4  PRIMARY CARE PSYCHOLOGY TRAINING AT VCU
Amidst this ever‐shifting pandemic, psychologists and psychology training sites across the United States scrambled both to continue and adapt their services and training models. For over a decade, VCU has had a training model built on placing psychology doctoral students in integrated care settings. The VCU Primary Care Psychology Training Collaborative (PCPTC; see pcpsych.vcu.edu) began in 2008 as an initiative to train psychologists to meet the national workforce demand for psychologists trained to work in integrated primary care in what was then a newly emerging specialty area of integrated behavioral health. The unique competencies in delivery of this type of service include interdisciplinary collaboration, provision of brief problem‐focused interventions for both mental health and health behavior concerns, briefer and less frequent sessions, and flexibility for accepting same‐day handoffs from other providers. Integrated care is widely recognized as a particularly important care model for reducing mental health disparities by minimizing barriers and enhancing access in underserved populations where mental health services are otherwise limited. HRSA has been funding training programs in integrated primary care because doing so meets their dual mission of filling the health care gap for underserved populations with trainee‐provided services and developing a workforce who have the skills and motivation to serve these communities. The VCU PCPTC has been continuously funded by HRSA since 2008 and has funded over 100 trainees who provided more than 18,000 sessions of pro bono care during that time. Currently, we operate in 12 different adult and pediatric safety‐net clinics in the community, have 5 faculty supervisors, 17 funded doctoral trainees, and another 15 more junior practicum trainees. The clinics we partner with run the gamut from large university‐based training clinics primarily serving low‐income patients to smaller free clinics that operate with private funding and a workforce of volunteer clinicians to supplement a limited number of paid staff. Two of our partners are clinics which have their own in‐house mental health clinics, with one being a large federally funded clinic serving individuals who are at risk for homelessness.
The services provided by our trainees address a wide range of issues in both children and adults, including mental health concerns such as depression, anxiety, anger management, anxiety, depression, grief, neurocognitive screenings, parent‐child relationship issues, postpartum depression, psychosis screenings, risk assessment of potential harm to self or others, stress management, and trauma‐informed care. Common health behavior issues that are addressed include adjustment to chronic medical conditions, diabetes management, chronic pain, insomnia, smoking cessation, substance use, and weight loss. The overall focus is on equipping future psychologists with the skills to work in the fast‐paced world of primary care psychology, providing first‐line behavioral health services in the same place where patients receive their routine medical care. These patients in general face a wide array of environmental stressors and traumatic experiences (Baylor Williams et al., 2019), having received either inadequate or no behavioral health services in the past. Studies have shown that the brief services delivered by our team are effective in reducing anxiety and depression (Sadock, Perrin, Grinnell, Rybarczyk, & Auerbach, 2017) and reducing preventable hospitalizations (Lanoye et al., 2017).