Colorado Springs, CO – Other than an occasional continuing education course or reading journal articles or textbooks on aging, “generalist” psychologists who want to become proficient in working with older adults have had no specific model to follow…until very recently.
Fifty leaders in research and practice of clinical geropsychology met at a national training conference here to create the Pikes Peak model outlining multiple pathways that lead to “gero-competence.”
One conference organizer, Michele Karel, Ph.D., (V.A. Boston Health Care System) said a key element that emerged was that continuing education courses alone are insufficient to ensure proficiency.
The model recommends combining didactic training and consultation with an expert on the phone or in person for psychologists with no formal academic background. A controversial and unresolved issue is whether psychologists should submit audio or videotaped examples of their work with older adults.
No consensus was reached as to how much training is necessary. Practitioners are urged to self-assess their current knowledge based upon APA’s guidelines for psychological practice with older adults published in The American Psychologist in 2004.
Bob Knight, Ph.D., (University of Southern California) another conference organizer, said it is rare for a national conference to attempt to set a model of training for already licensed clinicians.
He explained that the goal of the conference was to develop aspirational, not mandated, models that recognize an essential core of good training without creating barriers for psychologists entering the profession. “Nothing we are proposing will place demands on people. The best we can do is to offer a more systematic array of learning experiences.”
Building upon knowledge from conferences in 1981 and 1992 (Older Boulder I and II), delegates identified the knowledge and skills necessary for proficiency at a mid-level of competence across doctoral, internship, post-doctoral and post-licensure levels of training.
Planning committee member Michael Duffy, Ph.D., (College Station, Texas) said, “There was a tension in this conference between a concern for quality and competence and the strategic concern to be inclusive in a way that will attract already licensed practitioners to enhance their skills.”
Joe Casciani, Ph.D., delegate at large and president of VeriCare that employs 320 practitioners in long-term care settings in eight states, said, “There are hundreds if not thousands of psychologists already doing this work with older adults but who have no formal academic training in geropsychology. Our profession needs to recognize the services by these practitioners and carefully offer avenues for additional training in an inclusionary, not exclusionary way. It is possible to raise the bar without creating barriers to practice.”
There was general consensus that training on understanding Medicare regulations, the concept of medical necessity, coding and documentation is imperative to work ethically with older adults. An area of disagreement is whether this should be taught pre- or post-licensure.
Several didactic methods open to post-licensure professionals include workshops such as those offered through the Maryland Psychological Association or University of Colorado at Colorado Springs, courses offered through hospitals or universities and web-based or distance learning opportunities such as courses through the Fielding Institute or the American Society on Aging. A resource yet to be developed is a clearinghouse of courses and reading material.
Two years ago APA’s section on clinical geropsychology (Division 12, Section 2) identified a list of experts interested in consulting with practitioners on a range of content and professional practice areas and posted them at www.geropsych.org.
Future potential outcomes of the conference include a permanent geropsychology training council, expansion of training programs and resources at all levels and the development of a self-assessment tool.
Following the conference Forrest Scogin, Ph.D., (Tuscaloosa, Alabama) addressed the pragmatic side of the recommendations. “Until we come up with different ways to fund these programs, then our ideas are just aspirations, not reality.”
Spurring the development of the conference was denial of a petition in 2004 by APA’s Commission on the Recognition of Specialties and Proficiencies in Professional Psychology for recognizing geropsychology as a specialty area because of the lack of a clear training model. Funding for the Pikes Peak conference came from the Retirement Research Foundation and several divisions within APA, as well as Psychologists in Long Term Care and the Council of University Directors of Clinical Psychology.
A two-hour symposium is scheduled at the APA convention on Friday Aug. 11 describing the Pike’s Peak model.
Paula Hartman-Stein, Ph.D., is a consultant in private practice in Kent, Ohio and former president of the APA section on clinical geropsychology. She served on the planning committee of the Pikes Peak training conference and can be reached through her website, www.centerforhealthyaging.com.