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Families, Systems, & Health
Journal Prestige (SJR): 0.425  Citation Impact (citeScore): 1 Number of Followers: 8  Subscription journalISSN (Print) 1091-7527 - ISSN (Online) 1939-0602 Published by APA  [89 journals]
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- Developing a behavioral health workforce for team based care.
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Abstract: This is an introduction to the special issue “Innovations in Developing a Behavioral Health Workforce for Team Based Care.” The purpose of this special issue was to highlight emerging research and projects to address workforce shortages and innovations in training paradigms, including those that could address the need for increased diversity. In this introduction, the authors spotlight some of the key themes as well as a few of the noticeable gaps they found as they completed this project. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000767
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- Essential integrated behavioral health care skills for primary care
providers: A Delphi study.-
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Abstract: Introduction: Workforce development is a vital process for advancing the field of integrated behavioral health in primary care (IBHPC) and depends on the development of job-specific skills that meet the needs of patients and other team members. Job-specific skills guide both university- and worksite-based training programs in preparing future cohorts of health care professionals in IBHPC; however, there are no extant training criteria for nontrainee primary care providers. Method: A multiround survey using a modified Delphi technique was conducted. Participants were recruited from a large national research network, university alumni and community health center partners. Participants included allopathic and osteopathic physicians, physician assistants and nurse practitioners serving as primary care providers in a variety of IBHPC settings. In the survey, participants were instructed to categorize 22 skills as “Essential,” “Compatible,” or “Irrelevant” for IBHPC practice. Categorized responses were analyzed using descriptive statistics and comments were analyzed using a modified thematic analysis method. Results: Fifty-four participants were recruited for the study, with 43 participating in round 1, 38 participating in round 2, and 36 participating in round 3. After 3 rounds, 19 skills received at least 80% consensus as “Essential” and 22 received at least 50% consensus as “Essential.” Comment themes revealed participants were overall agreeable with skills, but had concerns about role, training, and time constraints. Discussion: Primary care providers can prepare for and enhance IBHPC practice by developing skills identified as essential. Employers can adapt this skill list for efforts related to recruiting, hiring, and onboarding. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000745
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- Trauma-informed interprofessional education: Preliminary evaluation of
building student capacity for system-wide collaboration.-
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Abstract: Introduction: In urban areas, numerous barriers exist for children and families to access needed behavioral health care. Compounding the general deficit of behavioral health workers in the United States is lack of access to culturally responsive care. Additional challenges include inherent racism and oppression in our health and human service systems and siloed approaches to behavioral health care training and practice. Integrated care is an emerging field nationally, yet training and education in integrated care is limited. This article provides an overview of the Child/Adolescent Interprofessional Practice and Education (CAIPE) program, a novel training approach in its first year of implementation for behavioral health students that prioritizes trauma-informed and social-justice oriented practice, integrated care, and interprofessional teamwork. Method: This study employs a mixed-methods approach to program evaluation. Data sources include program application materials (demographics and data related to clinical interests, student goals, and preparedness for interprofessional work). Data is also drawn from measures of student outcomes (self-efficacy navigating complex care patients, empathy, and complex care knowledge). Results: Baseline data are reported for demographics, students’ goals and interprofessional interests, and student outcomes. Information is also presented relevant to trainings conducted in the grant’s first year and planned for subsequent years. Preliminary data and implementation suggest that the program has drawn diverse trainees who are committed to interprofessional, integrated care for underserved youth. Discussion: Recruitment and program development challenges are discussed, along with grant goals’ fit with students’ interests and plans for future evaluation. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000761
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- Professionals ready to integrate care (PRI-Care): A mental health training
collaborative.-
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Abstract: Introduction: Increasing demand for integrated care necessitates interprofessional training of mental and behavioral professionals. This study examines the effect of an interprofessional training program for social work and counseling trainees (PRI-Care) in 3 areas: interprofessional valuing and socialization, team skills, and professional development, including the interrelationship between these 3 areas. Method: A cross-sectional survey-based pre-post design was utilized across 4 cohorts of students participating in the training program from 2018 through 2021. Results: Among 111 students, interprofessional valuing and socialization, team skills, and professional development increased in pre- to post surveys. Older trainees had higher self-perceptions of interprofessional valuing and socialization. Further, higher levels of interprofessional valuing after training predicted higher self-perceived professional development. Discussion: Students entering work in mental and behavioral health benefited from the specialized interprofessional training. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000769
