This guide identifies strategies for adding HIV/AIDS materials to psychology graduate courses, seminars, or training experiences. It also includes a section on experiential and didactic methods for classroom use with students.
Relevance of HIV/AIDS Information of Fields of Study
Barriers Including HIV/AIDS
Developing New Courses on Seminars
Adding HIV/AIDS to Existing Courses
Student Practicums and Internships
Continuing Education and Brief Training Workshops
Distance Learning
Suggested Reading and References
Experimental and Didactic Methods in Teaching HIV/AIDS– by Paula Britton
Relevance of HIV/AIDS to Specialties within the Discipline of Psychology
The HIV/AIDS epidemic raises issues that are relevant to many fields of study within psychology. Perhaps the most obvious disciplines within the field of psychology that should include information on HIV/AIDS in graduate training are health psychology and behavioral medicine. Community psychologists and social psychologists became increasingly involved in HIV/AIDS as the Centers for Disease Control and Prevention (CDC) and health workers in affected communities focused on prevention. The search for behavioral interventions that work became an imperative for the fields of public health and mental health. The AIDS epidemic also prompted health agencies to increase funding for the study of behavioral interventions. Since psychologists have long focused on behavioral research, the demand for their expertise in applying behavioral research to solving community problems increased as the AIDS epidemic progressed. However, since the field of prevention research is still in its nascent stages, new research is needed to refine and test theories of behavior change, and to develop primary and secondary prevention strategies and behavioral interventions. Psychology departments in universities must prepare graduate students to continue this work as they enter the profession.
Training in HIVAIDS is important to many fields of psychology. Because HIV disease has profound psychological impacts on persons living with HIV as well as their families and communities, clinical and counseling psychologists as well as neuropsychologists need to include the treatment for HIV/AIDS in graduate training courses. Similarly, developmental psychologists need to include HIV/AIDS issues in courses since vertical transmission from mother to child has an impact on families and since parents who have HIV or AIDS has an impact on children. Young people who contract HIV disease are forced to handle developmental issues out of sequence of the usual developmental stages of youth. For example, young people with AIDS confront social stigma, their own deaths, social isolation, and the unpredictable clinical course of the disease. Children who have parents with AIDS not only confront chronic illness and death but the issue of who will care for them when their parents die. Community-based programs that provide a range of services to persons living with HIV or AIDS need the input of prevention specialists in community psychology and health psychologists as well as the input of clinicians.
As the epidemic has broadened over the past two decades there has been some recognition among psychologists that more trained mental health workers and researchers are needed (Britton, 1998; Hunt, 1996; Hoffman, 1991; Diaz & Kelly, 1991; Campos et al., 1989). In a 1989 survey of APA approved graduate programs in psychology, only 19% offered courses on HIV and AIDS (Campos et al., 1989). Diaz and Kelly, using the same survey instrument developed by Campos, found that only 14% of master’s of social work training programs were offering courses on HIV/AIDS, although 63% offered at least a colloquium or part of a course on the subject. Hunt (1996) found that of 64 CACREP-approved counselor education graduate programs, 51% offered at least a colloquium on basic information about HIV/AIDS. The APA completed a survey in 1997 to identify graduate teaching faculty who offer HIV-related courses. The chairpersons of psychology departments in each college and university in the United States were contacted and asked to name faculty who were teaching courses on AIDS or courses with HIV/AIDS related content. Of the faculty identified, one-third returned questionnaires identifying their courses. Even though the sample was incomplete, the information provides information about the type of courses being taught across specialty areas within psychology.
Of 152 courses identified by survey respondents, only 22 had a primary focus on HIV/AIDS. Over half the courses were training courses in psychotherapy and counseling. Other disciplines within psychology were under-represented. There were only three courses that featured a general overview of HIV/AIDS issues, five with a prevention or behavioral change focus, one with a developmental focus, one with a multicultural focus, and one with a lesbian and gay focus.
In the other 130 courses, HIV/AIDS material was included but was not the primary focus of the course. The courses fell within 15 specialties. Only in five disciplines were more than 10 courses reported to include HIV/AIDS material. The types of courses in which HIV/AIDS materials were most often included were clinical or counseling psychology (25); health psychology and behavioral medicine (22); social psychology and behavior change (12); and, human sexuality (12). In the other areas of psychology reporting some courses, HIV/AIDS was included in 1-7 courses.
