Department of Psychiatry

Division of Clinical Psychology

Salud Family Health Centers
Primary Care Psychology Minor Rotation

Plan de Salud del Valle, Inc. (Salud) is a health care delivery system that provides quality, comprehensive primary health services to all the residents of a defined catchment area, covering parts of Weld, Boulder, Adams, Larimer, Morgan and Logan Counties. The 9 Salud clinics are federally qualified health centers.  Salud aims to improve the overall health of the communities it serves by reducing barriers to health care, including ability to pay, transportation, and language. Salud provides health care services without regard to age, sex, or disease process.  Salud has a firm commitment to provide care to all people, and does not turn patients away based on finances, insurance coverage, or ability to pay.
Salud has established that services will be provided:

• With migrant and seasonal farm workers and the poor and near-poor populations as the priority clientele;
• With cultural and linguistic understanding and sensitivity;
• With programs designed to eliminate or reduce the barriers to health care through the establishment of a network of clinics and provision of outreach and transportation services;
• With financial charges based on ability to pay through the utilization of income and size of family as key factors in a sliding-fee scale;
• With mechanisms through which quality secondary and tertiary health care can be obtained; and
• With the ultimate goal of significantly improving health status of Salud's population.

Goals of the Training Rotation

1)  To educate trainees about the psychological and medical functioning of patients who are cared for in primary care settings
2)  To teach trainees how to conduct health and behavior evaluations within a primary care medical center
3)  To teach trainees how to collaborate within a multidisciplinary team
4)  To teach collaborative care approaches in primary care
5)  To teach psychology interns to provide primary care psychology services to rural, Latino, migrant farm worker, refugee and underserved or disadvantaged populations.

Objectives of the Training Rotation

1)  The psychology trainee will be trained to administer health and behavior evaluations to assess for mental and behavioral health problems
2)  The psychology trainee will participate in weekly interdisciplinary team meetings that include physicians, nurses, rehabilitation specialists, nutritionists, and psychologists when/if possible
3)The psychology trainee will provide mental health screenings and arrange for appropriate follow-up care as needed
4) The psychology trainee will attend monthly case conferences and presentations and will provide one formal case conference OR one presentation during the six months of the rotation if possible
5) The psychology trainee will be trained to provide differential diagnosis to inform medication management and psychotherapeutic treatment

Specific Training Activities

Required Activities

Health and Behavior Screenings:  Each intern will receive training in the administration and reporting of the health and behavior screenings.  Each intern will be expected to independently complete evaluations after an appropriate training period.
PCP Collaborations:  Each intern will receive training in providing consultation-based services as requested by Salud physicians.
Psychotherapy:  Each intern will be expected to provide individual psychotherapy for 2 patients.  The intern will be responsible for all elements of care including scheduling, choice of intervention strategy, treatment planning, and documentation of services.
Supervision:  Each intern will receive one hour of weekly supervision by a licensed clinical psychologist.

Optional Activities

Group psychotherapy:  Interns will have opportunities to co-facilitate groups consistent with clinic needs and intern interests.
Testing & Assessment:  Interns will have opportunities to provide psychological and intellectual functioning testing batteries.
Additional supervision:  Interns with a strong interest in either solution-focused therapy or psychodynamic therapy can request additional supervision from behavioral health providers with specific expertise in these areas.

Additional Courses
Brief Psychotherapy:  When available, interns will attend a monthly class to learn about various types of brief psychotherapy.

Theoretical Approach

Clinica de Salud utilizes a biopsychosocial model of treatment for patients with chronic medical illness.  We seek to view the patient’s presenting problems by understanding how medical, psychological, and social problems are interconnected and influence one another.

Clinical Approach

In general, Salud aims to provide brief psychotherapy.  The primary clinical approach is solution-focused, although other appropriate approaches can be utilized as needed in consultation with the intern’s supervisor. 

Supervision

The intern will receive supervision for all aspects of treatment and assessment activities. 

Supervisor

Andrea Auxier, Ph.D. (Clinical Psychology, University of Massachusetts, Boston, 2007). Director of Integrated Services, Salud Family Health Centers.  Areas of expertise include assessing and treating underlying emotional, behavioral and interpersonal issues which may be complicating medical conditions.  Her primary theoretical orientation is psychodynamic, but she is trained in a variety of cognitive-behavioral approaches as well.  She specializes in the treatment of post-traumatic stress disorder and personality disorders, and also works with children and adolescents who do not require specialty services.

Given Salud’s population, it is strongly recommended that interns are either fluent or proficient in Spanish.