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- Integrated behavioral health education using simulated patients for
pediatric residents engaged in a primary care community of practice.-
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Abstract: Introduction: Novel teaching curricula using simulated patients (SP) and a team-based approach are needed to teach pediatric residents how to approach behavioral health (BH) conditions in an integrated care setting. Method: This mixed-methods study evaluated a pilot curriculum on BH integration in pediatric primary care. Two 1-hour didactic sessions and 3 hours of SP encounters focused on attention-deficit/hyperactivity disorder (ADHD) and anxiety, followed by facilitated debriefings that included interdisciplinary team members. Residents completed pre- and postcurriculum surveys on self-efficacy in patient assessment and management. A subset of residents participated in semistructured interviews, reviewing video recordings of their SP encounters to facilitate reflection on their learning. We conducted qualitative analysis of interview transcripts until we reached thematic saturation. Results: Residents (n = 31) reported significantly improved self-efficacy in the majority of BH skills (p ≤ .05 to p ≤ .0001), including assessing and discussing concerns with families, using screening tools, developing management plans, prescribing medications, and performing warm handoffs with BH clinicians. In analysis of 15 interviews, four themes emerged: shared experiences, mutual engagement, contextual meaning, and behavioral change, which aligned with the components of the communities of practice framework. Sharing experiences within an integrated BH-pediatric primary care learning community enhanced activated, self-reflective learning and consequent behavioral change that contributed to identity formation. Discussion: Resident participation in the integrated BH-pediatric curriculum improved self-efficacy in patient care for anxiety and ADHD. Curricula implemented in integrated learning communities could help promote reflection and improve integrated pediatric-BH care, including warm handoffs from pediatric to BH providers. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000738
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- Interprofessional microteaching: An innovation to strengthen the
behavioral health competencies of the primary care workforce.-
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Abstract: Background: There is significant variability in how residency programs prepare the primary care workforce in behavioral health competencies. One approach that warrants further exploration is to have integrated behavioral health consultants (BHCs) capitalize on in vivo clinical teaching opportunities in the context of team-based care. This article presents preliminary results from the implementation of a pilot program wherein BHCs use warm handoffs and other clinical interactions to provide brief, targeted education to medical residents. Method: Twelve BHCs from five resident training clinics participated in a 1-hr training on “microteaching” skills that could be used in clinical teaching interactions. BHCs were asked to track instances of microteaching using an Excel spreadsheet. After 3 months, BHCs and residents responded to electronic surveys that assessed the acceptability and feasibility of this process. Results: In 3 months, BHCs provided 269 instances of microteaching with 66 residents (66.7%) across five clinics. These microteachings occurred within the context of various interactions, including warm handoffs (n = 138, 51.3%), curbside consultations (n = 78, 29.0%), debriefs (n = 46, 17.1%), and team huddles (n = 7, 2.6%). Roughly half (n = 149, 55.4%) of these encounters involved Level 1 microteaching (i.e., lasting 2 min or less), while half (n = 120, 44.6%) involved Level 2 (i.e., lasting 3–10 min). BHCs and residents rated the microteaching interactions as acceptable and feasible. Discussion: Leveraging embedded BHCs as clinical educators in integrated care environments may hold value for increasing behavioral health competencies among medical residents. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000735
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- Integrated primary care psychology training programs: Challenges and
strategies.-
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Abstract: Introduction: Integrating behavioral health in primary care improves quality of care and outcomes for patients with comorbid conditions. Shortage of a trained behavioral health workforce limits adoption. Professional psychology training programs contribute to recruitment, retention, and development of skilled providers, who value and deliver behavioral health services in primary care. This study interviewed a cohort of established psychology training programs in real-world, state-wide clinical primary care settings and identified their strategies and challenges with teaching practices and program resources that impact the robust quality of training. Method: Between December 2020 and March 2021, we conducted semistructured interviews with 12 licensed psychologists who oversaw nine integrated primary care psychology training programs at the internship and postdoctoral levels across Washington State. Data were analyzed using a thematic approach. Results: Programs taught psychology trainees about integrated primary care via extensive onboarding, modeling and shadowing, structured learning environment, interprofessional education opportunities, flexible and cross-disciplinary supervision, and a psychologically safe space. Teaching challenges included balancing scheduled and curbside supervision, pivoting to telehealth, and aligning trainee expectations and program requirements. Training programs were funded through different and multiple sources, but most lacked a stable funding mechanism, compounded by barriers for psychology trainees to bill for services, a lack of control over organization’s budgeting decisions, and instability in funding renewal. Conclusion: Synergistic support from program, organization, and system/policy levels are needed to align teaching activities with clinical practice environments and invest in the growth and sustainability of psychology training programs on integrated primary care. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000770
