1.
Developing a Postdoctoral Psychology
Residency Program in Community Health
March 29, 2022
12:00-1:00pm Eastern / 9:00-10:00am Pacific
Tim Kearney, PhD; Chelsea McIntosh, PsyD

2.
Continuing Education Credits
In support of improving patient care,
Community Health Center, Inc. / Weitzman
Institute is jointly accredited by the
Accreditation Council for Continuing Medical
Education (ACCME), the Accreditation Council
for Pharmacy Education (ACPE), and the
American Nurses Credentialing Center
(ANCC), to provide continuing education for
the healthcare team.
A comprehensive certificate will be sent after
the end of the series, Summer 2022.
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3.
Disclosure
• With respect to the following presentation, there has been no relevant (direct or indirect) financial relationship
between the party listed above (or spouse/partner) and any for-profit company in the past 12 months which
would be considered a conflict of interest.
• The views expressed in this presentation are those of the presenters and may not reflect official policy of
Community Health Center, Inc. and its Weitzman Institute.
• We are obligated to disclose any products which are off-label, unlabeled, experimental, and/or under
investigation (not FDA approved) and any limitations on the information hat we present, such as data that are
preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion.
• This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of
Health and Human Services (HHS) as part of an award totaling $137,500 with 0% financed with non-
governmental sources. The contents are those of the author(s) and do not necessarily represent the official
views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit
HRSA.gov.
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4.
At the Weitzman Institute, we value a
culture of equity, inclusiveness,
diversity, and mutually respectful
dialogue. We want to ensure that all
feel welcome. If there is anything said
in our program that makes you feel
uncomfortable, please let us know via
email at nca@chc1.com
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5.
National Training and Technical Assistance Partnership
Clinical Workforce Development
Provides free training and technical assistance to health centers across the
nation through national webinars, learning collaboratives, activity
sessions, trainings, research, publications, etc.
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6.
Why Start a Postgraduate Clinical Psychology Residency Program?
Building the Case for Your Organization
Today’s Objectives:
1. Understand the value that psychologists bring to a multidisciplinary behavioral
health program in the context of an interdisciplinary client centered team.
2. Describe the nuts and bolts of how a postdoctoral psychology residency program
works.
3. Begin to understand the considerations of developing a postdoctoral psychology
residency program.

7.
CHC Profile
Founding year: 1972
Primary care hubs: 17; 200+ sites
Staff: 1,200
Patients/year: 100,000
Specialties: onsite psychiatry, podiatry,
chiropractic
Specialty access by e-Consult
Elements of Model
Fully Integrated teams and data
Integration of key populations into primary care
Data driven performance
“Wherever You Are” approach
Weitzman Institute
QI experts; national coaches
Project ECHO®— special populations
Formal research and R&D
Clinical workforce development
CHC Locations in Connecticut

8.
Staffing and Utilization
National 2020 UDS Data from 1375 Grantees
PERSONNEL BY MAJOR SERVICE CATEGORY FTEs Clinic Visits
(a) (b)
Psychiatrists 913.22 829,947
Licensed Clinical Psychologists 972.15 505,717
Licensed Clinical Social Workers 4,944.73 2,290,125
Other Licensed Mental Health Providers 4,495.65 2,269,073
Other Mental Health Staff 3,160.20 901,128
Source: Table 5. (2020). Health Resources & Services Administration. Retrieved March 2022, from https://data.hrsa.gov/tools/data-reporting/program-
data/national/table?tableName=5&year=2020

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What Psychologists add to a BH Team
• Readiness to practice post graduation
• Skilled in psychological assessment
• Research skills which may apply to QI work
• Likely to have had EBT training and experience
• In depth and intensive, often in specific areas (health psychology)

10.
“RxP” –Prescribing Psychologists
Prescriptive authority may be granted to psychologists with;
– 2 years of postdoctoral training, or Continuing Education training in clinical
psychopharmacology and related sciences,
– followed by 1 – 2 years of supervised prescribing, or a Certificate from the
Department of Defense program, or the Board Certified Diploma from the
Prescribing Psychologists Register (FICPP or FICPPM) to enable them, according
to state law, to prescribe psychotropic medications to treat mental and
emotional disorders.
Currently five states and one US territory permit certain psychologists to prescribe
medications to their patients; Idaho, New Mexico, Louisiana, Illinois, Iowa and
Guam.

11.
For the
common good
For the
good of the
resident
For the
good of
your
agency
Drivers: Why Start a
Postdoctoral Psychology Residency Program?

12.
For the Common Good
To develop staff to address behavioral health needs of our clients,
particularly using those trained to an integrated model of primary care and
behavioral health

13.
For the Good of Your Health Centers
• Influx of new energy and enthusiasm with the most recent evidence based knowledge
• Increased staff satisfaction
• Professional development:
• Learning to supervise
• Increasing skill of clinical teaching
• Recognition of skill
• Passing on knowledge
• Improved retention
• Increased access for clients
• Opportunity to build a strong talent pool from which to hire through training pipeline

14.
For the Good of the Resident
• Prepares residents to work with vulnerable
populations in an FQHC setting
• Builds confidence within a clinical setting to
become an independent clinician with enhanced
treatment abilities and leadership skills
• Learn by doing and introject a picture of the role
of a psychologist in an integrated care setting that
informs professional self image at the start of a
career
• Prepares the resident for the EPPP licensing exam
• Increases competitiveness in the job market for
those who do not remain at their residency site
by a broad clinical exposure