The small number of courses related to an epidemic that has had such an impact on our society suggests a need for wider distribution of courses in specialties already represented as well as the development of courses in fields with little or no representation if psychology is to train graduates who are prepared to pursue research and practice to meet the demand for HIV prevention and treatment in the future.
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Barriers to Including HIV/AIDS
This Guide is intended to assist you, as graduate teaching faculty in psychology to overcome barriers to developing courses on HIV and to provide suggestions and resource material that will make the task easier. If you already are teaching courses in HIV/AIDS, you may simply be interested in continually updating your curriculum materials as the epidemic keeps changing and becoming aware of new literature appearing in AIDS-related journals. Each section of this Guide lists a number of resources that can help to keep you up to date as well as save you time in course planning. We also direct you to other resources that can help you update your curricula (See Section 5).
For faculty who are not yet offering HIV-related courses, one barrier to adding new courses is the length of time that it takes for new course offerings to be approved by departmental curriculum committees. Generally, psychology departments plan their course listings several years in advance. Courses are selected that the faculty and accrediting organizations deemed to impart the core information in the field that graduate students should master prior to obtaining a degree. Many departments, however, have topics courses or seminars with general department numbers that can accommodate experimental offerings as electives.
If a new course devoted to HIV/AIDS cannot be added to the existing curriculum due to competing courses, then building HIV/AIDS materials into existing courses is a solution. Many of the current courses in counseling and psychotherapy have added special topics on counseling persons living with HIV and their families. A third alternative, if your own existing courses already cover too many issues, is to use HIV-related case studies or examples that illustrate course content. For example, behavioral medicine courses may include case studies related to HIV.
Faculty members lack of training in HIV/AIDS can be a barrier to offering courses. In their 1989 survey, Campos and his colleagues found that only 5% of clinical and counseling psychology graduate program faculty reported providing clinical services and only 2% were conducting research related to AIDS. It is understandable that without specialized training themselves, faculty would be reluctant to offer training to students. To overcome this barrier, psychology departments can support faculty training and collaborative arrangements with practitioners and researchers in related disciplines who can assist in the training of students. Continuing education programs for faculty, collaborative work with community-based HIV services agencies and local and state health and mental health agencies can provide opportunities for faculty as well as students to improve their competency in HIV prevention, treatment, and research.
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Developing New Courses or Seminars
If you have the opportunity to develop a new course on HIV and AIDS, a number of resources exist to assist in your planning. An increasing number of textbooks have been published that provide broad overviews of HIV-related topics or that focus on clinical treatment issues. (See Section 5). Other articles offer suggestions and techniques for incorporating AIDS-related materials into existing courses. Paula Britton’s article on techniques for teaching HIV counseling provides a brief overview of such articles (Britton, P. J. et al., 1998). Werth and Carney’s 1994 article (Werth, J., & Carney, J., 1994) offered suggestions for incorporating HIV-related issues into the training of graduate students. Internet web sites also can provide a wealth of information for course planning. Government agencies information on web sites includes consensus reports, statistics on HIV/AIDS and references to documents as well as related sites. For literature reviews, the National Library of Medicine references and databases now can be accessed on-line.
In addition to staying up to date by reading professional journals, one of the best ways to stay up to date on issues in the field of HIV/AIDS is to participate in listservs in which information and discussion is an ongoing occurrence. Whether you are a frequent contributor or a listserv "lurker" who is just listening and learning, the discussions keep you abreast of current debates in the field and can provide answers to specific questions you may have as you develop your course. Colleagues at another universities will probably readily share reading lists and curricula that would serve you well and save you time. The sharing of case examples and reviews of new books can also help you build your files and add to your library collections more rapidly.
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Adding HIV/AIDS to Existing Courses
You can find many opportunities to add HIV materials to existing courses. Case studies based on HIV treatment or research can be developed as applied examples of principles being taught in various psychology courses. For instance, in courses that teach principles of behavior and behavior change, you can include examples of behavioral interventions that have been tried in the field of HIV prevention.
In applied courses in clinical or community psychology you can use actual case examples for training students. For instance, in a clinical psychology training course, you can include a profile of a patient with HIV disease as a counseling case for students to work up. For community psychology courses, analysis of a metropolitan area’s Ryan White Title I Emergency Services plan or a state’s Ryan White Title II HIV Services request to the Health Resources and Services Agency (HRSA) or an HIV Community Prevention Planning proposal to the CDC gives students the opportunity to understand how community-wide planning works. You can request copies of plans that have already been implemented from state or city health departments.
