Integrated Behavioral Health Portfolio Program Application

Welcome! Please submit this form to indicate your interest in the Integrated Behavioral Health portfolio program. We admit students on a rolling basis. Our program coordinator will contact you to review your application and advise you on next steps.

First Name*

Last Name*

EID*

Email*

Phone*

Graduate Program Information

Current Degree Sought*

Masters

PhD

Other

College or School*

Select

What is the name of your degree program?*

When did you begin your graduate program?*

Please use MM/DD/YY format.

When do you anticipate finishing your graduate program?*

Please use MM/DD/YY format.

Please share the name of your advisor.*

Your advisor is the person responsible for signing off on your courses.

Please share the email address of your advisor.*

Your advisor is the person responsible for signing off on your courses.

Portfolio Program Plan

Have you completed any coursework that you wish to apply to the content area requirements for the IBH Portfolio Program? Please fill in the course information below. A full list of approved courses can be accessed here: https://utexas.box.com/s/rq166rjcgkkxf7nqau4t1a3p0u84hx9k

Integrated Teams - Course Details

Please enter the course number, course title, and professor.

Integrated Teams - Semester & Year

Please enter the semester and year you took or plan to take this course.

Social Determinants of Health & Cultural Diversity - Course Details

Please enter the course number, course title, and professor.

Social Determinants of Health & Cultural Diversity - Semester & Year

Please enter the semester and year you took or plan to take this course.

Evidence-Based Therapeutic Practices - Course Details

Please enter the course number, course title, and professor.

Evidence-Based Therapeutic Practices - Semester & Year

Please enter the semester and year you took or plan to take this course.

Organizational Dynamics, Ethics, & Communication - Course Details

Please enter the course number, course title, and professor.

Organizational Dynamics, Ethics, & Communication - Semester & Year

Please enter the semester and year you took or plan to take this course.

Short Answer Responses

Tell us about your interest in integrated behavioral health. How will completing the IBH Portfolio Program help advance your career goals?*

(2000 character limit)

Tell us about your past experiences with health or behavioral health settings.*

Consider including any past experiences that may be relevant to your commitment to integrated behavioral health - these may include employment, volunteering, research, or any other experiences you believe are relevant. (2000 character limit)

Field-Based Contact Hours Requirement

Students in the portfolio must complete at least 50 hours of documented field-based internship/practicum training or volunteer work on-site in an integrated behavioral health setting, or complete an alternative clinical or related experience as proposed by the student and approved by the IBH portfolio committee.

Is a field-based internship or practicum already a part of your graduate program?*

Yes

If no, please answer the following question.

Since a field-based experience is not already part of your graduate program, please describe how you plan to fulfill the field-based contact hours requirement. Even if you are unsure, please share ideas you have.

How did you hear about the Integrated Behavioral Health Portfolio?

Select or enter value

To complete the Graduate Portfolio Program in Integrated Behavioral Health, students must:

1. Complete four (4) approved courses, with one course in each of the following areas: (1) integrated practice, (2) social determinants of health, (3) evidenced-based practice, and (4) organizational dynamics, ethics, or communication. Courses must total a minimum of 9 credit hours of graduate coursework;

2. Complete at least two (2) of the four (4) courses listed in item 1 above outside the student’s primary academic discipline;

3. Complete at least 50 hours of documented field-based internship/practicum training or volunteer work in an integrated behavioral health setting, or complete an alternative clinical or related experience as proposed by the student and approved by the IBH portfolio committee; and

4. Deliver a presentation on an integrated topic of the student’s choosing, either to a professional audience in the clinical field-based setting or to a designated group of faculty associated with the portfolio, or complete an alternate project as approved by the IBH portfolio committee.

Courses taken on a credit/no credit basis may be used for the portfolio. Students must still maintain a GPA of 3.0 or higher for their graded coursework in the portfolio. Students should consult with their graduate advisor to make sure they are meeting the requirements for their graduate program.

APPROVED COURSES for the Portfolio can be accessed at this link: https://utexas.box.com/s/rq166rjcgkkxf7nqau4t1a3p0u84hx9k

By typing your full name, you certify that you have read the course requirements and understand you must stay in touch with the IBH Office to record your progress.*

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