Psychology Training Program Postdoctoral Fellowship Program
The Postdoctoral Fellowship Program in Clinical Psychology is administered by the Psychology Training Committee and resides primarily within the MEDVAMC Mental Health Care Line. The fellowship program offers seven postdoctoral positions. Five of these are one-year clinical positions that provide emphasis training in the areas of Serious Mental Illness (2 positions), Trauma/Anxiety Disorders (2 positions), and Primary Care Mental Health Integration (1 position). The Postdoctoral Fellowship Program in Clinical Psychology is currently APA accredited. We also have a two-year Neuropsychology Specialty Program (2 positions) that is directed by Robert Collins, Ph.D., ABPP-CN. This program is currently in the process of seeking APA accreditation. For specific information about the Clinical Neuropsychology Specialty Program follow this link: http://www.houston.va.gov/neuropsy_fellowship.asp
TRAINING MODEL AND PROGRAM PHILOSOPHY
The Psychology Postdoctoral Fellowship Program is based on a scientist-practitioner model of training. Fellows are expected to engage in clinical and didactic training 80% of their time and be actively involved in research 20% of the time. We view research and scholarly activities as informing and directing clinical practice and clinical practice, in turn, guiding research questions and activities. We view the vital inter-dependence of science and practice in clinical psychology as a core principle upon which the training system is structured. While our internship program is designed to provide a broad range of clinical experiences, the fellowship program aims to prepare Fellows for an advanced level of competency through focused training experiences in the clinical applications of psychology. This model of training fully supports the mission of the Department of Veterans Affairs by providing training and research opportunities that further the quality of clinical care provided to Veterans.
GOALS AND OBJECTIVES
The primary goal of the MEDVAMC Psychology Postdoctoral Fellowship Program is to provide a foundation in advanced clinical service delivery (and other relevant professional skill areas) to prepare our Fellows to become licensed psychologists qualified to work in public sector medical settings. This is accomplished by providing a systematic and sequenced program for developing advanced skills that expand and build upon the existing knowledge bases developed during graduate and internship training. By the completion of their training term, Fellows will have the preparation necessary to function as autonomous professional psychologists in a variety of settings, including VA medical centers and other public sector environments.
Training objectives include attaining advanced knowledge and skills in 1) comprehensive psychological assessment, 2) a broad range of psychological interventions, 3) strategies of scholarly inquiry, 4) relevant administrative and organizational activities, 5) consultation, program evaluation, supervision, and teaching, 6) professional issues and conduct, and 7) cultural and individual diversity competencies.
All Fellows work within their emphasis area, but also complete other clinical rotations and are expected to be involved actively in research and program evaluation activities. Fellows, working with their preceptors, must develop and follow an individualized training program with specific objectives, competencies, and time lines across the training term. In addition, competency attainment at advanced levels in core and specific areas must be demonstrated through work sample presentations and successful performance in broad competency areas as indexed by supervisory ratings on Fellow evaluation instruments.
AREAS OF EMPHASIS
Serious Mental Illness
The Serious Mental Illness (SMI) emphasis area provides training opportunities to Fellows in developing advanced knowledge of theoretical models and empirical studies related to the etiology, epidemiology, and evidence-based interventions for Veterans with major affective disorders, severe schizophrenic spectrum disorders and other chronic psychotic disturbances. Fellows learn through direct clinical service delivery and educational seminars to assess, diagnose, and treat persons with SMI, develop knowledge of family systems, comorbidities, and support groups relevant to this patient population. There are also opportunities to engage in program evaluation, research, and administrative experiences.
The Fellow in the SMI area works with the preceptor throughout the year and typically has rotations of varying lengths with the other supervisors within the emphasis area. The Fellow is expected to devote a minimum of 50% time throughout the training year to this emphasis area. Additional rotations outside of the emphasis area are encouraged and can be arranged as mutually acceptable with any psychology staff member approved to serve as a supervisor. These additional rotations may not exceed 25% (i.e., 10 hours) of a regular work week.
Fellows in the SMI emphasis area will gain:
The primary training sites for the SMI emphasis area include the Comprehensive Mental Health Program (CMHP), the Psychosocial Rehabilitation and Recovery Center (PRRC), and the two inpatient units (6A and 6F). The Preceptors for the Postdoctoral Fellow in the SMI emphasis area are Amy Cuellar, Ph.D, and Justin Springer, Ph.D. Fellows in this emphasis area and those who elect it as a rotation may have the following supervisors: Quang (Charlie) Nguyen, Ph.D., (CMHP); Amy Cuellar, Ph.D. (PRRC), Cristina Gamez-Galka, Ph.D. (Local Recovery Coordinator, Mental Health Careline [MHCL]), Deborah Mullins, Ph.D. (CMHP Program Director), Karen Waldman, Ph.D., (CMHP, geropsychologist), and Justin Springer, PhD (Inpatient).
