DEPARTMENT OF FAMILY MEDICINE AND
COMMUNITY HEALTH
POST DOCTORAL FELLOWSHIP IN
CLINICAL HEALTH PSYCHOLOGY IN PRIMARY CARE
The
Department of Family Medicine and Community Health of the University of Massachusetts Medical School announces its Fellowship in
Clinical Health Psychology in Primary Care.
This is a two-year, full time, training and service experience designed
to prepare clinical and counseling psychologists to work in the clinical
service, research, and training settings associated with primary medical
care. The fellowship training is
affiliated with the Family Medicine Residency Programs of the Department. We
will begin recruiting for 2010 in November, 2009. For application information, see the end of
this description.
The Setting:
The
first residency in Family Medicine at
There are presently Fellows based
at the Hahnemann and Family Health Center of Worcester. We hope to add positions at
Purpose:
The purposes of the Department for
instituting a post-doctoral training program for psychologists are: to provide significantly more teaching in
behavioral science to family medicine residents, to teach family medicine
residents to work collaboratively with behavioral health providers in providing
primary care services, to increase the capability of the department to conduct
research on primary care questions, to develop a group of providers for the
primary care practices that are part of the U.Mass/Memorial
system, and to increase the visibility and status of the department nationally
as a center for innovation in primary care service and training. The purposes of the fellows for choosing our
program are: to finish requirements for
licensure, to work in a medical setting, to have an opportunity to mix practice
and research, to have a teaching role while still in training, and to prepare
for a position as a health provider in primary care and/or as a faculty member
in Family Medicine or other medical education setting. Every effort is made identify fellows as part
of a resident class. Having behavioral
health providers as peers in their training helps residents develop the
personal relationships on which collaboration is based. Having family medicine residents as peers in
their training helps the fellows develop familiarity with the primary care
setting in an environment of support where help with the vagaries of “medical
culture” is easily available.
Core Faculty:
Nicholas
Apostoleris, PhD, is the Director of Behavioral
Science in the
Alexander
Blount, EdD, is the Director and a primary clinical
supervisor of the Fellowship. Dr. Blount
is the Director of Behavioral Science for the Department of Family Medicine and
Community Health. He was previously Director of the
Kathleen Braden, MD, is a
Developmental Behavioral Pediatrician with extensive experience in child
behavior problems, autism spectrum disorders and child
psychopharmacology. She is one of the faculty in
the Program for School Aged Children clinic in which fellows learn brief child
and family assessment and therapy.
William Ferrarone,
PhD, is a member of the faculty at the
Daniel Mullin, PsyD,
is the onsite supervisor at the
Tina Runyan,
PsyD, recently joined our faculty at Associate
Director of Behavioral Science. She has
extensive experience in health psychology in primary care. She has been a leader in developing
integrated primary care in the Air Force and has experience in teaching and
academic leadership in health psychology graduate training.
Craig Wiener, EdD,
is the on-site clinical supervisor at Family Health Center of Worcester.
He has extensive experience in residency training and a special interest in
child behavioral issues.
There are approximately
thirty-five physician faculty members who are active in training residents and
fellows at the different health centers.
The Program:
Fellows receive focused training
in clinical health psychology as it is practiced in primary care. They provide behavioral health treatment in
the health centers and in other Family Medicine practices in the U.Mass/Memorial system.
They provide behavioral science precepting (one on one observation and
teaching) for residents in Family Medicine and join them in collaborative
patient care. They teach selected
behavioral science subjects in the health centers. Finally, they participate in research on the
processes of primary care, either by proposing their own research studies or by
working in ongoing faculty research projects. Instead of doing their own
research, some fellows opt to attend the LEND program, (described below) to
work on health policy and research as as relates to
populations with disabilities.
Fellows receive one hour per week
of clinical supervision from the Director of the program and one from the site
supervisor in their health center in both years of their program. In
addition, they average one to two additional hours of supervision per week in
live supervision and case discussions.
During all their work, there is a medical faculty preceptor available on
site for back up with decisions, adding a second layer of guidance and support.
The first year is spent refining
skills that are necessary for the practice of clinical health psychology in
primary care, becoming familiar with the routines, language, and issues of
assessment and intervention in primary care.
They learn how to develop a role as a caregiver in primary care medical
practice. First year experiences
include:
Clinical practice and consultation in primary care - Six half-days per
week
The fellow spends the majority of
his or her time as a member of primary care treatment team in one of the family
practice residency clinics. This
involves observing resident physicians in their practice, seeing patients
jointly with physicians, and carrying a caseload referred by physicians in the
practice. In the beginning of the year,
the fellow’s time is fairly unstructured.
They learn what the residents are doing by observing them as they see
their patients. This leads quickly to
dual interviews in which residents and fellows work together to treat patients.
In their clinical work in this setting, fellows are most likely to see patients
who are anxious, depressed, coping with illness, child behavior problems,
having relationship or family problems, or are abusing substances. They
also consult to physicians concerning and do triage with patients with serious
mental illnesses.
This
is a family therapy oriented brief assessment and treatment clinic. Faculty members are Dr. Blount and Dr.
Braden. It serves children aged 5-12 and
their families. It is a training clinic
for residents in Family Medicine and Pediatrics. Fellows do clinical work in front of the
one-way mirror under the supervision or provide teaching for residents.
