The telehealth boom in the Covid era provided a much-needed resource for patients, giving them enhanced access to clinical care. But that shift from in-person care left some clinicians—like health psychologist Katherine Applegate, PhD—feeling a bit isolated from their colleagues. This longing for deeper professional camaraderie and support inspired Applegate to create an informal, ongoing professional development forum for her health psychology peers in the Department of Psychiatry & Behavioral Sciences.
In January 2022, just a few months after pitching the idea to department leaders, Applegate welcomed a small group of faculty and trainees to the inaugural Clinical Health Psychology Symposium. The virtual monthly series aims to build community and connection while providing learning opportunities specific to the unique challenges of providing psychological services in medical and surgical settings.
Three and a half years and 40+ sessions later, the series has taken off—with a fourfold increase in its email list, growing interest among clinicians and researchers within and beyond the department, and continuing education credit now being offered. Most importantly, it’s helped create a tighter-knit and better-equipped community of health psychologists.
What’s Unique about Health Psychologists
Clinical health psychologists specialize in treating psychological conditions among medical and surgical patients with complex health challenges.
“A lot of psychologists work in a clinic with other psychologists, but health psychologists work primarily in medical and surgical settings across the health system,” said Applegate, an associate professor of psychiatry and behavioral sciences who is based in the Duke Spine Center and the Duke Pain Medicine Clinic. “They’re often the only psychologist in a clinic.” Therefore, she noted, they have limited opportunities for joint continuing education, community practice development, and peer supervision.
Other health psychologists in the department work in areas such as the transplant program, cancer center, pain clinic, and weight loss surgery clinic.
Peer Supervision Meets Grand Rounds Meets Lunch & Learn
Associate professor Jennifer Pells, PhD, a health psychologist and frequent symposium participant, describes the one-hour sessions as “peer supervision meets Grand Rounds meets lunch and learn.”
She adds that “the tone Katherine sets is collegial, inclusive, and informal,” and that it's not only a place to learn from each other, but also a safe space to talk about one’s professional struggles.
Since the symposium’s first year, when most of the presenters hailed from Psychiatry & Behavioral Sciences, Applegate has broadened the scope of speakers and topics. Currently, about half of the sessions are led by experts from other areas of the health system. Presentations have ranged from “Communicating Difficult or Unexpected Treatment Plans” to “Defining and De-Mystifying Spiritual Care” to “Considerations for Active Duty and Veteran Populations,” to name just a few.
“I try to get speakers who can talk about services, programs, or resources available at Duke to support the clinical needs of our patient population,” Applegate said.
Pells says the series has had a tangible impact on her clinical practice. “You’re better at this work when you’ve got more in the toolbox,” she said.
“You’re better at this work when you’ve got more in the toolbox.”
— Jennifer Pells, PhD
She recalled a memorable session on trauma-informed reproductive healthcare, in which health psychologist Julia Woodward, PhD, shared a model for working with multidisciplinary team members to provide trauma-informed patient care. “We all encounter patients who have experienced trauma, so that was directly applicable. Her talk changed the way I approach trauma-related issues with my patients.”
Applegate noted that one of the most compelling and well-attended sessions focused on the intersection of psychology and end-of-life care. Palliative medicine specialist Christopher Jones, MD, talked about the medical side of palliative care, and Katherine Ramos, PhD, a clinical psychologist who works with older adults, addressed psychological services for patients who are terminally ill but are not yet in hospice care.
The discussion was so well-received, Applegate is working on a follow-up session featuring a panel of psychologists specializing in palliative care, transplant surgery, and oncology.
“Psychologists working in medical centers have a tremendous opportunity to collaborate with multidisciplinary teams to enhance the quality of life of our patients and families,” said Ramos. “Working with Chris and presenting to our health psychology colleagues was both great fun and offered a real, concrete example of how clinical care teams can work together and leverage each other’s expertise to optimize care across the disease continuum.”
“Working with Chris and presenting to our health psychology colleagues was both great fun and offered a real, concrete example of how clinical care teams can work together and leverage each other’s expertise to optimize care across the disease continuum.”
— Katherine Ramos, PhD
Getting Ahead through Duke AHEAD
In 2023, Applegate began a yearlong Certificate in Health Professions Education & Teaching Program through the Duke Academy for Health Professions Education and Academic Development (Duke AHEAD). The program helped Applegate strengthen her knowledge and skills related to curriculum development and medical education, enabling her to build on the early success of the symposium.
For her required project, she conducted a survey to assess participants’ satisfaction with the series and its impact on patient care and community building. Results reflected a range of positive outcomes, including increased familiarity with other clinical providers, patient resources, and referral options; a better understanding of best practices for working with diverse populations; feelings of professional renewal; and appreciation of time with colleagues.
These results affirmed what Applegate has heard anecdotally from her peers: “A lot of people feel they’ve gotten to know some of the faculty in other clinics well enough now that they can e-mail them directly and ask for help. It’s just made the connections. I think it steps up the level of care and service we can provide our patients.”
Balancing Growth with a Proven Formula for Success
Symposium attendance has grown from about 15 participants each session to an average of 22, and word of mouth has brought clinicians and researchers from other departments into the symposium community. And while Applegate is deeply grateful for the success of and interest in the series, she wants to be thoughtful about expanding the community while staying true to its original purpose and spirit.
“It’s very much, I think, keeping that focus on benefiting the clinical staff, supporting their work, building community, providing a safe place to ask questions, and learning about cool things that are happening in the health system as well as in the community,” she reflected.
“It’s very much, I think, keeping that focus on benefiting the clinical staff, supporting their work, building community, providing a safe place to ask questions, and learning about cool things that are happening in the health system as well as in the community.”
— Katherine Applegate, PhD