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

History of the Interdisciplinary Training Program at the MUN Counselling Centre First Family Practice Resident at the Counselling Centre First interdisciplinary practicum at the Centre Start of Family Practice Residents Training Program at the Counselling Centre Doctoral psychology interns begin teaching/supervising the seminar 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 1 st 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 Hurleys 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 ____ 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

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. 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.