Our training philosophy is strongly based on the scientist-practitioner model. The overall focus of training is on evidence-based approaches for a wide range of health concerns. Education in the scientific method, the application of scientific literature to inform clinical practice, methods of program evaluation, and the ethical conduct of psychological research are incorporated throughout our training program. Our training program also includes formal didactic training, structured supervision, and an apprenticeship model of training based on a "matrix model" of development of key "skill sets" across various training sites.

The “4 Skill Sets” Approach

The primary goal of our postdoctoral training program is to develop psychologist leaders with a strong foundation in the scientist-practitioner model. To accomplish this goal, a "matrix" system of training has been adopted. This system requires the postdoctoral resident to emphasize the development of four "skill sets" that serve as the main objectives of the training program while the clinical emphases encourage the development of several specific areas of expertise and competency within the broad domain of Clinical Health Psychology. The structure of this "matrix" system of training is developed through an individually-tailored training plan that meets the specific interests of each resident.

The four skill sets include:

1. Direct Service Provision - The provision of clinical care is an essential role for clinical health psychologists. For purposes of the postdoctoral training program, this element of training will allow the resident to complete requirements necessary for receipt of licensure, and provide the resident with opportunities for training in advanced consultation, assessment, and relevant empirically-supported interventions across several treatment modalities (i.e., the individual, couple, family, group, and or community-based intervention, as appropriate). It will also encourage the development of novel approaches to case management appropriate to the further bi-directional integration of mental health and medical/surgical services, thereby promoting "mind-body" medicine. The direct patient contact and ongoing therapy to be provided in this context will also provide opportunities to the resident for the generation of evaluative efforts and performance improvement initiatives. Hence, the resident will gain experience and insights into how direct service delivery experiences can be used to promote more systems-based thinking, program development, program improvement, and treatment evaluation.
    
2. Systems Design and Policy / Guideline Implementation - An example of this skill set would include systems for screening of veterans in primary care for the wide array of mental and behavioral health needs, such as those designated by VHA for special focus (tobacco and alcohol use, mood disorders, acute and/or chronic pain). Particular aspects of training will include methods for policy development and refinement, education efforts directed toward veteran, family members, and other members of the interprofessional team and/or community support systems involved in the veteran's care, and evaluation of both systems- and patient-focused interventions. This aspect of training will also allow the resident to bring their effort to the next level – that of contributing to the development and implementation of local policies and guidelines beyond their specific treatment team and across other teams within their Primary Care Firm. This effort will include such advance practice and leadership skills as directed education and training of a wide array of professionals within the medical setting.
    
3. Interprofessional Training and Teaching/Mentorship – The VACHS is affiliated with both the Yale Medical School and the University of Connecticut Health Center for the provision of education and training of medical and associated health professionals. These affiliations offer expanded opportunities for educational experiences for the residents in Clinical Health Psychology. Residents have numerous opportunities to participate in specific aspects of training and ongoing professional development, taking part as audience and presenter in the wide range of lectures, rounds, and clinical activities available in an academic medical setting within the VA and the broader academic community. Within the context of the various interdisciplinary treatment team settings, the resident will develop supervision skills in concert with their faculty mentor and mentor other trainees. Residents will also have the opportunity to refine their teaching and mentorship skills by serving as a direct supervisor for other psychology trainees (which may include predoctoral psychology interns, psychology practica students, undergraduate research assistants and/or medical residents seeking training in behavioral interventions), coordinating and evaluating a lecture series for psychology trainees, and delivering prepared lectures to various groups.
    
4. Conduct of Clinical Research - Residents will be expected to participate in ongoing and/or novel research projects under the direction of core faculty in the area(s) of their choice. Roles will include involvement in research project conceptualization, study design, oversight of data collection, management, and analysis, and preparation of manuscripts for presentation and publication. It is the expectation that residents' contributions will be substantive and deserving of authorship on both presentations and publications, with probability of a first author paper. As the faculty routinely serves on scientific review panels and review manuscripts for peer reviewed journals, there are opportunities for the resident to gain experience in the grant writing and peer review process as well.

