The objectives, activities, expected competencies and outcomes for each goal is described for practicum students as follows:
Competencies that guide our model of training are related to assessment, treatment, consultation, teaching, and program evaluation. Fellows participate in didactic learning that expands their information and knowledge in effective methods of psychological assessment, diagnosis and intervention. These are provided in the psychology training didactic seminars as well as experiential learning with clinical activities. These are further addressed in clinical supervision and observation by the supervisor. In each of the clinical settings, the process of learning and doing is the primary model. Trainees are assigned an appropriate case load that allows for learning and learning by observation. Cases are supervised by a licensed staff member. Clinical supervision is provided to meet with the Trainee for at least one hour for every 10 hours of time spent in training or a minimum of 2 hours per week or as much as needed and this is negotiated between the supervisee and the supervisor. More supervision is not necessarily a skills deficit but may reflect the complexity of the case load. Consultation and additional supervision varies depending on case load and issues and concerns. The Supervising Psychologist is available 24/7 by email and cell phone.
Consultation, program evaluation, supervision, and/or teaching are covered in various parts of our model. Consultation is a required competency element and is an ongoing day-to-day activity on most all of the medical units. This is a teaching hospital and medical students rotate through the clinics every 2 weeks and residents rotate through every 2 months. The psychology trainee is typically on the service for at least 6 months and is expected to provide consultation in a variety of cases not only to the students but to the clinic physicians as well. Trainees are exposed to consultation through an experiential model and are provided input and supervision on their integration and viability of consultation throughout the rotation. Most trainees come with the basics of consultation but may not have worked on medical units before. This is an integral part of their role on the medical unit and is clearly a valued component both by the trainee and the medical staff. Program evaluation is specified as a skill and is also expected for the Clinical Health Psychologist. Trainees are involved in this to a large extent that is also re-occurring throughout the year. Though all will have experience in program evaluation it typically takes on a variety of levels of skill and continues to build throughout the year. It may start with simply addressing why patients show up and why they do not. They might be expected to design an evaluation system and it may culminate in an intervention program such as developing handouts or phoning patients the night before (this was an actual project of a former trainee). It might increase in skill level and in one case the trainee took on the project of evaluating the psychology pain management structured group program. This took a much higher level of skill but was highly successful and led to some refinement and redesigning the program.
Finally, supervision and teaching is included as a goal/objective for trainees. They are likely to have the opportunity to provide case supervision to practicum students, under the supervision of a licensed staff member but all trainees are exposed to the variety of models of supervision through didactics. In reality they are supervising (through consultation) medical students and residents and provide continuous feedback regarding basic skills of interviewing.
Strategies of scholarly inquiry are specified as a goal for our model (part of Goals 1 and 2). In addition, while on the fellowship, time is made available for clinical research, didactics on advanced research skills, attention to relevant literature, construed broadly to include general information on the specialty population(s) of interest, general knowledge concerning psychopathology and other mental health issues in those populations, and empirically supported assessment and treatment approaches. This goal is met clinical experience, supervision, and formal didactics; numerous opportunities throughout campus, reading and integrating empirically supported treatments in case conceptualization and treatment are an integral part of learning in the advanced practice of psychology. Trainees are expected to integrate science into their treatment sessions and provide literature citations for their treatment during case conference and supervision.
Organization, management, and administration experience are provided as a component of the training model. Formal training is limited but trainees are exposed to a wide variety of issues related to organization, management, and administrative issues.
Professional issues and conduct, including law and ethics and service provider standards, are emphasized in our direct clinical supervision. During case discussion, supervisors routinely raise issues of ethical and legal standards and encourage Trainees to be sensitive to the ethical implications of various assessment information and treatment decisions especially in underserved populations. Supervisors also emphasize these issues when providing supervision for the Trainees’ teaching and supervision. In addition, many didactic experiences are available as these are daily issues in the provision of health care.
Cultural and individual diversity are important issues throughout our medical center. UTMB has a long history of providing care to underserved populations. UTMB has an enrollment greater than 30% of students from underserved backgrounds. UTMB provides service to a wide array of groups representing multiple categories of individual difference. UTMB serves all age populations, different sexual orientation (gay, lesbian, bisexual, and transgendered), the full spectrum of socioeconomic status and educational levels, and many racial/cultural groups. Cultural groups of highest prevalence in the UTMB population which has a lengthy history of providing underserved populations in Texas include Caucasian, African-American, Hispanic and Latino, Vietnamese, Indian and Native-Americans. In addition, many clinical settings serve the families and caregivers of patients. The UTMB has a roster of translators available when the concerns of patients cannot be well-addressed using English.
UTMB generally holds at least one major conference per year emphasizing cultural or other individual difference variables, as they affect the provision of psychological services. Trainees will be encouraged to attend the annual training and any other relevant didactic experiences (e.g., at Psychiatry Grand Rounds). Trainees, as researchers, will be able to study the impact of cultural diversity and individual differences on the diagnosis and treatment of specific medical conditions. Finally, the topic of individual differences and compliance are continuously offered on the campus and are fully integrated into the case conference and patient treatment seminars.