Universal Psychology Postdoctoral Directory

Elements of quality clinically focused postdoctoral training

The PTSD fellows are embedded in the PTSD clinical team (PCT). The fellow will rotate through the sub-teams of MHTS. Primary supervision will be provided by one of the 10 staff psychologists within the team. The MHTS team is an interdisciplinary team comprised on 4 psychiatrics, 10 psychologists, 3 social workers, and 1 nurse practitioner. It should be noted that MHTS is comprised of numerous supervisors with proficient and advanced skills in implementing EBPs such as Cognitive Processing Therapy (CPT), Prolonged Exposure (PE) therapy, Acceptance and Commitment Therapy (ACT) for depression, and Integrative Behavioral Couples Therapy. As such, the fellow would have opportunities to utilize and enhance their skills in the delivery of these therapies as well as others as appropriate. The fellow’s typical workday will reflect that of their supervisor, which would most likely be M-F 8-4:30. The MHTS team is comprised of 4 sub-team specialty areas including the OEF/OIF/OND team, PTSD Clinical team, PTSD/SUD team, and the Women’s Stress Disorder/Military Sexual Trauma team. The training year will be divided into two 6 month periods working with a different primary supervisor for each period (based on the fellow’s training goals).  Specialty training opportunities: • Develop and maintain a psychotherapy group such as a trauma-related guilt/moral injury group with Chaplain Fellow (potentially to use as program evaluation component of postdoc) • Facilitate CPT groups (potentially both TeleMH and an in-house MHTS group) • DBT group involvement all year (per training goals) • Participation in EBP consultation group within MHTS • Layered supervision of available trainees (either intern or practicum student, depending on licensed supervisor availability and interest in supervising supervision) Approximately 75% of the resident’s time will be spent in patient care related activities. These activities include: • Direct patient contact • Documentation • Providing layered clinical supervision (for interns or practicum students) • Receiving clinical supervision • Consultation with interdisciplinary team members Approximately 25% time will be spent in training activities. Such activities include: • Postdoctoral didactics (1 hr/week) • Cohort development (1 hr/week)  • Diversity Journal Club (1 hr/month) • Evidence-Based Psychotherapy Consultation Mtg (1 hr/week) • Research / Program Evaluation Project(s) (1 hr/week) • Staff training (varies) Summary of Mental Health Trauma Services sub-teams and the TeleMental Health team: OEF/OIF/OND Team OEF/OIF/OND Team: The OEF/OIF/OND Team has been treating patients from the Afghanistan and Iraq wars since 2007. Their primary focus is the treatment of mental health problems such as PTSD, depression, and anxiety. The patient population from these wars requires a specialized focus on the unique problems faced by this cohort. Clinical services include: diagnostic evaluation; group therapy, and individual treatment; case management; education; psychological testing; and psychopharmacological assessment and management. This rotation includes opportunities for trainees to learn and be supervised in delivery of any of the following EBTs: Imagery Rehearsal Therapy for Nightmares, Prolonged Exposure Therapy, Cognitive Processing Therapy and/or Integrative Behavioral Couple Therapy. PTSD/SUD Team The primary focus of this rotation is the assessment and treatment of veterans with comorbid PTSD and substance use disorders in an outpatient clinic (as part of an interdisciplinary MH treatment team). The patient population is comprised of male and female veterans from all war eras, with male OEF/OIF/OND being the most common. PTSD/SUD patients often have complex histories and symptom presentations, which gives trainees the opportunity to refine differential diagnosis skills and gain experience with treatment planning that best meets the patient’s needs/readiness level and stage of recovery. Trainees will gain exposure to therapeutic techniques relevant to this subpopulation (e.g., motivational enhancement, behavioral modification/activation, CBT for alcohol use disorders), Seeking Safety, EBPs for PTSD (CPT, PE) as well as present-centered, time-limited therapy geared toward developing coping skills for anxiety management, PTSD and sobriety maintenance/relapse prevention. Trainees will gain experience with assessment, including comprehensive PTSD intake evaluations, and opportunities for assessment of symptom validity and malingering. PTSD Clinical Team (PCT) The PTSD Clinical Team (PCT) has been in continuous operation since its inception in January, 1987. It is staffed by psychologists, a social worker, and a psychiatrist. Clinical services include diagnostic