Primary Training Sites

VACHS consists of an integrated system of healthcare delivery encompassing a tertiary care inpatient facility at its West Haven campus, an ambulatory care Center for Excellence at its Newington campus, six Community Based Outpatient Clinics, and three Veterans Outreach Centers. Although there are multiple opportunities to gain competency across the aforementioned 4 "skill sets" throughout VACHS, established sites for training within the Clinical Health Psychology Postdoctoral Residency Program is concentrated within three primary locations: (1) VACHS-West Haven Campus; (2) VACHS-Newington Campus; and (3) the Errera Community Care Center (ECCC), a long-term rehabilitation and recovery community-based program for veterans with severe mental illness (SMI). Further descriptions are presented below.

Health Psychology – Primary Care Clinics. (Dr. Frantsve) – The Health Psychology – Primary Care Program is the primary focus and setting for residents in our program. In addition to this site, residents select other settings that are specific to their interest and training objectives. The Primary Care Program, because of its structure, provides residents with the maximal opportunity to interact with the wide array of allied healthcare professionals that serve on associated Firms/Primary Care Clinics and treatment teams, following the interprofessional model. This includes physicians, nurse, medical technicians, social workers, rehabilitation specialists, dieticians, pharmacists, psychiatrists, geriatricians, and case managers. Residents participate in the evaluation/assessment, treatment planning, and direct care of patients with co-morbid medical and psychological/adjustment issues using empirically-based individual and group interventions. This emphasis provides the resident with an opportunity to design, implement, evaluate and facilitate within a primary care medical setting, a variety of treatment efforts directed toward the identification and reduction of health risk related life-style (e.g., tobacco use, obesity, stress management). Implicit in this approach is the utilization of "stepped care" and the integration of medical and mental health services, consistent with the spirit of recent Agency for Healthcare Policy Research guidelines. The task of the resident will be to facilitate the development of more effective and efficient care programs that take advantage of the interprofessional nature of primary care and the wide range of healthcare providers involved in the care of the veteran. NOTE: The primary training site for these training opportunities is VACHS-WH, similar opportunities may also be available at VACHS-Newington.

Comprehensive Pain Management. (Drs. Kerns, Shulman, Rosenberger, and Heapy) - This emphasis takes place within an interprofessional clinical, research and training program committed to the evaluation of the interaction of the physical, psychological, and sociological aspects of chronic pain problems and the development of mind and body integrated approaches to pain management. Evaluation, treatment planning, active intervention, and case management occur in outpatient settings. Opportunities for inpatient consultation also exist. Roles of the resident will include that of primary clinician and program manager within the context of an interprofessional team directed by a psychologist. Residents will learn to design and manage a comprehensive program within the context of a primary care setting. In addition, specific clinical skills developed will include the conduct of a comprehensive cognitive-behavioral evaluation and provision of treatment within cognitive-behavioral and rehabilitation perspectives. This focus has a treatment process and outcomes research orientation, and residents are routinely involved as co-investigators on any of several funded research projects including roles as study therapists and opportunities for secondary data analyses of archived data. NOTE: While these training opportunities are primarily located at VACHS-WH, opportunities are also available at VACHS-Newington.

Obesity Clinics: M.O.V.E. and M.O.V.E. – I.T: VACHS-WH. (Drs. Heapy and Frantsve) – This emphasis provides training in the context of the Managing Obesity/Overweight in Veterans Everywhere (M.O.V.E.) Program that was developed nationally by the VA in response to efforts to address the obesity epidemic. Since its inception and dissemination, the M.O.V.E. program at VACHS has been divided into two, interrelated and interdisciplinary clinics: (1) M.O.V.E., which offers ongoing psychoeducational groups to promote long-term, effective weight management; and (2) M.O.V.E. – Individualized Treatment (M.O.V.E. – I.T.), which offers comprehensive evaluation and individually-tailored, empirically-supported treatment for veterans with obesity. Both M.O.V.E. programs provide ample opportunities for intraprofessional collaboration and mentoring, program development and evaluation, as well as participation in ongoing research collaborations. NOTE: These training opportunities are located primarily at VACHS-WH; expansion to VACHS-Newington and the ECCC may be available.

