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Schmidt NE, Carpenter B, Steffen AM. Brief Aging Education Affects Continuing Education Preferences and Behaviors of Mental Health Providers. THE GERONTOLOGIST 2024; 64:gnae085. [PMID: 38943477 DOI: 10.1093/geront/gnae085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND AND OBJECTIVES This study examined the impact of receiving foundational information about aging on continuing education (CE) interests, preferences, and behaviors of mental health providers. RESEARCH DESIGN AND METHODS Participants were practicing licensed professional counselors (N = 120) recruited from a random sampling of a state registry. The study employed a 3-group randomized controlled design with participants assigned to 1 of 3 conditions: an aging-specific reading, an opioid use disorder-specific reading, and a CE requirement-specific reading. As outcomes, participants rated their interest in aging-specific CE and selected to receive an aging-specific CE or Motivational Interviewing-specific CE program. RESULTS Perceived competence for working with older adults, assessed before the experimental manipulation, predicted choice and degree of interest in the aging-specific CE across conditions. Participants in the Aging-Reading condition rated a higher interest in aging-specific CE and were marginally more likely to select the aging-specific CE option than those in the other 2 conditions. Those in the Aging-Reading condition were also more likely to register for and complete an actual CE program focused on any topic. DISCUSSION AND IMPLICATIONS Foundational knowledge about aging may increase practitioners' interest and behaviors toward gaining competency for working with older adults, supporting the Positive Education about Aging and Contact Experiences model (Levy, S. R. (2018). Toward reducing ageism: PEACE (positive education about aging and contact experiences) model. Gerontologist, 58(2), 226-232. https://doi.org/10.1093/geront/gnw116) of reducing ageism.
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Affiliation(s)
- Nicholas E Schmidt
- US Department of Veterans Affairs, Geriatrics and Extended Care, Augusta, Maine, USA
| | - Brian Carpenter
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Ann M Steffen
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, Missouri, USA
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Schmidt NE, Cottone RR, Steffen AM. Working with older adults impacts training preferences of counselors. GERONTOLOGY & GERIATRICS EDUCATION 2024; 45:86-91. [PMID: 36317689 DOI: 10.1080/02701960.2022.2139693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Clinicians specializing in working with older adults make up a very small portion of providers, and the majority of the service provision falls on general practitioners. Licensed Professional Counselors (LPCs) have heavily focused on Multicultural Competency in training and practice, but the profession has not specified standards of competence for work with older adults. Efforts to increase competency for generalists providing care for older adults are needed. A random sampling of LPCs was surveyed regarding demographic variables, work characteristics, perceived competence for working with older adults, and interest in aging-specific continuing education (CE). About half of the sample reported engaging in practice with older adults over the previous year. Counselors who reported practicing with older adults over the last year were more interested in aging-specific CE and reported higher perceived competence for working with older adults.
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Affiliation(s)
| | | | - Ann M Steffen
- University of Missouri-St. Louis, St. Louis, Missouri, USA
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3
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Bhar S, Davison TE, Schofield P, Quinn S, Ratcliffe J, Waloszek JM, Dunkerley S, Silver M, Linossier J, Koder D, Collins R, Milte R. Study protocol for ELders AT Ease (ELATE): a cluster randomised controlled trial of cognitive behaviour therapy to reduce depressive symptoms in aged care residents. BMC Geriatr 2023; 23:555. [PMID: 37700236 PMCID: PMC10498637 DOI: 10.1186/s12877-023-04257-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND This protocol describes a study of the effectiveness of cognitive behaviour therapy (CBT) for reducing depressive symptoms in older adults living in residential aged care (RAC) facilities in Australia. Depressive symptoms are highly prevalent in this population, yet the benefits of CBT for reducing such symptoms in RAC facilities have not been widely investigated. Elders at Ease (ELATE) is a 16-session CBT intervention designed for implementation in RAC facilities. The intervention includes cognitive, behavioural and reminiscence strategies and is delivered by mental health trainees (MHTs) in collaboration with RAC facility staff and residents' family. METHODS AND ANALYSIS ELATE will be evaluated using a cluster randomised trial comparing outcomes for residents who participate in the intervention with those living in usual care control facilities. The participants are RAC residents aged 65 years or above, with depressive symptoms (Patient Health Questionnaire-2 ≥ 3) and normal cognition or mild cognitive impairment (Standardised Mini Mental Status Examination ≥ 21). They are assessed at four time points: baseline prior to randomisation (T1), mid-treatment (T2; 2.5 months post randomisation), post-treatment (T3; 5 months post-randomisation) and 