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Pre-doctoral Internship Program Minneapolis VA Medical Center. Wayne G. Siegel, Ph.D., ABPP Director of Training Thad Strom, Ph.D. Assistant Director of Training. What to Expect Today?. Information Overload!.
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Pre-doctoral Internship Program Minneapolis VA Medical Center Wayne G. Siegel, Ph.D., ABPP Director of Training Thad Strom, Ph.D. Assistant Director of Training
What to Expect Today? Information Overload! • Actually, a good understanding of our Internship and our dedication to excellent clinical training
Schedule • 8:00 - 9:00 Intros. Brief Program Description • 9:00 – 9:30 Overview of Research Opportunities • 9:30 - 10:20 Interview block • 10:30 - 11:20 Interview block • 11:30 - 1:30 Lunch/ Rotation/Adjunctive Supervisors (2nd Floor Atrium – see map) • 1:30 - 2:30 Interview block • 2:30 - 3:15 Meet with current interns • 3:15 - 3:45 Tour by Postdoctoral Residents • 345 – 4:14 Wrap up with TDs • Each applicant will have 2 interviews of approximately 45 minutes. Two interviews in three blocks. • The second interview will include a clinical vignette.
Minneapolis VAMC Approximately 500,000 veterans residing in our primary service area, Tertiary referral center for VSIN 23 Ethnic minorities - 7% of those treated 65+ is the largest single clientele category but a growing mid 20’s cohort Women Veterans Comprehensive Health Center VA Lead Polytrauma Center State of the art Spinal Cord Injury center (SCI ) Telemedicine / CBOC Opportunities Will host VISN Tertiary Chronic Pain Tx Center
Competitively Funded Research Programs • Psychologists - more than $11,000,000 in merit-reviewed, multi-year research grants • One of the largest education and training programs in the VA system • Affiliations with 50 colleges, universities, and technical schools in allied health professions
The Presence of Psychology • 70 doctoral psychologists many of which hold clinical faculty positions at the University of MN • Psychologist are assigned to one or more of the specialized treatment units an have a strong presence in almost every area of the medical center • Many psychologists are in key leadership roles in the medical center and nationally. • Staff hold a diversity of interests, expertise, theories, and techniques • The discipline of Psychology is highly valued in the Medical Center
Training Model & Philosophy • Accredited by the Commission on Accreditation of the APA • Member of APPIC and abides by its guidelines • Member of APCS • Scientist Practitioner Model • Scientific data and scholarly work are incorporated into all training experiences • Significant opportunity to be involved in research through the internship year
Training is Developmental • Close supervision, mentorship, and intensive instruction to relatively autonomous functioning over the course of the year • Interns take an active role in developing their training plan • Graduating interns develop the competencies and a sense of professional identity needed for entry-level positions or post docs
Broad Training Goals • Goal 1: Psychological Evaluation and Assessment Diagnostic interviewing • Goal 2: Psychological Interventions • Goal 3: Providing Consultation & Supervision • Goal 4:Ethics & Diversity • Goal 5: Maturing Professional Identity • Goal 6: Interface Between Science and Practice
Training Tracks • 2 tracks with 2 separate Match numbers • Think of them as separate internships • 6 General Clinical/Counseling positions • 2 Neuropsychology positions • Emphasis on neuropsych training meeting APA Division 40 and Houston Guidelines (at least 50%) • Training is still broad and general in clinical psychology
The Neuropsychology Track • Neuropsychology and neuropsychological assessment • Meets the Houston Conference and APA Division 40 specialty training guidelines • Approximately 50% of his or her time to neuropsychology • 2 rotations 17 week-long rotation in neuropsychology and rehabilitation psychology as well as providing assessment and intervention services in our GRECC. • 3rd rotation areas outside of neuropsychology, usually dealing with severe mental illness • Weekly neuropsychology case conference, neurology rounds, and PM&R team rounds • Supervisors: Drs. Carter, Clason, Eidson, Lamberty, Lundgren, and Sim.