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- Assessing counseling student self-reported competencies in primary care
behavioral health.-
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Abstract: Introduction: Professional counselors are becoming increasingly represented in the Primary Care Behavioral Health (PCBH) workforce. Accordingly, models for training these professionals to work in integrated health care settings are needed. Method: This article presents the results of 34 master’s level counseling students’ self-reported competencies in PCBH as a result of a PCBH training program. Results: Results indicated that students’ self-perceived competence across all domains increased over time. Discussion: Implications for the function of self-reported skill development in students training as behavioral health consultants in primary care are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000744
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- Interprofessional skills as a predictor of culturally congruent practice
behaviors.-
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Abstract: Introduction: Evidence suggests that the development and implementation of interprofessional skills can positively impact culturally congruent practice among providers and patients, improving access and quality of care. Exploring the relationship between interprofessional skills and culturally congruent practice within health profession education can inform curricular efforts that better prepare the emerging workforce to provide accessible, high-quality care. Method: This study examined if interprofessional skills predict culturally congruent practice behaviors in an interprofessional health care simulation with Master of Social Work and Master of Science in Nursing students (N = 79). Simple linear regressions were conducted to evaluate whether interprofessional skills, across five domains (team structure, leadership, situation monitoring, mutual support, and communication) in the Performance Assessment Communication and Teamwork, significantly predicted culturally congruent practice behaviors, overall and across three subscales (culturally specific care; cultural assessment; and culturally sensitive and professionally appropriate attitudes, values, and beliefs), in the Cultural Competence Clinical Evaluation Tool—Student Version. Results: Among the sample, the interprofessional skill domains of leadership, situation monitoring, and communication predicted culturally congruent practice behaviors overall. Additionally, results indicated that communication predicted culturally specific care; team structure, leadership, situation monitoring, mutual support, and communication predicted cultural assessment; and communication, situation monitoring, and leadership predicted culturally sensitive and professionally appropriate attitudes, values, and beliefs. Discussion: Opportunities to learn and practice interprofessional skills within health profession curricula may predict Master of Social Work and Master of Science in Nursing students’ culturally congruent practice behaviors; implications and limitations are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000762
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- Interprofessional team based learning to enhance behavioral health care
for Latinx patients: Results of a teleconsultation program.-
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Abstract: Culturally sensitive behavioral health services are scarce, particularly in rural and underserved areas. To expand integrated behavioral health care training for providers, specifically those working in rural communities and federally qualified health centers, an interprofessional teleconsultation program was developed. Given the desire to focus on culturally informed care training, this was done in partnership with a nonprofit community mental health agency which focuses on behavioral health within Latinx populations. The teleconsultation sessions were provided bimonthly using Zoom and included didactic components and case-based discussion using the Multidimensional Ecosystemic Comparative Approach (MECA; Falicov, 1995; Falicov, 2017). Participants represented a diverse, interprofessional group composed of behavioral health professionals (45.2%), primary care physicians (26.8%), family medicine residents (15.3%), and others (medical students and administrative staff [12.7%]). The program evaluation demonstrates that participants valued the teleconsultation sessions and articulated specific skills that they subsequently planned to integrate into their clinical practice to enhance care. This teleconsultation model allows interprofessional training across multiple types of organizations to enhance knowledge in providing integrated behavioral health care for Latinx populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000741
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- An innovative behavioral health care curriculum: The integrated advanced
practice addictions nursing subspecialty.-
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Abstract: Introduction: There is a significant shortage of behavioral health providers trained in caring for patients with problematic substance use, particularly within integrated care settings. Method: An innovative addictions nursing subspecialty curriculum was designed by interdisciplinary faculty from psychiatric nursing, family nursing, counseling, and social work and informed by integrated care, addictions, and telehealth competencies. The subspecialty included prevention, treatment, and recovery approaches to care and encouraged enrollment of students from various health-related disciplines to enhance the students’ experiences of integrated care for substance use treatment prior to completion of the program. Results: Subspecialty courses increased the number of advanced practice nurses in the behavioral health care workforce with enhanced knowledge of integrated telehealth substance use treatment. Discussion: Implementation of similar innovative curricula across health disciplines may significantly improve the care delivered to patients with problematic substance use in traditional medical settings. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000747