3-month follow-up (T4; 8 months post randomisation). The primary outcome is change in depressive symptoms between T1 and T3. Secondary outcomes are depressive symptoms at T4, anxiety, suicide ideation, sleep problems, quality of life, staff and family knowledge of late-life depression, stress levels and efficacy in caring for residents, and MHT levels of geropsychology competencies. Residents receiving the intervention are hypothesised to report a greater decrease in depressive symptoms between T1 and T3 compared to residents receiving usual care. The primary analysis is a regression, clustered over site to account for correlated readings, and independent variables are condition and depressive symptoms at T1. A cost-utility analysis is also undertaken. DISCUSSION ELATE is a comprehensive CBT intervention for reducing depressive symptoms in RAC residents. It is designed to be implemented in collaboration with facility staff and residents' families, individually tailored to residents with normal cognition to mild cognitive impairment and delivered by trainee therapists. ELATE offers a model that may be widely applicable across the RAC sector. TRIAL REGISTRATION Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number ACTRN12619001037190, prospectively registered on 22 July 2019.
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Affiliation(s)
- Sunil Bhar
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia.
| | - Tanya E Davison
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
- Silverchain, Osborne Park, WA, Australia
| | - Penelope Schofield
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC, Australia
- Health Services Research and Implementation Sciences, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Stephen Quinn
- Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Joanna M Waloszek
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Sofie Dunkerley
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Mark Silver
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Jennifer Linossier
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Deborah Koder
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Rebecca Collins
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Rachel Milte
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
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Graham KL, Moye J. Training in Aging as a Diversity Factor: Education, Knowledge, and Attitudes Amongst Psychology Doctoral Students. PSYCHOLOGY LEARNING AND TEACHING-PLAT 2023; 22:39-54. [PMID: 36787228 PMCID: PMC9881225 DOI: 10.1177/14757257221130483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The population of older adults is growing rapidly and there will be an increased need for psychological services for this population. Current estimates indicate a significant workforce gap such that all psychologists, regardless of specialty area, will likely be called upon to work with older adults. Education and experience in the care of older adults has been consistently connected with improved competence and interest in working with this population. Further, the APA requires that training programmes adequately cover aspects of individual diversity, though age-related education and training may be largely lacking and/or minimally addressed. The present study explores age-related training within a sample of psychology doctoral students. Participants (n = 85) consisted of doctoral trainees recruited via email (listserv) to complete an anonymous online survey as part of a larger study. Results indicate that (1) training in aging varies and is inadequate in some programmes; (2) knowledge in aging varies and is associated with training opportunities; (3) training in aging is less than training in race/ ethnic diversity; and (4) attitudes toward older clients are most strongly predicted by extent of training in aging. The authors offer suggestions for expanding age-related aspects into generalist training.
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Affiliation(s)
| | - Jennifer Moye
- New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA
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Plys E, Vaughan CL, Kutner JS, Berk J, Kolva E. Interdisciplinary neuropalliative care: A unique and valuable clinical training experience for geropsychology trainees. GERONTOLOGY & GERIATRICS EDUCATION 2022; 43:551-563. [PMID: 34044751 PMCID: PMC8626543 DOI: 10.1080/02701960.2021.1925891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
To address workforce issues in professional geropsychology, clinical training sites must offer opportunities to build skills for working with older adults and aging families. Neuropalliative care (NPC) may offer a valuable learning environment for geropsychology trainees to develop professional competencies, while positively contributing to patient care. This article describes a novel clinical rotation for an advanced geropsychology trainee in an interdisciplinary specialty NPC clinic. A co-assessment model emerged as a useful strategy for integrating the trainee into the established NPC team. Two case examples illustrate the co-assessment's ability to enhance: collaboration within the clinic; psychological care for patients and care partners; and opportunities for the trainee to build competencies related to assessment, intervention, teams, and consultation. This paper concludes with a discussion of the benefits of NPC as a clinical training rotation for geropsychology trainees, as well as practical considerations for implementation in other clinics.
