Only about 30% of the people who need mental health support in Texas are getting it. The shortage of behavioral health care providers has been characterized as a crisis, particularly in rural areas, and is projected to worsen over the next decade. A UT Health San Antonio clinical psychologist has developed a program he hopes will ease the strain by getting more people trained to help.
David Roberts, PhD, is an associate professor in the Department of Psychiatry and Behavioral Sciences at the Joe R. and Teresa Lozano Long School of Medicine, and he has developed a program called Reflective Training that is designed to teach counseling and psychotherapy skills to what he calls "non-specialist providers" to help address the state's behavioral health care crisis. Non-specialists who could learn how to offer mental health support in Reflective Training include community health workers, faith-based practitioners, and even care providers like birth and postpartum doulas.
Reflective Training is unique because small groups of non-specialist providers participate in a series of coaching sessions over eight to twelve weeks during which they learn basic counseling skills and then practice them on each other, Roberts said. "We sometimes say, 'Throw the windows open on your practice,'" he explained. "You come into these sessions uninhibited, willing to be seen making mistakes and feeling more comfortable because your coach is not your supervisor or your evaluator."
Reflective Training could create a whole new front line of people to support Texans experiencing behavioral health challenges, and change how mental health care is delivered, particularly in rural areas.
"What we're headed towards, hopefully, is a hub-and-spoke model where our community clinics become resources where licensed clinicians are able to host these small group sessions with non-specialist providers in their communities who can then use the skills there," Roberts said. And for those who need more specialized care, providers will "always have a touchpoint back to the clinic for consultation on difficult cases and for resources."
Science & Medicine is a collaboration between TPR and UT Health San Antonio about how scientific discovery in San Antonio advances the way medicine is practiced everywhere.
