PITCH Expanded Providers (PEP) program

Welcome to the Program for the Integrated Training of Counselors in Behavioral Healthcare

The Departments of Counseling and Social Work at the University of Texas at San Antonio (UTSA) and UT Health Science Center San Antonio are collaborating under a HRSA Behavioral Health Workforce Education & Training (BHWET) to offer specialized training and clinical placements in integrated school, primary care, and community settings.

In 2017, the Department of Counseling was awarded BHWET funding to establish the Program for the Integrated Training of Counselors in Behavioral Healthcare (PITCH). PEP expands these efforts through inclusion of behavioral health trainees from three additional disciplines, diversified clinical sites, and extensive interprofessional education.

In 2021, the Department of Counseling was awarded an additional $1.6 million to continue expanding efforts to training counselors, social workers, school counselors, and psychologists for an additional 4 years.

PITCH at UTSA recently awarded HRSA Behavioral Health Workforce Education and Training Grant

The four-year interdisciplinary project is funded by a $1.6 million grant from the Health Resources and Services Administration. This partnership will guide close to 100 students from additional disciplines to provide real-time services in the local region.

Training Program

PITCH Expanded Providers (PEP) includes behavioral health trainees from four disciplines: clinical mental health counseling (CMHC), school counseling (SC), social work (SW), and clinical psychology (PSY). All trainees complete didactic and clinical training focused on serving adults, children, adolescents, and transition-aged youth. Additionally, all PEP trainees participate in ongoing interprofessional education workshops.

Additional training details by track are provided below:

Clinical Mental Health Counseling (CMHC)

Twelve CMHC PEP trainees are selected through a competitive recruitment process each year. PEP CMHC trainees complete two consecutive clinical rotation semesters in integrated primary care or community-based settings. Stipend support of $5,000/semester is dispersed following completion of all PEP requirements. PEP CMHC trainees also complete two elective courses (IBH-1 and IBH-2) and are eligible to earn a 12-hour graduate certificate in integrated behavioral healthcare.

School Counseling (SC)

Six PEP SC trainees are selected through a competitive recruitment process each year. PEP SC trainees complete 12 hours of online learning modules focused on the role and functions of professional school counselors on integrated care teams. PEP SC trainees complete two consecutive clinical rotation semesters at their home schools. Stipend support of $5,000/semester is dispersed following completion of all PEP requirements.

Social Work (SW)

Four PEP SW trainees are selected through a competitive recruitment process each year. PEP SW trainees complete 12 hours of online learning modules focused on the role and functions of social workers on integrated care teams. PEP SC trainees complete two consecutive clinical rotation semesters at integrated community settings. Stipend support of $5,000/semester is dispersed following completion of all PEP requirements.

Clinical Psychology (PSY)

The two PEP PSY trainees will be part of the 1-year, 2000 hour, APA accredited Pre-Doctoral Clinical Psychology Internship (Primary Care track) within the Department of Psychiatry and Behavioral Sciences, Long School of Medicine at UT Health Science Center San Antonio. During the year-long internship, PEP trainees from the PSY discipline track will participate in one or two major rotations as well as several year-long clinical activities. Trainees will receive clinical training within the PCBH model across the lifespan.

The PEP Team is devoted to the interprofessional training of behavioral health professionals from four disciplines serving children, adolescents, and transition-aged youth in the San Antonio and surrounding areas.

PEP Team

Heather Trepal, Ph.D., LPC-S

PEP Project Director – University of Texas at San Antonio

Primarily responsible for oversight of the UTSA BHWET PEP project. Meets with key staff to monitor the implementation of each of the components and works collaboratively with all parties to assure maximum accountability, reliability, and validity for this project.

Jessica Lloyd-Hazlett, Ph.D, LPC-S

PEP Counseling Track Coordinator

Primarily responsible for oversight of the development and coordination of the Clinical Mental Health and School Counseling tracks. Works collaboratively with the Project Director, PCBH Consultant, faculty, and site supervisors to coordinate site development and maintenance. Assumes primary responsibility for communication with the counseling faculty and supervisors, Project Director, and Evaluator.

Stacy Ogbeide, PsyD, ABPP, CSOWM

PCBH Consultant and Clinical Psychology Track Coordinator – UT Health Science Center San Antonio

Primarily responsible for oversight of the development and coordination of the Clinical Psychology (PSY) track and the Interprofessional Education Curriculum. Primarily responsible for providing consultation related to primary care behavioral health integration course development, trainee clinical training, site supervisor training, and primary care clinic team training for the UTSA BHWET PEP project but works collaboratively with Project Director.

