The Portland VA Medical Center offers a coordinated training program at the postdoctoral level with five focused training tracks in Health Psychology, Palliative Care, Polytrauma, Mental Health/Primary Care Integration, and Mental Illness Research. We provide enthusiastic advanced training through clinical experience, didactic seminars, and opportunity to work on research, all in the setting of Portland, Oregon’s thriving culture and spectacular natural beauty.
Our training philosophy reflects deeply held principles of respect for individual differences, supportive training towards professional growth and transition to an autonomous psychology career, emphasis on science informing psychological practice and vice versa, and ethical practice and decisionmaking. We view the postdoctoral training year as an opportunity to consolidate and advance assessment, treatment, and consultation skills established during internship, while increasing autonomy across the training year to allow our graduates to feel fully prepared to enter an independent psychology career at the end of training. In supervision we reflect the advanced skills of the postdoctoral trainee by eliciting the Fellow's case conceptualization and plan at the outset, and offering reflective supervision to assist the Fellow in deciding on therapeutic goals and actions.
All fellows will attend a didactic seminar weekly. The structured series features twice-monthly seminars focused on professional development and advanced topics for postdoctoral trainees, alternating with attendance at self-selected didactics that enhance emphasis training and drawing from resources at the VA, at Oregon Health and Science University (OHSU), and in the community. The fellows will receive two hours of individual supervision weekly and one hour of group supervision with other VA psychology fellows. The fellows will also obtain experience in supervised supervision of interns or predoctoral practicum students. We present descriptions of each focused training opportunity below; please find instructions for all applicants on page six of this document.
FOCUSED FELLOWSHIPS DESCRIPTIONS:
Palliative Care Fellowship; Elizabeth Goy, Ph.D.; Melissa Ranucci, PhD., lead supervisors. People approach the end of life with the sum total of their experiences, strengths, and vulnerabilities, and these aspects can influence the quality of life at the end of life. As a result, psychologists working in palliative and hospice care have the opportunity to address needs related to personality, culture, mood, acceptance, substance abuse history, family, pain and other symptom management, meaning and purpose, history of trauma, behavioral activation, resilience, cognition/capacity, goals of care, existentialism, spirituality, caregiver strain, grief; in other words, the whole person.
This fellowship is part of the VA Interprofessional Palliative Care Postdoctoral Fellowship. This is a one-year training program in which the psychologist fellow will join an interdisciplinary palliative care team including other fellows in social work, palliative medicine, nursing, and chaplaincy. The psychology fellow will function year round as a palliative care consult team member, attending palliative care rounds, taking psychology referrals for palliative care inpatients (in hospital and nursing skilled care units) and outpatients, and providing expertise to other hospital disciplines caring for palliative and hospice-enrolled inpatients. Additionally, the fellow will complete several 4 or 6-month training site rotations which may include:
• VA Community Living Center (includes inpatient hospice)
• VA Consult-Liaison Psychiatry
• VA Outpatient Mental Health Clinic - individual therapy for end-of-life processing and bereavement
• Oregon Health & Science University (OHSU) Hematology/Oncology clinics
• VA Interdisciplinary Lung Clinic or Heart Failure Clinic
• VA Home-Based Primary Care
Training will be designed to maximize the fellow's expertise in psychological aspects of end-of-life care, including: evaluation of mood and quality of life; knowledge and treatment of common end of life psychiatric syndromes (including depression, anxiety, delirium, post traumatic stress disorder, anticipatory grief, substance abuse, and sleep disorders); caregiver strain and processing of grief; in-depth understanding of disease-specific end-of-life trajectories; working with other disciplines including chaplains, social workers, nurses, pharmacists and physicians to maximize palliative support and identify unmet needs for psychological services; empirical basis of assessment and treatment planning; and in-depth understanding of end-of-life pain treatment protocols and symptom management. Overall, this health psychology training opportunity with people at the end of life is very much about living.
Fellows will have one day per week available for development and conduct of faculty/IRB-approved research; this option can be adjusted if more time is desired for clinical activities. Fellows will participate in a psychology postdoc-specific professional development and didactic seminar series twice monthly, a weekly Interprofessional Palliative Care Team didactic, and a monthly all-city palliative care conference. The fellow will receive two hours of individual supervision weekly and one hour of group supervision with other psychology postdoctoral trainees. The fellow will obtain experience in supervised supervision of interns/practicum-students.