Health Promotion and Psychosocial Rehabilitation. (Drs. Klee and Frantsve) – This training site rises out of a novel program at VACHS that focuses on meeting the health and wellness needs of veterans with severe mental illness (SMI) and interfaces with existing psychosocial rehabilitation (PSR) programs offered in community-based settings, including the Errera Community Care Center (located approximately 1 mile from the VACHS-West Haven Campus with frequent free shuttle service available from VACHS-West Haven and Yale University Medical School). Given the fact that individuals with SMI also experience increased morbidity and mortality associated with health-risk behaviors (such as poor nutrition, lack of exercise, cigarette smoking, and/or alcohol/substance use), this program seeks to integrate existing evidence-based interventions from health psychology/behavioral medicine and PSR to provide comprehensive medical and psychiatric care for veterans with SMI. Evaluation, treatment, consultation and program development opportunities are highlighted in this setting. Research opportunities related to the design and implementation of treatment outcome studies are also available. NOTE: These training opportunities are located at both VACHS-WH and ECCC.

Newington Campus. (Drs. J. Cooney, N. Cooney, and Gaupp) – Training opportunities exist in the substance abuse clinic, in the smoking cessation program, in the geropsychology clinic and in the primary care setting. VA and NIH supported research is underway with a focus on smoking cessation in the context of substance abuse treatment. There are ongoing clinical trials and process studies using real-time data-capture methodology. The resident also has the opportunity to learn how to provide clinical supervision to psychology interns and practicum students. An opportunity exists to develop a tele-mental health clinic with video linkages to small VA clinics in remote areas of Connecticut. Fellowship training at Newington, as at West Haven, is highly individualized based on the interests and needs of each resident. NOTE: These training opportunities are offered at VACHS-Newington only.

The Matrix Training Model

The basic model that we follow at all levels of training is that of an intensive experience working with a variety of patients within the context of specific clinical services while under close supervision - essentially an apprenticeship model. Residents obtain mentoring from a primary supervisor assigned to provide training in each of the 4 "skill sets" within a matrix model across the resident's area(s) of interest. A primary supervisor for each skill set is formally selected during the first weeks of the fellowship, largely as a function of the resident's interests. While residents may choose a different primary supervisor for each skill set, residents often work closely with 1-2 staff members and develop long lasting relationships with these supervisors as they move forward in their career.

Each resident develops a self-directed plan of study. For example, the "matrix model" of training for a resident with interests in obesity and interest in smoking cessation might be as follows:

Example of Matrix Training Model

Though the specific experiences of residents varies, all are provided a strong basis in evaluation, intervention, consultation, interprofessional education, and the scientific and ethical basis of professional practice. Residents work in conjunction with licensed clinical psychologists who maintain primary clinical and programmatic responsibility for patient care. Formal supervision is provided for at least two hours per week individual/face to face, and four hours overall. Further, the overall amount of supervision is enhanced by the informal contacts and discussions that occur between resident and faculty routinely during the day. Over the course of their experience, residents are given increasing levels of independence, consistent with the level of skill they demonstrate. In addition, the level of both clinical challenge, and programmatic design and management are increased. At year's end, the resident is expected to meet requirements for licensure and be competitive for advanced practice leadership positions at major medical facilities (either within VHA or in other sectors) and/or related academic positions.

The training experience is buttressed by a combination of formal didactic seminars within the Psychology Service, informal, one-to-one teaching during the course of regular supervisory meetings, and the wide array of formal seminars, grand rounds, case presentations, and other similar activities that are a part of the overall milieu associated with Yale University School of Medicine and the University of Connecticut Health Center. This approach further grounds the training experience in the scientist-practitioner model to which we are committed. Practice, theory and research are fully integrated into the training program through modeling, didactics, colloquia/seminars, and support for trainee research. The conduct of clinically relevant research is strongly emphasized in our setting, and the faculty within Clinical Health Psychology has a strong record of funded research and publication. As part of their training requirements, residents become engaged in aspects of these funded projects, initiate ancillary studies to these projects, or develop their own research agenda in the context of the clinical foci they choose. They are also encouraged to attend relevant national workshops and scientific meetings throughout the training year.

