Academic journal article Journal of Mental Health Counseling

Behavioral Health Training Is Good Medicine for Counseling Trainees: Two Curricular Experiences in Interprofessional Collaboration

Academic journal article Journal of Mental Health Counseling

Behavioral Health Training Is Good Medicine for Counseling Trainees: Two Curricular Experiences in Interprofessional Collaboration

Article excerpt

Based on training efforts at two universities, this article explores considerations when mental health professionals (MHPs) are trained to work effectively in primary care settings. It first outlines the curriculum of an advanced doctoral level course in health psychology practice. To better refine the experiences of trainees, it then describes a qualitative pilot study of counseling psychology practicum students (N = 4) in a primary care setting. Six themes from the interviews and focus groups are identified: mental health culture, primary care context, challenging entry, adapting to the primary care context, managing complex cases, and results of the collaborative process. Finally, it provides recommendations for future training and research direction.

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The passage of the Patient Protection and Affordable Care Act (ACA; 2010) has reinforced the need for partnerships between medical and behavioral healthcare providers. The ACA requires establishment of Patient-Centered Medical Homes in which primary care (PC) providers serve as team captains and mental health providers (MHP) participate as team members (Beacham, Kinman, Harris, & Masters, 2012).

MHPs are necessary to address the psychological needs of PC patients (Strosahl, 1996). For example, 75% of depressed patients seek health care mainly for physical complaints (Uniitzer, Schoenbaum, Druss, & Katon, 2006). Integrating MHPs into PC settings holds promise for increasing access to mental health services for underserved populations, promoting healthy lifestyle changes, and increasing patient quality of life.

With relatively few training opportunities for MHPs to practice in the PC setting, acquiring the requisite skills is a challenge (Twilling, Sockel, & Sommers, 2000). For MHPs to work effectively in the PC setting requires a dedicated focus in their curriculum and training (McDaniel, Belar, Schroeder, Hargrove, & Freeman, 2002); Rozensky and Janicke (2012) have stressed the importance of incorporating interprofessional competencies into graduate curricula for MHPs. McDaniel et al. (2002) and Talen, Fraser, & Cauley (2005) offered guidance on PC training curriculum for MHPs.

This article focuses on two early components of student training in behavioral health psychology practice--coursework and practicum training--and describes an advanced doctoral-level course designed by one of the authors for a counseling psychology program, typically taken in a student's third year. The primary course objectives are to (a) prepare students to use psychological interventions in treating and managing medical illness; (b) clarify the role of the MHP on a multidisciplinary healthcare team; and (c) explore the ethical and multicultural issues that arise in health psychology practice.

The course has three components: a didactic portion, a shadowing experience, and a series of practice intervention assignments. The didactic portion discusses assigned textbook readings augmented by primary-source published papers. Several excellent textbooks give students a thorough exposure to issues typically encountered by MHPs in medical settings (e.g., Frank, McDaniel, Bray, & Heldring, 2004; Hunter, Goodie, Oordt, & Dobmeyer, 2009; Ruddy, Borresen, & Gunn, 2008). The topics covered in class are consistent with the 13 theoretical and practical topic areas suggested by McDaniel, Hargrove, Belar, Schroeder, and Freeman (2004), such as the biological, sociocultural, and cognitive/affective aspects of health and illness and exploration of the MHP role on the multidisciplinary team.

In the shadowing experience students spend time observing and interacting with an MHP working in a hospital-based PC practice. For example, they may observe sessions conducted by the MHP and a medical resident; the precepting (brief, on-the-spot supervision) process between medical residents and attending physicians accompanying medical visits, and consultation on patient issues from a psychological standpoint. …

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