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- Out of textbook and [almost] into the clinic: Case simulation in
integrated care training.-
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Abstract: Introduction: A growing recognition of the need for specialized training to prepare health care providers to work in integrated care (IC) settings requires innovative methods to educate learners. There is an opportunity to provide IC trainees with relevant experiential opportunities to practice these techniques using simulation-based learning, a well-established training approach in medical education. Method: This pilot study sought to examine the feasibility of using simulation-based learning in the interprofessional training of Marital and Family Therapy (MFT) and Family Nursing Practitioner (FNP) trainees in relevant integrated care competencies. Participants included 26 learners (21 MFT and five FNP). The case simulation event involved students completing a video telehealth clinical encounter involving a warm handoff. Clinical faculty observed trainees, completed a checklist designed specifically for the event, and provided feedback directly after the event. Results: Trainees reported high satisfaction with the use of simulation-based learning. Observational coding revealed that trainees successfully implemented many elements of a warm handoff, however, aspects involving interprofessional communication, brief intervention, and follow-up planning appeared more challenging. Discussion: Increased utilization of interprofessional case simulation training in masters and doctoral level behavioral health programs could help accelerate the development of a competent integrated care workforce. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000757
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- Advancing integrated care through cotraining of residents and psychology
postdoctoral fellows.-
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Abstract: Introduction: While integrated behavioral health (IBH) is growing as a primary care practice paradigm, there are gaps in developing the workforce needed. In particular, there are few examples of cotraining curricula in IBH for family medicine residents with postdoctoral psychology fellows. Furthermore, even fewer programs incorporate a colearning primary care practice environment featuring a targeted approach to care for patients with chronic illness using panel management and integrated care. Method: In this article, the authors describe a cotraining experience in an urban federally qualified health center supported by a 5-year Health Resources and Services Administration Title VII grant, within a social justice mission-driven academic department to prepare both family medicine (FM) residents and primary care psychology (PCP) postdoctoral fellows for IBH practice. The article will discuss the specific components of the shared/parallel curriculum, integration of social justice and population health principles and practices, and a structured approach for resident/fellow partnership. Results: The authors share the clinical and educational impacts of this integrated cotraining curriculum model as described by the FM residents and PCP fellows. The article describes workforce results measuring the diversity of the trainees and their postprogram jobs serving vulnerable populations. Discussion: The interdisciplinary cotraining between FM residents and PCP fellows presents an innovative approach to developing workforce capacity for integrated practice in medically underserved settings. This article describes the creation and implementation of a cotraining curriculum and provides recommendations for other programs and residencies preparing their residents and future PCP psychologists to practice and teach skills in integrated care. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000754
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- Interdisciplinary training academy for integrated substance/opioid use
disorder prevention and health care: A workforce catalyst report.-
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Abstract: Introduction: Addressing the opioid crisis requires attention to the fact that people with opioid use disorder are affected by multiple systems and professionals working across disciplines (e.g., primary health care, social work, psychology). Thus, we developed the Interdisciplinary Training Academy for Integrated Substance/Opioid Use Disorder Prevention and Health care (ITA). The purpose of the ITA is to connect multiple systems to aid in the development of practitioners who are broadly prepared to address the opioid crisis. Method: Herein, we use preliminary descriptive methods to illustrate early outcomes related to 30 weeks of interprofessional training rotations across all system levels related to policy, prevention, treatment, integrated care, harm reduction and recovery support services. Results: Overall, the ITA has assisted fellows in garnering 7,257 hr of training to become holistically competent behavioral health providers. Preliminary data indicate that most cohort graduates intend to pursue employment in a telehealth or primary care setting that serves medically underserved communities. Discussion: In sum, we offer a new concept for remote field education that engages learners as curriculum developers, educators, and emerging practitioners with expertise across ecological systems. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000743
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- Expanding interprofessional teams: Training future health care
professionals in screening, brief intervention, and referral to treatment
(SBIRT).-