Polytrauma Fellowship; Daniel Storzbach, Ph.D., & Amy Wagner, Ph.D., lead supervisors. The trainee in this position will develop skills primarily in the assessment and treatment of Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD). This Fellow will work within the current PTSD Clinical Team (PCT) and the Neuropsychology Service located in the Mental Health Clinic. It is expected that the majority of the Fellow's clinical activities will be with veterans who have recently returned from Iraq and Afghanistan, a population that has been shown to have high rates of TBI and PTSD.
The TBI portion of the fellowship will be managed by the Neuropsychology Service. This training experience is designed to enhance the skills of Fellows with prior neuropsychology experience by exposing them to the unique population of veterans with combat-related TBI and other possible combat-related exposures. The emphasis will be on acquiring specialized expertise in assessment and rehabilitation of the effects of both combat-related TBI and co-occurring adverse psychological effects, particularly post-traumatic stress disorder (PTSD), depression, and adjustment reactions. The assessment approach at Portland VAMC combines structured and flexible techniques. In addition to clinical training, fellows will attend seminars that provide theoretical and practical reviews of current issues including formal case presentations, Neuropsychology Case Conferences led by Dr. Muriel Lezak at OHSU, and Neuroscience Grand Rounds. There may also be opportunities to work in collaboration with staff from the VA's Center for Polytrauma Care in Seattle and the Psychology Department at Madigan Army Medical Center.
Fellows will also have opportunities to participate in clinical research, including the ongoing VA Merit Review study "Cognitive Rehabilitation of OIF/OEF Veterans with Cognitive Disorder." This study is a multisite randomized control trial of a manualized cognitive rehabilitation intervention for OIF/OEF veterans with cognitive problems. We are also piloting manualized hybrid PTSD treatment/cognitive rehabilitation interventions.
Within the PCT, fellows will participate in nationally recognized group education and therapy programs developed at the Portland VAMC. They will also gain experience in evidence-based individual treatment models. The Portland and Vancouver PCT staff have expertise in such treatment models as Dialectical Behavioral Therapy (DBT), Prolonged Exposure (PE), and Cognitive Processing Therapy (CPT). Training emphasizes conceptualization and treatment of acute and chronic posttraumatic sequelae. The fellow will participate actively in the provision of clinical services, supervise interns, and contribute to ongoing research. The goal of training for the PTSD element is to instill specialized knowledge of and treatment for PTSD and related conditions. Particular emphasis will be on learning and further developing adaptations of PTSD treatments for individuals with TBI.
Mental Health/Primary Care Integration Fellowship; Linda Gonzales, Ph.D., lead supervisor. This fellow practices for one year in settings that integrate Mental Health and Primary Care services. The fellow works closely with members of the General Medicine-Psychiatry teams (GM-Psych), groups of mental health professionals embedded in Primary Care clinics. Their placement allows for better coordination of psychiatric and medical care, especially for those patients with multiple co-morbidities. The philosophy behind this approach is that many patients can be successfully managed after brief collaborative interventions on an ongoing basis by their Primary Care Providers (PCP), with ongoing consultation by mental health providers
Psychologists and trainees have been part of GM-Psych Team from its inception twelve years ago. GM Psych clinicians serve two clients—the Veteran and the Primary Care Provider. Training emphasizes both sets of skills, utilizing a systems approach to mental health evaluation and intervention. The Fellow in this position will primarily develop skills in the assessment and treatment of patients seen in Primary Care settings. The Fellow will provide various psychological services, including time-limited individual treatment, cognitive behavioral therapy, Acceptance and Commitment therapy, joint brief visits with the PCP and patient as needed, psychological assessment, as well as easily accessible mental health "curbside" consultations.