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• If we want a team-based model of fully integrated
primary care and behavioral health, we have to
train the members of the team to that model
• Licensed clinical psychologists are an invaluable
member of the healthcare team and they must
acquire supervised postgraduate hours for
licensure in most states
• Today, only a handful of 112 APA accredited
postdoctoral residency programs are based in
FQHCs

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Preliminary Issues to Consider
• Value postdoctoral residency adds to
your program
• What you can give residents
• Your resources
• Association of Psychology Postdoctoral
and Internship Centers and American
Psychological Association standards
• State licensing regulations
• Telehealth considerations

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CHCI Postdoctoral Training Content
• Direct clinical care
• In integrated care settings, school based health
centers, and homeless/domestic violence shelters
• Minimum of 900 visits/year
• Goal of three groups/week
• Full age range
• WHOs
• Real time consults: reactive and proactive, face-to-
face or remote
• Brief screening with care planning
• Supervision
• Meets CT licensing requirements
• 2 hours individual, 1 hour group
• Multidisciplinary teams (peer supervision)

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CHCI Postdoctoral Training Content (cont.)
• Quality Improvement Training
• Program development and methods of change
• Integrated quality improvement project
• Participation in quality improvement initiatives,
Performance Improvement committee,
BHQI committee
• Weekly didactic seminar
• Individualized training opportunities
• IRB, school-based, Project ECHO
• Supervision of practicum students with supervision
of supervision

19.
A year in the life CHCI Postdoctoral Residency
Getting Ready
• Our resident’s year runs Sept 1 to August 31st. The
leadership team is working before the residents
arrive
• Minus 3 months: Postdoctoral leadership retreat
to plan for coming year and recruitment one year
out
• Minus 2 months: Review training materials, ensure
placements and supervisors are finalized, plan
orientation
• Minus 1 month: Make individualized templates for
client scheduling, plan individualized schedules
(time and place at each site), match outgoing
residents’ clients with incoming residents

20.
A year in the life of the CHCI Postdoctoral Residency
Residents Arrive!
September
• Joint residency orientation with shared training
and tracks for each specialty
• Saturday brunch with supervisors, residents, and
significant others/spouses
• Individual and group training goals set
• Shadow medical staff and supervisors
• Start seeing clients (ramp up starting with intake,
transfers and warm-handoffs):
• Didactic seminar
• Individual and group supervision
• Reflective journal

21.
A year in the life of the CHCI Postdoctoral Residency
The Resident’s Ramp Up
October – February
• Building a caseload
• Assignment to specialized training and other duties
• Recruiting for the next cohort begins in the fall
• Monthly supervisor meetings
• First written evaluation in December
• Halfway through! - structured feed back session
with Residents in February
• Residents participate in interviews for next year’s
class Tentative discussions begin about interest in
staying on post residency as the budget process for
the next fiscal year gets underway in February

22.
A year in the life of the CHCI Postdoctoral Residency
The residents settle in
March – June
• Residents each lead one didactic seminar December to
February (This is now the second half of the year)
• Established relationships with medical providers lead
to increased confidence
• Deepening relationships with cohort. Program should
provide ways to encourage this
• Focus on skill development and self awareness as soon
to be independent psychologists
• Second formal written evaluation occurs in April
• New class is finalized
• Residents attend the Behavioral Health Annual
meeting
• Interviews for CHCI positions which will be open or
created in the fall occur and job offers for those staying
on are made

23.
A year in the life of the CHCI Postdoctoral Residency
Preparing to move on
July and August
• Future plans at CHCI or elsewhere are finalized
• Those accepting academic appointments may need
to plan to leave earlier than end of August
• For some states EPPP may be taken when
supervised hour requirements are met even prior
to completion of postdoc
• Transfer and termination of clinical cases completed
• Third and final written feedback completed by
supervisors and reviewed with Residents
• Program ends last week in August
• Graduation celebration for residents and families,
supervisors, and clinical staff

24.
Stories from the Field
• Courtney Clark: Current Postdoctoral Resident at the CHC site in Middletown, CT.
• Sita Nadathur: Former Postdoctoral Resident and Current Supervisor and Clinician at
the CHC site in Middletown, CT.
Questions:
1. What made you decide to join a Postdoctoral Residency Program?
2. What were you looking for when you came to CHC?
3. How do you feel the postdoc shaped you as a Psychologist?

25.
What we have learned
1. Offering a Postdoc Residency is possible
2. Postdocs increase access for clients, bring their added strengths to
clinical programs, and add current knowledge to administrative
committees and processes
3. Supervisors and staff enjoy participating in the Residency program
4. Postdoc training is a great recruitment tool
5. APPIC membership is a worthwhile investment

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What we have learned (cont.)
6. Plan ahead for the APA accreditation process – especially data on
success of program
7. Supervision training is needed
8. One day per week for didactics, supervision, and cohort activity is
invaluable
9. Be very clear about expectations and what you can and cannot offer
10. Post-docs improve processes and systems by providing feedback to
staff about workflow issues
11. Post-docs aid in the testing of new initiatives
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27.
The Road to Developing a
Postdoctoral Psychology Program
• Answer the question: What are your drivers for starting a postgraduate program?
• Learn the essential elements of a postgraduate program
• APPIC/APA standards
• State licensing requirements
• Assess your own resources (physical, human, financial)
• Secure board, leadership, and clinical buy-in
• Develop financial and strategic plan including potential partners
• Costs and benefits:
• Direct and indirect costs
• Return on Investment: immediate and longer term
• Benefits beyond the financial return

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Questions?

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Contact Information
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For information on future webinars, activity
sessions, and learning collaboratives:
please reach out to nca@chc1.com or visit
https://www.chc1.com/nca