Rotations • Assigned by interest and training needs • Orientation week • Learn about different rotations • Work with TDs to choose and sequence rotations so that intern training goals and program competency standards are met • Track activities are guaranteed, rotations are not • Schedules can be adjusted as needed later in the year
Addictive Disorders • Supervisors: Drs. Deloyski, Silversmith, and Siegel • Flexible and individual treatment by matching patient needs with interventions • Assessment and intervention services to patients with primary SUDs and those dually diagnosed • Individual and group therapies (process-oriented and structured skill-building), behavior and case management, and patient education • Diagnostic interviewing, objective and projective testing, and neuropsychological screening • Provide consultation in the context of a multi-disciplinary team
Admissions/Crisis/Consultation Team (ACC) Supervisor: Drs. Arbisi • Main intake and evaluation center • Work closely with the Medical Center ER • Diagnostic interviewing, psychological and neuropsychological screenings and assessments, brief therapy, crisis management
The Mood Disorders and General Psychiatry Team • Supervisors: Drs. Hess, Perry, and Walden • Specializes in mood disorders and general psych patients • Diverse theoretical perspectives • Emphasizes diagnostic interviewing, psychological assessment, and psychological intervention • Intake evaluations, outpatient personality assessment, and neuropsychological screening evaluations, individual and group psychotherapy
Neuropsychology (rotation) • Supervisor: Drs., Carter, Clason, Eidson, Lamberty, Lundgren, and Sim. • Ok for specialization as well as those wanting just experience • Eclectic test battery • Competence in consultation skills - TBI Team, Neuropsychology Case Conferences, and MS Team • Variety of patients – dementia, strokes, TBI, tumors, seizures, and MS, etc.
Psychiatric Partial Hospitalization (PPH) • Supervisor: Dr. Isenhart, Peterson, Schumacher, and Broden • Not a treatment team - cost-effective and clinically viable alternative to full hospitalization • Intensive treatment while avoiding some of the malignant regressive temptations often associated with inpatient care • Organized within a therapeutic community or milieu setting, the broad range of treatments include: • Case management, educational therapy, group therapy, occupational therapy, recreational therapy, and medication management • Opportunity for psychoeducational and process group experience
Post-Traumatic Stress Recovery (PTSR) Program – Team L • Supervisors: Drs. Curry, Ferrier-Auerbach, Kaler Meyers, Polusny, Voller, and Wagner • Training in the assessment and treatment of patients with acute and chronic trauma-related disorders • Assessment – diagnostic interviewing, objective, projective, and neuropsychological instruments • Individual, family, and group psychotherapy • EST – CPT, PE, MI and Seeking Safety • Consultation to the multidisciplinary team • Psychoeducational activities • Ongoing research • Female veterans, OIF/OEF service members • Variety of traumas.