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Affiliation(s)
- Evan Plys
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine
- Department of Psychiatry, University of Colorado School of Medicine
| | - Christina L. Vaughan
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine
- Department of Neurology, University of Colorado School of Medicine
| | - Jean S. Kutner
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine
| | - Julie Berk
- Department of Neurology, University of Colorado School of Medicine
| | - Elissa Kolva
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine
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6
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Gregg JJ, Rodriguez RL, Mehta PS, Kramer BJ, Gould CE. Enhancing specialty training in geropsychology competencies: an evaluation of a VA Geriatric Scholars Program advanced topics workshop. GERONTOLOGY & GERIATRICS EDUCATION 2022:1-10. [PMID: 35491904 DOI: 10.1080/02701960.2022.2069764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There is a growing need for psychologists with specialized training in geriatric mental health competencies. The Geriatric Scholars Program for Psychologists (GSP-P) was created to address this shortage within a large integrated healthcare system. In 2019, GSP-P piloted an advanced workshop designed to enhance expertise in geriatric mental health competencies among graduates of its foundational competencies core course. The workshop included 3.5 days of expert-led seminars regarding the biopsychosocial needs of older adults with chronic medical illness and was followed by completion of an individualized learning plan. This paper describes the evaluation of the course using a mixed methods with data collected prior to the workshop, immediately post-workshop, and six months post-workshop. Results indicated enthusiasm for the workshop, significant improvements in four geropsychology domains on the Pikes Peak Geropsychology Knowledge and Skill Assessment Tool, and benefit from completion of the independent learning plans. Our findings demonstrate that continued enhancement of geropsychology competencies through advanced coursework is feasible and improves knowledge and skill, particularly when combined with individualized learning plans.
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Affiliation(s)
- Jeffrey J Gregg
- Mental & Behavioral Health Service, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Medicine-Geriatrics, Duke University, Durham, North Carolina, USA
| | - Rachel L Rodriguez
- Mental & Behavioral Health Service, Durham VA Health Care System, Durham, North Carolina, USA
| | - Priyanka S Mehta
- Palo Alto Geriatric Research, Education, and Clinical Center, VA Palo Alto, Health Care System, Palo Alto, California, USA
| | - B Josea Kramer
- Greater Los Angeles Geriatric Research Education and Clinical Center, Greater Los Angeles VA Health Care System, Los Angeles, California, USA
- Division of Geriatric Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Christine E Gould
- Palo Alto Geriatric Research, Education, and Clinical Center, VA Palo Alto, Health Care System, Palo Alto, California, USA
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
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7
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Lenouvel E, Lornsen F, Schüpbach B, Mattson J, Klöppel S, Pinilla S. Evidence-oriented teaching of geriatric psychiatry: a narrative literature synthesis and pilot evaluation of a clerkship seminar. GMS JOURNAL FOR MEDICAL EDUCATION 2022; 39:Doc20. [PMID: 35692363 PMCID: PMC9174071 DOI: 10.3205/zma001541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 11/22/2021] [Accepted: 02/09/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The field of geriatric psychiatry has in recent decades developed into an independent discipline, incorporating elements of psychiatry, neurology and internal medicine. In view of demographic changes, this field is becoming increasingly relevant for primary care and undergraduate medical training. So far, however, there is little educational guidance for instructional design of geriatric psychiatry in undergraduate medical education. PROJECT DESCRIPTION A narrative literature review of medical education studies in the field of geriatric psychiatry was conducted. Student evaluations of a geriatric psychiatry clerkship seminar were analyzed, followed by a target group analysis. Results informed the iterative development of new clerkship seminar content and structure. This was implemented and evaluated over several academic cycles. Learning material was made available via the open-source learning management system "ILIAS". RESULTS A total of 29 medical education articles were identified and evaluated. The previous seminar in geriatric psychiatry at our university hospital was rated below average (Likert item overall rating of 4.3/6 compared to other seminars with an average overall rating of 5.2, p<0.001). An evidence-oriented revision of the content and instructional design was implemented. Activation of learners, self-reference effect, and audience questioning were used during the lecture. Additionally, two geriatric psychiatry case scenarios were adapted for discussion. We saw continuous improvement of student evaluations of the revised course, reaching a rating improvement of 5.3 out of 6 (p<0.01, U=135.5 Cohen's d=1.28). CONCLUSION A systematic approach was used to develop a geriatric psychiatry clerkship seminar, based on medical education evidence, for undergraduate medical students, resulting in better student evaluations. The teaching materials can be adapted for local implementation at other teaching hospitals. Future studies should also explore effects regarding higher learning outcomes.