Clinical training for the postdoctoral fellowship training will emphasize the following:
1. Appreciation of, and adaptation to the culture of the Primary Care Clinic and the way physicians and other PCPs view and treat mental health problems, including minimalist approaches and fast-paced, high productivity practice
2. Coordinating care with the other providers in a clinic setting
3. Understanding common chronic medical problems and their relationships with psychiatric disorders
4. Understanding commonly used psychotropic medications and how to investigate whether there may be drug interactions with other medicines the patient is taking
5. Providing consultation and brief intervention model within a Primary Care Clinic
6. Utilizing ACT therapy adapted to Primary Care setting
In addition to the GM Psych team experience, a rotation with Home Based Primary Care is an expected rotation during the year. This provides a rich experience in evaluation and intervention with patients and their caregivers in their homes, as well as interdisciplinary treatment and consultation skill development. Additional rotations are developed based on the interests of the Fellow.
Health Psychology Fellowship; Bret Fuller, Ph.D, lead supervisor. The health psychology fellow develops behavioral medicine clinical and research skills in a variety of integrated care settings over one year. As the only VHA facility in the nation housing both a Liver Transplant Program and a Hepatitis C Resource Center (HCRC), the Portland VAMC offers a unique training experience as a member of an interprofessional care team for a complex specialty medicine condition, hepatitis C virus (HCV) infection. The NW HCRC is a national program charged with developing evidence-based best practices for HCV care with a particular focus on psychiatric and substance use disorders co-morbidity in veterans with hepatitis C. Patients with HCV commonly present with a complicated set of mental health, substance abuse, and medical issues. Fellows will be full members of the HCV, Liver Transplant, and Substance Abuse interprofessional care teams. Through firsthand observation and then direct supervision, they will develop a unique set of skills that can be applied to any complex medical condition requiring interprofessional care:
1. Conducting Pre-Interferon Evaluations to determine patients' suitability to begin interferon treatment, including developing plans to help unsuitable candidates become prepared for treatment and to monitor high-risk patients throughout the course of treatment. These evaluations assess HCV disease knowledge and progression, treatment and side effect knowledge, psychiatric stability, substance use and abuse, psychosocial security, treatment planning and monitoring, and treatment adherence and self-management.
2. Conducting Pre-Transplant Evaluations to determine patients' suitability to receive and make best use of a rare organ donation. The Fellow will conduct assessments of mental health, substance use, and behavioral issues, including procedure knowledge, psychosocial and material support, and adherence and self-management.
3. Delivering Motivational Interventions to address entrenched substance abuse and other behaviors that impede health and access to medical services.
4. Providing In-Situ Psychological Interventions to Medical Patients. The Health Fellow will have the unique opportunity to be part of specialty medical clinics and provide psychological services in Liver Clinics, Primary Care Clinics, and the Liver Lodge (residential facility for patients undergoing liver transplant and evaluation for liver transplant). The Fellow will learn cognitive-behavioral treatments for typical symptoms of depression, irritability, anxiety, and panic, as well as behavioral medicine interventions for managing complex conditions such as chronic pain and other somatic symptoms exacerbated by psychological factors.
5. Conducting Clinical Research. PVAMC is home to many grant-funded psychologists researching health-related topics. The Health Fellow can select from many existing research opportunities or develop new ones. The NWHCRC has access to a number of local, regional, and national databases that allow a Fellow to develop a research inquiry to address aspects of care.
6. Receiving Research Mentorship. The Health Fellow selects a primary research mentor for the year and can design a training plan involving several principal investigators. Fellows can spend up to 50% of their time on research-related activities.
Mental Illness Research Education and Clinical Center (MIRECC) research fellowship; Lynn Van Male, Ph.D., lead supervisor. The PVAMC MIRECC Fellowship offers a research training emphasis on violence risk and threat assessment in health care settings with a clinical training emphasis in posttraumatic stress disorder (PTSD). The Portland Oregon VA is an unequalled pioneer in development of national VHA protocols for assessing and responding to violence threat potential with evidence-driven procedures. The VHA Central Office Behavioral Threat Management Program (BTMP) is based in Portland, producing original research on violence assessment and management, including a number of peer-reviewed articles and book chapters (Dr. David Drummond, recently retired from PVAMC and past Director of the BTMP, was the formative influence and first author on many of these publications). The Fellow will train under the supervision of Lynn Van Male, PhD, the Director of the BTMP and former national Director of VHA’s Prevention and Management of Disruptive Behavior (PMDB) program. Dr. Van Male is the Vice President of the Northwest Chapter of the Association of Threat Assessment Professionals (ATAP). Fellows devote 75% of their time to research and education activities (25% of research activity must be clinically-focused) and 25% to clinical training. In collaboration with their mentors, fellows will develop and implement research projects, publish and present findings, write grants, and utilize the latest technology for educational activities and clinical service delivery. The program is designed to prepare graduates for grant-funded research careers in mental health systems.
