Universal Psychology Postdoctoral Directory

Elements of quality clinically focused postdoctoral training

The Sepulveda Ambulatory Care Center (SACC), located in the San Fernando Valley of Los Angeles, is part of the VA Greater Los Angeles Healthcare System.  SACC is the major outpatient facility that provides care to the Veterans living in Northern Los Angeles.  The aim of the Postdoctoral Residency Training Program is to promote advanced competencies necessary for the independent practice of psychology in healthcare settings specializing in the assessment and treatment of patients with behavioral and mental health problems.

This residency program is accredited by the Society for Behavioral Sleep Medicine (SBSM). Training for the psychology resident will be focused in the Behavioral Sleep Medicine (BSM) Program and Primary Care Mental Health Integration (PCMHI) Clinic. The resident will spend approximately half of their clinical time in each of these two programs. 

The SBSM Accredited BSM program is located within the VAGLA/UCLA AASM-Accredited Sleep Medicine Center as part of comprehensive patient-centered care program for sleep disorders. The resident will work closely with the supervising psychologists (all of whom have received board certification in behavioral sleep medicine) to deliver evidence-based treatments for a variety of sleep disorders including insomnia, circadian rhythm sleep/wake phase disorders, parasomnias, hypersomnolence, and to address adherence issues in the use of positive airway pressure therapy (“CPAP”) in Veterans with obstructive sleep apnea. The resident will also have opportunities to participate in BSM-specific research activities. 

The resident will spend 8 hours per week in the BSM clinic. The primary focus of the clinic is the assessment and treatment of patients diagnosed with insomnia disorder using Cognitive Behavioral Therapy for Insomnia (CBT-I), the gold-standard treatment for insomnia. The BSM clinic follows the case conceptualization-based approach that is disseminated by the VA Office of Mental Health and Suicide Prevention. This clinical program was developed and implemented by a Diplomate of the American Board of Behavioral Sleep Medicine who is also a National Expert Trainer and Subject Matter Expert for the VA’s National Provider training program in CBT-I (Dr. Jennifer Martin). The resident will begin the training year by attending a 1.5-day intensive training on CBT-I. This training is the same training VA staff psychologists attend as part of the VA national evidence-based psychotherapy roll out of CBT-I and, combined with clinical cases seen in the BSM clinic, will allow for the resident to meet equivalency training status as a certified CBT-I provider in the VA system should the resident decide to continue on to a staff position within the VA. The resident will gain expertise in delivering CBT-I including how to modify the treatment in special populations including patients with comorbid PTSD, mild neurocognitive disorder, and serious mental illness. 

Based on clinical need and resident interest, residents may also be involved in delivering behavioral treatments to patients with other sleep disorders, including circadian rhythm sleep-wake disorders (delayed/advanced sleep wake phase disorders), nightmare disorder, and narcolepsy. Additionally, the resident will also have the opportunity to gain proficiency in addressing issues related to Continuous Positive Airway Pressure (CPAP) adherence including Motivational Interviewing targeting adherence to CPAP treatment and exposure-based CPAP desensitization protocols. These clinical experiences may be combined with time spent in the BSM clinic or for up to 2 hours per week outside based on resident interest and supervisor approval. The resident will also co-lead a BSM clinic orientation group with one of the BSM supervisors designed to help Veterans participate in shared decision making about engagement in BSM services (1 hour per week).

Behavioral Sleep Medicine Didactics (2-3 hours): Residents will participate in behavioral sleep medicine-focused continuing education (CE). Didactics include local trainings through the VAGLA sleep medicine clinic and grand rounds at UCLA as well as remote/virtual didactic training opportunities including quarterly training through the VA-ECHO Sleep Group and weekly BSM-focused virtual trainings through the University of Arizona department of Psychiatry. The resident will also have the opportunity to attend the annual APSS Sleep conference (usually occurs in June).

Primary Care Mental Health Integration (PCMHI): SACC was an early adopter of Primary Care Mental Health Integration (PCMHI) and has consistently performed above national goals for mental health visits within primary care. The postdoctoral resident will be engaging in co-located collaborative care on an interprofessional primary care team, providing initial assessments to patients presenting with a wide variety of issues who may be experiencing their first contact with mental health services. Residents will have the opportunity to conduct brief (30 min.) functional assessments, to provide short-term interventions, and to consult with other providers in the primary care setting. Residents will also be involved in conducting groups, seeing patients during open access, and will be responsible for providing patients with psychoeducation, coping skills, and/or facilitating patients' involvement in the next step of their mental health treatment. The resident will work closely with supervising psychologists to deliver brief interventions and to provide consultation services within an interprofessional team. Treatments delivered in PCMHI may target anxiety, depression, insomnia, history of trauma, adjustment disorders, chronic pain, and psychological factors related to chronic medical conditions. Additionally, residents may engage in diagnostic clarification and treatment planning to aid in making appropriate referrals to specialty mental health. Residents will have various opportunities to work with interprofessional team members and will attend weekly team meetings with our PCMHI staff. 

There are opportunities for residents to co-facilitate primary care resident didactics on various mental health topics depending on the resident’s clinical interests. Past topics have included Motivational Interviewing in the Primary Care Setting, Overview of Evidence-Based Treatments, and Psychological Interventions for Coping with Chronic Pain. Residents will also have opportunities to participate in primary care education days and present on various mental health topics to primary care staff. Patients seen in the PCMHI clinic are treated on a brief basis (4-6, 30-minute sessions) using a variety of evidence-based treatment approaches which can include skills-based interventions, Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Problem-Solving Therapy for Primary Care, Mindfulness-based psychotherapy, Brief Behavioral Treatment for Insomnia (BBT-I), Cognitive Behavioral Therapy for Insomnia (CBT-I), Imagery Rehearsal Therapy for Chronic Nightmares (IRT), and Motivational Interviewing (MI). 

Residents will also provide supervision to a pre-intern working in the same setting and will receive structured supervision on their supervision.  Resident didactics include a monthly clinical research seminar, a monthly DEI seminar; a monthly supervision seminar; a weekly supervision of supervision seminar; and a weekly psychology training seminar.  Training takes precedence over productivity requirements and revenue generation.