Working in practice with Dr. Blount at
Fellows spend one half-day rounding in the
hospital with teams of residents. The fellow is an integral part of the
team, helping highlight psychosocial issues and offering a psychologist’s
perspective on the patients each team sees.
In addition, fellows are currently developing a Quality Improvement
program on the Family Medicine Inpatient Service by screening patients who have
been admitted to rule out a heart attack for anxiety and depression.
Team Precepting – One half-day
“Team precepting” is a process in
which a medical faculty member and a behavioral science faculty member work
together with a resident who sees a regular half-day of patients in front of
the one-way glass. Being with the team
allows the fellows to observe primary care services and hear the feedback of
faculty about what they are seeing.
Fellows can observe or participate in the process as they gain
confidence and experience.
Seminar in Primary Care Behavioral Health
Fellows take and often help teach
the Certificate Program in Primary Care Behavioral Health. The program consists of six all day workshops
given one Friday a month for six months which are designed to provide the skills
and tools needed by mental health professionals who want to work successfully
as a behavioral health clinicians in primary care. The course is given
twice a year. The curriculum appears at
the end of this document.
In addition . . .
In
addition, fellows give occasional lectures on mental health topics of interest
to residents at both
YEAR TWO
The second year is spent
developing skills in some of the special kinds of care offered by primary care
psychologists, in formal precepting with residents, and in some sort of research
in primary care. Whereas in the first
year, the Fellows are functioning more as peers and collaborators with
residents, in the second year they take on more faculty-like responsibilities.
Second year experiences include:
Clinical practice and consultation in primary care – Five or six
half-days per week
As in the first year, the fellow
spends the majority of his or her time as a member of primary care treatment
team in a family practice residency clinic. There is special emphasis on
consultation to help residents care for patients that they would have referred
before. There is also an experience of
developing population-based clinical care.
The fellow identifies a particular group of patients who need a
behavioral aspect to their care and researches, develops, proposes and helps
implement one “critical pathway” of care to be offered to every patient in the
practice with the identified illness.
During
this day the fellow is flexibly available for patient care and consultation at
a practice that is new to him or her. We
are offering the experience of joining a practice and meeting the needs there
when the practice is not used to having a fellow. It teaches organizational transformation
skills in addition to allowing the fellow to use their clinical and
consultation skills in a new venue.
Fellows
pursue their own research project. The Department
of Family Medicine and Community Health has developing and ongoing research in
primary care in areas such as pain, homelessness, depression and substance
abuse. The fellow is also invited to
develop their own project.
Alternatively,
fellows can opt to take one half-day from their health center practice and
their research time to spend a day per week at the LEND program.
LEND is a post graduate training experience that has been
designed to enhance the knowledge and skills of future leaders and clinicians
in interdisciplinary, family-centered and culturally competent care of children
with neurodevelopmental disabilities and their
families, or other populations with similar disabilities. Funding from the
Maternal Child Health Bureau (MCHB) is used to develop a comprehensive program
that ensures that attention is paid to identifying leadership potential in
individuals, to creating learning opportunities that will enhance this
potential, and to monitoring the progress of selected individuals in acquiring
the skills and competencies they will need to be effective in the worlds of
policy and advocacy. http://www.umassmed.edu/shriver/education/lend/index.aspx
Evaluation:
Fellows participate in a “360
degree” evaluation twice yearly.
Feedback relevant to each group’s experience with the fellow is
solicited from psychological and medical faculty, nursing and office staff
members and residents. The fellows and
immediate supervisors complete a rating of the fellows on the competencies
identified by the program. A summary document, signed by the Fellow, Director,
site supervisor and Residency Director is placed in the record. The Fellow is permitted to add a comment on
the document if they choose. Feedback on
Fellows' work is ongoing. Because
Fellows view their supervisor's clinical work and are observed in their work,
the process of exchange for mutual growth is ongoing, making formal evaluations
usually enjoyable, and sometimes redundant in feel. A Due Process plan has been adopted for
trainees. It is available on
request. In areas that are relevant to
fellows not covered by the Due Process plan, the Residency Policy Manual of
residency of the fellow’s main placement is observed.
Qualifications:
Admission requirements
include completion of all professional doctoral degree requirements in clinical
or counseling psychology from an APA/CPA-accredited program and pre-doctoral
internship meeting APPIC standards. We will give preference to candidates with demonstrated
training and experience in family therapy and/or behavioral medicine. Successful candidates commonly have previous
experience in primary care settings.
Bilingual (English/Spanish) candidates are especially sought after. Candidates who show enthusiasm for working in
a diverse workforce with a very diverse patient population are sought. Minority and candidates with disabilities are
urged to apply.
Information for Applicants:
The salary is $40,000 ($42,000 the
second year). Fellows are employees of the University of
Massachusetts Medical School and receive the same benefits package as medical
residents. This includes four weeks vacation, low cost individual or
family health plan, disability and life insurance. Applications will be accepted until the position is filled or February
15, whichever comes first. Early submission improves a candidate’s
chances. Start date is July 1, 2010, though this can be delayed if
the candidate we select is not available until September. The fellow will
be invited to an orientation program which occurs the last week of June.
To Apply:
A
letter stating interest, a CV and three letters of recommendation constitute an
application. We prefer to receive these by e-mail to Alexander Blount, Ed.D. The email address is Amy.Green@umassmed.edu . Applications can be mailed to Any Green, Department
of Family Medicine and Community Health,