The Teaching Tips Sheets in Section 3 are intended to illustrate how HIV/AIDS has added to theory development and applications in various psychology specialty areas. Psychologists have contributed brief summaries and examples from the literature of the relevance of HIV/AIDS material to various topics taught in different types of courses. Each Teaching Tip Sheet also includes strategies for involving students in discussion of HIV and AIDS.
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Student Practicums and Internships
Faculty advisors can assist students in taking advantage of a wide range of opportunities for completing practicums or internships that will give them either a broad overview of HIV/AIDS issues or a focused, in-depth training experience. In every community, state and local health departments, mental health agencies, drug abuse clinics, planning commissions, community-based organizations (CBOs), housing agencies, home care agencies, hospices, and treatment facilities are potential sites for student training.
Students may complete a required or voluntary practicum experience by assisting a community-wide planning committee in its development of a state or local HIV prevention plan or HIV services plan. Clinical students may work in out-patient or in-patient settings learning to counsel patients and families who are coping with HIV and AIDS.
As most faculty already know, arranging placements requires that you develop one or more contacts with persons within the agency and that a training plan for each student be developed, tailored to the student’s training goals, the agency’s needs, the supervisory requirements, and the length of time of the practicum.
For clinical students who must complete a formal internship, a variety of nationwide placements exist. The Association of Psychology Postdoctoral and Internship Centers? (APPIC) Guide to Internship and Postdoctoral Programs in Professional Psychology (Hall, et al., 1997) includes placements in which students will have opportunities for clinical work with patients who are HIV positive. Other students may work at the National Institute of Mental Health (NIMH), the CDC, or other agencies within Department of Health and Human Services (DHHS) to complete training experiences.
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Continuing Education and Brief Training Workshops
Graduate teaching faculty may want to consider offering opportunities for specialized training on specific HIV-related topics through continuing education seminars, grand rounds at academic medical centers and brief, intensive training workshops. Such intensive training experiences may allow greater flexibility to target training to the latest developments in research. Such short courses can be offered to graduate students, alumnae, and practitioners.
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Distance Learning
Distance learning courses are increasing in number and variety throughout the United States. These types of courses not only offer faculty opportunities to update their own training and meet continuing education (CE) requirements but can serve as opportunities for graduate students to participate in learning opportunities that may not be offered at their own universities. Often, the CE office at a university oversees such offerings and can assist faculty in preparing courses.
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Suggested Reading and References
Anderson, J., Campos, P., & Hamid, G. (1998). A Survey of Graduate Faculty Teaching HIV/AIDS Courses. Washington, DC: American Psychological Association.
Britton, P. J., Cimini, K. T., & Rak, C. F. (1999). Techniques for Teaching HIV Counseling. Journal of Counseling and Development.
Campos, P. E., Brasfield, T. L., & Kelly, J. A. (1989). Psychology Training Related to AIDS: Survey of Doctoral Graduate Programs and Predoctoral Internship Programs. Professional Psychology: Research and Practice, 20 (4), 214-220.
Crawford, I., Humfleet, G., Ribordy, S.C., Chu Ho , F., & Vickers, V.L. (1991). Stigmatization of AIDS patients by Mental Health Professionals, Professional Psychology - Research and Practice 22(5), 357-361.
Diaz, Y. E., & Kelly, J. A. (1991). AIDS-related training in U.S. schools of social work. Social Work, 36, 38-42.
Hall, R. G., Cantrell, P. J., & Boggs, K. R. (1997). Internship and Postdoctoral Programs in Professional Psychology, 26th Ed., 1997-1998, Washington, DC: Association of Psychology Postdoctoral and Internship Centers (APPIC).
Hoffman, M. A. (1991). Training mental health counselors for the AIDS crisis. Journal of Mental Health Counseling, 13(2), 264-269.
Hunt, B. (1996). HIV/AIDS Training in CACREP-Approved Counselor Education Programs. Journal of Counseling & Development, 74 (3), 295-299.
Robiner, Parker, Ohnsorg, & Strike (1993). HIV/AIDS Training and Continuing Education. Professional Psychology, Research and Practice, 24 (1), 35-42.
Werth, J. L., & Carney, J. (1994). Incorporating HIV-related issues into graduate student training. Professional Psychology: Research and Practice, 25 (4), 458-465.
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