When Corinn A. Elmore, PhD, was in private practice, she sometimes found herself wanting to hurry patients along to their next goal, even if they weren’t quite ready. With hour-long therapy sessions, she admits, “it was really hard for me to stay focused and motivated.” Fortunately, her current job suits her much better.
“I’m a fast-paced, problem-solver type person,” says Elmore, now a clinical health psychologist in pediatric primary care at Walter Reed National Military Medical Center in Bethesda, Maryland. Now, she says, she can see a child for 30 minutes, help solve a problem and see the impact she has made right away.
For others, the very factors that make integrated care appealing to Elmore and Blaney are off-putting.
If you’re a fan of structure and knowing whom you’ll be seeing each day, integrated care may not be a good fit, says Cerissa Blaney, PhD, a clinical assistant professor of psychology and assistant professor of internal medicine at the University of Central Florida in Orlando. Similarly, if you appreciate longer appointments, long-term relationships with patients and the opportunity to watch patients change over a long period of time, it might be best to stick to a traditional practice. However, brief treatment and integrated team-based care can be very rewarding and effective for patients and providers.
If you’re wondering whether an integrated setting is right for you, try these tips:
- Know yourself. Think long and hard about how you feel about the characteristics of the integrated versus traditional model of care. Could you handle an unpredictable schedule? Are you OK with sharing an appointment with a physician? Feel comfortable being the only psychologist around? Assertive enough to let physicians know how you can help? For a handy list of behaviors characteristic of integrated care, see the recent article by Blaney and co-authors in Families, Systems & Health®.
- Seek out training. “You can’t know how you’d fare in an integrated setting until you actually do it,” says Elmore, who got her first exposure on internship. Blaney also suggested seeking a postdoc in an integrated setting or specialty training via programs like that offered by the UMass Medical School’s Center for Integrated Primary Care. And network with — or even shadow — psychologists in integrated settings. To find them, check out the Society of Behavioral Medicine’s integrated primary care special interest group, which Blaney co-chairs; the integrated primary care committee of APA’s Div. 38 (Society for Health Psychology); the integrated primary care special interest group of Div. 54 (Society of Pediatric Psychology); or psychologists working at Veterans Affairs facilities or federally qualified health centers.
- Overcome preconceptions. Many psychologists are trained by professors steeped in the traditional model. “A lot of us are trained that it takes a long time to build rapport, that we need to collect as much information as possible in order to best intervene or conceptualize patients’ needs,” says Blaney. Some may worry that brief assessments and interventions mean you’re somehow cheating patients. Not so on either count, says Blaney. By chipping away at patients’ behavioral health and lifestyle needs and seeing patients where they already are, she says, psychologists are helping to ensure all patients get the access to care they need. As necessary, they are often the bridge that helps get patients to longer-term care as needed.
This column is geared toward early career psychologists working in practice settings. "Running start ... to a great career" features topics typically not covered in graduate school and includes tips and advice from psychologists.