Pediatric primary care behavioral health track
Geisinger’s pediatric primary care behavioral health (PCBH) track offers a comprehensive training program in short-term, evidence-based treatment within the primary care setting. As an innovative healthcare system serving thousands of patients within rural settings, Geisinger is focused on improving patient access to both physical and mental healthcare. As such, pediatric psychologists are fully integrated into primary care teams throughout the system. This training program offers an exciting opportunity for interns to work side by side with medical professionals to provide effective interventions to children, adolescents and families across central Pennsylvania.
As the field of psychology continues to shift toward an emphasis on team-based care, the demand for well-qualified integrated primary care psychologists is growing. Our program offers a unique opportunity to acquire skills and knowledge needed to thrive in this fast-paced field by immersing trainees full time in an established integrated primary care model. Interns will leave the program with a strong knowledge of clinical skills, operational factors, administrative procedures and program evaluation approaches unique to integrated care. Trainees will build and maintain strong relationships with medical partners, conduct brief consultation and intervention, and implement systems-level interventions and design program evaluation. Many program graduates pursue careers in integrated primary care and serve as leaders in implementation of this model at major health systems and universities.
At Geisinger, we adhere to the scientist-practitioner model of psychological practice. Clinical training experiences follow the apprentice model. Trainees are supervised by faculty members with active clinical practices and function with considerable autonomy, assuming junior level staff responsibilities.
Participants in the program are expected to:
- Develop clinical skills to support independent practice
- Collaborate in the medical setting by learning about the medical culture, serving as interdisciplinary team members, and consulting with physicians
- Work with culturally diverse groups and respect individual differences
- Apply research skills in a clinical setting
- Uphold high standards of patient care and professional ethics
- Use scientific evidence to guide practice
- Advocate for the profession of psychology
Over the training year, interns expand their skills in the areas of assessment, treatment, consultation and research. Clinical experiences are of primary importance with particular emphasis placed on learning behavior change methods. Faculty members provide supervision in empirically supported therapies including cognitive-behavioral therapy, acceptance and commitment therapy, and motivational interviewing.
Pediatric PCBH clinics are currently located in 13 practices across central Pennsylvania. These clinics are divided into three regions: Western, Central and Eastern. Some clinics, known as “hubs," also accept patients from nearby partnering clinics, known as “extensions.” Interns are assigned to regions and have multiple clinical experiences within that region. Primary care sites vary in terms of level of integration, patient populations and treatment experiences. Intern cohorts in each region meet for a full day of training per month in addition to the monthly seminar day for all interns. During full-day trainings, interns participate in trainings on current evidence-based care, receive time to collaborate on shared research projects, and build connections within cohorts. Additional opportunities for bonding among the entire training class are available during monthly seminar days.
Click here to view a map of our pediatric PCBH clinics.
Clinical practice in pediatric PCBH setting
Interns provide evidence-based individual, group and family therapy approaches in the primary care setting. In this setting, there is an emphasis on short-term, problem-focused assessment and brief intervention. Interns develop treatment plans in collaboration with primary care providers (PCPs) and deliver all services on-site in medical practices. Trainees operate on a similar schedule as faculty, offering 60-minute new patient evaluations and 30-minute return therapy sessions.
Consultation & collaboration
Behavioral health clinicians (BHCs) and trainees function as central members of the primary care team. As such, consultation time is built into the schedule to allow for frequent face-to-face consultation to PCPs throughout the clinic day. This consultation may include education on a behavioral health topic or specific guidance on their approach to a patient issue. Trainees also receive warm hand-offs from medical providers throughout the day. During a warm hand-off, a medical provider introduces a patient to the BHC for an unscheduled visit or consultation. Warm hand-offs may involve patient education, brief intervention, triage for evaluation, introduction to and scheduling of services, or assistance with behavioral issues during the medical visit (e.g., shot administration).
