Current Practices in Clinical Supervision in Primary Care

The purpose of this study was to examine current clinical supervision practices within primary care settings. We used a descriptive survey design, which blends quantitative and qualitative data, and examined the current state of clinical supervision practices and approaches in primary care and the type of training the behavioral health consultants received to provide supervision to pre-licensure level behavioral health trainees. Ninety-four participants completed the survey in 2022. Seventy-one percent of respondents felt they had adequate training to be an effective integrated behavioral health (IBH) supervisor; however, most training came from sources, such as workshops, continuing education, or supervision of supervision. Further efforts to establish universal competencies and formal training programs are needed to meet the growing need for IBH services in primary care.

Navigating Supervision and Interprofessional Relationships in Health Psychology

Previous literature has focused on either individual models of supervision, developing trainees' interprofessional competencies, or on developing and maintaining interprofessional relationships outside of training. For psychologists in medical settings, these concepts are inextricably linked, and supervision must combine these professional practices to successfully meet the needs of psychology trainees, patients, and interprofessional colleagues, in an increasingly integrated healthcare landscape. This paper presents a model for advancing interprofessional collaborative practice competencies in supervision as health psychology trainees progress through the developmental stages of clinical competency, while supervising psychologists also maintain interprofessional relationships. The Interprofessional Collaboration Supervision Model (IPCSM)for Psychology describes trainee, patient, and interprofessional team factors for supervising psychologists to consider in supervision, as well as various interventions to deploy when these interrelated dynamics impact training. Case examples are provided along with discussion on how to implement this model in supervision.

The Continuum of Intervention Models in Integrated Behavioral Health

The current models of clinical collaboration between physicians and psychologists/social workers in the pediatric outpatient primary care setting fall along a continuum of integration of services and philosophies of care. Domains of integration include physical office location, the targeted patient population, the level of professional adaptation to other professions' model of training, and the influence of current models of reimbursement. Included here is an analysis of those models based on each continuum of integration. Each model is discussed with respect to where it falls on each continuum.

Training Psychologists in Integrated Primary Care and Child Maltreatment: Trainee and Supervisor Perspectives on Lessons Learned

Psychologists are key team members in the delivery of integrated behavioral healthcare. Healthcare reform has supported a shift toward a team-based, interdisciplinary model of service delivery, with increasing emphasis on primary care services, prevention, and health promotion. In conjunction with this shift has been a greater focus on psychosocial problems and social determinants of health, particularly childhood adversity. Psychologists in primary care are uniquely positioned to advance efforts to prevent and ameliorate childhood adversity, which are essential to improving care for underserved populations and reducing health disparities. Targeted training efforts are needed to increase the number of psychologists equipped to work in primary care settings with underserved populations. This paper provides an overview of a training program designed to provide psychology trainees with specialized training in both integrated primary care and child maltreatment. The overarching goal of the program is to provide trainees with the skillset to work within integrated primary care settings and the expertise needed to further efforts to address and prevent child maltreatment, as well as childhood adversity more broadly, to improve outcomes for underserved populations. The paper reviews strengths, challenges, and lessons learned from this program.

Improving Integration of Behavioral Health Into Primary Care for Adolescents and Young Adults

Problems related to mood, substance use, anxiety, body image issues, post-traumatic stress, and suicidality are common in adolescence and become even more common in young adulthood. Integrated behavioral health (IBH) in primary care has shown great promise in identifying and treating adolescents and young adults who have these problems. Treatment outcomes in IBH settings outperform those in usual primary care settings where a primary care provider may identify behavioral health problems and refer youth to colocated or outside behavioral health specialists. Despite the success of IBH care systems, limited training opportunities and inadequate financial compensation for these services jeopardize the wide scale expansion and universal adoption of IBH. To optimize patient care, providers from all disciplines in adolescent primary care settings should have dedicated professional training in IBH. This should include incorporating IBH professional competencies into each discipline's formal training program and building interprofessional, multidisciplinary IBH training settings. Likewise, payers should work with primary care systems to create and implement reimbursement models for IBH services. Efforts to expand the footprint of IBH would pay off significantly by building more worldwide BH systems with increased efficacy at identifying and treating adolescents with BH conditions.

Social Worker Integrated Care Competencies Scale (SWICCS): Assessing social worker clinical competencies for health care settings

Integrating physical and behavioral health services has the potential to reduce health disparities and service inequities among persons most at risk. However, clinical social workers in integrated health settings must possess relevant knowledge and skills to provide quality care to diverse populations. The Social Worker Integrated Care Competency Scale (SWICCS), developed to complement the Integrated and Culturally Relevant Care (ICRC) field education curriculum, measures students' self-perceptions of knowledge and skills associated with providing behavioral health care. Three student cohorts (n = 38) completed the SWICCS three times during an integrated care field practicum. Results indicated a statistically significant increase in student knowledge and skills at each time point, with a large effect size (r = -.87). The SWICCS demonstrated utility in measuring and tracking social work student acquisition of knowledge and skills required for practice in integrated care environments.

Education programs for medical psychiatry collaborative care: A scoping review

OBJECTIVE

To understand the current state of collaborative care education programs reported in the literature.

METHODS

Following Arksey and O'Malley methodology for scoping reviews, data was abstracted in following domains: article details, program details, program outcomes, and implementation factors. Numerical summaries were calculated where necessary. Implementation factors underwent a qualitative thematic analysis.

RESULTS

This review identified 40 unique collaborative care education programs. Most programs (n = 25; 62.5%) were delivered to a multi-disciplinary group of learners through didactic (n = 34; 85.0%) and/or in vivo (n = 32; 80.0%) training methods. The majority of programs focused on clinical knowledge/skill acquisition (n = 38; 95.0%) as opposed to attitudes towards mental health and collaboration (n = 27; 67.5%). Implementation factors fell within four themes: program development, supportive environment, necessary resources, and clinical change agents/leaders.

CONCLUSION

Despite the growing evidence for collaborative care, few collaborative care education programs are reported in the literature. Key elements of collaborative care education programs include: routine multi-disciplinary interaction, curriculum focus on attitudes; clinical change agents and leaders to accelerate implementation; and a user-centred design development process. Future implementations can learn from these experiences to avoid potential barriers and focus on enabling successful programs to enhance care.