Devon Jefferson, LCSW

Social Work Track, Coordinator – University of Texas at San Antonio

Primarily responsible for oversight of the development and coordination of the Social Work (SW) track. Works collaboratively with Project Director, faculty, and site supervisors to coordinate training coursework and site development and maintenance. She assumes primary responsibility for communication with the SW faculty and supervisors, Project Director, and Evaluator.

Mercedes Ingram, Ph.D., LPC

Evaluator – University Health

Primarily responsible for providing evaluation oversight for the UTSA BHWET PEP project but works collaboratively with Project Director, faculty, and site supervisors to evaluate the project. Assumes primary responsibility for using data to help address health disparities and to inform the continuous quality improvement process.

Swathi Weaver, MA, LPC-S

Graduate Research Assistant

The Graduate Research Assistant works closely with team members to play a supporting role in the PEP program.

Online Library

Journal Articles

Recent Articles

Strengthening the Behavioral Health Workforce: Spotlight on PITCH

Read Here

Integrated Primary Care Literature

For additional journal articles and resources for supervisors, visit the PITCH Dropbox.

Introduction to Integrated Primary Care

Robinson, P., & Reiter, J. (2016). Behavioral consultation and primary care: A guide to integrating services (2nd ed.). New York, NY: Springer Publishing. Chapters 1 and 2

Vogel, M., Malcore, S., Illes, R., Rose, A., & Kirkpatrick, H. (2014). Integrated primary care: Why should you care and how to get started. Journal of Mental Health Counseling, 36(2), 130-144.

Behavioral Health's Role in Primary Care

Robinson, P., & Reiter, J. (2016). Behavioral consultation and primary care: A guide to integrating
services (2nd ed.). New York, NY: Springer Publishing. Chapters 3-5

Heath B, Wise R. P., & Reynolds K. A. (2013). Review and proposed standard framework for levels of integrated healthcare. Washington, DC: SAMHSAHRSA Center for Integrated Health Solutions

Primary Care Patients & Behavioral Health

Robinson, P., & Reiter, J. (2016). Behavioral consultation and primary care: A guide to integrating services (2nd ed.). New York, NY: Springer Publishing. Chapter 15

Kessler, R. (2009). Identifying and screening for psychological and comorbid medical and
psychological disorders in medical settings. Journal of Clinical Psychology, 65, 253-267.

Kohn-Wood, L., & Hooper, L. (2014). Cultural competency, cultural-tailored care, and the primary care setting: Possible solutions to reduce racial/ethnic disparities in mental health care. Journal of Mental Health Counseling, 36(2), 173-188.

Integrated Primary Care Interventions

Robinson, P., & Reiter, J. (2016). Behavioral consultation and primary care: A guide to integrating services (2nd ed.). New York, NY: Springer Publishing. Chapter 7

Bridges, A., Gregus, S., Rodriguez, J., Andrews, A., Villalobos, B., Pastrana, F., & Cavell, T. (2015). Diagnoses, intervention strategies, and rates of functional improvement in integrated behavioral health care patients. Journal of Consulting and Clinical Psychology, 83(3), 590-601, doi: http://dx.doi.org/10.1037/a0038941

Hudgins, C., Rose, S., Fifield, P. Y., & Arnault, S. (2013). Navigating the legal and ethical foundations of informed consent and confidentiality in integrated primary care. Families, Systems, and Health, 31, 9-19.

Health Promotion and Disease Prevention in Primary Care

Fisher, L., & Dickinson, W. P. (2014). Psychology and primary care: New collaborations for providing effective care for adults with chronic health conditions. American Psychologist, 69, 355-363.

Kalmakis, K., & Chandler, G. (2015). Health consequences of adverse childhood experiences: A systematic review. Journal of the American Association of Nurse Practitioners, 27, 457-465.

Shay, L. A., & Lafata, J. E. (2015). Where is the evidence? A systematic review of shared decision making and patient outcomes. Medical Decision Making, 35, 114-131.

Depression Management in Primary Care

Thota, A. B., Sipe, T. A., Byard, G.J… (2012). Collaborative care to improve the management of depressive disorders: A community guide systematic review and meta-analysis. American Journal of Preventative Medicine, 42, 525-538.

DIAMOND Program, Institute for Clinical Systems Improvement. (2010). A new direction in depression treatment in Minnesota. Psychiatric Services, 61, 1042-1044.

