WelcomeImplementing Post-Graduate
Nurse Practitioner and Clinical Psychology Residencies
February 24, 2016
WEBINAR 3: From Recruitment to Graduation: The Structure, Design, and Content
of the 12-month Postdoctoral Clinical Psychology Residency Program
Community Health Center, Inc.
Foundational Pillars1. Clinical Excellence- Fully Integrated teams,
Fully integrated EMR, PCMH Level 3
2. Research & Development- The Weitzman Institute is the home of formal research, quality improvement, and R&D 3. Training the Next Generation: Post Graduate Training Programs for nurse practitioners, postdoctoral clinical psychologists, and students of the health professions
CHC Profile:•Founding Year - 1972•200+ delivery sites•130k patients
The Community Health Center, Inc. and its Weitzman Institute will provide education, information, and training
to interested health centers in: Transforming Teams• National Webinars on the team based care model• Invited participation in Learning Collaboratives to launch team
based care at your health center
Training the Next Generation• Two National Webinar series on developing Nurse Practitioner
and Clinical Psychology residency programs and successfully hosting health professions students within health centers
• Invited participation in Learning Collaboratives to implement these programs at your health center
Email your contact information to [email protected] and visit www.chc1.com/NCA.
From Recruitment to Graduation: The Structure, Design and Content of the 12-month
Postdoctoral Clinical Psychology Residency Program
Today’s Objectives:1. Participants will describe the key components of the process of implementing a postdoctoral clinical psychology training program at their health center.2. Participants will identify the necessary structure, design, and content of a 12 month postdoctoral clinical psychology training program.
Get the Most Out of Your Zoom Experience• Send in your questions using Q&A function in Zoom• Look out for our polling questions• Live tweet us at @CHCworkforceNCA and #StartingResidencies and
#HRSAnca • Presentation and slides will be available after on our website• CME approved activity – please complete survey • Upcoming webinars: Register at www.chc1.com/nca
Preliminary Issues to Consider
1. Value postdoctoral residency adds to your program2. What you can give residents3. Your resources4. Association of Psychology Postdoctoral and Internship Centers and American Psychological Association standards5. State licensing regulations
CHCI Postdoctoral Training Content 1. Direct clinical care
• In integrated care settings, school based health centers, and homeless/domestic violence shelters
• Minimum of 900 visits/year• Goal of 3 groups/week• Full age range
2.WHOs• Real time consults: reactive and proactive• Brief screening with care planning
3. Supervision• Meets CT licensing requirements• 2 hours individual, 1 hour group• Multidisciplinary teams (peer supervision)
CHCI Postdoctoral Training Content (Cont.)4. PI Training
• Dartmouth Institute model/resident projects
• Participation in quality improvement initiatives, performance improvement committee, BHQI committee,
5. Weekly training seminar6. Individualized training
opportunities• IRB, school-based, BHQI, Project
ECHO, research 7. Supervision of externs with supervision of supervision (new)
A year in the life CHCI Postdoctoral Residency
Getting Ready • Our resident’s year runs Sept 1 to August 31st. The leadership team is working before the residents arrive.
