Skip to main content

Advertisement

SpringerLink
Log in

Integrating mind and body: Graduate psychology education in primary behavioral health care

  • Original Paper
  • Published:
Journal of Clinical Psychology in Medical Settings Aims and scope Submit manuscript

Abstract

Extensive research supports the biopsychosocial model, but the current health care system generally operates according to a model of mind-body dualism. Integrated primary behavioral health care offers an alternative to this dualism. This paper describes the University of Louisville Graduate Psychology Education (GPE) program, a pre-doctoral integrated primary behavioral health care training program. This program emphasizes four shared psychosocial determinants that have been associated with physical health status: Victimization and potentially traumatic stress exposure, emotional functioning, social relationship functioning, and illness representations. It does so within the broader context of providing care for individuals who are underserved and economically disadvantaged. The initial phase of the program is evaluated and implications for graduate psychology education and patient care are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Kahn, R. L., & Syme, S. L. (1994). Socioeconomic status and health: The challenge of the gradient. American Psychologist, 49, 15–24.

    Article  PubMed  CAS  Google Scholar 

  • Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001). The prevalence of comorbid depression in adults with diabetes: A meta-analysis. Diabetes Care, 24, 1069–1078.

    Article  PubMed  CAS  Google Scholar 

  • APA (1998). Interprofessional health care services in primary care settings: Implications for the education and training of psychologists. Education Directorate, American Psychological Association.

  • Berkman, L. F., Leo-Summers, L., & Horwitz, R. I. (1992). Emotional support and survival after myocardial infarction: A prospective, population-based study of the elderly. Annals of Internal Medicine, 117, 1003–1009.

    PubMed  CAS  Google Scholar 

  • Blount, A. (1998). Introduction to integrated primary care. In A. Blount (Ed.), Integrated Primary Care: The Future of Medical and Mental Health Collaboration (pp. 1–43). New York: W. W. Norton.

    Google Scholar 

  • Boscarino, J. A. (2004). Posttraumatic stress disorder and physical illness: Results from clinical and epidemiologic studies. Annals of the New York Academy of Sciences, 1032, 141–153.

    Article  PubMed  Google Scholar 

  • Cacioppo, J. T., & Hawkley, L. C. (2003). Social isolation and health, with an emphasis on underlying mechanisms. Perspectives in Biology and Medicine, 46, S39–S52.

    PubMed  Google Scholar 

  • Cohen, S., Tyrrell, D. A. J., & Smith, A. P. (1991). Psychological stress and susceptibility to the common cold. The New England Journal of Medicine, 325, 606–612.

    PubMed  CAS  Google Scholar 

  • Coker, A. L., Davis, K. E., Arias, I., Desai, S., Sanderson, M., Brandt, H. M., & Smith, P. H. (2002). Physical and mental health effects of intimate partner violence for men and women. American Journal of Preventive Medicine, 23, 260–268.

    Article  PubMed  Google Scholar 

  • Collins, K. A., Westra, H. A., Dozois, D. J. A., & Burns, D. D. (2004). Gaps in accessing treatment for anxiety and depression: Challenges for the delivery of care. Clinical Psychology Review, 24, 583–616.

    Article  PubMed  Google Scholar 

  • Coyne, J. C., Thompson, R., Klinkman, M. S., & Nease, D. E. (2002). Emotional disorders in primary care. Journal of Consulting and Clinical Psychology, 70, 798–809.

    Article  PubMed  Google Scholar 

  • DeGruy, F. (1996). Mental health care in the primary care setting. In M. S. Donaldson, K. D. Yordy, K. N. Lohr, & N. A. Vanselow (Eds.), Primary Care: America's Health in a New Era. Washington, DC: National Academy Press.

    Google Scholar 

  • Deykin, E. Y., Keane, T. M., Kaloupek, D. G., Fincke, G., Rothendler, J., Siegfried, M., & Creamer, K. (2001). Posttraumatic stress disorder and the use of health services. Psychosomatic Medicine, 63, 835–841.

    PubMed  CAS  Google Scholar 

  • DiMatteo, M. R. (2004). Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology, 23, 207–218.

    Article  PubMed  Google Scholar 

  • Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–135.