Crisis evaluation & treatment
PCBH clinics aim to provide timely patient care close to home and reduce unnecessary utilization of high intensity services in the emergency room or inpatient setting. Consistent with this goal, interns and faculty support PCPs in the same-day management of crisis situations. Trainees expand skills in crisis risk assessment, safety planning and stabilization within the primary care setting.
PCBH interns provide valuable training and education to PCPs, medical residents, nurses and office staff within the primary care setting. Formats vary across clinics and may include scheduled lectures and trainings, individual consultation, case conference and clinical observation. Educational topics are tailored to meet the needs of the clinic and have included motivational interviewing, school anxiety and refusal, behavioral parent training skills, supporting transgender youth and behavioral strategies for shot administration. In addition to training the medical staff, interns often supervise undergraduate students, master’s level trainees and medical residents.
Group treatment programs
Group treatment programs in primary care include:
- Behavioral parent training and children's problem-solving skills training for school-age children with disruptive behavior disorders/ADHD
- Acceptance and commitment therapy (ACT) for adolescents
- Gender group for members of the LGBTQ+ community
- Groups related to supporting kids and families through the COVID-19 pandemic
Not all primary care sites offer groups; however, trainees will spend time in multiple sites throughout the training year.
Program development & evaluation
Psychology trainees often contribute to clinic-wide improvement efforts and assist staff in implementation, problem solving and evaluation of these approaches. Examples of past efforts include creating a token economy to improve compliance during medical visits, development of school note policies, and revision of shot administration procedures.
The Geisinger PCBH team is committed to conducting clinical outcomes research on the integrated primary care model. Schedules include protected research time, and interns are strongly encouraged to participate in evaluation and dissemination efforts during their training. Trainees have routinely presented at national conferences, and contribute on manuscripts for publication.
Interns attend two full days a month of educational seminars. One meeting a month takes place in Danville with all Geisinger psychology interns and one meeting a month takes place in a regional location with all PCBH staff from that region. Educational experiences during the training year include the following:
- Clinical didactics: Trainees participate in educational seminars in advanced therapy techniques of motivational interviewing, acceptance and commitment therapy, and dialectical behavioral therapy
- PCBH team meeting: Includes discussion of administrative and operational factors, ethical concerns in PCBH settings, faculty lectures, and focus on professional development and career planning
- PCBH journal club: Trainees and faculty lead discussions of recent literature from integrated primary care settings with focus on clinical applications
- Case conference: Discussion and problem solving of challenging clinical cases
- Faculty-led seminars on evidence-based techniques, ethical and professional issues, supervision and diversity and culture
Selection procedures and benefits
Nine pediatric PCBH interns will be accepted for the 2021-2022 academic year. Preference is given to applicants who meet four admission criteria:
- Enrolled in an APA- or CPA-approved doctoral training program;
- At least three years of full-time graduate level training (four years preferred);
- Passed the comprehensive or qualifying exam by the application deadline; and
- Approved dissertation proposal by application deadline.
All qualified applicants regardless of race, color, sex, marital status, age, religion or national origin are encouraged to apply.
Salary & benefits for interns
For the 2021-2022 academic year, each intern will receive a $27,000 yearly stipend, paid bi-weekly. Paid time off includes nine vacation days, six personal holidays and five sick days. Interns also receive five days that may be used for relocation or interview purposes, five days for external CMEs and three internal CME days to be used for conferences and activities within Geisinger. Attendance and presentations at appropriate psychology conferences is encouraged, and $600 is provided to support conference expenses. An additional $500 is available to purchase educational materials and pay dues for professional organizations. Upon completion of orientation, interns will receive a Bank of America debit card for $750. Further benefits include comprehensive health insurance for interns and dependents, professional liability insurance, life insurance and assistance with moving expenses.
Interns have the opportunity to apply for a full-time postdoctoral fellowship in pediatric PCBH. PCBH fellows are provided more in-depth training in clinic administration, metrics, teaching and supervision of others. PCBH fellows assist in the supervision of interns.