Perry, D. F., Nicholson, W. Christensen, A. L., & Riley, A. W. (2011). A public health approach to addressing perinatal depression. International Journal of Mental Health Promotion, 13, 5-13.

Bryan, C. J., Corso, K. A., Neal-Walden, T. A., & Rudd, M. D. (2009). Managing suicide risk in primary care: Practice recommendations for behavioral health consultants. Professional Psychology: Research and Practice, 40, 148-155.

Anxiety Management in Primary Care

Roy-Byrne, P., Craske, M. G., Sullivan, G., Rose, R. D., Edlund, M. J., Lang, A. J., … Stein, M. B. et al. (2010). Delivery of evidence-based treatment for multiple anxiety disorders in primary care: A randomized controlled trial. Journal of the American Medical Association, 30, 1921-1928.

Roy-Byrne, P. ., Veitengruber, J. P., Bystritsky, A., Edlund, M. J., Sullivan, G., Craske, M. G., … Stein, M. B.(2009). Brief intervention for anxiety in primary care. Journal of the American Board of Family Medicine, 22, 175-186.

Professional Training Resources

Events

Upcoming conferences for PEP trainees

CFHA Conference (October 13-15, 2022 Boise, ID)

Presented by the PEP Team:

Clinical Supervision within Primary Care Behavioral Health: A Community of Practice Example

Introduction: Primary Care Behavioral Health (PCBH) workforce development is of great need due to the growth of behavioral health (BH) integration into primary care, specifically at a time when behavioral health needs are increasing because of the COVID-19 pandemic (Kanzler & Ogbeide, 2020). Therefore, it is imperative to support BH clinical supervisors in primary care to build up the BH workforce to meet the BH needs that often present in primary care, which is also known as the “de facto mental health system” in the United States (Ede et al., 2015). BH supervisors are often asked to supervise pre-licensure level masters and doctoral behavioral health trainees with little to no support from their organization or the host institution of the trainees as clinical supervision is provided in addition to their full-time clinical and administrative duties. Additionally, it is imperative to provide current and future behavioral health clinical supervisors in primary care settings support and guidance when engaging in clinical supervision in primary care, given there is no formal training to become a BH clinical supervisor in primary care.

Methods: Clinical supervisors participated in communities of practice (CoP) focused workshops focused on clinical supervision within the Primary Care Behavioral Health (PCBH) model over a 4-year prior. These workshops occurred twice a semester (in person and virtually) for supervisors hosting students participating in a Health Resources and Services Administration (HRSA) Behavioral Health Workforce Education Training (BHWET) grant focused on preparing masters-level clinical mental health counseling students to function as Behavioral Health Consultants (BHCs) in primary care settings in rural and urban areas. Clinical supervisors completed a post-workshop survey after each workshop, providing their feedback not only on their satisfaction with the content but the impact of the workshop content on building their skills and providing clinical supervision within the PCBH model.

Results and Discussion: Clinical supervisors were satisfied with the content presented during the CoP workshops as well as indicated improvements in their confidence with providing clinical supervision within the PCBH model. Overall, this demonstrates an approach to building clinical supervisor confidence in working with pre-licensure trainees within the PCBH model. CoP workshops show promise as an approach institutions of higher education and health care organizations can adopt to improve clinical teaching and clinical supervision in primary care as well as support clinical supervisors in the community who work with trainees in primary care.

Objectives: At the end of this presentation, participants will be able to:

1: Describe the Community of Practice (CoP) Model;

2: Identify the necessary components of building a CoP for clinical supervision in primary care; and

3: Identify at least one (1) potential barrier and one (1) solution for CoP implementation.

SACES Conference (Nov 3-5 Baltimore, MD)

Presented by the PEP Team:

Preparing Student Counselors for Work in Integrated Behavioral Healthcare: An Express Review of Empirical Research

This 25-minute express session summarizes original empirical and evaluative research stemming from the HRSA-funded Program for the Integrated Training of Counselors in Behavioral Healthcare (PITCH). PITCH provides specialized training to counselors working in integrated primary care settings. Empirical research areas to be discussed student learning outcomes and integrated care competencies, clinical site development, supervision, and the training of bilingual integrated service providers. Presenters will also orient participants to the extant literature base on counselor training in integrated behavioral healthcare. Interactive discussion of in progress and future research initiatives will also transpire. 

Community Partners

PITCH

PITCH Expanded Providers (PEP) program