• Minus 3 months: Postdoctoral leadership retreat to plan for coming year and recruitment one year out
• Minus 2 months: Review training materials, ensure placements and supervisors are lined up, plan orientation
• Minus 1 month: Make individualized templates for client scheduling, plan individualized schedules (time and place at each site), match outgoing resident’s clients with incoming residents
A year in the life of the CHCI Postdoctoral Residency
Residents Arrive!September• Joint residency orientation with shared training and tracks for
each specialty Saturday brunch with supervisors, residents, and significant others/spouses• Individual and group training goals set• Shadow medical staff and supervisors• Start seeing clients ( ramp up starting with intake, transfers
and warm- handoffs) didactic seminar
individual and group supervisionreflective journal
A year in the life of the CHCI Postdoctoral Residency
The Resident’s Ramp UpOctober to February• Building a caseload• Assignment to specialized training and
other duties • On line applications for the next cohort
begin in the fall.• Monthly supervisor’s meetings.• First written evaluation in December
(via Survey Monkey for data collection)• Residents each lead one didactic
seminar December to February• Halfway through! - structured feed back
session with Residents in February• Residents participate in interviews for
next year’s class in late February • Tentative discussions begin about
interest in staying on at CHCI as the budget process for the next fiscal year gets underway in February
A year in the life of the CHCI Postdoctoral Residency
The residents settle inMarch to June• Established relationships with medical providers lead to increased • Deepening relationships with cohort. Program should provide ways to
encourage this.• Focus on skill development and self awareness as soon to be independent
psychologists • Second formal written evaluation occurs in April• New class is finalized in April (Phase II interviews and selection)• Residents attend and present at the Behavioral Health Annual meeting • Interviews for CHCI positions which will be open or created in the fall occur and
job offers for those staying on are made
A year in the life of the CHCI Postdoctoral Residency
Preparing to move onJuly and August• Future plans at CHCI or elsewhere are
finalized• Those accepting academic
appointments may need to plan to leave earlier than end of August
• For some states EPPP may be taken when supervised hour requirements are met even prior to completion of postdoc).
• Transfer and termination of clinical cases completed
• Third and final written feedback completed by supervisors and reviewed with Residents
• Program ends last week in August• Graduation celebration for residents
and families, supervisors, and clinical staff
What we have learned1. Offering a Postdoc Residency is possible. 2. Postdocs increase access for clients, bring their added strengths to clinical programs, add current knowledge to administrative committees and processes.3. Supervisors and staff teaching didactics enjoy participating in the Residency program.4. Postdoc training is a great recruitment tool. 5 APPIC membership is a worthwhile investment.6. Plan ahead for the APA accreditation process – especially data on success of program7. Supervision training is needed.8. One day per week for didactics, supervision, and cohort activity is invaluable.9. Be very clear about expectations and what you can and cannot offer to avoid conflicts and recriminations later in the training year.10. Post-docs improve processes and systems by providing feedback to staff about workflow issues. Post-docs aid in the testing of new initiatives, including a planned care dashboard for behavioral health.
Salud Family Health Centers Psychology Postdoctoral Fellowship (APPIC Member)
Jonathan Muther, PhD, Director of Behavioral Health & Psychology Training
2010-'11 2011-'12 2012-'13 2013-'14 2014-'15 2015-'16 2016 --->02468
1
75 4 4 3 3
# of Postdoctoral Fellows
WorkforceFundingRecruitmentRigorous Training GroundRange of Services
Grant SupportExpanded Ψ Testing Postdoc Project
APPIC MemberExtern Expansion
Enhanced DidacticsSpanish Group Sup
Billing
Program Eval.Policy/ Healthcare Landscape
Prep for ACC 2.0
Current Positions 8 8 4
Health Psych IPC Other
Acknowledgements: Andrea Auxier, PhD, Katrin Seifert, PsyD, Yaira Oquendo-Figueroa, PhD
Sustainability
Psychology Training Program
