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Psychotherapy and Clinic Administration

The primary goal of this track is to offer residents administrative and program development responsibilities with regard to psychology students providing mental health services within VA Bedford’s Outpatient Mental Health Clinic (MHC).

Psychotherapy and Clinic Administration
Dr. Melanie Manning |
Dr. Maura Pellowe |

The primary goal of this track is to offer residents administrative and program development responsibilities with regard to psychology students providing mental health services within VA Bedford’s Outpatient Mental Health Clinic (MHC). In this role, each resident works directly with all psychology students (other post-doctoral residents, interns, and practicum students), serving both as administrative supervisor and mentor. The two residents work closely with one another and staff clinic leadership in overseeing and coordinating much of psychology student training within the MHC. The residents triage MHC referrals to trainees and ensure that follow-up and other administrative requirements are completed. The two residents also co-facilitate a weekly group supervision for the psychology practicum students training within MHC, wherein practicum students present their clinical cases for review and discussion with this resident-led supervision group. This track is particularly well-suited for residents who wish to become involved in program administration and leadership related to psychology student training and development. Ample opportunities are present to function in mentoring and supervisory roles with earlier-in-training students.

Training within our this outpatient track of training offers residents a breadth of opportunities to provide individual, couples, and group psychotherapy. Our MHC is comprised of five interprofessional teams, affording residents collaborative contact with clinicians from psychology, nursing, psychiatry, and social work. Within MHC, residents are afforded an opportunity to engage a variety of Veterans in episodic, evidence-based psychotherapy. A range of psychological issues and severity are represented, including PTSD (combat and non combat related), anxiety disorders, mood disorders, couples/family issues, and disorders of addiction, personality disorders, and SMI. Individual psychotherapy is informed by an overall Veteran-centered and strengths-based approach to integrative therapy. A variety of time-limited psychotherapy groups are offered, (e.g., a CBT series, ACT for PTSD, a mindfulness series, positive psychology groups, and a series of PTSD skill development groups). All psychotherapy groups are co-led with either two psychology students or a psychologist supervisor and student.

On a clinical level, the MHC operates from an integrative psychotherapeutic orientation. In addition, a focus on strengths and recovery from a psychosocial rehabilitation is embodied in the overall approach of the clinic. Within this larger integrative orientation, an appreciation of and training in specific evidence-based psychotherapies (EBPs) is also a key component of training and practice within the program. Residents will have an opportunity to learn and implement at least one of VA’s Evidence-Based Psychotherapy protocols. Residents are afforded significant opportunity to tailor their clinical work in accord with their interests.

On an organizational level, the principles and practices of effective inter-professional collaboration and practice is a key foundation of both the MHC and the larger hospital. Specific didactics, grand rounds, and interdisciplinary dialogues support this hospital’s ongoing evolution to an inter-professional model.

Residents are expected to conceptualize clinical cases broadly and from more than one perspective, and they are similarly encouraged to implement interventions thoughtfully from relevant therapeutic schools to best meet the presented clinical needs of a Veteran. Supervisors represent a range of theoretical and clinical expertise, including cognitive-behavioral, psychodynamic, humanistic, positive psychology, experiential, and transpersonal/integral orientations. Many supervisors also work from third-wave cognitive-behavioral approaches that emphasize mindfulness and acceptance. Many staff members have expertise in the treatment of PTSD, and a number of supervisors are trained in one or more EBPs for PTSD (primarily cognitive processing therapy and prolonged exposure), with both formal training and ongoing supervision available in these modalities. Staff also have training in a variety of other EBPs relevant to care of the Veteran population.

Learning Objectives
1. Accurately conceptualize overall client functioning from resident’s primary psychotherapeutic orientation.

2. Ability to conceptualize specific aspects of client functioning from other psychotherapeutic orientations.

3. Effective implementation of interventions related to one’s primary orientation to facilitate client’s integration of new knowledge/skills into everyday functioning.

4. Effective implementation of interventions related to other psychotherapeutic orientations to facilitate client’s integration of new knowledge/skills.

5. Ability to implement evidence-based practices.

6. Ability to empathically join with the client and elicit necessary cooperation.

7. Ability to recognize one’s overt as well as subtle feelings as they arise within the psychotherapy.

8. Ability to respond effectively to the content (client’s thoughts, feelings, and behavior) of the psychotherapy.

9. Ability to target and work toward specific goals in collaboration with the client.

10. Accurately diagnose according to DSM-5.

11. Ability to incorporate client’s dynamics, functioning, and treatment readiness in order to determine appropriate treatment considerations.

12. Ability to effectively facilitate a psychotherapy group.

13. Possess a clear integrated understanding of the range of clinical services and the relevance of each to a variety of clinical presentations.

14. Demonstrate a clear understanding and sound application regarding the various protocols, procedures, and mechanisms within the MHC.

15. Effectively model and teach relevant clinical theory and application to earlier-in-training psychology students.

16. Demonstrate good judgment and common sense across a range of administrative situations.

17. Ability to evaluate the various aspects of the clinic’s inter-professional care in order to determine necessary program needs and modifications.

18. Ability and initiative to design and implement programmatic changes.

19. Ability to effectively communicate and collaborate within an inter-professional team.

20. Ability to collaboratively contribute to inter-professional treatment planning and care.

21. Demonstrate positive attitudes toward Veteran-centered care.

Target professional experiences
1. Carry a caseload of approximately 12-15 psychotherapy clients, providing about 14 hours/week of individual treatment.

2. Co-facilitate an evidence-based psychotherapy group related to one’s particular area of clinical interest.

3. Collaborate with inter-professional trainees and faculty on an inter-professional MHC team to provide an promote Veteran-centered clinical care and recovery.

4. Provide consultation and outreach to clinicians and professionals across the medical center.

5. Provide consultation and supervision to earlier-in-training psychology students.

6. Determine specific clinic/program needs and modifications.

7. Assume relevant administrative responsibilities within the MHC

8. Design and initiate program development activities, in collaboration with administrative staff and supervisors in the MHC