Wednesday, Sept. 11, 2019

The Health Resources and Services Administration has awarded a $1.35 million grant to a program that embeds Virginia Commonwealth University psychology doctoral trainees in eight Richmond-area health safety-net clinics, where they provide free behavioral health services to underserved populations.

The grant to the Primary Care Psychology Training Collaborative, part of the Department of Psychology in the College of Humanities and Sciences, will fund the program’s continuation and expand it to include training in substance abuse screening and treatment, behavioral health services to supplement medical treatment for opioid use disorder, and telehealth services to primary care clinics in rural Virginia.

“First and foremost, our goal is to provide care to vulnerable and underserved communities in Richmond, including adults and kids, as well as the growing Latinx community in Richmond,” said Bruce Rybarczyk, Ph.D., a professor of clinical psychology and principal investigator on the grant. “And all of the services we provide are pro bono and are integrated into the places where they are already receiving primary care services. So these patients don’t have any financial or access barriers.”

The program places clinical and counseling psychology doctoral trainees at VCU-affiliated and other safety-net clinics throughout Richmond. They provide behavioral health care services alongside medical providers, often including VCU Health medical residents.

The trainees provide services for issues such as adjustment to chronic medical conditions, diabetes management, pain, insomnia, smoking cessation, substance use and weight loss. Also, mental health issues such as attention deficient hyperactivity disorder, anger management, anxiety, depression, grief, neurocognitive screenings, parent-child relationship issues, postpartum depression, psychosis screenings, risk assessment of potential harm to self or others, stress management, and trauma-informed care.

The Primary Care Psychology Training Collaborative operates at the VCU Health Ambulatory Care Center, the VCU Academic Medical Center Pediatric Residents Clinic, the VCU Adult Cystic Fibrosis Clinic, the VCU Complex Care Clinic, CrossOver Healthcare Ministry Clinic, Daily Planet, the Hayes E. Willis Health Center and Health Brigade. As part of the new grant, the training collaborative also will operate at the VCU Health Multidisciplinary Outpatient Intensive Addiction Treatment Clinic, or the MOTIVATE Clinic, and with Telehealth at VCU Health in partnership with VCU Health Community Memorial Hospital in South Hill.

Since the program started in 2008, the Primary Care Psychology Training Collaborative has provided more than 16,000 pro bono sessions at Richmond-area clinics.

A key part of the program’s mission is to equip future psychologists to meet the workforce demands of a changing health care system that includes integrated primary care. Since 2008, it has trained 140 doctoral students.

Each year, the Primary Care Psychology Training Collaborative provides 15 to 20 graduate student fellowships for both clinical and counseling doctoral students in the Department of Psychology. It also provides practicum training experiences for another 10 to 15 students annually.

“We’re training up a cadre of students who are equipped to work in the fast-paced world of primary care psychology, an emerging new area of health care that provides first-line behavioral health services in the same place where patients get their routine medical care. They are also being equipped to work with vulnerable individuals who face a wide array of environmental stressors and traumatic experiences and have received either inadequate or no behavioral health services in the past,” Rybarczyk said. “Of the 140 people we’ve trained, we have a remarkable number who’ve given us the feedback that this was a game-changing experience for them in developing their skills and also in helping them make a choice to work with underserved populations in their future careers.”

The program also involves research into the effectiveness of brief behavioral interventions in health safety-net settings, as well as the overall efficacy of the integrated care model. The team has published 18 chapters and research articles, with three more currently under review, as well as more than 50 conference presentations.

“We’re the first line of treatment. We try to do the most good we can by providing brief but effective interventions to the largest possible population of patients and their families,” Rybarczyk said. “So we’re studying how well this model works. We’re seeing low-income patients who have very limited access to mental health care. Can we make a significant difference with brief interventions? Which interventions work best? Can we prevent mental health problems from becoming chronic and debilitating by catching and treating them at their earliest stage?”

The idea, he said, is that with brief interventions, the program can have a broad impact across the region’s underserved populations.

“We’re distributing our services across a very wide population of patients, more than 1,000 every year,” he said. “The idea is to give each patient two, three or four sessions, and try to make an impact within this brief intervention framework.”

The Graduate Psychology Education grant is from the Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services. The program has a goal of expanding training in psychology services for low-income, underserved populations, while also creating a professional pipeline of future clinical psychologists to serve those communities.

This is the fourth consecutive Graduate Psychology Education grant in support of the Primary Care Psychology Training Collaborative awarded to Rybarczyk and is paired with another important HRSA training grant awarded to Heather Jones, Ph.D., associate professor in the Department of Psychology. Combining these grants, they have created the largest psychology doctoral training program nationally in terms of HRSA funds awarded, number of students and faculty who participate, and clinics and patients served.   

In addition to Rybarczyk and Jones, faculty on the new grant include Paul Perrin, Ph.D., associate professor in the Department of Psychology, and Leila Islam, Ph.D., assistant professor in the Department of Psychiatry, along with program alumna and community psychologist Carla Shaffer, Ph.D.

Key partners also include F. Gerard Moeller, M.D., chair of the Division of Addiction Psychiatry in the VCU School of Medicine; Vimal Mishra, M.D., associate professor in the School of Medicine and medical director for the Office of Telemedicine; and Alan Dow, M.D., the Seymour and Ruth Perlin Professor of Medicine and Health Administration and assistant vice president of health sciences for interprofessional education and collaborative care in the Department of Internal Medicine.