Universal Psychology Postdoctoral Directory

Elements of quality clinically focused postdoctoral training

The Health & Rehab Psychology Fellowship is split between two 6 month rotations. Fellows have the option of choosing two of three health-focused rotations including: Spinal Cord Injury (SCI), Community Living Center (CLC), and Medical/Surgery. Spinal Cord Injury (SCI) The Spinal Cord Injury Center (SCIC) is an 11-million dollar addition to the Dallas VA that opened in 1996. The center includes a 30-bed inpatient unit to care for the medical and rehabilitation needs of persons with spinal cord injuries or other neurological dysfunctions (e.g., Multiple Sclerosis, Guillain-Barre Syndrome, and Cervical Stenosis) as well as an outpatient clinic for comprehensive care throughout the lifespan. The SCIC operates a CARF-accredited rehabilitation program for spinal cord injury. The clinical mission of the Spinal Cord Injury Center is to enhance the health, functional abilities and quality of life for persons with spinal cord injury or disease. Psychology is an integral part of the interdisciplinary team that works together toward this stated goal. Other members of the team include: physicians, nurses, social workers, occupational therapists, physical therapists, kinesiotherapist, recreational therapists, chaplains, and dietitians. The overriding goal of the rotation will be applying clinical skills to help individuals achieve optimal psychological, behavioral, and social functioning. To accomplish this task, the fellow will master strategies for functioning effectively in a dynamic inpatient medical unit and as a member of the interdisciplinary team. Patients served at the SCI Center comprise a diverse population in terms of ages (19-98), disabilities, medical conditions, education (4th grade through Ph.D. level), occupations, family support, and psychiatric diagnosis. Fellows working in this unit will increase their comfort level working with individuals with disabilities and gain an exposure to a vast array of medical conditions. Fellows will conduct comprehensive assessments of an individual’s coping status and adaptation to chronic illness and disability in the context of personality, cognitive status, as well as family and social systems in order to implement an appropriate treatment plan. Services fellows may provide as a member of the SCI team include: neuropsychological assessment, interview-based clinical evaluations, behavioral modification, marital and/or family therapy, sexuality counseling, smoking cessation services, pain management, substance abuse screening, and consult liaison services for the SCI Outpatient clinic. Another important role for psychology is providing staff consultation and education. Community Living Center (CLC) The CLC is a rehabilitation and hospice unit of the hospital. It is an inpatient facility at the Dallas VA Medical Center. The CLC inpatient population includes Veterans who are admitted for rehabilitation due to stroke, traumatic brain injury, amputation, deconditioning, and various medical conditions, as well as those who are receiving wound care, or who are admitted for hospice care. The Fellow’s role will involve both that of clinician and as consultant to the interdisciplinary teams, including evaluation and management of psychological issues and behavioral problems, neuropsychological evaluation, individual and family psychotherapy, staff development interventions, and supervision of interns and/or practicum students. Assessment of Veterans in the CLC involves evaluation of cognitive functioning and mood, including decision-making capacity; determining both pathological and non-pathological changes in functioning associated with “normal aging”; recognition of the role of acute health problems, chronic and/or terminal illness and disability in the older adult population. Consultation within the interdisciplinary team context of an inpatient setting allows the Fellow to develop autonomy and professional identity while also providing Health Psychology’s perspective on the Veteran’s functioning. Interventions at the CLC include: • providing counseling and support to Veterans with moderate to severe disability in the context of rehabilitation and the potential for loss of function, • providing psychotherapy to older adults , • developing interventions for pain management, • addressing smoking cessation, and • encouraging adherence to treatment recommendations. • within the hospice unit, the fellow will offer support to terminally ill Veterans and their family members, as well as the professional staff who provide their care, including end of life issues (suffering, grief, bereavement), symptom management as needed for pain, depression, or anxiety, and may include psychoeducational groups for Veterans, families and staff. The fellow will demonstrate program development and evaluation by designing and implementing a program or a change in a program and evaluating its results. The fellow will be expected to carry out professional responsibilities in timely fashion, to follow through on tasks, and to keep commitments. The fellow will be expected to display professionally appropriate demeanor and decorum (including appearance) with allowance for variation in individual style. An important aspect of the Fellow’s work is to establish and maintain effective, cordial, and respectful task-oriented working relationships with the interdisciplinary team members and other staff at the CLC. From the perspective of ethics, the Fellow will be expected to behave in accordance with the APA Ethical Principles and the Dallas VA Medical Center By-laws, and to raise appropriate ethical concerns as they occur. The fellow will be involved in the process of determining the appropriate provision of psychological services for Veterans at the CLC. This involvement will include, but will not be limited to the following: • Assigning newly admitted Veterans to an intern, practicum student, or psychologist for the initial screening evaluation or providing the evaluation in the absence or unavailability of other staff. • Providing weekly supervision of the intern on the CLC rotation, including choice of assessment measures, competency of test administration, report writing, and giving feedback to Veterans, family members, and staff, and insuring that the evaluation report or progress note is documented in the Veteran’s chart within the appropriate time frame. • Assisting in determining the need for additional assessment, both for mental health issues and for cognitive functioning. • Assisting in determining Veterans’ need for ongoing psychotherapy, or behavioral intervention, and determining which staff member (Fellow, intern, or practicum student) will address these issues. The Fellow will assist in determining how many Veterans the intern and practicum student will follow at any given time. The Fellow will be responsible for providing leadership for these tasks. • Assisting in disposition of referrals for family intervention. • Participation in weekly group supervision involving the staff psychologist(s), Fellow, intern, and practicum student. • Participation in individual supervision with the staff psychologist for 2 hours per week. • Accessing status of Veterans on a daily basis through attendance at meetings and/or through chart review. • Attending the interdisciplinary treatment team meetings on Monday, Tuesday, Wednesday, and Thursday afternoons. Approximately 30% of a fellow's training time will be spent in treatment oriented activities and 70% in assessment.

https://https://www.va.gov/north-texas-health-care/work-with-us/internships-and-fellowships/psychology-internship-and-postdoctoral-residency-training-program/