Internship in Professional Psychology |
VA Tennessee Valley Healthcare System
Rotations in Mental Health
| PTSD | OEF/OIF | Inpatient | Polytrauma |
Post-Traumatic Stress Disorder Program
Important Note: There have been recent staff and structural changes in this program. Dr. Simms has just assumed her responsibilities there. Because of these changes it is not certain if a training experience in the PTSD program will be offered next year, or if it is, what the nature of the experiences in the program will be. The description below is of the rotation last year under a different supervisor.
Location: Nashville Campus
Supervisor: Dr. Lori Simms
Setting: The PTSD program provides comprehensive treatment for veterans and active duty soldiers with PTSD. Treatment options in the PTSD program include a six week intensive program, a four month weekly group, individual psychotherapy, and medication management. Initial entry to any of these treatment options involves a comprehensive evaluation. The evaluations are conducted based on extensive clinical interview and mental status exam. The PTSD program has an active treatment team which meets daily. The psychologist serves as coordinator of the program as well as conducting evaluations, doing individual psychotherapy, and doing group therapy.
What Interns Will Do: The intern will spend a large portion of his or her time conducting initial evaluations and doing individual psychotherapy. In addition, there will be opportunity to conduct groups, both in the intensive program and in one of the weekly groups. These groups include both didactic and process methodologies. The intern will also function as a member of the treatment team and as such, will consult with other staff members on a regular basis. The intern will additionally have an opportunity to participate in the formulation of initial treatment plans and in treatment plan reviews. All of these activities will be conducted in an environment where a premium is placed on gaining a more advanced understanding of PTSD, the military environment, and the nature of combat.
Research: While there is no ongoing research project on this rotation, the potential for future research projects is being discussed.
Location: Nashville Campus
Supervisor: Dr. Shari Harwell
Setting: The SeRV-MH (Services for Returning Veterans-Mental Health) program is a nation-wide program offered through the Department of Veterans Affairs to provide mental health services specifically for those individuals who have served in the combat areas of Afghanistan (Operation Enduring Freedom/OEF) and Iraq (Operation Iraqi Freedom/OIF) since 2001. The program is designed to provide early intervention for those serving in recent conflicts to promote a more rapid reintegration back into the family environment and the community. TVHS has two psychology positions allocated for the program (one based at the Nashville campus and one at the Murfreesboro campus) to provide clinical evaluation, therapeutic intervention, and in-reach services. Due to recent hire of the Murfreesboro OEF/OIF Psychologist, it is believed that an intern position will only be available through Nashville for the upcoming 2010-2011 year.
Intervention services are available to OEF/OIF veterans of all ages and both genders, to National Guard and Reserve veterans, and possibly to some active duty military. Therapeutic opportunities may include individual, group, couple, or family counseling using such modalities as Cognitive Behavioral Therapy, supportive/talk therapy, stress inoculation/coping skills training, and/or trauma processing. Although the primary emphasis is on adjustment issues, there is also opportunity to treat a range of mental health disorders. Anxiety, anger, depression, sleep problems, post-traumatic stress, parenting problems, and marital discord are prominent issues within this population.
Psycho-education for medical staff may be provided through in-service presentations. Staff members are provided education on the effects of acute stress reactions from having served in a combat zone, as well as the effects of military training on readjustment to the civilian realm.
What Interns Will Do: The intern will have the opportunity to conduct psychological evaluations consisting of a structured clinical interview and possibly the administration of brief assessment instruments, such as the Beck Depression Inventory-II and the Posttraumatic Checklist List-military version, as indicated. The intern will provide individual and/or group psychotherapy to those experiencing difficulty upon their return stateside from deployment to a conflict arena. Opportunities to work with couples and family members may also be available. There may be opportunities for the intern to assist the psychologist with in-service presentations.
Research (Nashville): Currently there is no ongoing research project with this rotation; however the opportunity may arise in the near future.
Location: Murfreesboro Campus
Supervisor: Drs. Paul Lima and Dawn Wilkinson Setting:
The Inpatient Rotation involves working on a 30 bed acute unit and a 30 bed
sub-acute unit. The patient population is 90+% male and ranges in age from 18 –
85. In addition to psychiatric admissions the acute unit also functions as the
detoxification unit for the Addiction Medicine program. There are 4 treatment
teams consisting of a psychiatrist and social worker. These teams meet daily
with the patients and are supplemented by nursing staff, the unit chaplain,
psychiatric residents and medical students. Admissions are assigned on a
rotational basis. Lengths of stay vary from a few days to several months.
Psychology works by consultation. What
Interns Will Do:
The intern is responsible for a caseload of at least 3 patients who are seen
daily. Interventions are time limited and focused. Patients are referred for
issues such as PTSD, depression, grief, coping skills training, anger
management, relaxation training and supportive therapy. The intern is expected
to attend treatment team meetings when their patients are seen and/or
discussed. There is also an opportunity for group therapy to be conducted. The
intern is encouraged to observe numerous adjunct therapies such as music
therapy, occupational therapy and kinesiotherapy. If available
during the rotation there is the opportunity to observe commitment procedures
and electroconvulsive therapy. Timely documentation in the computerized record
is expected as is verbal communication with the treatment team.
Research: There is no current active research on the units.
Location: Two Polytrauma Rotations are offered. One rotation is in the Nashville Polytrauma Clinic and one in the Murfreesboro Polytrauma Clinic.
Supervisor: Drs. Pamela Drury (Nashville) and Elizabeth Fenimore (Murfreesboro)
Setting: The Polytrauma Clinics at Nashville and Murfreesboro are specialty clinics that provide comprehensive health care for veterans of Iraq and Afghanistan who have sustained multiple injuries, including at least one traumatic brain injury (TBI). The types of TBI range from concussions with residual neurological symptoms to moderate to severe TBIs. The latter veterans have often undergone inpatient and outpatient rehabilitation at acute centers and are now reintegrating back into their communities. These veterans in particular tend to have a number of co-existing medical, mental health, and psychosocial issues associated with their transition from combat to home. The clinic is composed of an interdisciplinary team, consisting of physiatrists, psychologists, speech and language pathologists, physical therapists, occupational therapists , social workers, registered nurses, and nurse care managers. This team works together closely to provide comprehensive care within the context of post-deployment readjustment.
What Interns Will Do: Interns will respond to consults from the Polytrauma team for neuropsychological evaluations. Interns will be expected to conduct one to two evaluations per week depending on their level of experience and competency. Evaluations typically involve a chart review, a clinical interview, a flexible battery of neuropsychological tests, and personality assessment. The intern will be expected to score and interpret results, and produce a well-written report. The intern will also attend weekly interdisciplinary team meetings and present oral summaries of reports to the team as needed. The intern may have the opportunity to co-lead a cognitive rehabilitation group with the supervisor, depending on veteran needs.
Supervision: Supervision will consist of 1-2 hours of scheduled face-to-face time each week, plus informal supervision as needed. Written feedback will be provided regularly on interns' report writing.
Research: There are no ongoing opportunities to conduct research on this rotation, though interns will be encouraged to stay abreast of latest research regarding mild TBI and PTSD, as this is an evolving field particularly relevant to the Polytrauma veterans.
9-22-2009