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Abstract: Introduction: Substance misuse persists and is undertreated across the United States (Substance Abuse and Mental Health Services Administration, 2021). Further enhancing the skill sets and capacity of interprofessional members of primary care teams to include proficiency in the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model could help to alleviate the “treatment gap” (those requiring treatment, but not receiving it) by enhancing interprofessional teams at the pregraduate level (e.g., health educators, health coaches) to expand capacity and meet the volume of patients with substance use-related needs. Method: In this study, SBIRT knowledge, training satisfaction, and efficacy were evaluated among undergraduate and graduate health and behavioral health students before and after exposure to a series of online training modules. Results: On completion of the training, there were positive percent increases in overall mean knowledge and self-efficacy when compared with pretraining. At posttraining, graduate level students, regardless of discipline, reported greater knowledge than undergraduate students; there were no differences in efficacy or satisfaction among the groups. Additional analysis at the graduate level evaluated differences between behavioral health and medical trainees. No differences were found in knowledge or efficacy between groups at posttest, despite medical trainees reporting significantly lower efficacy at pretest. Discussion: The findings of this study reinforce the need and potential to incorporate SBIRT training into higher education curricula for interprofessional health care professions to begin expanding the integrated care team’s knowledge and efficacy in the provision of SBIRT to address the treatment gap. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000755
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- Leveraging community health workers in extending pediatric telebehavioral
health care in rural communities: Evaluation design and methods.-
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Abstract: Objective: The pandemic exacerbated and intensified pediatric behavioral health and access needs in rural and underserved areas due to long-standing workforce shortages, lack of resources, and multigenerational poverty and trauma. Kansas is a predominantly rural and frontier state with 94% of counties designated as mental health professional shortage areas. Innovation: The Telehealth ROCKS (THR) program is among the first of its kind to increase the behavioral health workforce capacity by integrating trained school-based community health workers (CHWs) directly into rural communities. CHWs facilitate the coordination of behavioral health appointments and access to social determinants of health needs. Methods and Results: We plan to assess the implementation, clinical outcomes, quality of care, and access to care through a mixed-methods design to evaluate the process and impact of expanding the rural behavioral health workforce via CHWs. Preliminary program data suggest CHWs have supported over 90 students/families around social determinants of health in the first 6 months. Conclusion: The THR program aims to bring childserving systems of care together, cultivate relationships with rural communities, empower and increase workforce capacity in health care and education, and build trust to enhance acceptance and thus program sustainability. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000742
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- Training health service psychology students in an in-person and telehealth
integrated behavioral health service delivery model in primary care.-
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Abstract: Telehealth has become an integral part of integrated behavioral health (IBH) service delivery in light of the global pandemic. In order to accommodate the rapid changes in service delivery, integrated behavioral health settings have transformed to provide services via telehealth alongside in-person services. While traditionally believed to be an in-person model, this article demonstrates the potential for using telehealth technology to continue offering training and service delivery in an IBH setting in response to the COVID-19 pandemic and beyond. The purpose of this catalyst report is to describe an IBH service delivery and training model including creative adaptations to the model using telehealth and present an evaluation plan of health service psychology trainee experiences. A mixed-methods design will be used to capture student experiences and competency. Data methods will include interviews with participants (qualitative) and the Interprofessional Collaborative Competency Attainment Survey (quantitative). (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000752
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- Alumni perspectives on interprofessional experiential learning and
interprofessional collaborative practice in health care settings.-
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Abstract: Introduction: Interprofessional collaborative practice (ICP) is essential for optimizing patient outcomes in health care settings. Experiential learning (EL) is a method of modeling ICP to students during their education. No studies have evaluated the lasting impact of EL on self-reported clinical practice after students graduate. The aims of this study are to (a) examine what opportunities for ICP are available for alumni in current health care settings and (b) explore the early career impact of interprofessional EL on self-reported current clinical practice. Methods: This study utilized a mixed-methods design using descriptive statistics and a phenomenological approach. Participants included Doctor of Physical Therapy (DPT) and Master of Arts in Marriage and Family Therapy (MAMFT) alumni who previously participated as graduate students in Balanced Families (BF), an interprofessional EL program. Sixty-four alumni were contacted through e-mail, of which 17 (27%) agreed to be interviewed. Results: Quantitative data were analyzed utilizing descriptive statistics to describe demographics and summarize Likert scale responses. Qualitative data were analyzed using an interpretative phenomenological analysis approach. Five major themes were reflected in the transcripts: (a) The impact of interprofessional experiential learning on future clinical practice, (b) The value of holistic approaches, (c) The collaboration in holistic care, (d) The interconnected health care system and family system, and (e) The development of empathy for patients and their families. Discussion: Interprofessional EL positively impacted DPT and MAMFT alumni, improving interprofessional communication skills and leading to more holistic approaches to care. Study outcomes support continued implementation of interprofessional EL in health care graduate study programs. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000771
