VA Puget Sound, American Lake Psychology Postdoctoral Residency Program

 The application, interview notification, and interview/open house dates are all the same for all of our residency programs.

 Important Dates
Please be mindful of the below dates in applying for our program. Note that we will notify applicants of their interview status no later than the listed date, though notification may be provided earlier. Interviews most often occur the week of Information Day listed below, though are sometimes scheduled to occur before or after that date, based on interviewee/interviewer availability. Our Information Day and all interviews will occur virtually.

Residents receive a competitive stipend paid in 26 biweekly installments. VA residency stipends are locality adjusted to reflect different relative costs in different geographical areas. The Office of Academic Affiliations has published that the annual residency stipend at our site for training year 2026-2027:
First Year: $60,670
Second Year: $63,947

Resident Recruitment and Selection
The procedures for resident recruitment and selection include development of residency Selection Committees for each residency program composed of American Lake psychologists who practice within the setting(s) where the residency training occurs, the Director of Training, and members of the Training Committee. The Selection Committees are responsible for careful review of applications to the residency programs. Each application is reviewed by at least two raters for goodness-of-fit which is determined by strength in a variety of categories, including research skills, scholarly productivity, cultural competency, intervention experience with adults related to the specialty program and/or focus area (within the Clinical Program, assessment experience with adults related to the specialty and/or focus area of the residency, quantity and quality of supervision received, evidence of interpersonal and communication skills, academic rigor of the doctoral program, and overall aptitude and fit with the to which program and/or focus area they are applying.

We look for residents whose academic background, clinical experience and personal characteristics give them the knowledge and skills necessary to function well in our setting and within the specific postdoctoral program. At the same time, we look for residents whose professional goals are well suited to the experiences we offer such that our setting would provide them with a productive training experience.

All applications are initially reviewed for eligibility in the order that they are submitted. We notify all applicants on the status of their applications by the date noted above. The Selection Committee will invite applicants remaining under consideration for interview*. In order to support applicants’ health and safety, and in recognition of the resource disparity our applicants may present with, we will not host on-site interviews but will make every effort to provide applicants with as much information about our setting, culture, and training resources as feasible. The final rank list for each residency program (and each Focus Area within the Clinical Psychology Program) is determined by a combined score of the application review mean score and interview mean score with the former being weighted more heavily than the latter.
 

*Applicants requiring any interview accommodation due to disability are asked to request such assistance at the time they receive notification of interview.

Applications and Interviews
Onsite visits and onsite interviews are not expected for this year’s application season. To get a glimpse of our campus, please feel free to look at the very brief video created by our Medical Media: VA Puget Sound Health Care System American Lake Campus - YouTube. More information about scheduling virtual interviews and opportunities to attend virtual presentations about our training program will be forthcoming.
 

All application materials should be uploaded to the APPA CAS system by the due date noted above:
https://appicpostdoc.liaisoncas.com/applicant-ux/#/login. Please note that our program does not “go live” in APPA CAS until November 1st each year, at which point you will be able to search for our program and begin uploading documents.

1. Graduate transcripts
2. Three Letters of Recommendation
   1. Please ask three people to write a letter of recommendation in support of your application to our program who are knowledgeable of your competency in the following areas: Integration of Science and Practice, Individual and Cultural Diversity, Ethical and Legal Matters, Professional Attitudes/Values/Behaviors, Interpersonal Skills and Communication, Intervention, Assessment, Interprofessional and Consultation Skills, Teaching and Education, and your Knowledge of the Focus Area (in the Clinical Program) and/or Specialty Area (Geropsychology) relevant to your application. We encourage you to share with them the areas of competence upon which we are making our evaluations.
3. Curriculum Vita
4. Cover Letter
   1. Please submit a cover letter detailing your interests in our program and goodness-of-fit across multiple domains:
      1. your fit within the Focus Area (in the Clinical Program) and/or Specialty Area (e.g., Geropsychology Program) relevant to your application;
      2. the diverse worldview you would bring to our training community
      3. your preparation in the following competency domains - Integration of Science and Practice, Individual and Cultural Diversity, Ethical and Legal Matters, Interpersonal Relationships and Communication, Interprofessional and Consultation Skills, Teaching and Education, and Knowledge of the Focus Area (in the Clinical Program) and/or Specialty Area (Geropsychology); and
      4. your goals for postdoctoral residency training and how these relate to your career goals.
5. Follow AAPI online application procedures.
    

Resident Eligibility
The following are requirements for selection to and initiation of residency training at all VA Psychology Training Programs:
1) Compliance with Eligibility Requirements for all VA Psychology Training Programs, available at: www.psychologytraining.va.gov/eligibility.asp (these will need to be verified via the TQCVL process prior to the start of residency, see: https://www.va.gov/OAA/TQCVL.asp for details)
2) Completion of an APA, CPA, and/or another VA recognized accrediting body (e.g., PCSAS) accredited doctoral program in clinical or counseling psychology
3) Completion of an APA or CPA accredited doctoral internship or any VA internship training program
4) U.S. Citizenship
5) Completion of our application materials
 

Note: All applicants who are U.S. citizens, required to register for the Selective Service, born after December 31, 1959, and who are not otherwise exempt, must show proof of Selective Service registration as part of their VA application.  Acceptance of residents is contingent upon the results of a background check, TQCVL verifications (as indicated above), and possible drug screening.

Contacting Current Residents
Current residents are one of the best sources of information about our postdoctoral programs. We strongly encourage applicants to talk with current residents about their satisfaction with the training experience. Please feel free to email the Training Director and request to speak with a resident. Your request will be forwarded to current or recent residents and one will contact you.
Questions about the residency programs and application process can be directed to the Director of Training, Dr. Jason Stolee at Jason.Stolee@va.gov.

