people get sick,’” says Diane Elmore, PhD, associate executive
director of the Government Relations Office in APA’s Public
Interest Directorate. “We’re going to invest money on the front
end — on the prevention and wellness side.” The law broadens
coverage for preventive screenings and some preventive care, for
It also created a Prevention and Public Health Fund to
support proven preventive and public health programs to tackle
such problems as obesity and smoking. Protecting that fund
has been an ongoing struggle, says Elmore, as some in Congress
have attempted to raid or even repeal the fund. As part of
a group of public health associations, other health-related
societies and other groups, APA helped fend off those attacks.
Preparing psychology’s workforce
Not all practitioners want to work in integrated health-care
settings, of course. And that’s OK, says Cynthia D. Belar, PhD,
executive director of APA’s Education Directorate. Having
multiple models of care not only accommodates practitioners’
desires, but also best serves a public that needs access to a wide
variety of services.
But given the direction the health-care system is moving,
says Belar, it’s critical that APA and the rest of the psychology
community work to prepare psychologists who can thrive in
integrated, prevention-focused health-care settings.
“Health-care reform is based on expanding and
strengthening the primary-care system,” says Belar. “We need to
train psychologists for broader roles in health care than just the
traditional mental health services.”
To help achieve that goal, APA has established a Primary
Care Training Task Force. The task force’s first priority is to
determine what psychology training programs are already
doing when it comes to preparing students for work in primary
care. The group is now analyzing data from a survey of doctoral
programs, internship sites and postdoctoral programs. That
information will help the group craft recommendations about
what APA can do to help ensure future psychologists are
prepared to work in a transformed health-care system.
APA’s strategic plan already includes continuing-education
programs to familiarize psychologists with service in primary-
The Education Directorate is also working with the Patient-Centered Primary Care Collaborative. “We have to ensure that
the broad range of psychological services are available in the
health-care system, that psychologists are seen as an integral
part of primary care teams and that people understand that
we provide the education and training psychologists need to
be able to fulfill those roles,” says Belar. Along with a family
physician, Belar co-chairs the collaborative’s Task Force on
Education and Training, which is examining the educational
needs of both the current and future work force and faculty
across multiple disciplines.
APA also participated in a Health Education Summit
convened by the Carter Center last year. The discussions
resulted in a report outlining five “prescriptions” for
overhauling the primary-care education system — including
more rigorous training in diagnosing and treating mental illness
— as a way of fulfilling health-care reform’s potential.
APA also continues to advocate for the Graduate Psychology
Education program, which prepares psychologists to work with
other health-care disciplines. Psychologists visited Capitol Hill
to advocate for the program during APA’s Annual Convention
and the Education Leadership Conference in September.
The Affordable Care Act also expanded training
opportunities for psychologists specializing in geriatrics.
Before health reform, the federal Health Resources and
Services Administration (HRSA) had three programs for
training providers for the aging field, with psychologists
eligible for only one. APA and other members of the Eldercare
Workforce Alliance pushed to expand eligibility and create new
opportunities. As a result, there are now four programs, and
psychologists are eligible for three of them.
But winning legislatively is only half the battle, says Elmore,
explaining that the next step is to make sure psychologists
take advantage of the new opportunities. Take the Geriatric
Academic Career Awards, which used to be open only to
physicians. At HRSA’s request, APA helped draft the request
for proposals that went out to psychologists. “We then did a
massive outreach to our geropsychology community, saying,
‘We fought to get you all in there and said how relevant you
were and how important it was to include you; now you need to
apply,’” says Elmore. The result? Psychologist Kristen Sorocco,
PhD, of the University of Oklahoma Health Sciences Center
became the first psychologist to win the award.
APA is also helping to shape the priorities of the Patient-Centered Outcomes Research Institute established by the
Affordable Care Act. The institute is an independent, nonprofit
research organization with a mission of helping patients and
caregivers make more informed health decisions. The institute
will support research on how to effectively prevent, treat and
manage health conditions.
So far, the institute has issued two calls for comments to help
shape its research agenda. The first asked for comments on the
institute’s working definition of “patient-centered outcomes
research.” APA encouraged psychological scientists to share their
input and submitted comments of its own.
“We urged the institute to incorporate the behavioral
and social aspects of health into the working definition,”
says Christine Jamieson, science policy associate in APA’s
Science Directorate. APA also urged the institute to support
research on such topics as decision-making, behavior change,
treatment adherence, patient/provider interactions and cultural
differences in health-related beliefs and behaviors.
The second call for comments asked for input on the