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ETSU training psychologists to perform in primary care settings

Rex Barber • Jan 28, 2012 at 11:40 PM

Have you ever been visited by a psychologist at the conclusion of a routine physical at your doctor’s office?

Probably not. Not yet, anyway. But East Tennessee State University is training psychologists to perform in primary care settings rather than only the traditional closed-door office setting.

According to Dr. Michael Floyd, professor emeritus with the ETSU department of family medicine, this kind of setup is referred to as a patient-centered medical home model of health care. This model brings together many health professionals, but ETSU’s new clinical psychology concentration in the Ph.D. in psychology focuses on training psychologists to work in such settings.

“At least 30 percent of the problems people have who come into a primary care clinic have a strong psycho-social focus,” Floyd said.

These problems can include mourning or schizophrenia.

Floyd said early on in a mourning process, for example, a person may be less willing to go seek the aid of a psychologist. But if the psychologist is already in the primary care setting, the patient would be more likely to take advantage of the services.

Floyd also said about 20 percent of people who go to a clinical care setting have been using substances like alcohol in an unhealthy manner.

Floyd helps facilitate the psychology students’ participation in three family medicine clinics managed by the James H. Quillen College of Medicine’s department of family medicine.

According to ETSU, an article, “The Patient-Centered Medical Home: Unprecedented Workforce Growth Potential for Professional Psychology,” featured in the current online issue of Professional Psychology: Research and Practice — a journal of the American Psychological Association — lauds ETSU for its coursework and experiential training in primary care psychology.

Jodi Polaha, associate psychology professor, said psychologists can assist in treating depression, sleep problems, weight loss, quitting smoking, asthma and diabetes.

She said this is important, because doctors can prescribe all kinds of treatments, but if a patient does not follow the prescribed procedures or treatments or take the prescribed medications, treatment is for naught.

“You can have the most knowledgeable doctor in the world ... but if the person won’t take the pill, it kind of stops there,” Polaha said.

As far as prevention, Polaha said psychology can also assist in preventing things like domestic violence or postpartum depression.

Wallace Dixon, chairman of the department of psychology, said it will become more and more common for doctor’s clinics to become integrated with many health professionals. These clinics will likely seek accreditation as a medical home, he said. Such facilities will require a work force that includes psychologists like those now being trained at ETSU, Dixon said.

“And we’re at the cutting edge of providing that work force,” he said.

Dixon said the typical physician will save time by having a psychologist on staff, because on average, 20 to 30 percent of the issues physicians deal with are behavioral issues.

“Not only does it take their time, but do these physicians know what they’re doing?” Dixon asked. “Probably not.”

Polaha said psychology has developed a lot of evidence-based treatment but traditionally it can take weeks to work with a patient. Increasingly, psychologists are trying to adapt those treatments for use in a faster-paced primary care setting, where doctors can see more than 20 patients in a day.

Polaha said she hoped people realize there is value in having a mental health professional operating out of a primary care setting and also that area health professionals realize that such mental health professionals are being trained here in Johnson City.

She said psychology is no longer a private one-on-one conversation in a room with the psychologist in one chair and the patient on the couch. She said today, psychologists have research-based services that are marketable to the public.

“It’s about a new kind of way of viewing psychology,” she said. “There is a myth that human suffering is not OK or not normal. That’s just not true. Everybody experiences some level of suffering. It’s all about how you manage it.”

There are about 25 students in the psychology doctorate program right now. The first students are scheduled to graduate this year.

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