A. Clay