Comprehensive Mental Health Program (CMHP)
Psychosocial Rehabilitation and Recovery Center (PRRC)
Inpatient Units 6A and 6F
Mental Health Care Line (MHCL):
The Trauma/Anxiety Disorders emphasis area provides training opportunities to Fellows in developing advanced knowledge of theoretical models and empirical studies related to the etiology, epidemiology, and treatments for Veterans with PTSD and related anxiety problems such as panic disorder and generalized anxiety disorder. Fellows learn through direct clinical service delivery and educational seminars to assess, diagnose, and treat these patient populations. Fellows also will advance their understanding of how psychiatric and medical comorbidities impact treatment and learn to incorporate family systems and support groups in treatments with this patient population. There are also opportunities to engage in program evaluation, research, and administrative experiences. Within the Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) track, Fellows work primarily with returning Veterans and develop additional advanced competencies in readjustment issues as they impact Veterans and their families.
Fellows in the Trauma/Anxiety Disorders emphasis area work with their preceptors throughout the year and typically have rotations of varying lengths with other supervisors within the emphasis area. Fellows are expected to devote a minimum of 50% time throughout the training year to this emphasis area. Additional rotations outside of the emphasis area are encouraged and can be arranged as mutually acceptable with any psychology staff member approved to serve as a supervisor. These additional rotations may not exceed 25% (i.e., 10 hours) of a regular work week. There are two Fellows in this emphasis area. One works primarily with the general Veteran population (i.e., Gulf War, Vietnam, Korean) and the other works with the returning OEF/OIF Veterans.
Fellows in the Trauma/Anxiety Disorders emphasis area will gain:
The primary site for this emphasis area is the Trauma Recovery Program (TRP). The TRP was established in April 1994 to provide care for Veterans suffering from PTSD and related anxiety disorders. The TRP is a comprehensive program that provides specialized mental health services to over 5,000 Veterans and their family members. The vast majority of patients suffer from combat-related chronic PTSD. TRP treats patients from all wartime eras, including World War II, the Korean War, Vietnam War, Operation Desert Storm, and Operation Enduring Freedom/Operation Iraqi Freedom. Psychiatric comorbidity is common in this patient population and includes substance abuse/dependence, mood disorders, personality disorders, and psychotic disorders. Outpatient services are designed to meet the needs of Veterans in need of psychiatric treatment but who do not require hospitalization. Following the initial assessment, we offer a variety of mental health services that range from psychoeducational groups, skills groups, process groups, individual therapy, case management, and medication management. Inpatient mental health care is provided on nursing units 6A, 6D, and 6F. These units provide respite for Veterans in need of brief, crisis-oriented interventions. Nursing Unit 6D specializes in the care of returning OEF/OIF Veterans and women Veterans. A team approach is used in the TRP because bringing together professionals from Psychiatry, Nursing, Social Work, Psychology, and other disciplines allows us to provide comprehensive assessment and treatment for Veterans. The preceptors for this emphasis area are Helen (Minette) Beckner, Ph.D., and Darlene Witcher, Ph.D.. Fellows in this emphasis area and those who elect it as a rotation may have the following supervisors: Helen (Minette) Beckner, Ph.D., Ashley Clinton, Ph.D., Nancy Jo Dunn, Ph.D., Ellen J. Teng, Ph.D., Wright Williams, Ph.D., ABPP, and Darlene Witcher, Ph.D.
The TRP provides interdisciplinary care to Veterans with PTSD and related anxiety disorders. Treatment options include pharmacological management of symptoms and/or outpatient programming. The TRP offers empirically supported treatments such as Prolonged Exposure Therapy, Cognitive Processing Therapy, Anxiety Management, and Panic Control Treatment, to name a few. A number of additional groups are regularly offered, such as, PTSD Education, Seeking Safety, Expressive Therapy, and Anger Management. There are several specialty treatment tracks available within the TRP that provide excellent training opportunities to Fellows:
Intensive Outpatient Program (IOP)
The TRP offers a six-week Intensive Outpatient Program to a cohort of Veterans that meets three days a week and provides a structured series of therapeutic activities for Veterans with PTSD. IOP includes psychodrama, anger management, process group, Cognitive Processing Therapy, and a community meeting and breakfast held on Fridays.