Resident progress is assessed by all supervisors during the course of informal and formal supervision. Formal acceptance of the resident's proposed training plan and informal feedback of resident's performance is provided after 1 month of training. Explicit and documented performance evaluations are conducted and reviewed with all residents at regularly scheduled 4-month intervals. Though the process of supervision may provide the primary feedback to the resident regarding progress toward goals and the development of targeted skills, the formal evaluations are considered essential for overview and the mutual communication of resident and supervisors regarding progress. Intermediate goals for each evaluation period are set for the resident. These goals are monitored and evaluated, with newly devised goals at each evaluation time point. This process is highly interactive between the resident and faculty. It is also further structured and monitored by the Psychology Service Training Committee, which meets monthly.

Resources/Benefits

A host of resources is an essential part of the proposed postdoctoral residency program. Not the least of these resources is the faculty and other program and service line leaders who are actively involved in our training program. In addition, the Primary Care Program and the opportunities for special emphases as described above are a rich resource for interaction, interprofessional training, and the development of future leaders. Residents can expect to have office space both within the Clinical Health Psychology suite and the Primary Care Clinic setting. These spaces are further equipped with personal computers tied into the central computer network, thereby facilitating direct access to such diverse information as patient medical records and internet based literature and internet search services. Specialized equipment and testing materials are available to the resident from within the Psychology Service, including audio- and videotaping equipment. An excellent library is on site with journal holdings relevant to the focus of this application. In addition, residents have open access to the full range of library and other resources that comprise Yale University School of Medicine. Hence, the richness of resources and degree of support for the proposed fellowship program is outstanding. The salary for the postdoctoral fellowship program is consistent with national VA standards and locality pay differentials. Currently, the salary for our residents is $44,884 per year plus benefits including health insurance and funding for travel to professional and/or scientific meetings.

Eligibility Criteria

Applicants for our Clinical Health Psychology Postdoctoral Residency Program must meet the following minimum requirements:

1. Successful completion of all requirements towards earning a doctoral degree from an APA-Accredited Clinical or Counseling Psychology (including dissertation defense).
    
2. Successful completion of an APA-Accredited Psychology Predoctoral Internship Program.
    
3. U.S. Citizenship.
    
4. Successfully meet mandatory requirements for appointment as a Federal Employee, including, but not limited to: willingness to participate in the government's drug testing procedures and consent to participate in a background check to verify your application information and/or criminal history. Applicants who do not successfully pass this background check and/or drug test are ineligible for our program.

Application Procedure

Application review begins on JANUARY 15th and continues until all positions are filled. Applications will be accepted and reviewed after the application review process begins on January 15th, provided that our training program has a position available.

To apply, please send the following:

1. A letter of interest describing career goals and how the features of the program as described will facilitate the realization of these goals
    
2. 2 copies of your vita;
    
3. 3 letters of recommendation;
    
4. A total of 3 professional writing samples to include at least 1-2 research/scholarly writing samples (e.g., manuscript under review, published, or in press in a peer-reviewed journal; text of poster and/or paper presentation at a professional/scientific conference.) Samples of clinical evaluations and reports are also acceptable. Identifying information should be excluded from all clinical writing samples (use of pseudonyms – identified as such – is permissible).

Application materials can be sent in one package or separately to the attention of the Director of Training for the Clinical Health Psychology Postdoctoral Residency Program:

Robert Kerns, Ph. D.
Chief, Psychology Service
VA Connecticut – West Haven
Psychology Service – 116B
950 Campbell Ave.
West Haven, CT 06516
Robert.Kerns@va.gov
203-932-5711 x 2468