Monitor on Psychology - March 2012 - (Page 5)

president’s column Increasing psychology’s role in integrated care By Dr. Suzanne Bennett JohnSon • aPa PreSiDent Expanding psychology’s role in advancing health is one of three components of APA’s strategic plan. To reach this goal, psychology must become a bigger player in integrated care. Our current fee-for-service health-care system is not working; U.S. health-care costs continue to rise and far exceed the expenditures of other developed countries with poorer health outcomes.1 The passage of the Patient Protection and Affordable Care Act has stimulated new approaches to health care that are patientcentered, rather than provider-centered. Such approaches attempt to address all of a patient’s needs — both medical and psychological — through the efforts of an interdisciplinary health-care team committed to an integrated care model. Integrated care is not entirely new. As a licensed practitioner who specialized in childhood diabetes, I saw my patients in a pediatric diabetes clinic. Childhood diabetes is a lifelong illness that cannot be cured. Not only is the diagnosis of the disease a shock to the child and family, but the daily demands of managing the disease are sobering (e.g., giving insulin injections, pricking the child’s finger to test blood glucose). On top of this, families have to live with the normal developmental challenges associated with nurturing a child into adulthood, all of which may negatively impact the child’s diabetes management. The psychological demands of the disease are as great as the medical demands. Having a psychologist on the health-care team eases the burden on the child, family and the medical provider. Further, having a psychologist on the team eliminates the stigma of seeing a psychologist for the patient and family and provides immediate access to someone with specialty training in diabetes. However, the need for integrated care — one that marries both psychological and medical treatment in a patient-centered approach — is not limited to specialty clinics for children with life-threatening diseases. Most patients with mental health conditions are seen in primary care and most receive no mental health treatment.2 Primary-care providers do their best to address patients’ complaints; however, this often involves many diagnostic tests and referrals to specialists, at considerable expense, before the underlying psychological issue is discerned — if it is identified at all. Integrated care teams can better address patients’ needs by providing the full range of expertise M a rc h 2 0 1 2 • M o n i to r o n p s yc h o l o g y in a collaborative team-based approach. While there is no question that appropriately trained psychologists have much to offer integrated care teams, many health providers are unfamiliar with the particular skills psychologists offer and may turn to other professionals — such as social workers and nurses — for these services. Adding to the problem is that most psychologists are not trained to practice in integrated care settings. As the health-care system moves toward integrated care, it is essential we prepare psychologists to effectively practice in team-based, primarycare settings. I am pleased to report that APA has initiated an interorganizational effort to specify the competencies needed for psychologists to practice in primary care. Several APA divisions that have a long history of integrated care training and practice (Div. 20, Adult Development and Aging; Div. 38, Health; Div. 54, Pediatric) have joined with the Association of Psychologists in Academic Health Centers, the Collaborative Family Healthcare Association, the Council of Directors of Clinical Health Psychology Training Programs, the Society of Behavioral Medicine, the Society of Teachers of Family Medicine and the Veterans Administration Training Council to form this inter-organizational work group. It is chaired by Dr. Susan McDaniel, a pioneer in the delivery of psychological services as part of primary care. Their work will inform 1. training programs preparing the next generation of psychologists to practice in this new health-care environment, 2. practicing psychologists who want to expand their skills to practice in primary-care settings; and 3. other healthcare providers about the many important contributions psychologists can make to integrated care teams. n 1 2 Ann Intern Med. 2008;148:55-75. Psychosomatic Medicine 2010;72:511-518 5

Table of Contents for the Digital Edition of Monitor on Psychology - March 2012

Monitor on Psychology - March 2012
Letters
President’s column
Contents
From the CEO
Supreme Court rejects eyewitness protections
New member benefit: prevention screenings
A psychodynamic treatment for PTSD shows promise for soldiers
Was ‘Little Albert’ ill during the famed conditioning study?
New research identifies ways to improve eyewitness identifications
In Brief
‘Our health at risk’
Perspective on Practice
APA endorses higher education guidelines
TIME CAPSULE
QUESTIONNAIRE
Random Sample
Judicial Notebook
Help for struggling veterans
Driving out cancer disparities
In the Public Interest
SCIENCE WATCH
Practice, virtually
The legal and ethical issues of virtual therapy
Psychologist PROFILE
EARLY CAREER PSYCHOLOGY
Bringing life into focus
Pay attention to me
AMERICAN PSYCHOLOGICAL FOUNDATION
Division Spotlight
Personalities

Monitor on Psychology - March 2012