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- Advancing the behavioral health workforce: An innovative integrated care
and substance use disorder training model to improve outcomes for people
in medically underserved communities.-
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Abstract: Introduction: It is critical that we strengthen the ability of the behavioral health workforce to better manage the complex behavioral and physical health needs of people in medically underserved areas. Despite the knowledge that integrated care (IC) models improve patient outcomes and experience, provider satisfaction, and health care costs, educational and experiential training in IC is limited, limiting workforce capacity to deliver this care. Method: Through the Health Resources and Services Administration-funded Rutgers University Integrated Substance Use Disorder Training Program (RUISTP), we partner with community-based primary care clinics to implement an interprofessional fellowship program for psychologists, social workers, physician assistants, and advanced practice nurses. The RUISTP simultaneously provides training and implements IC within these community-based systems. Our multiple-methods evaluation design examines data-driven indicators of feasibility, uptake, and program success during implementation and sustainability phases and assesses changes in organizational beliefs and practices, provider competencies, and service utilization throughout the project period. Results: This article describes the significance and innovation of (a) an IC training program, (b) an implementation plan for sustained change within systems of care, and (c) evaluative methodology to assess and improve IC and SUD service delivery and training. These data will be used to create a template for other academic and health care systems nationally. Discussion: It is the mission of this program to use an innovative training, implementation, and evaluation design to enhance IC and SUD services, bolster the behavioral health workforce trained to provide high-quality IC, and inform replications of this model in other geographic and clinical settings, particularly those in medically underserved communities. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000739
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- Assessing for socioeconomic background diversity in behavioral health
workforce development programs.-
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Abstract: Assessing workforce diversity is an increasing area of evolution. A comprehensive assessment of socioeconomic diversity is important in that it can help identify needs and enable planned inclusion across a range of students. Subsequently, a more comprehensive set of background indicators is needed. The purpose of this brief report is to describe the approach we are using to determine socioeconomic background among individuals participating in a behavioral health workforce program. By using 3 strategies to assess background, we were able to determine that 4 individuals reported being unable to pay for housing, 3 indicated they had sold plasma, and 1 had experienced homelessness since starting graduate school. Our findings provide a starting point for using a comprehensive set of indicators to guide the recruitment and selection process in workforce development programs. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000751
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- Developmental/behavioral training innovation in a high-need, low-resource
state: The child health and development promotion fellowship.-
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Abstract: Introduction: Developmental and behavioral problems are prevalent in early childhood, whereas the workforce available to identify and address early problems is comparatively limited. Beyond workforce shortages, additional barriers to developing and training a highly skilled workforce in this area exist—particularly in rural, high-need, and underserved U.S. states. As the health care landscape emphasizes expertise in interdisciplinary care, training approaches that provide intensive learning opportunities for supporting a skilled early childhood developmental workforce necessitate novel training approaches. This Workforce Catalyst report summarizes the initial conceptualization, development, execution, and evaluation of a Child Health and Development Promotion (CHDP) postgraduate fellowship in a high need, underserved rural area. Method: Three cohorts totaling 15 trainees across fields including psychology, pediatric nursing, speech-language pathology, social work, and occupational therapy were recruited and cross-trained in an intensive postgraduate fellowship in early childhood development and behavior. Results: The CHDP fellowship led to experiences across the care continuum and resulted in multiple clinical, educational, and scholarly products. Outcomes revealed a training program aligned with Infant and Early Childhood Mental Health competencies, high in-state retention (71%) and employment (93%) following training, and graduates who report leadership positions and sharing of specialty developmental-behavioral knowledge in organizations focused on early childhood. Discussion: The CHDP Fellowship is a novel, immersive, and interdisciplinary training experience demonstrating positive initial training outcomes in Mississippi. The model and experience may serve as a roadmap for bolstering a skilled early childhood workforce in other underserved and high-need states. Aspects regarding scale of reach, funding, and accreditation are discussed as barriers. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000756
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- A commentary and call to action for inclusive workforce development.