Primary Care Psychology/ Health Psychology • Supervisors: Drs. Billig, Helbok, Mallen Olson, Chiros, and Skroch • Integration of mental health with primary care • Co-located working collaboratively with PC staff • Rapid access and tx for acute psychiatric disorders • Innovative models of co-managing care for patients with chronic medical and mental health conditions. • Interns will have the opportunity to learn innovative models and skills for managing mental health conditions within an integrated primary care clinic setting. • Chronic pain assessment and intervention, • Training in the assessment, treatment and consultation of medical patients. • Orientation - Integrative, emphasizing contemporary behavioral approaches. • Telemedicine opportunities
Polytrauma/Rehab • Supervisors – Drs. Petska, Collins, Blahnik, Lamberty, McGuire, Sim, Howard, Kennedy, and Merladet • Training in Rehabilitation and Neuropsychology • Recognized as a center of excellence • 1 of 4 such programs in the country • Provides a full range of intensive inpatient treatment to brain injured veterans and active duty patients, many in their late teens and early 20's • Psychotherapeutic and behavioral interventions • Neuropsychological evaluations • Family interventions • Bed rounds • Neurological and psychiatric examinations
VISN Pain Center • New VSIN Tertiary Pain Center • New rotation or part of rehab rotation? • Staff being hired. • We will know more at start of training year • Assessment and intervention with chronic pain
SPMI (Serious and Persistent Mental Illness) Team • Supervisors: Dr. Hegeman, Nienow, Rogers, and Sponheim • Assessment and treatment of patients with psychotic disorders including bipolar disorders • Patients vary in their level of functioning and persistence of psychopathology • Competence in the conceptualization and assessment of psychosis and other psychiatric symptoms as well as in the assessment of cognitive and social functioning in outpatients and inpatients • Individual therapy, group therapy, and couples or family interventions • New Programs – CBSST, Family Program, recovery Oriented
Adjunctive Training Experiences • Interns select 3 Adjunctive Training Experiences: • Family Therapy Training Clinic (FTTC) • Dialect Behavior Therapy (DBT) • Anxiety Intervention Clinic (AIC) • Time-Limited Dynamic Psychotherapy (TLDP) • Motivational Interviewing (MI) • CBSST • Cognitive Processing Therapy (CPT) • Prolonged Exposure (PE) • Psychodynamic Psychotherapy • Acceptance and Commitment Therapy (ACT) • Assessment Clinic • Administration • Research
Family Therapy Training Clinic • Supervisor: Drs. Leskela and Erbes • Training in the assessment and treatment of couples and family-related concerns • Staff, postdoctoral fellows, and interns participate • Didactic presentations • Clinical experience using structural, strategic, solution-focused, and narrative techniques • Group supervision
Anxiety Intervention Clinic • Supervisor: Dr. Possis • Utilizes empirically-supported approaches to treat Anxiety disorders • Critical thinking and professional development are emphasized • Interdisciplinary training setting • Peer consultation/supervision model
Prolonged Exposure • Supervisors – Drs. Polusny and Strom (VA National Trainers); Drs. Voller and Ferrier-Auerbach • Didactics starting with 1.5 day PE training and weekly readings • Weekly 90 min. appointments with 1-2 veterans • Bi-monthly consultation group • Weekly group and individual supervision • Video tape and review by supervisor • Will be PE certified with the VA (same as staff)
Cognitive Processing Therapy Clinic • Supervisors: Drs. Curry & Petska (VA Regional Trainers) • Utilizes empirically-supported time-limited approach to treat trauma-related disorders such as PTSD • Readings and discussions of didactic material, review of video and audio tapes of interactions with patients, and role-playing • Interdisciplinary training setting • Peer consultation/supervision model • Opportunity to serve as individual therapist and co-leader for group • Ongoing clinical outcome assessment
Time-Limited Dynamic Psychotherapy (TLDP) • Supervisor: Dr. Wagner • Empirically-based treatment model: • Strupp and Binder (Psychotherapy in a New Key: A Guide to Time Limited Dynamic Psychotherapy • Training in a group/peer supervision/consultation format
Motivational Interviewing (MI) • Supervisor: Dr. Isenhart • Empirically supported directive, client-centered therapeutic style for eliciting behavioral change • Help clients explore and resolve ambivalence about making changes • Applicable to SUDs and other psychological disorders • Will learn basic MI goals and principles • Readings and discussions of didactic material, review of video and audio tapes of interactions with patients, and role-playing
Acceptance & Commitment Therapy:ACT • Supervisors: Drs. Billig & Hess (VA Consultants) • A functional contextual therapy that views psychological problems dominantly as problems of psychological inflexibility. • Uses acceptance and mindfulness processes, and commitment and behavior change processes, to produce greater psychological flexibility. • Six months for the later part of the year
Dialectical Behavioral Therapy (DBT) • Supervisors: Drs. Meyers and VanEgeren • Empirically-supported, manualized treatment approach developed by Linehan, 1993) • Used to treat male and female patients who share key features with those diagnosed with Borderline Personality Disorder, particularly emotion deregulation • Didactic, group supervision, consultation group • Individual and/or group interventions
DBT/PE • New pilot program • Co-lead skills group (6 week intensive module) • Co-lead mindfulness exercises • Lead community outings – skill practices • Individual patient if experience with DBT
Psychoanalytic Therapy • Supervisor: Dr. Walden • This year-long clinic is intended to give trainees experience with psychoanalytic-informed approaches to psychotherapy with individuals. • One to two cases, meeting once or twice weekly, for a total of two clinical hours per week. • Process notes for use in a weekly group supervision meeting. • Readings covering various psychoanalytic ways of thinking about and working with people are assigned and discussed in supervision.