The MIRECC fellow has a variety of novel training opportunities:
1. Complete OHSU’s Human Investigations Program (HIP), which teaches basic clinical research skills and results in a Certificate in Human Investigations.
2. Present research to various disciplines of health practitioners in both the psychiatry research conference and the MIRECC Presents videoconference series.
3. Design and implement CME conferences and distance learning programs for VA and non-VA professional staff, and programs for veterans and their families, throughout the Pacific Northwest.
4. Serve as faculty for the BTMP Mini-Residency in Behavioral Limit Setting, an intensive training experience focusing on evidence-based threat assessment and management protocols that is offered quarterly to invited VA personnel from across the country.
5. Collaborate on program evaluation and administrative projects with personnel from VHA’s Office of Public Health, Occupational Health Strategic Healthcare Group (10P3D) in Washington DC.
6. Network with violence risk and threat assessment professionals from the corporate/private sector as well as from other federal, state and local agencies, through regular attendance at ATAP-sponsored training events and conferences.
For information about the MIRECC fellowship nationwide, please contact Ruth O’Hara, Ph.D. or Sherry Beaudreau, Ph.D., at the Fellowship hub site, (650) 493-5000 x64119 or Sherry.Beaudreau@va.gov). http://www.mirecc.va.gov/mirecc-fellowship.asp
The MIRECC fellowship is a two-year interdisciplinary program training psychologists to become outstanding clinical researchers in high priority areas of mental health, serving as change agents to help lead VA and other public and private health care systems through the 21st century. The Portland VAMC MIRECC fellowship site is linked electronically to the other national MIRECC sites for didactic, academic, and research efforts. Overall, the clinical center at the Portland VAMC focuses on posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), geropsychology, and dementia.
FOR ALL APPLICANTS TO PVAMC POSTDOCTORAL FELLOWSHIPS:
Eligibility: We seek candidates who are US citizens and will have completed an APA-accredited doctoral program in clinical or counseling psychology and an APA-accredited internship by the start date of the Fellowship. The dissertation must be verified as completed prior to the fellowship start date. As an equal opportunity training program, the internship welcomes and strongly encourages applications from all qualified candidates, regardless of racial, ethnic, religious, sexual orientation, disability or other minority status.
Deadlines: Applications must be postmarked by January 1, 2012. We will interview select candidates by telephone. We comply with Uniform Notification Day. We will make an offer to the top-ranked applicant in each emphasis track at the beginning of the day, and we will keep all other active candidates informed as the day progresses.
Application Instructions:
To apply, the following materials are required:
1. A letter of interest (identifying the desired fellowship; a brief summary of your interests and qualifications for this specialty training; why you are interested in this position; aspirations for your psychology career)
2. CV (including a brief description of your internship rotations)
3. Three letters of recommendation (at least one from an internship supervisor)
4. A letter from your graduate program Training Director or Dissertation Chair stating that you will complete all graduation requirements, including dissertation, by the start of the Fellowship.
5. Official Graduate school transcripts
Please send all application materials in one envelope. Letters of reference should be signed across the envelope seal. If you submit your application electronically, please have letters of recommendation sent directly from the letter-writer’s professional email address. We understand some applicants may have overlapping interests and wish to apply for consideration for more than one track. We will accept up to two complete applications for separate tracks per applicant. The essays should be distinct and clearly targeted to the specific track. Two applications may be submitted in a single mailing if clearly demarcated. Send application materials to:
Elizabeth Goy, Ph.D., Director
Psychology Postdoctoral Fellowships (R & D 66)
Portland VA Medical Center
3710 SW US Veterans Hospital Road
Portland, OR 97239
Please feel free to contact Dr. Goy with any questions: (503) 220-8262, Ext. 57470
elizabeth.goy@va.gov
Note: VA interns and fellows are subject to all employment rules applying to federal
employees. We look forward to hearing from you, and encourage interested candidates to begin application as soon as possible