    Article  PubMed  CAS  Google Scholar 

  • Frayne, S. M. (1998). Clinical challenges in primary care of women with prior sexual trauma. Supplement to Federal Practitioner, May, 3–5.

    Google Scholar 

  • Gray, G. V., Brody, D. S., & Johnson, D. (2005). The evolution of behavioral primary care. Professional Psychology: Research and Practice, 36, 123–129.

    Article  Google Scholar 

  • Kagawa-Singer, M., & Kassim-Lakha, S. (2003). A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes. Academic Medicine, 78, 577–587.

    Article  PubMed  Google Scholar 

  • Katon, W., Von Korff, M., Lin, E., Simon, G., Walker, E., Unutzer, J., Bush, T., Russo, J., & Ludman, E. (1999). Stepped collaborative care for primary care patients with persistent symptoms of depression: A randomized trial. Archives of General Psychiatry, 56, 1109–1115.

    Article  PubMed  CAS  Google Scholar 

  • Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. (1995). Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry, 52, 1048–1060.

    PubMed  CAS  Google Scholar 

  • Kiecolt-Glaser, J. K., & Newton, T. L. (2001). Marriage and health: His and hers. Psychological Bulletin, 127, 472–503.

    Article  PubMed  CAS  Google Scholar 

  • Kimmel, P. L., Peterson, R. A., Weihs, K. L., Shidler, N., Simmens, S. J., Alleyne, S., Cruz, I., Yanovski, J. A., Veis, J. H., & Phillips, T. M. (2000). Dyadic relationship conflict, gender, and mortality in urban hemodialysis patients. Journal of the American Society of Nephrology, 11, 1518–1525.

    PubMed  CAS  Google Scholar 

  • Kleinman, A. (1980). Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley: University of California Press.

    Google Scholar 

  • Koss, M. P., Koss, P. G., & Woodruff, J. (1991). Deleterious effects of criminal victimization on women's health and medical utilization. Archives of Internal Medicine, 151, 342–347.

    Article  PubMed  CAS  Google Scholar 

  • Lazarus, A. A. (1985). Casebook of multimodal therapy. New York: Guilford Press.

    Google Scholar 

  • Leventhal, H. (1982). Behavioral medicine: Psychology in Health Care. In D. Mechanic (Ed.), Handbook of Health Care Policies and the Health Professions (pp. 709–743). New York: Free Press.

    Google Scholar 

  • Leventhal, H., Leventhal, E. A., & Cameron, L. (2001). Representations, procedures, and affect in illness self-regulation: A perceptual-cognitive model. In A. Baum, T. A. Revenson, & J. E. Singer (Eds.), Handbook of Health Psychology (pp. 19–47). Mahway, New Jersey: Lawrence Erlbaum.

    Google Scholar 

  • McDaniel, S. H., Hargrove, D. S., Belar, C. D., Schroeder, C., & Freeman, E. L. (2004). Recommendations for education and training in primary care psychology. In R. Frank, S. McDaniel, J. Bray, & M. Heldring (Eds.), Primary Care Psychology (pp. 63–92). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Newton, T. L., & Doron, S. E. (2000). Cognitive-behavioral processes in managing the stress and anxiety of medical illness. In D. I. Mostofsky & D. H. Barlow (Eds.), The Management of Stress and Anxiety in Medical Disorders (pp. 84–99). Boston: Allyn & Bacon.

    Google Scholar 

  • Newton, T. L., Parker, B. C., & Ho, I. K. (2005). Ambulatory cardiovascular functioning in healthy postmenopausal women with victimization histories, Biological Psychology, 70, 121--130.

    Google Scholar 

  • Schnurr, P. P., & Green, B. L. (2004). Understanding relationships among trauma, posttraumatic stress disorder, and health outcomes. In P.  P. Schnurr & B. L. Green (Eds.), Trauma and health: Physical health consequences of exposure to extreme stress (pp. 247–275). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Seeman, T. E. (2000). Health promoting effects of friends and family on health outcomes in older adults. American Journal of Health Promotion, 14, 362–370.

    PubMed  CAS  Google Scholar 

  • Sherbourne, C. D., Wells, K. B., Meredith, L. S., Jackson, C. A., & Camp, P. (1996). Comorbid anxiety disorder and the functioning and well-being of chronically ill patients of general medical providers. Archives of General Psychiatry, 53, 889–895.

