VA-VU Psychology Internship

Setting: The PTSD program provides comprehensive outpatient treatment for veterans, including psychotherapy, medication management, and ancillary services such as occupational therapy. Treatment options in the PTSD program include weekly group therapy (support groups and coping-skills groups), individual psychotherapy, including evidenced-based trauma processing therapies such as Prolonged Exposure, Cognitive Processing Therapy, and EMDR. Treatment is also available to veterans diagnosed with co-occurring PTSD and substance use disorders. Initial entry to any of these treatment options involves a comprehensive psychological evaluation. The evaluations are conducted based on extensive clinical interview, mental status exam, and when indicated, administration of formal psychological assessments and structured interviews (e.g. the CAPS, SCID). The PTSD program has an active treatment team which meets weekly. The psychologist serves as a member of the interdisciplinary treatment team, conducts evaluations, individual psychotherapy, and group therapy.

What Interns Will Do: The intern will spend a large portion of his or her time conducting initial evaluations and doing individual, couple, and group psychotherapy. The specific break down of these activities can be adapted to fit the selected intern's training needs and desires. In addition, the intern will have the opportunity to learn and practice evidenced-based psychotherapies for PTSD such as Cognitive Processing Therapy and Seeking Safety. The intern will also function as a member of the treatment team and as such, will attend weekly treatment team meetings and 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. All of these activities will be conducted in an environment where a premium is placed on gaining a more advanced understanding of PTSD, current evidence-based treatments for PTSD, the military environment, and the nature of combat.

Research: While there is no ongoing research project on this rotation, the potential for future resarch projects is being discussed.

[top]

OEF/OIF/OND Rotation

Important Note: There are two OEF/OIF/OND Rotations, one at each campus

Location: Nashville Campus and Murfreesboro/York Campus

Supervisors: Dr. Shari Harwell (Nashville); Dr. Regina Austin (Murfreesboro)

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, as well as post war support during the reunification of Iraq (Operation New Dawn/OND). 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 psychologists working in the program (one based at the Nashville campus and one at the Murfreesboro campus) to provide clinical evaluation, therapeutic intervention, and in-reach services.

Intervention services are available to OEF/OIF/OND 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 readjustment 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 the Intern 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: Currently there is no ongoing research project with these rotations; however the opportunity may arise in the near future.

[top]

Polytrauma

Location: Nashville VA Medical Center Polytrauma Clinic

Supervisor: Dr. Pamela Drury

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 with the supervisor cognitive rehabilitation or symptom management groups, either on site or via telehealth 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.

Secondary Placement: A secondary placement opportunity will be available in the Polytrauma Clinic in Nashville for interns with primary placements at Vanderbilt. This secondary placement will be supervised by Dr. Pamela Drury, and will consist of evidence-based psychotherapy for PTSD and other mental health issues experienced by this population.

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. [top]

9-6-2011