• APPIC Member, Postdoc • Licensed Psychologists • 2-4 Postdoctoral Fellows• Pre-doctoral Intern• Advanced practicum
students (DU GSPP, DU Counseling & Clinical, CSU, UNC, CU Denver)
Catchment Area
• Ft. LuptonFrederick ● ● Longmont
●Brighton ●Commerce City
● Estes Park
● Ft. Morgan
● Sterling ● Ft. Collins
Who Are Our Patients (2015, All sites)
• ~70,000 Unique Patients, ~300,000 Visits/YearPatients by Age Group
0 to 5 5 to 17 18 to 64 65 and over
Percentage 14.9% 22.2% 57.6% 5.3%
Insurance
Below Poverty
line
Medicaid Medicare Private CHP+ Uninsured
Percentage 61% 52.5% 5.7% 13.0% 2.8% 26.0%
Who Are Our Patients (2015, All sites)
Language
English Spanish Other
Percentage 59.11% 37.4% 3.49%
Race/EthnicityHispanic NH/White NH African
AmericanNH Other Unreported
Percentage 57.61% 34.74% 2.24% 2.20% 3.22%
Services we Provide• Universal screening of all
patients for psychosocial stressors and MH conditions– Follow up assessment and
treatment for positive screens• Consultation: PCP requests
evaluation and/or intervention by BHP
• Brief/Short-term therapy• Psychological assessment for
adults & children in English and Spanish
• Shared Medical Appointments
Qualifications
• A generalist – able to address the full range of symptoms seen in primary care
• Interested in, and strongly value importance of cultural awareness and interventions designed to meet the need of a diverse population
• Have some degree of understanding of medical terminology and medical illnesses
• Have at least a rudimentary understanding of normal and abnormal human developmental processes across the lifespan to be able to work with people of all ages
• Willing to see patients in the medical rooms, often with interruptions
• Able to make quick connections with patients, formulate assessments rapidly, determine appropriate intervention, and communicate the relevant findings to the PCP immediately
Training Components
• Weekly individual supervision, 2 hours– Sup of Sup, Professional Development, Project
• Act independently as a part of the Behavioral Health team
• Provision of supervision to practicum extern• Bi-weekly psychology didactics– Healthcare Policy; Short-term therapy; Behavioral Medicine;
Clinical Spanish & Latina/o Culture; Guest speakers• Bi-monthly Behavioral Health meetings• Participation in Denver-area postdoctoral meetings• Opportunities to provide trainings to colleagues,
Americorps members, medical team
Program Development & EvaluationThe Postdoc “Project”
• Reducing ER overutilization: Targeted screening & intervention to identify risk factors, e.g., complex medical, co-morbidities, chronic pain
• DM Shared Medical Appointments: Predictors of barriers and engagement, BH and physical outcomes
• BH Outcomes: Validating PCOMS measures in primary care; comparing outcomes to other treatment settings
• Team-based care: Improving BH and biomedical outcomes; casting a broader net; demonstrating our model works
• IPC to meet the needs of Latina/os
Requirements
• Completion of APA accredited Pre-doctoral internship• Completed Ph.D. or Psy.D. in Clinical or Counseling
Psychology • Strong commitment to working with underserved
populations • Ability to provide services with cultural competence and
sensitivity• Ability to deliver services in Spanish (preferred)
Important Dates
August November January February March April/May June/July
Orientation/Training
Marketing
Applications due 1/15
Offers made/Mid-year Eval
EPPPJob Search
Academic Year Timeline
Open Space for Discussion
RemindersSign up for our next webinar in this series:
What Your Board, Management, and Staff Need to Know about
Starting a Postgraduate Residency Program in Your Federally
Qualified Health CenterWed., March 9th, 3–4 p.m. EST
Our “Transforming Teams” series:Enhancing the Role of the Medical Assistant
Thurs., March 3rd, 2–3 p.m. EST
Sign up at www.chc1.com/NCA
SpeakersFrom Community Health Center, Inc.Margaret Flinter, APRN, PhD, Senior Vice President & Clinical Director Kerry Bamrick, MBA, Senior Program Manager Timothy Kearney, PhD, Chief Behavioral Health OfficerAdriana McCormick, Psy.D., Training Director, Postdoctoral ResidencyErica Preston, Psy.D., Behavioral Health Clinician II, Danbury CT, Supervisor and Former Postdoctoral Resident
From Callen-Lorde Community Health CenterDavid Guggenheim, PsyD, Chief Mental Health Officer
From Salud Family Health CenterJonathan Muther, PhD, Director of Behavioral Health & Psychology TrainingYajaira Johnson-Esparza, Ph.D., Current Postdoctoral Resident
Recommended
