Pre-Doctoral Internship - Rotation in Home-Based Primary Care

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Organization Type: 
Program Type: 
Standing Program
Education Level: 
Postgraduate (e.g., residency, fellowship)
Educational Elements: 
Independent Study
Self Reflection Activities
Experiential not including services to patients
Experiential including clinical contact with patients
Program Description: 

The Lexington VA Medical Center offers healthcare to approximately 94,000 veterans living in 36 counties in Central and Eastern Kentucky.  The primary objective of the internship program is to provide an integrated, flexible, and balanced set of learning experiences necessary for interns to emerge as competent professional psychologists. These experiences are intended to provide the aspiring psychologist with opportunities to practice and expand on previously learned skills, to develop new skills and to experience personal and professional growth. 

This program emphasizes six core competency areas including: 1) ethical and professional issues, 2) psychological assessment, 3) psychological interventions, 4) documentation, 5) providing services to diverse patients, and 6) use of science/research in practice.

Part of this 12-month internship program includes a “minor” rotation in VA Home-Based Primary Care (HBPC), which provides comprehensive, in-home, interdisciplinary primary care for veterans with complex and chronic, disabling disease.  In addition to primary care interventions, HBPC provides palliative care, rehabilitation, disease management, hospice and care coordination services. In this elective rotation, interns are involved in screening, assessment, diagnosis and treatment for psychiatric and cognitive disorders.  Behavior management planning and caregiver support are important components of the HBPC rotation.

Interns participating in the HBPC rotation spend one day per week performing duties associated with this “minor” rotation, three days per week with their “major” rotation, one day in training-related activities such as group supervision, didactic seminars, and peer supervision. Activities and roles associated with the rotations include individual and/or group psychotherapy, psychological assessment, documentation, report writing, training, and supervision.

Each intern is expected to devote 25% of his/her time to direct patient contact which includes "face-to-face" contact with patients for any type of group or individual therapy, psychological testing, rounds or patient education. Other activies the interns participate in include: delivering a presentation to at least one diagnostic and one therapy conference in order to evaluate the intern’s level of competency as it relates to basic diagnostic assessment and psychotherapy; completion of a diversity project in order to increase awareness of and attention to diversiy issues in the practice of psychology; and give a 90-minute lecture presentation on a psychological topic of their choosing.  Interns receive formal, written evaluations at the middle and end of each rotation from the major and minor rotation supervisor. Additionally, interns are asked to provide written and oral feedback regarding their internship experiences at the end of the year

Targeted Professions
Clinical Health
Self-Reported Competencies
PCPCC’s Education and Training Task Force identified 16 interprofessional training competencies critical for preparing health professionals for practicing in team-based, coordinated care models such as patient-centered medical homes. Listed below are the self-reported competencies that this program has achieved, which have been organized by the five core features of a medical home as defined by the Agency for Healthcare Research and Quality
Patient-Centered Care Competencies: 
Advocacy for patient-centered integrated care
Cultural sensitivity and competence in culturally appropriate practice
Development of effective, caring relationships with patients
Patient-centered care planning, including collaborative decision-making and patient self-management
Comprehensive Care Competencies: 
Assessment of biopsychosocial needs across the lifespan
Population-based approaches to health care delivery
Risk identification
Coordinated Care Competencies: 
Care coordination for comprehensive care of patient & family in the community
Interprofessionalism & interdisciplinary team collaboration
Quality Care & Safety Competencies: 
Assessment of patient outcomes
Quality improvement methods, including assessment of patient-experience for use in practice-based improvement efforts
Last updated November 15, 2013

* Please note: Information contained in this database is self-reported by representatives from each program. It does not represent an exhaustive list of education and training programs and inclusion does not constitute an endorsement from the PCPCC.


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