PCR003: A Qualitative Study of Strategies and Challenges in Training Behavioral Health Workforce for Integrated Primary Care
Kris (Pui Kwan) Ma, PhD; Maria Prado, MPH; Erin LePoire, BA, BS, MPH; Anna Ratzliff, MD, PhD; Kari Stephens, PhD
Abstract
Context: COVID-19 has underscored the need to accelerate behavioral health (BH) integration in primary care, where many patients seek mental health services. Expanding BH integration requires a strong and sustainable BH workforce trained to work in primary care. Psychology internship is a critical period of development when doctorate-level therapists receive supervised clinical experiences with integrated primary care. Objective: To explore the strategies and challenges of teaching psychology trainees to practice BH in primary care. Study Design: Qualitative study. Setting: Nine out of 11 psychology internship and postdoctoral fellowship programs across the Washington State that provide integrated primary care training were recruited. Response rate was 82%. Population studied: Twelve training leads and supervisors completed semi-structured interviews between December 2020 – March 2021. Outcome measures: Interviews focused on participant experiences with providing educational training and supervision to psychology trainees practicing integrated primary care. Data were analyzed using grounded theory approach. Results: Four strategies emerged – orient trainees with extensive onboarding to the culture, context, and function of primary care; provide a psychologically safe space for open dialogues that facilitate professional identity development; model the skills needed to collaborate with primary care teams; and create a structured environment for trainees to practice the skills. Training leads and supervisors also reported three challenges – strategies to address trainees’ difficulties with acculturating to the culture of primary care; loss of opportunities to shadow and interact with primary care providers due to telemedicine during COVID-19; and limitations of the traditional supervision structure to accommodate the unpredictable and urgent crises experienced by trainees in fast-paced primary care settings. Conclusion: Future recommendations include early exposure to primary care during psychology graduate training, a hybrid model of fixed and flexible supervision schedules, and intentional efforts to define and balance in-person and remote teaching for different types of training needs.
Jack Westfall
jwestfall@aafp.org 11/19/2021great poster. terrific research. consider submitting to the special issue on integrated behavioral health workforce. https://www.apa.org/pubs/journals/fsh/call-papers-innovations-behavioral-health-workforce