Universal Psychology Postdoctoral Directory

Elements of quality clinically focused postdoctoral training

Emphasis Training in Health Psychology: The goal of this focus area within the Postdoctoral Residency Program is to prepare the resident to function as independent, culturally-responsive, patient-centered practitioner, with a focus on advanced competence in health psychology in interdisciplinary settings. Health Psychology, according to the APA “examines how biological, social and psychological factors influence health and illness. Health psychologists use psychological science to promote health, prevent illness and improve health care systems” (2014). This focus area within the Postdoctoral Residency Program provides in-depth, supervised clinical training in the practice areas where mental and physical health meet, preparing psychologists for independent practice in medical settings. Residents receive training in how psychological principles can be applied to influence well-being through prevention, treatment, and management of medical conditions. The resident will complete one 6-month rotation in Primary Care-Mental Health Integration, and one 6-month rotation in Integrated Wellness. The resident will also have the option of completing a minor experience in the Mental Health Clinic in which they learn to provide biofeedback and clinical hypnosis services (see rotation description for more details).

Rotation Settings: 

Integrated Wellness: This rotation serves patients across Primary Care and Specialty Medical Clinics who present with an array of medical and psychological disorders. The Integrated Wellness rotation also serves medical staff in an educational capacity, with ample opportunity for residents on this rotation to gain experience in providing in-service education and consultation to medical professionals. 

The Integrated Wellness Department houses 3 divisions: Whole Health, Healthy Living, and Non-Interventional Pain Management Services. The primary activities in this rotation fall into six main categories: 

1. Behavioral Medicine and Whole Health Assessment, Evaluations and Interventions 
2. Psychology, Pain, Whole Health and Healthy Living Program Development in Medical Settings 
3. Medical Staff Education and support 
4. Exposure to and experience working within the PACT model of patient healthcare 
5. Pain University 
6. Administrative opportunities 

This rotation aims to develop skills across these domains through various available opportunities, including: 

1. Behavioral Medicine Intervention skills will be developed through opportunities to participate in one or more of these specialty clinics (Non-Interventional Pain Management, Pain University, Whole Health). The resident will conduct assessments, individual and group-based interventions within a Biopsychosocial and Behavioral Medicine focus. Opportunities for brief individual therapy, may be available, depending on resident interest. Safety assessments, mood assessments, sleep assessments, and whole health coaching personal health inventories may also be available within the Integrated Wellness clinic setting. 

2. Residents will develop skills in educating medical staff from an array of professional backgrounds through the provision of in-services, didactics, and consultations with a focus on Whole Health/Healthy Living and Wellness within a PACT, patient-centered model of care in the medical community. Educational emphasis will include Whole Health, Behavioral Health Coaching, Health Promotion Disease Prevention, Motivational Interviewing, and Pain Management programs as well as other behavioral health topics. 

3. Participation in the Integrated Wellness Non-Interventional Pain Management division will provide opportunities to improve overall assessment, individual and group facilitation skills within the pain management realm. Residents will learn about Whole Health and Pain Health Coaching utilizing the Circle of Health and the Personal Health Inventory as well as additional coaching and motivational enhancement skills. Opportunities for educating patients and providers/staff in the neuroscience of pain and in a multitude of topics related to the Biopsychosocial approach to pain management will be available. Multiple opportunities will be available for building administrative and leadership skills including program development of Whole Health, Healthy Living and Pain University programs in medical settings and within multidisciplinary teams. Residents will also be expected to contribute to further development of existing programs. There will be additional administrative opportunities in program marketing and promotion, and outcome research for the interested resident. Residents will be exposed to and encouraged to attend many multidisciplinary pain management meetings which include policy and legislation as well as in-depth multidisciplinary pain management review committee meetings.  

Integrated Wellness differs from Primary Care Mental Health Integration in its emphasis on patient and provider education about the mind/body connection through a Biopsychosocial Whole Health approach rather than just conducting individualized, health psychology and mental health treatment in a primary care setting. There is a possibility to work with PCMHI as well as other Integrated Wellness programs, including Nutrition/MOVE program, and Risk Mitigation.

Mental Health Clinic: The outpatient MHC is comprised of six interprofessional BHIP teams that serve a diverse population of Veteran and Active Duty patients with varied presenting concerns. The MHC provides patient-specific, in-person or telehealth, recovery-oriented treatment tailored to patient goals, and can include short-term or long-term therapy and use of evidence-based protocols. Specifically, the Health Psychology Emphasis Area postdoctoral resident can work in the MHC for the optional minor experience in biofeedback and clinical hypnosis. Briefly, biofeedback is a technique that helps a person learn to control their body's physiological responses, such as their heart rate coherence, by analyzing data, to experience improved functioning in their physical, emotional, and mental health. The resident will be trained in HeartMath Biofeedback, which helps patients (in 4-6 sessions) regulate heart rate coherence (heart-rhythm patterns). Additionally, the resident can be trained in clinical hypnosis, defined as the process of (a) deliberately triggering a trance state and (b) utilizing that state to encourage helpful cognitive, emotional, or physical healing responses. Clinical hypnosis is a set of practices and communication techniques (inductions/elicitations) which can increase relaxation (not always), alter (either narrow or expand) focus, and alter response to suggestions, resulting in a new experience for the participant and designed to cause specific changes. 

Primary Care Mental Health Integration: The PCMHI program serves as the co-located mental health resource for the Patient Aligned Care Teams (PACTs). The PCMHI team is comprised of three psychologists, one social worker, one registered nurse, one peer support, and a psychiatrist. The focus is on general service delivery (consultation, assessment, and treatment) for a wide range of concerns and resolving problems within the primary care service context. PCMHI within the VA is a national endeavor to provide ease of access into behavioral health services right within the primary care setting. As such, this rotation differs from other psychology rotations in that the PCMHI team maintains daily open-access availability to see patients as warm hand-offs from physicians who recognize emotional and/or behavioral symptoms during routine primary care visits. Often times, patients are brought directly to the PCMHI team after a visit with their doctor for a brief assessment and introduction into the services that PCMHI offers. 

Additional roles of the behavioral health providers (BHP) within PCMHI include monitoring Veteran responses to newly initiated medication trials, risk assessments and diagnostic clarification. BHPs can also provide education, prevention, adherence, and health behavior change. The PCMHI team functions as an excellent resource for Veterans in managing issues such as insomnia, pain, lifestyle issues, adjusting to illness or adherence concerns. 

The general service delivery model within PCMHI involves brief interventions (e.g., 4-6 sessions, 30-45 minutes in length) for cases that typically fall within the mild-moderate range of severity. The PCMHI team will then triage/refer to specialty care services as appropriate if more severe or complex cases cannot be treated within the short-term PCMHI model (e.g., chronic PTSD, severe depression, bipolar disorder, etc.). The resident will work with geriatric adults that present to the Primary Care clinic. 

The primary responsibilities of the resident within the PCMHI rotation may include: 

• Maintaining daily open-access availability to see patients as warm hand-offs from providers 
• Performing brief functional assessments 
• Providing feedback and consultation to medical staff regarding patients’ presenting concerns 
• Facilitating brief (4-6 session) evidence-based treatment models 
• Triaging/coordinating care within other specialty area of the hospital for Veterans who voice interest in treatment but may not benefit from the brief treatment model offered within PCMHI.