Health Psychology, the Next Generation: Supervision in the Hospital Setting

After 12 years of working with trainees, it’s interesting to look back on how training has impacted me as a psychologist and the lessons I’ve learned. I’ve worked with many different types of trainees, primarily postdoctoral fellows but also practicum students, medical residents, and psychiatry residents. I have been privileged to be part of growing the field of health psychology by training professionals to provide integrated care, and I have learned from each trainee over the years as well. Being a part of training in integrated care settings is a terrific way to help medical staff learn more about how psychology can contribute in the medical setting as well as provide much needed training for the next generation of health psychologists.

Matching supervision to developmental stage as a clinician. Most of my work has been done with postdoctoral fellows, who are truly at a point of specialization in health psychology. Remembering to foster your supervisee’s own clinical judgment rather than imposing your own is so important. It’s important to balance autonomy with appropriate training.
Providing opportunities for professional growth. I like to co-present with supervisees at psychology society and medical association meetings. It gives them the opportunity to show their expertise and engage them in professional service, while also networking with others in the field.
Including discussion of professional issues in supervision. Supervisees are our next generation of advocates in psychology. It’s important to mentoring supervisees to be engaged and serve, especially as we work to have psychology at the table in the changing healthcare environment.
Including supervisees as part of the multidisciplinary team. Recognizing supervisees as competent professionals able to contribute to the healthcare team is a great way to involve them in integrated settings.
Balancing politics and working with multiple supervisors. Often in the hospital setting, there is more than one supervisor. This can enrich the training, but it’s important to set boundaries and keep communication open.
Informed consent and patient care. In the fast paced world of health psychology, supervisors need to be mindful that the supervisory status of trainees is clear. I meet with each supervisee’s patient at the outset, and the written informed consent makes it clear the trainee is supervised. We also co-lead groups. Hospital settings offer more opportunities for direct observation, and even the medical model of presenting the patient case in the front of the supervisor gives additional data that can enhance training.
Navigating logistics of reimbursement and building a sustainable practice. For many trainees, the real world issues of billing, insurance, and developing a business plan as a health psychologist are brand new concepts.
Identifying trainee strengths. Supervisors in any setting can’t do enough of reminding their trainees of their strengths. There can particularly be an “imposter syndrome” in medical settings. Always start with reinforcing the positives!
Networking and building contacts. As supervisors, we need to mentor beyond direct training in healthcare settings. Helping our supervisees build contacts within the hospital, in professional organizations, and with other healthcare workplaces is key.
Being open to new ideas. One of the things I most enjoy about supervisees is how they bring in new research and clinical practices. They help keep me on my toes about the latest and greatest in health psychology!
Building resilience and skills for the healthcare environment. Difficult situations arise when working in the hospital, from dealing with a difficult front desk staff to coping with the death of a high risk medical patient. Helping supervisees build skills for working with the hospital team and being mindful of the emotional effects of working with high risk patients is vital.
Enhancing leadership skills. There are many opportunities for leadership for supervisees, whether it is giving a grand rounds, presenting a challenging case at a team meeting, or starting a new intervention program. Look for the chance to let your supervisee lead, and you’ll find it enhances your program, helps your supervisees to succeed, and makes you look like a stronger leader.
Providing consistency and structured training opportunities. Even seasoned postdocs like to know that you’ve set aside the time to meet with them and give them your full attention. While it’s still important to be available and present for unstructured consultation, it’s too easy to lose track of supervision time in a hospital setting if you don’t prioritize it.
Engaging trainees in research, outcomes evaluation, and evidence based practice. In an increasingly value-based and population health focused healthcare environment, our skills in outcomes research and evidenced based practice need to be a priority in our work with our supervisees.
Modeling self-care and personal balance. As a professional in a hospital setting, the hours and pace can be grueling. Modeling how to manage a caseload, set limits, and engage in self-care like healthy eating and exercise is important. Making sure your supervisees leave at a reasonable hour or making your next supervision session a walking meeting shows you value their time and well-being. Discussing how you manage your family/personal life and the pace in the hospital can be helpful for those looking to become staff. Learning to avoid burnout starts with trainees!

I hope my trainees have enjoyed working with me as much as I have enjoyed working with them. It’s amazing to see them becoming leaders in health psychology across the country. Thank you to all the training programs and health psychology supervisors who provide this specialty training, and all the talented and skilled trainees who have chosen to pursue specialty training in health psychology. Together we can enhance patient care by integrating our psychological skills into the healthcare system.