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Affiliation(s)
- Eric Lenouvel
- University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland
| | - Finn Lornsen
- University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland
| | - Brigitte Schüpbach
- University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland
| | - Janet Mattson
- Karolinska Institute, LIME, Department of Learning, Informatics, Management and Ethics, Solna, Sweden
| | - Stefan Klöppel
- University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland
| | - Severin Pinilla
- University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland
- University of Bern, Institute for Medical Education, Department for Assessment and Evaluation, Bern, Switzerland
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Jacobs ML, Mlinac ME. Healthcare Quality Improvement Competency: A Clinical and Training Imperative for Geropsychology. J Clin Psychol Med Settings 2021; 28:897-908. [PMID: 34596823 DOI: 10.1007/s10880-021-09824-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2021] [Indexed: 11/26/2022]
Abstract
Quality improvement (QI) work is increasingly necessary to ensure healthcare is delivered safely, efficiently, and equitably. As geropsychologists play an increasingly vital role in healthcare service delivery for older adults, it is imperative that they develop professional competence in QI, yet there is little formal QI training aimed at geropsychologists or to graduate students pursuing geropsychology. This article aims to elucidate the importance of QI education and training in geropsychology. In line with the Pikes Peak model for training in professional geropsychology, we outline QI knowledge and skills competencies for geropsychology training and suggest a rubric for integrating QI education into academic and clinical training from graduate school to professional practice. We provide recommended readings that geropsychology educators can read to become familiar with QI or use as part of a syllabus. Finally, we offer some recommendations for how current and future geropsychologists can be leaders in quality improvement work.
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Affiliation(s)
- M Lindsey Jacobs
- Research & Development Service, Tuscaloosa VA Medical Center, 3701 Loop Road, Tuscaloosa, AL, 35404, USA.
- Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA.
| | - Michelle E Mlinac
- VA Boston Healthcare System, Jamaica Plain, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Vaitheswaran S, Balasubramanian S, Natarajan N, Venkatesan S, Srinivasan N, Nagarajan G, Ramanujam V, Sargunan S. Ethical Issues in Delivering Psychological Therapies in Geriatric Psychiatry in India. Indian J Psychol Med 2021; 43:S66-S70. [PMID: 34732957 PMCID: PMC8543620 DOI: 10.1177/02537176211026970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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10
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Lauderdale SA, Martin KJ, Oakes KR, Moore JM, Balotti RJ. Pragmatic Screening of Anxiety, Depression, Suicidal Ideation, and Substance Misuse in Older Adults. COGNITIVE AND BEHAVIORAL PRACTICE 2021. [DOI: 10.1016/j.cbpra.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Strong JV, Allen RS, Tighe C, Jacobs ML, Dorman H, Mast B. What geropsychology trainees think geropsychologists do and what we actually do: A mixed-methods Study. GERONTOLOGY & GERIATRICS EDUCATION 2021; 42:277-296. [PMID: 33939939 DOI: 10.1080/02701960.2019.1697253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A shortage of individuals in academic geropsychology positions further perpetuates the shortage of clinicians trained to meet the needs of the aging population. Barriers to recruiting geropsychology trainees into academia and what attracts trainees into career paths within geropsychology are not understood. The current mixed-methods study examined 1) geropsychology trainees' (n = 28) knowledge and attitudes toward work in clinical or academic positions and 2) professional geropsychologists (n = 67) activities, career expectations, ideal activities, and work/life balance. We asked geropsychology trainees to estimate the amount of time their supervisors spent in clinical, research, education, and administrative activities, and professional geropsychologists reported how they currently spent their time in these same activities. We conducted qualitative interviews asking geropsychology trainees about experiences in academic or clinical settings and geropsychologists about career expectations, opportunities, and work/life balance. Geropsychology trainees had less accurate estimates of academic work time compared to clinically focused work time. Trainee interviews revealed negative perceptions of the university system, including bureaucracy, low salary, and perceived workload. Professional geropsychologists reported high agreement between actual and ideal work time with some individual differences. Each group discussed work-life balance, based on career stage or work setting. Interventions for recruiting more geropsychology trainees into academic jobs are discussed.