General Anxiety Treatment
Veterans who experience unhealthy levels of anxiety on a regular basis are able to participate in the anxiety treatment track. This eight-week program provides brief interventions designed to help Veterans gain coping skills to manage their anxiety and prevent the development of more serious problems.
Sexual Trauma Treatment Track
The TRP provides a treatment track for both men and women Veterans who have experienced sexual trauma. This 12-week program meets twice a week. The goals in this track are to teach coping skills to increase quality of life, provide opportunities for Veterans to gain mutual support from one another, and to create a safe environment in which Veterans can work through unresolved issues related to past sexual trauma.
Specialty Track for OEF/OIF Veterans
The needs of Veterans who served during Operation Enduring Freedom and/or Operation Iraqi Freedom often differ from issues of older Veterans from previous wars. The TRP provides a separate treatment track to meet their unique needs. This component of TRP offers a variety of services to address mental health issues resulting from service during OEF/OIF, including educating Veterans and their families about stress-related symptoms and offering groups to teach new coping skills and provide peer support. Additional services include identifying resources to help Veterans with housing, finances, education, employment, legal, and other concerns.
Primary Care Mental Health Integration
The Primary Care Mental Health Integration (PCMHI) emphasis area allows the Fellow the opportunity to develop advanced training skills primarily in health psychology/behavioral medicine in a primary care setting. The Fellow learns from a combination of direct client care, in the form of advanced and brief interventions, and psychological assessments for surgical procedures. Training will go beyond that of an intern level and is designed to prepare a future clinician for employment in a health setting, particularly in a major medical center. The Fellow will also participate in didactics, seminars, and research opportunities which promote the scientist-practitioner model shared by the overall fellowship program. The Fellow in the PCMHI area works with the preceptor, Paul Sloan, Ph.D., throughout the year and typically has rotations of varying lengths with the other emphasis supervisors. The Fellow is expected to devote a minimum of 50% time throughout the training year to this emphasis area. Additional rotations outside of the emphasis area are encouraged and can be arranged as mutually acceptable with any psychology staff member approved to serve as a supervisor. These additional rotations may not exceed 25% (i.e., 10 hours) of a regular work week.
Fellows in the PCMHI emphasis area will gain:
The primary setting for the fellowship is in the Primary Care Mental Heath Integration Program at the MEDVAMC. In the first nine months of operation, the PCMHI program provided mental health care to approximately 2,800 Veterans and is expected to serve more than 3,500 Veterans in the 2011-2012 academic year. The PCMHI is a busy program and the Fellow will have opportunities to gain diverse training experiences, as Veterans present with a variety of mental health concerns including, depression and other mood disorders (56%), anxiety (27%), adjustment disorders (7%), substance use (5%), psychoses (1%), and other disorders (3%) including somatization, cognitive difficulties, sexual dysfunction or identity disorders, and personality disorders. These psychiatric conditions are typically co-morbid with medical problems such as pain, diabetes, cardiovascular disease, and obesity.
The PCMHI includes four psychiatrists, a registered nurse, two licensed clinical social workers, and supports three medical residency/fellowship positions. This diversity provides the Fellow with an interdisciplinary work environment. The Fellow has many opportunities to plan and coordinate activities with PCMHIproviders in nursing, psychiatry, social work, and psychology. There are also opportunities to engage in research, program evaluation, and administrative activities consistent with the Fellow's interest and past experience. Established supervisors for this emphasis area include 7 psychologists. Each psychologist provides expertise in a specific area that offers specialized training experiences in addition to the provision of behavioral medicine services for mood, anxiety, and adjustment disorders. Kaki York-Ward, Ph.D. is in the specialty behavioral medicine section and conducts pre-surgical evaluations for organ transplants and also treats patients with hepatitis. Paul Sloan, Ph.D., specializes in pain management with medical patients. Carrie Dodrill, Ph.D. treats substance abuse and anger management problems. Jeffrey Cully, Ph.D. operates a cognitive-behavioral clinic for patients with comorbid medical disorders. A number of PCMHI psychologists provide services within other specialty clinics, including Angelic Chaison, Ph.D., who provides services within the Women's Clinic and the Post-Deployment Center, and Michael Kauth, Ph.D., who provides services within the HIV Specialty Clinic. Karen Waldman, Ph.D. is a geropsychologist within the Comprehensive Mental Health Program who conducts bariatric assessments and weight management classes for PCMHI patients.
Program Consultation and Accreditation