Training Psychologists in Integrated Primary Care and Child Maltreatment: Trainee and Supervisor Perspectives on Lessons
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Training Psychologists in Integrated Primary Care and Child Maltreatment: Trainee and Supervisor Perspectives on Lessons Learned Elizabeth A. Miller1 · Puanani J. Hee2 · Barbara L. Bonner3 · Amanda S. Cherry4
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Psychologists are key team members in the delivery of integrated behavioral healthcare. Healthcare reform has supported a shift toward a team-based, interdisciplinary model of service delivery, with increasing emphasis on primary care services, prevention, and health promotion. In conjunction with this shift has been a greater focus on psychosocial problems and social determinants of health, particularly childhood adversity. Psychologists in primary care are uniquely positioned to advance efforts to prevent and ameliorate childhood adversity, which are essential to improving care for underserved populations and reducing health disparities. Targeted training efforts are needed to increase the number of psychologists equipped to work in primary care settings with underserved populations. This paper provides an overview of a training program designed to provide psychology trainees with specialized training in both integrated primary care and child maltreatment. The overarching goal of the program is to provide trainees with the skillset to work within integrated primary care settings and the expertise needed to further efforts to address and prevent child maltreatment, as well as childhood adversity more broadly, to improve outcomes for underserved populations. The paper reviews strengths, challenges, and lessons learned from this program. Keywords Integrated primary care · Training and education · Child maltreatment · Primary care psychology
Introduction Behavioral health concerns, such as depression and anxiety, disruptive behavior, traumatic stress, and substance use, are quite common in both pediatric and adult populations, with lifetime rates approaching 50% (Kessler et al., 2005; Moffitt et al., 2010). However, many individuals do not receive treatment for these concerns because of limited access and * Elizabeth A. Miller [email protected] 1
Department of Medicine, University of Pittsburgh, 545 Bellefield Towers, 100 N. Bellefield Ave, Pittsburgh, PA, USA
2
Hawaiʻi Department of Health, Child and Adolescent Mental Health Division, Kauaʻi, HI, USA
3
Department of Pediatrics, Section of Developmental and Behavioral Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
4
Department of Pediatrics, Section of General and Community Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
availability of specialty mental health care and low acceptability of mental health care in some populations (Maura & Weisman de Mamani, 2017; Wang et al., 2005; Ziller, 2014). Members of underserved populations, including ethnic and racial minority groups and residents of rural areas, have especially limited access to behavioral health care (Lambert, Ziller, & Lenardson, 20
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