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Affiliation(s)
- Jessica V Strong
- Department of Psychology, University of Prince Edward Island, Charlottetown, Canada
- VA Boston Healthcare System, Brockton, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Rebecca S Allen
- Department of Psychology, University of Alabama-Tuscaloosa, Tuscaloosa, AL, USA
| | - Caitlan Tighe
- VA Pittsburgh Healthcare System, Mental Illness Research, Education and Clinical Center, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - M Lindsey Jacobs
- VA Boston Healthcare System, Brockton, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Hillary Dorman
- Department of Psychology, University of Alabama-Tuscaloosa, Tuscaloosa, AL, USA
| | - Benjamin Mast
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
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12
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Huh JWT, Rodriguez RL, Gregg JJ, Scales AN, Kramer BJ, Gould CE. Improving Geropsychology Competencies of Veterans Affairs Psychologists. J Am Geriatr Soc 2021; 69:798-805. [PMID: 33453084 DOI: 10.1111/jgs.17029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/07/2020] [Accepted: 12/18/2020] [Indexed: 11/28/2022]
Abstract
Older adults are more likely to seek mental health care through integrated care settings such as primary care. Currently, there exists a significant shortage of mental health providers trained in geropsychology and integrated care competencies. To address this need within the Veterans Health Administration, a national workforce development program was extended to include psychologists, which is called the Geriatric Scholars Program-Psychology Track (GSP-P). The GSP-P has two overarching educational program aims: (1) to improve geropsychology competencies of practicing VA psychologists, particularly those working within integrated settings (e.g., primary care) and (2) enrich psychologists' abilities to enact change in their clinical settings. Ninety-eight VA clinicians participated in the GSP-P, which includes a multi-day in-person course, from 2014 to 2018. Participants completed measures assessing confidence and self-reported knowledge in geropsychology and integrated care competencies pre-course and 3-months post-completion. Two-weeks post-course participants responded to open-ended survey questions regarding their perceptions of the course and potential applications of learning. Significant improvements in confidence in and knowledge of geropsychology and integrated care competencies emerged from pre-course to 3-months post-completion. Qualitative findings demonstrated that participants valued the face-to-face, integrated multimodal educational program. Findings provided insights regarding clinicians' planned application of the knowledge acquired, such as modifying treatments for older patients. Specialized workforce programs such as the GSP-P have a significant, positive impact on the care of older Veterans.