Assessment Training Clinic • Supervisors: Drs. Arbisi and Siegel • Ensures that all interns get good training in psychodiagnosis • Diagnostic interviewing • Intellectual assessment • Objective instruments • Exposure to projective instruments • Meets weekly for entire year • Wide range of cases are assigned on a rotating basis • Interns provide consultation and peer supervision • Interns can expect to become familiar with the relevant assessment related literature
Research/Scholarly Experiences Research: Consistent with our Scientist Practitioner Model, interns may participate in a research or other scholarly project for six or 12 months of the training year Averaging four hours of release time per week. Can devote more on own time.
Administrative Experiences • Interns may elect to obtain administrative experience with psychologists who are actively involved in clinical administration. • This experience will involve some didactic, readings, shadowing staff and completion of a project based on intern’s interests.
Seminars • Seminars: weekly Psychology Training Seminar • Didactic focus (interns help choose) • Adjunctive experiences have a didactic component • One of the presentations occurs in Mental Health Grand Rounds (formal and multidisciplinary in nature) ***** Want to foster development of competency, critical thinking abilities, knowledge, and professional identity
Optional Didactics • Neuropsychology Case Conference • Year-long conference involves didactics and case presentations • Opportunity to improve their competence in interpretation of neuropsychological tests, consultation and peer supervision • Other educational seminars and case conferences throughout the hospital and community
Time Commitment • A one-year, full-time training commitment - averaging 45 to 50 hours a week on site • Expected that some work will occur off site as well • Balance of work and learning
Supervision • 2 + hours of individual supervision per week • 2 + hours of group supervision per week • Style and modes of supervision vary • Videotapes, audiotapes, observation, role-plays, process notes, and co-therapy are among the tools used to aid in supervision • May be assigned readings and literature searches • Mostly consultative in nature
Mentors • Each intern will choose a mentor • A non-evaluative but not absolutely confidential relationship Role: • Help the intern negotiate the internship program • Integrate feedback from various supervisors • Plan for post-internship goals
Postdoc Opportunities • 2 postdocs in the specialty of Clinical Neuro (2 years) • 4 Postdocs in Clinical Psychology – emphasis (1 year) • PCMH/Health • Rehab Psychology/Polytrauma • SMI (interprofessional center) • Trauma • Accredited – Clinical focus with 25-49% time in research • Current interns very competitive but no overt preference (about 50% selection)
The Application Process We seek applicants who have: • A sound clinical and scientific knowledge base • Strong basic skills in standard assessment, intervention, and research techniques • Personal characteristics necessary to function well in our internship setting • Open to supervision, thirst for learning, strong initiative • Selection criteria are based on a "goodness–of–fit" with our scientist-practitioner model
Training Term • Full-time for one year beginning on about the 3rd week of August • One year at full-time equals 2080 hours Leave: • 10 federal holidays • Sick leave and annual leave (4 hours of each per two-week pay period (a total of 13 days of each) • Authorized leave for conferences, presentations, PD interviews, and to complete activities required by your university - # day is flexible
Stipend and Benefits • $25,402 per year • Health and life insurance is available. • The United States Government covers interns for malpractice under the Federal Tort Claims Act
Our Strength is Our Weakness • Opportunity and Choice! • Many training options • Can be overwhelming! • Cannot pick them all • Need to try and prioritize • Many ways to get training goals met • Several rotations/options can meet goals