Posted By Jodi Polaha,
Thursday, November 8, 2012
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Each Fall I teach a course called "Primary Care Psychology 1” to our doctoral students at East Tennessee State University (ETSU), covering the gamut of current health care policy, rationale for integration, models, research, innovation, and administration. Each Fall, I ask my Department Chair to offset some of the CFHA travel costs for the students in the course. The conference is a perfect content match, and they love hearing talks given by the authors of their readings! This year, once again, Dr. Dixon came through, and that, combined with scholarship and volunteer opportunities within CFHA, made it possible for three class members to attend.
A little seed money for student travel and conference costs goes a long way. Isolated "course content” is transformed by a "culture” of professional engagement: when we arrived in Austin, we were joined by two recent ETSU graduates and two advanced students, most of whom attended in prior years on this patched-together "gift trip.” On Friday night, the eight of us had dinner with two ETSU faculty from Family Medicine. What a delight to sit and reflect on what we’d all learned that day! As you will read in the reflections below, the students in our program struggle with professional identity: "Are we psychologists or behavioral health consultants?” " "How do we be both?” The CFHA annual conference was a place for them to explore this creatively and with the supportive sounding board of "comrades” from their home institution.
As a second year student in a clinical psychology doctoral program with an emphasis on rural integrated care, I am beginning to develop my own sense of professional identity. Attending the CFHA conference furthered that development, inspiring me to think critically about the role of the Behavioral Health Consultant (BHC). In particular, I was surprised to hear several BHCs identify more closely with Family Medicine and the provision of primary care than Psychology or mental health services. I found myself asking questions such as: What are the ethical, legal, and professional implications of the shift in professional identity that comes with working as a BHC in primary care? What implications does this have for training BHCs? In what ways can BHCs who are just starting their careers develop a strong sense of professional identity, especially those who work in rural areas and who may have limited contact with their peers? I was fortunate to participate in a lunch discussion with Dr. Patricia Robinson and discuss some of these questions. One particularly salient suggestion that Dr. Robinson raised involved the need for and value of mentoring BHCs in order to foster a strong sense of professional identity. Overall, I plan to take what I have learned at the conference back to ETSU to promote increased collaboration between students in psychology and other academic health sciences. The conference was a great experience, and I am especially grateful for the volunteer and scholarship opportunity, which allowed me to attend.
As a doctoral student in a clinical psychology with a special focus on rural integrated care, I found the CFHA conference to be highly rewarding. Some concepts were familiar, such as integrated healthcare models and the function of a behavioral health consultant. Other topics were new to me, such as electronic medical records, legal issues, and specific ethical considerations. I learned a great deal; however, a few things stand out. The first of these is the lack of standardization for integrated care models and the role of the BHC, which seems, in some cases, to vary in critical ways by primary care context. As a student in rural east Tennessee, my future work as a BHC will likely differ greatly from a BHC in an urban area. Given the importance of contextual factors, in what ways should the role and training of a BHC be standardized? A second point that stands out relates to the use of technology to advance integrated care. I greatly appreciated the focus on social media and technology as means for patient and provider engagement. The idea of provider consultation via technology was especially new to me. Within smaller integrated care networks (especially in rural areas), it is likely that the BHC will be relatively isolated having few opportunities for consultation on difficult cases. Technology allows for communication between providers worldwide, which can improve both job satisfaction and patient outcomes. A final focal point for me relates to ethical standards and guidelines. As integrated care and technology become standard components of behavioral healthcare there will be a vital need for more research and guidance in this area.
My experiences at CFHA bolstered my conviction that I have chosen to engage an exciting field, burgeoning with new opportunities for mental health professionals and new promises to improve the quality of care for many in our country. As a doctoral student in psychology ETSU, I am being trained in integrated primary care for rural areas. This emphasis is both challenging and inspiring. Many sessions at CFHA helped me close my own mental "gap” between the traditional approach to clinical psychology and the application of these principles to the primary care setting. There were numerous sessions that focused on real world problems that behavioral health consultants may face in their journey for fully integrated care that gave shape to many of the questions that I sometimes find myself asking. One of the highlights, for me, was the opening plenary by Sarah Kliff regarding the opportunities that are currently developing for further integration of mental and behavioral health services into primary care. Ultimately, my experiences at CFHA left me feeling very aware of critical problems in our current healthcare system as well as aware of the potential solutions.
Hooray for growing traditions …
we’ll see you next year in Denver!
Polaha is an Associate Professor in the Department of Psychology at East
Tennessee State University where her primary professional interest is
research, training, and workforce development in rural integrated
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