    PubMed  CAS  Google Scholar 

  • Simonsick, E. M., Wallace, R. B., Blazer, D. G., & Berkman, L. F. (1995). Depressive symptomatology and hypertension-associated morbidity and mortality in older adults. Psychosomatic Medicine, 57, 427–435.

    PubMed  CAS  Google Scholar 

  • Smedley, B. D., Stith, A. Y., & Nelson, A. R. (Eds.). (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: National Academies Press.

    Google Scholar 

  • Sobel, D. S. (1995). Rethinking medicine: Improving health outcomes with cost-effective psychosocial interventions. Psychosomatic Medicine, 57, 234–244.

    PubMed  CAS  Google Scholar 

  • Spitzer, R. L., Williams, J. B. W., Kroenke, K., Linzer, M., DeGruy, F., III, Hahn, S. R., Brody, D., & Johnson, J. G. (1994). Utility of a new procedure for diagnosing mental disorders in primary care: The PRIME-MD 1000 study. Journal of the American Medical Association, 272, 1749–1756.

    Article  PubMed  CAS  Google Scholar 

  • Stetson, B. A., Barnes, N., Barton, T., Starr, C., Raake, P., Broadstone, V., & Mokshagundam, S. (2000). The role of depression in glycemic control and CHD risk factors in diabetes. Diabetes, 49, A64.

    Google Scholar 

  • Strosahl, K. (1998). Integrating behavioral health and primary care services: The primary mental health care model. In A. Blount (Ed.), Integrated Primary Care: The Future of Medical and Mental Health Collaboration (pp. 139–166). New York: W. W. Norton.

    Google Scholar 

  • Strosahl, K. (2001). The integration of primary care and behavioral health: Type II change in the era of managed care. In N. Cummings, W. O’Donohue, S. C. Hayes, & V. Follette (Eds.), Integrated behavioral healthcare: Positioning mental health practice with medical/surgical practice (pp. 45–76). San Diego, CA: Academic Press.

    Google Scholar 

  • Williams, R. B., Barefoot, J. C., Califf, R. M., Haney, T. L., Saunders, W. B., Pryor, D. B., Hlatky, M. A., & Siegler, I. C. (1992). Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease. Journal of the American Medical Association, 267, 520–524.

    Article  PubMed  CAS  Google Scholar 

  • Wilson, D. K., Kliewer, W., & Sica, D. A. (2004). The relationship between exposure to violence and blood pressure mechanisms. Current Hypertension Reports, 6, 321–326.

    Article  PubMed  Google Scholar 

  • Yali, A. M., & Revenson, T. A. (2004). How changes in population demographics will impact health psychology: Incorporating a broader notion of cultural competence into the field. Health Psychology, 23, 147–155.

    Article  PubMed  Google Scholar 

  • Zautra, A. J., Hoffman, J. M., Matt, K. S., Yocum, D., Potter, P. T., Castro, W. L., & Roth, S. (1998). An examination of individual differences in the relationship between interpersonal stress and disease activity among women with rheumatoid arthritis. Arthritis Care Research, 11, 271–279.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

We gratefully acknowledge the Department of Health and Human Services, Health Resources and Services Administration, for supporting this work through GPE grant D40HP00001. We would also like to thank the patients, attendings, residents, and staff of the AIM clinic for generously welcoming psychology and helping to make this program possible.

Author information

Authors and Affiliations

  1. Department of Psychological and Brain Sciences, University of Louisville, 317 Life Sciences, Louisville, KY 40292, USA

    Tamara L. Newton, Janet Woodruff-Borden & Barbara A. Stetson

Authors
  1. Tamara L. Newton
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Janet Woodruff-Borden
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Barbara A. Stetson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tamara L. Newton.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Newton, T.L., Woodruff-Borden, J. & Stetson, B.A. Integrating mind and body: Graduate psychology education in primary behavioral health care. J Clin Psychol Med Settings 13, 3–11 (2006). https://doi.org/10.1007/s10880-006-9037-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10880-006-9037-4

Keywords

Search

Navigation