Training Program for Palliative Care and Geriatric Medicine
Mission Statement
The UAB Center for Palliative and Supportive Care serves patients and families experiencing serious illness by providing compassionate clinical care, demonstrating leadership in training health professionals and trainees, conducting collaborative research, and influencing health care delivery and public policy.
Counseling/Psychology Service is one of the core disciplines of the interdisciplinary services offered through UAB Center for Palliative and Supportive Care. We provide psychological assessment, counseling service, hospital consultation, staff support, and clinical training (add link to Training/Education section) to achieve the aforementioned mission statement. We participate in research to assess psychosocial distress and develop interventions to improve cognitive, emotional, and behavioral outcomes of individuals living with serious and/or terminal illness. We are committed to the development, evaluation, and refinement of our service to best serve the needs of our patients, families, staff members, health care professionals and trainees.
Executive Summary
Highlights
UAB Palliative Medicine Counseling/Psychology Service has been providing compassionate clinical care to patients and family caregivers since 2006, making it one of the leading pioneers in Palliative Care Psychosocial Service in the country. Under the leadership of Dr. Kay Knowlton and Dr. Diane Tucker, the Counseling/Psychology Service has served more than 16,787 patients and families, provided 547 staff consultations, and trained 34 master- and doctoral-level counseling and psychology interns. As active members on the Palliative Care interdisciplinary team, our counselor and psychologist also provided training and education to 38 palliative medicine fellows since 2006. As the need for training and interdisciplinary support continues to grow, the Counseling/Psychology Service has expanded its clinical care and training to Geriatric Medicine since 2014.
Key Responsibilities
Service Volume
Between 2009-2016, UAB Palliative Medicine Counseling/Psychology Service provided an average of 1,137 counseling sessions to 532 patients, 1,291 family members, and 60 staff members per year.
Clinical Service
I. Counseling & Grief Support for Patients and Family Members
Faculty and interns of Counseling/Psychology Service provide individual, couple, and family counseling sessions through inpatient, outpatient, and hospital consult services to enhance patients’ symptom management and overall quality of life. The challenges of advanced disease have been found to trigger or exacerbate depression, anxiety, PTSD, insomnia, demoralization syndrome, and anticipatory grief among patients and family members. Using a patient-centered approach, we strive to meet the specific needs of each patient and family as they cope with a wide range of psychosocial impacts of chronic, serious and or terminal illness.
II. Counseling & Self Care for Staff Members
Palliative care providers are at higher risk of burnout (62%) compared to those who serve in similar disciplines such as medical oncology (45%) [Kamal, et al, 2016). Self-care and team support play a crucial role in preventing professional compassion fatigue and enhancing work performance and satisfaction. Faculty members of Counseling/Psychology Service provide counseling on an as-needed basis and self-care sessions to staff members annually to prevent burnout and secondary traumatic stress.
III. Service Sites
During the past decade, the demands for the Counseling/Psychology Service continue to grow to meet the needs of patients and families dealing with chronic, serious, and/or terminal illnesses. We currently cover inpatient and outpatient counseling and hospital consultation for Palliative Care and Geriatric Medicine at the following sites: Palliative and Comfort Care Unit, Supportive Care and Survivorship Clinic, Acute Care for the Elderly Unit, and Geriatric Clinic.
Clinical Service Sites: FY 2005-2017
Training & Education
Counseling/Psychology Clinical Training Program
Training Institution:
Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, UAB
Cynthia Brown, MD, MSPH, Director, Division of Gerontology, Geriatrics, and Palliative Care
Center Directors:
Rodney Tucker, MD, MMM, Center for Palliative and Supportive Care
Cynthia Brown, MD, MSPH, Comprehensive Center for Healthy Aging
Site Directors:
Ashley Nichols, MD, Palliative and Comfort Care Unit
Elizabeth Kvale, MD, MSPH, Supportive Care and Survivorship Clinic
Katrina Booth, MD, Acute Care for Elderly Unit
Marianthe Grammas, MD, Geriatric Clinic
Training Supervisors:
Kay Knowlton, PhD, LPC
Certified Clinical Mental Health Counselor
National Board Certified Counselor
AASECT-Certified Sex Therapist
Approved Clinical Supervisor (Alabama and NBCC)
Diane Tucker, PhD
Licensed Clinical Psychologist
Professor, UAB Department of Psychology
Director, University Science and Technology Honors Program
Description of Training:
Target Population:
Palliative and Geriatric patients and families/caregivers with diverse cultural, religious, racial, educational, economic, sexual orientation, addiction and mental health issues:
- Palliative and Supportive Care: Adults aged 19 and above with advanced, life-limiting and terminal illness receiving inpatient palliative care, hospital-based palliative care consult service, and/or outpatient supportive care. Families/caregivers consist of a wide range of ages from children to older adults
- Geriatric Medicine: Older adult patients with acute and/or chronic geriatric conditions receiving inpatient and outpatient geriatric care. Patients often present with comorbid medical and psychological conditions. Range of functioning includes individuals with physical ailments to those with cognitive impairments. Families/caregivers consist of a wide range of ages from children to older adults
Service Delivery Methods:
- Face-to-face and/or phone counseling sessions with individuals, couples, family, and groups
Theoretical Orientation:
- Eclectic approaches include but not limited to Cognitive-Behavioral Therapy (CBT), Client-Centered Therapy, Acceptance and Commitment Therapy (ACT), Dignity Therapy (DT) and other evidence-based treatments
Training Goals:
- Trainees will experience the integration of psychology services into an interdisciplinary team, will appreciate the dynamics of this team, and will become proficient contributors to the team.
