Postgraduate Residency Presentation #3 Postdoctoral Psychology

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Welcome

Implementing Post-Graduate Nurse Practitioner and Clinical Psychology ResidenciesFebruary 24, 2016WEBINAR 3: From Recruitment to Graduation: The Structure, Design, and Content of the 12-month Postdoctoral Clinical Psychology Residency Program

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Community Health Center, Inc.

Foundational Pillars

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 - 1972200+ delivery sites130k patients

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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 modelInvited 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 centersInvited participation in Learning Collaboratives to implement these programs at your health center

Email your contact information to nca@chc1.com and visit www.chc1.com/NCA.

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From Recruitment to Graduation: The Structure, Design and Content of the 12-month Postdoctoral Clinical Psychology Residency ProgramTodays 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.

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Get the Most Out of Your Zoom ExperienceSend in your questions using Q&A function in ZoomLook out for our polling questionsLive tweet us at @CHCworkforceNCA and #StartingResidencies and #HRSAnca Presentation and slides will be available after on our websiteCME approved activity please complete survey Upcoming webinars: Register at www.chc1.com/nca

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Preliminary Issues to Consider1. 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

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CHCI Postdoctoral Training Content 1. Direct clinical care In integrated care settings, school based health centers, and homeless/domestic violence sheltersMinimum of 900 visits/yearGoal of 3 groups/weekFull age rangeWHOsReal time consults: reactive and proactiveBrief screening with care planning3. SupervisionMeets CT licensing requirements2 hours individual, 1 hour groupMultidisciplinary teams (peer supervision)

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CHCI Postdoctoral Training Content (Cont.)4. PI TrainingDartmouth Institute model/resident projectsParticipation in quality improvement initiatives, performance improvement committee, BHQI committee, 5. Weekly training seminarIndividualized training opportunitiesIRB, school-based, BHQI, Project ECHO, research 7. Supervision of externs with supervision of supervision (new)

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A year in the life CHCI Postdoctoral ResidencyGetting Ready Our residents 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 outMinus 2 months: Review training materials, ensure placements and supervisors are lined up, plan orientationMinus 1 month: Make individualized templates for client scheduling, plan individualized schedules (time and place at each site), match outgoing residents clients with incoming residents

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A year in the life of the CHCI Postdoctoral Residency Residents Arrive!SeptemberJoint residency orientation with shared training and tracks for each specialty Saturday brunch with supervisors, residents, and significant others/spousesIndividual and group training goals setShadow medical staff and supervisorsStart seeing clients ( ramp up starting with intake, transfers and warm-handoffs) didactic seminar individual and group supervisionreflective journal

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A year in the life of the CHCI Postdoctoral ResidencyThe Residents Ramp UpOctober to FebruaryBuilding a caseloadAssignment to specialized training and other duties On line applications for the next cohort begin in the fall.Monthly supervisors meetings.First written evaluation in December (via Survey Monkey for data collection)Residents each lead one didactic seminar December to FebruaryHalfway through! - structured feed back session with Residents in FebruaryResidents participate in interviews for next years 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

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A year in the life of the CHCI Postdoctoral ResidencyThe residents settle inMarch to JuneEstablished 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 AprilNew 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

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A year in the life of the CHCI Postdoctoral ResidencyPreparing to move onJuly and AugustFuture plans at CHCI or elsewhere are finalizedThose accepting academic appointments may need to plan to leave earlier than end of AugustFor some states EPPP may be taken when supervised hour requirements are met even prior to completion of postdoc).Transfer and termination of clinical cases completedThird and final written feedback completed by supervisors and reviewed with ResidentsProgram ends last week in AugustGraduation celebration for residents and families, supervisors, and clinical staff

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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.

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Salud Family Health Centers Psychology Postdoctoral Fellowship (APPIC Member)Jonathan Muther, PhD, Director of Behavioral Health & Psychology Training

WorkforceFundingRecruitmentRigorous Training GroundRange of ServicesGrant SupportExpanded Testing Postdoc Project APPIC MemberExtern ExpansionEnhanced DidacticsSpanish Group SupBilling Program Eval.Policy/ Healthcare LandscapePrep for ACC 2.0

Acknowledgements: Andrea Auxier, PhD, Katrin Seifert, PsyD, Yaira Oquendo-Figueroa, PhDSustainability

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Psychology Training ProgramAPPIC Member, Postdoc Licensed Psychologists 2-4 Postdoctoral FellowsPre-doctoral InternAdvanced practicum students (DU GSPP, DU Counseling & Clinical, CSU, UNC, CU Denver)

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Catchment Area

Ft. LuptonFrederick Longmont Brighton Commerce City Estes Park

Ft. Morgan Sterling

Ft. Collins

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Who Are Our Patients (2015, All sites)

~70,000 Unique Patients, ~300,000 Visits/Year

Patients by Age Group0 to 55 to 1718 to 6465 and overPercentage 14.9%22.2%57.6%5.3%

Insurance Below Poverty lineMedicaid MedicarePrivate CHP+UninsuredPercentage61% 52.5%5.7%13.0%2.8%26.0%

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Who Are Our Patients (2015, All sites)LanguageEnglishSpanishOtherPercentage59.11%37.4%3.49%

Race/EthnicityHispanicNH/WhiteNH African AmericanNH OtherUnreportedPercentage57.61%34.74%2.24%2.20%3.22%

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Services we ProvideUniversal screening of all patients for psychosocial stressors and MH conditionsFollow up assessment and treatment for positive screensConsultation: PCP requests evaluation and/or intervention by BHPBrief/Short-term therapyPsychological assessment for adults & children in English and SpanishShared Medical Appointments

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QualificationsA generalist able to address the full range of symptoms seen in primary careInterested in, and strongly value importance of cultural awareness and interventions designed to meet the need of a diverse populationHave some degree of understanding of medical terminology and medical illnessesHave at least a rudimentary understanding of normal and abnormal human developmental processes across the lifespan to be able to work with people of all agesWilling to see patients in the medical rooms, often with interruptionsAble to make quick connections with patients, formul