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Affiliation(s)
- J W Terri Huh
- VA San Francisco Health Care System, San Francisco, California, USA.,Wright Institute Clinical (PsyD) Program and Berkeley CBT Clinic, Berkeley, California, USA
| | - Rachel L Rodriguez
- Mental & Behavioral Health Service, Durham VA Health Care System, Durham, North Carolina, USA
| | - Jeffrey J Gregg
- Mental & Behavioral Health Service, Durham VA Health Care System, Durham, North Carolina, USA.,Department of Medicine-Geriatrics, Duke University, Durham, North Carolina, USA
| | - Ashley N Scales
- Palo Alto Geriatric Research, Education, and Clinical Center, VA Palo Alto, Health Care System, Palo Alto, California, USA.,Research Service, Atlanta VA Health Care System, Atlanta, Georgia, USA
| | - B Josea Kramer
- Greater Los Angeles Geriatric Research Education and Clinical Center, Greater Los Angeles Health Care System, Los Angeles, California, USA.,Division of Geriatric Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Christine E Gould
- Palo Alto Geriatric Research, Education, and Clinical Center, VA Palo Alto, Health Care System, Palo Alto, California, USA.,Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
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Knight BG. Training in Professional Psychology in the US: An Increased Focus on Competency Attainment. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2011.00026.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Bob G Knight
- Davis School of Gerontology and Department of Psychology, University of Southern California
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14
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Huh JWT, Rodriguez R, Gould CE, R Brunskill S, Melendez L, Kramer BJ. Developing a program to increase geropsychology competencies of Veterans Health Administration (VHA) psychologists. GERONTOLOGY & GERIATRICS EDUCATION 2020; 41:463-479. [PMID: 29989527 DOI: 10.1080/02701960.2018.1491402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There is an alarming supply and demand gap for geropsychology expertise within the United States. Health policy experts called for increasing geriatric mental health competencies for all mental health providers, including within Veterans Health Administration (VHA), to address this problematic gap. The VHA Geriatrics Scholar Program (GSP) Psychology Track was developed because there were no commercially available trainings in geropsychology for licensed psychologists. Developing the GSP Psychology Track was based on an evidence-based educational model for the VHA primary care workforce; and included a stepwise curriculum design, pilot implementation, and program evaluation. The educational program was pilot tested with eight VHA psychologists. Evaluation results demonstrated feasibility of implementing an innovative integrated multimodal educational program in geropsychology. Furthermore, this program was associated with reports of increased confidence in geropsychology competencies and self-reported implementation of geropsychology knowledge, indicating the potential for this educational model to improve mental health care for older Veterans.
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Affiliation(s)
- J W Terri Huh
- Psychology Service/Medical Practice, San Francisco VHA Health Care System , San Francisco, CA, USA
| | - Rachel Rodriguez
- Psychology Service, Durham VHA Health Care System , Durham, NC, USA
| | - Christine E Gould
- Palo Alto Geriatric, Research, Education and Clinical Center (GRECC), VHA Palo Alto Health Care System , Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine , Stanford, CA, USA
| | | | - Luis Melendez
- Geriatric Research Education and Clinical Center (GRECC), VHA Greater Los Angeles Health Care System , Los Angeles, CA, USA
| | - B Josea Kramer
- Geriatric Research Education and Clinical Center (GRECC), VHA Greater Los Angeles Health Care System , Los Angeles, CA, USA
- Division of Geriatrics, David Geffen School of Medicine at University of California, Los Angeles (UCLA) , Los Angeles, CA, USA
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15
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Molinari V, Rosowsky E. Commentary on Special Issue on Geriatric Assessment. Assessment 2019; 25:394-398. [PMID: 29558819 DOI: 10.1177/1073191117711023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We provide commentary about the articles in this special section of "Assessment in Older Adults" by using van Alphen's framework of a systematic multidimensional approach for diagnosis and treatment in older adults.
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Moye J, Karel MJ, Stamm KE, Qualls SH, Segal DL, Tazeau YN, DiGilio DA. Workforce Analysis of Psychological Practice With Older Adults: Growing Crisis Requires Urgent Action. TRAINING AND EDUCATION IN PROFESSIONAL PSYCHOLOGY 2018; 13:46-55. [PMID: 31131069 DOI: 10.1037/tep0000206] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
As the proportion and sheer number of older adults in the United States continues to increase, we need to plan for their behavioral health care. Access to accurate data about current workforce characteristics in psychology can provide essential information to inform workforce planning. In this paper, we present results of the American Psychological Association's Center for Workforce Studies survey of psychologists, with a focus on older adults. Participants (N = 4,109) were doctoral psychologists identified through state licensing boards. Only 1.2% of those surveyed described geropsychology as their specialty area, although 37.2% reported seeing older adults frequently or very frequently, most often from the specialties of rehabilitation psychology, clinical neuropsychology, and clinical health psychology. Frequent providers of aging services were more likely to be older, nonethnic minority, working in independent practice as their primary work setting, and self-employed as compared to other respondents. In addition, frequent providers of services to older adults were more likely to be in practices colocated with medical professionals and to accept Medicare as payment. Low reimbursement rates were cited as a reason for not accepting Medicare by those who did not. There was strong interest in further education in aging from all psychologists in areas including adjustment to medical illness/disability, depression, bereavement, dementia, anxiety, psychotherapy, and caregiver stress. The results of this survey suggest a continued urgent need to train psychologists across subfields in foundational geropsychology competencies that all psychologists should possess to be prepared for the rapidly growing and increasingly diverse population of older adults.