evaluation; group, individual and couples treatment; education; psychological testing; and psychopharmacological assessment and management. PCT services may be time-limited or open-ended, depending on the specific needs of the veteran. Group therapies offered to veterans include both ongoing support groups as well as time-limited groups, including psychoeducational groups as well as ACT groups. Individual therapies include supportive psychotherapy, and evidence-based therapies such as Prolonged Exposure Therapy, Cognitive Processing Therapy (CPT) and Acceptance and Commitment (ACT) Therapy. PCT services may be time limited or open-ended, depending on the specific needs of the veteran. The Women’s Stress Disorder and Military Sexual Trauma Program (WSD-MST) is a program that provides outpatient mental services to male and female Veterans who have experienced a Military Sexual Trauma (MST), and female Veterans with childhood, adult civilian and combat trauma histories. The term Military Sexual Trauma (MST) is defined by Federal law (Title 38 U.S. Code 1720D) and is “psychological trauma, which in the judgment of a VA mental health professional, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty, active duty for training, or inactive duty training.” Sexual harassment is further defined as "repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character.” The VA is committed to treating Any Veteran who had an experience of sexual assault or repeated, threatening sexual harassment during a period of active duty, active duty for training, and inactive duty for training. The Veteran does not have to be service connected for a mental health condition secondary to MST or have reported the MST while in the military in order to receive MST-related care through the VA. Also, Veterans who do not meet length of active duty requirements for general enrollment in VA health care are still eligible to receive care only for MST-related conditions. Veterans with an Other than Honorable discharge may receive MST-related care if a VBA Regional Office rules that the character of discharge is not a bar to health care benefits. Both women and men can experience MST and are eligible to receive services. The outpatient mental services offered in the WSD/MST program include evidence-based individual psychotherapies such as Prolonged Exposure (PE), Cognitive-Processing Therapy (CPT), Acceptance and Commitment Therapy (ACT), Cognitive-Behavioral Therapy for Depression (CBT-D), and Dialectical Behavior Therapy (DBT). Treatment is individually tailored for each Veteran after a thorough psychological evaluation that includes objective, standardized interviews and psychometrically valid measures of psychopathology and distress. The WSD-MST Team offers three types of therapy groups: structured/didactic (psychoeducational, skills-based, and support). Pharmacotherapy is also offered via a psychiatrist assigned to the program. Opportunities to learn about assessment, clinical treatment, and research with this specialty population are available to interns. Telemental Health (TMH) Team Technology is expanding the ways in which VA psychologists may reach out to Veterans with mental health needs. The Telemental Health (TMH) program provides outpatient mental health care to Veterans served in rural Texas VA community-based outpatient clinics (CBOCs) located in Bridgeport, Denton, Greenville, Sherman, and Tyler. The program aims to increase patient access to specialty mental health care in rural and underserved areas, and to reduce the number of miles that patients must travel to receive mental health services. Using secure videoconferencing technology, the TMH service connects mental health providers to clinics that require additional mental health services for their patients, including consultation, initial patient assessments, individual psychotherapy, group psychotherapy, and specialized interventions (e.g., evidence-based therapies). The TMH provider collaborates with the patient’s other local VA providers to ensure quality comprehensive care. Because the TMH program serves an array of different clients with variable clinical needs, the placement may align with a diversity of training goals. Commonly requested services include Cognitive Processing Therapy, Prolonged Exposure, Cognitive Behavioral Therapy, and Integrative Behavioral Couples Therapy. Emphasis is placed on the provision of empirically supported treatments. In addition to these clinical opportunities, fellows have the option of contributing to several ongoing quality improvement and research projects. Fellows will receive training in the technology used in telemental health, as well as specialized clinical and programmatic considerations for this mechanism of service delivery.

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