General practice, primary care, and health service psychology: concepts, competencies, and the Combined-Integrated model.

The profession of psychology is being impacted profoundly by broader changes within the national system of health care, as mental and behavioral health services are being recognized as essential components of a comprehensive, preventive, and cost-efficient primary care system. To fully define and embrace this role, the discipline of professional psychology must develop a shared disciplinary identity of health service psychology and a generalized competency-based model for doctoral education and training. This very framework has been adopted by Combined-Integrated (C-I) doctoral programs in professional psychology, which train across the practice areas (clinical, counseling, and school psychology) to provide a general and integrative foundation for their students. Because C-I programs produce general practitioners who are competent to function within a variety of health service settings, this innovative training approach has great potential to educate and train psychologists for a changing health care marketplace. Copyright 2004 Wiley Periodicals, Inc.