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Affiliation(s)
- Jennifer Moye
- VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts
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Hinrichsen GA, Emery-Tiburcio EE, Gooblar J, Molinari VA. Building foundational knowledge competencies in professional geropsychology: Council of Professional Geropsychology Training Programs (CoPGTP) recommendations. ACTA ACUST UNITED AC 2018. [DOI: 10.1111/cpsp.12236] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Zeiss AM. Cognitive Behavioral Therapy as an Integral Component of Interprofessional Care. COGNITIVE AND BEHAVIORAL PRACTICE 2016. [DOI: 10.1016/j.cbpra.2016.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The Knowledge and Skills Assessment (KASA) tool in the Australian Dementia Behaviour Management Advisory Service: development and initial testing. Int Psychogeriatr 2016; 28:833-44. [PMID: 26732175 DOI: 10.1017/s1041610215002070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND As the global population ages, it is important that the professional care workforce is well prepared to support the needs of people with dementia. In Australia, the Dementia Behaviour Management Advisory Service (DBMAS) supports people with dementia and their carers through an interdisciplinary team approach. To provide DBMAS Behaviour Consultants with a tool to guide them in their professional development, this project aimed to develop a self-assessment tool to enable self-reflection on clinical competencies required for working in the service and identification of areas where further development would be required. METHODS A multi-stage process was applied in the development of the tool, including review of the relevant literature and focus groups with DBMAS Behaviour Consultants and Team Leaders. The tool encompasses both skills and knowledge in working with people with dementia and caregivers. A pilot study including 14 DBMAS consultants was conducted to assess the utility of the measure and ensure variability of ratings across knowledge and skill areas relative to time working in DBMAS. RESULTS The Knowledge and Skills Assessment (KASA) was developed and is now used in DBMAS service both with novice Behaviour Consultants and more experienced staff, and is also being used as an on-line version, accompanied with case vignettes. CONCLUSIONS The KASA provides a valuable self-assessment tool for professional care staff working in dementia care, but would nevertheless still warrant further testing of its psychometric characteristics.
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Curyto KJ, Vriesman DK. Development of the Knowledge of Dementia Competencies Self-Assessment Tool. Am J Alzheimers Dis Other Demen 2016; 31:18-26. [PMID: 26006789 PMCID: PMC10852629 DOI: 10.1177/1533317515581703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Competent dementia care requires caregivers with specialized knowledge and skills. The Knowledge of Dementia Competencies Self-Assessment Tool was developed to help direct care workers (DCWs) assess their knowledge of 7 dementia competencies identified by the Michigan Dementia Coalition. Item selection was guided by literature review and expert panel consultation. It was given to 159 DCWs and readministered to 57 DCWs in a range of long-term care settings and revised based on qualitative feedback and statistical item analyses, resulting in 82 items demonstrating good internal consistency and test-retest reliability. Performance on items assessing competencies rated as most important was significantly related to training in these competencies. The DCWs in day care obtained higher scores than those in home care settings, and their sites reported a greater number of hours of dementia training. Validation in a more diverse group of DCWs and assessing its relationship to other measures of knowledge and skill is needed.
