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 PsychInternship Training Director, University Counselling Centre, Memorial University of Newfoundland, Canadawww.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 ContentSession Topics

New ParticipantsIntroduction to IPR, Session Topics, Participant Record, IPR Inquiry Leads, Four Active Listening Skills, George Hurley’s IPR Heuristics

Week 1Transference/Counter transference

Week 2Stages of ChangeMotivational Interviewing I

Week 3Motivational Interviewing II

Week 4Solution-Focused Counselling I

Week 5Solution-Focused Counselling II

Seminar Content: ContinuedWeek 6

Depression & Cognitive-Behavioural Therapy (CBT) IWeek 7

Depression & Cognitive-Behavioural Therapy (CBT) IIWeek 8

Grief & BereavementWeek 9

Gender & Diversity IssuesWeek 10

Couples CounsellingWeek 11

Personality Disorders/Difficult PatientsWeek 12

Stress Management & Self-Help Resources

IPR SeminarParticipant 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 ____ Unsatisfactory• Participant: _______________• IPR Facilitator: _______________• Date: _______________

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

ReferencesHurley, 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. Inter national 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.