- Trainees can describe the role of various health professionals in the interdisciplinary team
- Trainees can describe the dynamics at work within the team and describe their implications for team effectiveness
- Trainees can describe the roles of a psychologist in palliative care settings.
- Trainees can communicate to the referring physician and health care team relevant information about the patient and family and show appropriate judgment about what should be documented in the medical record
- Trainees will develop acute and short-term intervention skills using an eclectic therapeutic approach.
- Trainees can prepare clear assessment and treatment plans which are appropriate to the situation
- Trainees will learn to develop appropriate treatment goals with patients using a collaborative approach
- Trainees will apply their academic and didactic background in their clinical work and will acquire new information to augment their clinical capabilities
- Trainees will actively participate in weekly supervision in which cases are discussed in the context of related academic background
- Trainees will develop a professional demeanor and become a trusted and valued member of the health care team.
- Interdisciplinary team members view trainees as displaying professional behavior
- Trainees will be aware of professional and ethical standards
- Trainees will display appropriate professional judgment
Available Training Experiences:
- Trainees can pursue practicum (3 credit hours), internship (6 credit hours), and pre-doctoral internship (9 credit hours) training offered through our palliative/geriatric training sites.
- Individual, couples, and family group counseling. Trainees will gain experiences in addressing common issues for counseling referrals including depression, anxiety, insomnia, panic disorder, post-traumatic stress, dementia, relationship issues, caregiver stress, life transitions, survivorship coping, and loss and grief
- Live supervision of counseling/psychotherapy sessions by site supervisor
- Weekly 1-hour group supervision by site supervisor; intermittent group/individual supervision is provided as needed
- Weekly 1-hour interdisciplinary team meeting to plan and evaluate care of patients and their families; trainee will have opportunities to interact with physicians, physician assistants, nurse practitioners, nurses, patient care technicians, social workers, chaplains, music therapists, massage therapists, pet therapists, pharmacists, administrative personnel, volunteers, supervising LPC, and supervising psychologist
- Intermittent consultation with individual staff members related to care of patients/families
- Mandatory reporting of child and/or elder abuse
- Learning about diagnosing, planning, providing, and evaluating care for persons with variety of mental disorders
- Identifying and making appropriate psychological testing or community referrals
- Assessing persons for suicide risk, counseling with those persons and making appropriate referrals
- Participating in in-service continuing education provided by hospital on various medical/psychosocial/ethical & legal/public health policy issues
- Participating in division grand rounds on topics related to mental health and/or interdisciplinary team training
- Opportunities to participate in new or ongoing research studies conducted in palliative/geriatric care
Trainee Orientation:
- TDAP, MMR, Varicella vaccinations (or current documentation of those) and TB test at UAB Employee Health and ID badge before beginning practicum/internship
- Mandatory HIPAA training
- Face-to-face site orientation by site supervisors, including review of parking options
- Mandatory patient rounds with physician/nurse practitioner on at least two different days
- Mandatory shadowing of site supervisors
Trainee Schedule (including times/days and activities each day, particularly if multiple sites):
- Hospital units accessible 24 hours per day, 7 days per week
- Outpatient clinics available 8:00 a.m.-5:00 p.m. during weekdays.
Trainee Administrative Duties:
- Documenting counseling sessions for review by staff and site supervisors
- Keeping a log of counseling sessions and referrals made with patients/families
- Participating in mandatory weekly interdisciplinary team/staff meeting
For more information, please download our UAB Division of Gerontology, Geriatrics, and Palliative Care Counseling/Psychology Service Executive Summary (add link) and contact:
- Diane Tucker, PhD (add link to Training Supervisors Page) (Medical & Clinical Psychology) at 205-934-8885 or dtucker@uab.edu
- Kay Knowlton, PhD (add link to Training Supervisors Page) (Counseling) at 205-531-6207 or kknowlton@uab.edu