Teaching Pre-Doctoral Psychology Interns to Train/Supervise First Year Family Practice Residents on Behavioral Health Theory and Issues Through a Half-Day 12 Week Seminar Format George Hurley, PhD, R Psych Internship Training Director, University Counselling Centre, Memorial University of Newfoundland, Canada www.mun.ca/counselling/internship History of the Interdisciplinary Training Program at the MUN Counselling Centre • 1981 - First Family Practice Resident at the Counselling Centre • 1981 - First interdisciplinary practicum at the Centre • 1983 - Start of Family Practice Residents’ Training Program at the Counselling Centre • 2004 - Doctoral psychology interns begin teaching/supervising the seminar • 2009 - About 500 family practice residents have participated in the seminar at the Centre Assumptions of the Program • The helping professions are more alike than different in a number of areas. • Trainees, regardless of discipline, struggle through much the same process of growth and development . (Hurley and Schoenberg, 1983) • Common training experiences promote an increased understanding of shared as well as differing perspectives. (Hurley, 1986) Program Structure • 1st year Requirement of FPU rotation • 12 week Wednesday morning seminar - baseline standardized patient - review two patient videotapes - participate in seminar discussion - pre-post learning goals review - pre-post interviewing skills self assesment Standardized Patient Evaluation • • Standardized Patient Grading Scale: 1 = Poor; 2 = Adequate; 3 = Good; 4 = Very Good; 5 = Excellent • • • • • • Introduced Self and greeted you warmly using your name Demonstrated courteous and professional behavior Language: non-jargon; easily understood Explored your expectations of care Elicited and responded to the main points of your concerns Demonstrated active listening by using the techniques of restatement, reflection and clarification Perceived a sensitive and caring attitude to your needs and feelings; acknowledged your emotions Checked your level of understanding of your illness, treatment etc. Instilled a sense of confidence in their ability and/or desire to help you and eased your concern Rate your satisfaction with this Patient-Doctor encounter Comments: • • • • • • Typical SP baseline rating Seminar Content Session Topics New Participants Introduction to IPR, Session Topics, Participant Record, IPR Inquiry Leads, Four Active Listening Skills, George Hurley’s IPR Heuristics Week 1 Transference/Counter transference Week 2 Stages of Change Motivational Interviewing I Week 3 Motivational Interviewing II Week 4 Solution-Focused Counselling I Week 5 Solution-Focused Counselling II Seminar Content: Continued Week 6 Depression & Cognitive-Behavioural Therapy (CBT) I Week 7 Depression & Cognitive-Behavioural Therapy (CBT) II Week 8 Grief & Bereavement Week 9 Gender & Diversity Issues Week 10 Couples Counselling Week 11 Personality Disorders/Difficult Patients Week 12 Stress Management & Self-Help Resources IPR Seminar Participant Record Participant Name:_________________________________________________ Residency, Practicum, or Internship: ____ Family Medicine ____ MEd in Counselling Psychology ____ MN ____ MSW ____ PhD or PsyD in Psychology ____ Psychiatry Self-identified areas of interpersonal interviewing strength: 1. ______________________________________________________________ 2. ______________________________________________________________ 3. ______________________________________________________________ Self-identified growth areas in interpersonal interviewing: 1. ______________________________________________________________ 2. ______________________________________________________________ 3. ______________________________________________________________ Personal education plan for IPR seminars (learning goals for the 12 weeks): ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Participant Record: cont. Participant Summary of 12-Week IPR Seminar • what I feel that I accomplished vis-à-vis my learning goals • what I will continue to address as learning growth edges • how the seminars might be enhanced for future participants Comments by IPR Facilitator • Final Appraisal: ____ Satisfactory • Participant: _______________ • IPR Facilitator: _______________ • Date: _______________ ____ Unsatisfactory Typical Interdisciplinary Training Issues Unfamiliarity with other disciplines – Different languages – Lack of exposure to other trainees – Assumed power differentials – Assumed criticisms – Negative alliances training history • Us vs. them Typical Interdisciplinary Training Tasks Finding mutual ground & developing empathy for one another – Role struggles • Work hours • Salaries • Trainee status – Complementary perspectives synergies – Mutual problem solving Interdisciplinary Training Goals Forging Positive Alliances – Short term alliances • Socializing together • Informal consultations – Medium term alliances • Referrals to one another – Long term alliances • Setting up multidisciplinary practices Competencies required by psychology interns to train FP residents Supervision experience – Supervise practicum students UCC experience – Comfort with interdisciplinary environment • Working with other residents one-on-one Practical strategies for training interns to supervise residents Agency Factors: - Model a positive interdisciplinary environment with faculty/staff hirings. - Develop interdisciplinary case conferences - Cross refer and consult regularly with interdisciplinary colleagues Training Strategies • Get psychology interns facilitating medical students’ learning • Let interns see medical students as clients • Have interns supervise graduate students • Have interns initially co-facilitate residents’ seminars with faculty/senior staff • Have interns train/supervise residents towards the end of internship References Hurley, G., & Garland, J. (Eds.). (1988). Introduction to Medical Interviewing, St. John's, Newfoundland: University Counselling Centre, Memorial University of Newfoundland. Hurley, G. (Ed.) (1986). Teaching family practice residents counseling skills in a university counseling centre. International Association of Counselling Services Monograph Series, No. 2. Alexandria, VA: IACS. Hurley, G. and Schoenberg, B. M. (1983). Interdisciplinary practicum training at a university counselling centre [Summary]. Proceedings of the 1983 Canadian Association of College and University Student Services National Conference, 20.