Public Health Service appoints psychologist to key fellowship

By Jamie Chamberlin
Monitor staff

The recognition of psychologists as primary-care providers was given a boost with the appointment of a psychologist to a prestigious public health fellowship.

Susan McDaniel, PhD, is the first psychologist to land a slot in an intensive three-week primary-care policy fellowship sponsored by the U.S. Public Health Service.

'It wasn?t long ago that the U.S. Public Health Service didn?t recognize psychology as one of the professions that was involved in prevention-oriented primary-care services,' says Russ Newman, PhD, APA?s executive director for practice.

Even many psychologists tend to think of themselves as mental health providers only, says Randy Phelps, PhD, assistant executive director of professional issues for practice, who has worked to get a psychologist accepted for the fellowship.

The U.S. Public Health Service selects health-care leaders who are strongly committed to primary care to serve as fellows in the program, which began in 1991. The purpose of the fellowship is to create a cadre of health professionals that are effective advocates for improving primary care.

McDaniel has worked in family medicine for more than 17 years. She speaks about family medicine and family therapy at meetings and conferences all over the world that are attended by both physical and mental health professionals. Her numerous publications in the areas of medical family psychology, family systems medicine and family therapy supervision garner national and international attention.

A growing number of psychologists are beginning to work as part of primary-care teams, devoting their careers to working in family medicine and educating physicians about the efficacy of psychological services.

APA has been working to get more psychologists involved in primary care for the past four years. In 1993, APA?s Practice Directorate launched an in-house group to explore the integration of psychological and physical health services. APA?s Committee for the Advancement of Professional Practice (CAPP) created APA?s Primary Care Task Force in July 1995, which focused on promoting the practice of psychology in a range of health settings, including primary care. The task force explored ways to educate primary-care providers about psychology and explore means to support psychologists who want to expand their role as health providers in primary-care settings.

A golden opportunity to move forward arose in 1995 when the U.S. Public Health Service invited APA for the first time to nominate a member for its 1996 primary-care policy fellowship.

APA?s nominations for two years were turned down, but the initial invitation got the ball rolling. APA?s Practice Directorate then identified McDaniel, a member of CAPP?s primary-care task force and a psychologist with an extensive background in family medicine, as an excellent candidate. APA strategically promoted McDaniel?s qualifications to the U.S. Public Health Service a year in advance. The effort paid off?McDaniel was selected for the 1998 group.

'We couldn?t have a better person participating in the fellowship given her experience, background and credentials in the primary-care area,' says Newman. 'We are able to start with our best foot forward when psychology comes to that fellowship program for the first time, knowing full well that folks didn?t see psychologists as professionals who were doing this kind of work.'

A perfect match

McDaniel has already started the fellowship, which is held in two segments?one week at the end of March and two weeks at the end of May and early June.

McDaniel is a professor of psychiatry and family medicine at the University of Rochester School of Medicine and Dentistry, and the director of the Division of Family Programs at the school?s department of psychiatry. She divides her time equally between educating physicians and working with psychologists and other mental health professionals interested or involved in primary care. She teaches physicians how to be sensitive to psychosocial issues, to assess patients for important behavioral or mental health problems, to refer and collaborate with psychologists, and to improve interaction with patients. She educates psychologists and mental health professionals about the skills and flexible thinking they need to collaborate effectively with physicians.

Her expertise also enables her to work with physicians world-wide. One of her books, 'Medical Family Therapy: A Biospsychosocial Approach to Families with Health Problems,' (Basic Books, 1992) is published in five languages and inspires international physicians and psychologists who read it to request McDaniel?s help with solving problems they face while trying to provide comprehensive health care. In May, she will return to Germany to help a group of physicians she has been working with understand the role of the psychologists they collaborate with. She will also travel to Romania to assist with a project she started there two years ago?helping the government develop a psychosocial curriculum for their medical schools.

Primary care is a huge growth area for psychologists, says McDaniel. She wants to help psychologists expand their thinking and become interested in joining the primary-care team. McDaniel says physicians are extremely receptive to having psychologists involved with primary care.

'Really good primary-care physicians understand they need to collaborate with psychologists and other mental health professionals to provide comprehensive care for many of their patients,' she says. 'There is a huge amount that we can give each other to support what can be very stressful work.'