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Abstract: I have the privilege of serving as the Director for the Washington State Allied Health Center of Excellence; one of 12 Centers of Excellence (each representing a different “driver” industry) devoted to addressing the workforce needs of the State. The Center provides statewide leadership in workforce education and training within the health care sector: Allied Health–Nursing–Behavioral Health–Health Sciences. We serve as a state-wide hub, connecting with the state’s community and technology college system as well as health care industry. Our Center serves as the point of contact and resource for industry trends, best practices, innovative curriculum, and professional development activities. The Center works to maximize resources by bringing together workforce education and industry partners to develop highly skilled, work ready graduates. The Center of Excellence system in Washington State is an important workforce development innovation. In this commentary I am excited to share some of our work in the health care sector. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000772
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- Integrating legal services to improve behavioral health, a challenge met
from a different angle.-
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Abstract: The United States’ current healthcare delivery system is not prepared to address the expanding behavioral health (BH) crisis without treatment of upstream social determinants that contribute to downstream BH exacerbations. Medical Legal Partnerships (MLP) utilize lessons from integrated BH to create efficiencies, augment the reach of the current BH workforce, network community resources, and likely provide BH prevention at the family unit. Payment policy changes are needed, however, to provide sustainable access to these services. The current surge of federal and state funding for BH care needs may provide the policy window necessary to sustainably fund MLP lawyers as a novel, high-impact, professional on the integrated healthcare team. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000773
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- There is more to the story.
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Abstract: For most patients, primary care and generalist settings are the first clinical touchpoints to accessing medical care. As such, they present the formative opportunity for stories to be communicated and trust to be developed between patients and the health care system. The skills of listening, supporting, communicating, and empathizing are essential in providing patient care and promoting strong patient–physician relationships. They are particularly crucial for people who have experienced interpersonal violence. In this piece, I reflect on my experience as a crisis counselor working with an underage survivor of sexual violence. This encounter provides an application of trauma-informed approaches to caring for survivors of violence and contextualizes the effects of intergenerational trauma. Narratives like this one shed a timely, sorely needed light on the role of physicians in understanding and intervening upon the cycle of violence. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000759
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- The aftermath of a diagnosis: From resistance to reconciliation.
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Abstract: The author, a doctor, describes the aftermath of being diagnosed with attention deficit hyperactivity disorder (ADHD) in his late 30s. He was incredulous and immediately resented the diagnosis. He reluctantly agreed to try the prescribed medication but struggled with that as well. Instead of rejecting the ADHD label, he later began reading and watching informative videos about ADHD and the many ways that executive functioning deficits affect behavior, including impulsive outbursts. The communication gap with his psychiatrist widened because of their “virtual” visits during the pandemic. He turned to his primary care physician, with whom he felt less inhibited, and shared his fears and concerns for his family, his career, and himself. As of now, he is looking for the added support of a therapist experienced at helping people with ADHD. Despite everything, he knows he will slip at times. But he is determined to get better at stemming episodes before they reach a tipping point. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000764
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- Finding hearts at peace: A new workforce competency.
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Abstract: While there is no single agreed upon set of competencies for the behavioral health workforce in primary care, there is a consensus about the importance of communication, the role of the behavioral health provider as part of a larger team, and the critical need to value diverse perspectives. In this column, the current and incoming Presidents of the Collaborative Family Healthcare Association (CFHA) present a framework that focuses on a “way of being”; a lens to reflect and process the sense of division and injustice, and to pave the path ahead. We believe that the fundamental question that can scale this “way of being” to a higher level of acquired skill or internalized competency for ongoing workforce development is: as we engage in dialogue on difficult, highly personal, moral, and valued topics with others, “Is your heart at peace, or is your heart at war'” May each of us in the CFHA family and community be anchored in hearts of peace as we continue to advance the mission of providing equitable care through our love of integrated behavioral health. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1037/fsh0000763
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