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Affiliation(s)
| | - Deedre K Vriesman
- Maple Creek-Lutheran Social Services of Michigan, Grand Rapids, MI, USA
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21
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Bush SS, Allen RS, Heck AL, Moye J. Ethical Issues in Geropsychology: Clinical and Forensic Perspectives. PSYCHOLOGICAL INJURY & LAW 2015. [DOI: 10.1007/s12207-015-9242-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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June A. Providing Competent Care During Advanced Illness and the Dying Process. THE GERONTOLOGIST 2015. [DOI: 10.1093/geront/gnv042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Hoge MA, Karel MJ, Zeiss AM, Alegria M, Moye J. Strengthening psychology's workforce for older adults: Implications of the Institute of Medicine's report to Congress. AMERICAN PSYCHOLOGIST 2015; 70:265-78. [PMID: 25844650 PMCID: PMC4860607 DOI: 10.1037/a0038927] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Professional psychology faces an urgent crisis, which the following facts paint in stark relief. Adults over age 65 will rise to 20% of the U.S. population over the next 15 years and already account for a third of the country's health care expenditures. Up to 8 million older adults experience mental health and substance use conditions in a given year, yet most psychologists receive no training in their assessment and treatment. No more than an estimated 4%, or 3,000, psychologists nationwide specialize in geropsychology; a ratio approaching 3,000 to 1. A small group of advocates within the profession have sounded the alarm and worked to strengthen geropsychology as a specialty, but this has had very limited impact on the actual supply of psychologists qualified to provide services to this population. In 2012, an Institute of Medicine (IOM) committee released a report on the crisis regarding the mental health and substance use workforce for older adults. Drawing on that report, a team composed of geropsychologists, along with psychologists who served on the IOM committee, identifies in this article priority areas for workforce development. The authors assess the progress of psychology in each of these areas and offer a set of recommendations for future efforts by this profession to develop its own workforce and to strengthen the ability of other caregivers to address the behavioral health needs of older adults. Strengthening its own workforce and responding to the needs of this population is imperative if psychology is to maintain its relevance as a health profession and meet its ethical obligations to an increasingly diverse society.
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Affiliation(s)
- Michael A Hoge
- Department of Psychiatry, Yale University School of Medicine
| | - Michele J Karel
- Mental Health Services, U.S. Department of Veteran Affairs, Central Office
| | - Antonette M Zeiss
- Mental Health Services, U.S. Department of Veteran Affairs, Central Office
| | - Margarita Alegria
- Center for Multicultural Mental Health Research, Cambridge Health Alliance
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24
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Segal DL. Introduction. Clin Case Stud 2012. [DOI: 10.1177/1534650112465350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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25
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Holtzer R, Zweig RA, Siegel LJ. Learning From The Past and Planning For The Future: The Challenges Of And Solutions For Integrating Aging Into Doctoral Psychology Training. TRAINING AND EDUCATION IN PROFESSIONAL PSYCHOLOGY 2012; 6:142-150. [PMID: 23483705 PMCID: PMC3590915 DOI: 10.1037/a0029365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The long forecast "elder boom" has begun. Beginning in 2011, ten thousand members of the "baby boom" generation began turning 65 each day. This demographic shift in our society mandates that pre-doctoral programs in clinical psychology incorporate aging as an integral component of their core and elective training. While fully supporting the concept of broad and general training for predoctoral professional psychology programs, we maintain that the infusion of aging into doctoral psychology training curricula has been inadequate. In this manuscript we provide an overview of geropsychology training models and discuss the challenges involved in incorporating aging to the curriculum of pre-doctoral training in clinical psychology. Potential solutions and examples for accelerating infusion of aging knowledge base are discussed in the context of different geropsychology training models. We conclude that providing services to this rapidly growing segment of our population presents both an employment opportunity to broaden the reach of our profession as well as an ethical responsibility to train future professionals who will practice within their area of knowledge and expertise.
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Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University
- Department of Neurology, Albert Einstein College of Medicine, Yeshiva University
| | - Richard A. Zweig
- Ferkauf Graduate School of Psychology, Yeshiva University
- Department of Psychiatry, Albert Einstein College of Medicine, Yeshiva University
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Molinari V, Edelstein BA. Commentary on the current status and the future of behavior therapy in long-term care settings. Behav Ther 2011; 42:59-65. [PMID: 21292052 DOI: 10.1016/j.beth.2010.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 08/06/2010] [Indexed: 10/18/2022]
Affiliation(s)
- Victor Molinari
- College of Behavioral and Community Sciences, University of South Florida, Tampa, FL 33612, USA.
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