Application Due = December 3, 2026
Interview Notification = December 21, 2026
Information Day = January 27, 2027

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The postdoctoral residency programs at American Lake VA are accredited by the Commission on Accreditation. The Clinical Psychology program was initially accredited on July 21, 2019 (next site visit will be in 2029), the Geropsychology was initially accredited on July 21, 2019 (next site visit will be in 2029), and the Neuropsychology program was initially accredited on July 21, 2019 (next site visit will be in 2029). ***However, please note that due to staffing, the Geropsychology and Neuropsychology programs are not currently recruiting, and are on “Accredited, Inactive” status with the APA’s Commission on Accreditation.

Questions related to APA accreditation should be directed to the Commission on Accreditation:
Office of Program Consultation and Accreditation
American Psychological Association
750 1st Street, NE
Washington, DC 20002
Phone:
Email: apaaccred@apa.org
Web: https://accreditation.apa.org/

APPIC Membership Status
The postdoctoral residency programs at American Lake are Association of Psychology Postdoctoral and Internship Centers (APPIC) member programs (since May 2015).
 

Questions related to APPIC Membership can be directed to APPIC Central Office:
Association of Psychology Postdoctoral and Internship Centers
17225 El Camino Real
Onyx One - Suite #170
Houston, TX 77058-2748
Phone:
Email: appic@appic.or
Web: https://www.appic.org/

Public Health and Safety Update

In 2020 the VA Puget Sound psychology training programs quickly transitioned to primarily telehealth, telework, telesupervision, and other virtual training. While we are unable to predict how public health requirements and institutional policies may evolve by the fall of 2026, these capabilities are all currently in use to varying degrees across our training site. As of this writing, most psychologists and all residents are working fully on-site, providing both in-person and telehealth care. Our facility is committed to following public health guidelines based on the best available scientific evidence, and we will continue to pursue optimal training within that context.
 

Overview
With a reputation for excellence in caring for of our Nation’s Veterans, VA Puget Sound strives to lead the nation in terms of quality, efficiency and public service. As the primary referral site for VA's northwest region, VA Puget Sound provides care for Veteran populations encompassing Alaska, Washington, Idaho and Oregon. Since its inception, VA Puget Sound Health Care System has distinguished itself as a leader in teaching, research and patient care while earning prestigious recognition as part of the largest health care network in the country. We consider it our privilege to serve the health care needs of more than 80,000 Veterans living in the Pacific Northwest.

In addition to two divisions located at American Lake and Seattle, VA Puget Sound offers services at community-based outpatient clinics. They are located in Bellevue, Bremerton, Federal Way, Mount Vernon, North Seattle, Port Angeles, and South Sound (Chehalis). VA Puget Sound is affiliated with the University of Washington, School of Medicine, in Seattle.

Mission
Honor America’s Veterans by providing exceptional and innovative care that improves their health and quality of life.

Vision
The Veterans Health Administration will continue to be the benchmark of excellence and value in health care. Our Mental Health Service strives to provide services reflective of the latest technologies in patient-centered and evidence-based care. We provide this care in engaged, interprofessional teams who support learning, discovery and continuous quality improvement. Our efforts also emphasize prevention and population health and contribute to the Nation’s well-being through education, research and service in national emergencies.

Core Values
Compassion, Commitment, Excellence, Professionalism, Integrity, Accountability, Stewardship

More information on the VA Puget Sound Health Care System can be found at: https://www.va.gov/puget-sound-health-care/

The VA Puget Sound Health Care System (VAPSHCS) is comprised of two divisions (American Lake and Seattle), each with its own Psychology Training Program. The American Lake Division of VAPSHCS is located in Lakewood, a major suburb of Tacoma, Washington. Nestled along 1.8 miles of the beautiful American Lake shoreline with Mt. Rainier standing to the East, this Division enjoys one of the most beautiful settings in the VA system. The 378 acres of medical center grounds include 110 acres of natural habitat, 8 acres of lawns, and a 55-acre golf course.

The American Lake campus was founded in 1923 as the 94th Veterans Hospital built by the War Department for the provision of care to World War I Veterans. The Secretary of the Army authorized, under a revocable license, the Veteran Bureau's use of 377 acres of the 87,000 acre Fort Lewis Army Base property.
The planning committee chose a site on the western shores of American Lake and aspired to build a facility that was both functional and aesthetically pleasing. They chose a Spanish-American architectural style reminiscent of the United States early military structures, such as the Alamo. Many of the stucco and terra cotta buildings are listed on the National Register of Historical Buildings and are still enjoyed by both patients and staff for their beauty.
The medical center was dedicated in 1924 and chartered with a single mission — neuropsychiatric treatment. On March 15, 1924, the first 50 patients were admitted to the hospital, by transfer, from Western State Hospital at Fort Steilacoom. Over the years, American Lake has grown from its original mission to a national leader in integrated health care. Medical Center Grounds
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Psychologists, physicians, social workers, nurses and ARNPs, dentists, rehabilitative medicine, physician assistants, and auxiliary staff make up the approximately 800 individuals employed at this campus. American Lake's Psychology Training Program has been training doctoral psychology interns since the 1950s. Postdoctoral residency training began at American Lake in 2014.

Briefly describe in narrative form important information to assist potential applicants in assessing their likely fit with your program. This description must be consistent with the program’s policies on intern selection and practicum and academic preparation requirements:

Incoming residents are required to have completed a doctoral degree in Clinical or Counseling Psychology from a program that is accredited by the APA CoA, CPA, and/or another VA recognized accrediting body (e.g., PCSAS). To be eligible to attend residency at American Lake, incoming residents must have adequate academic preparation, including receipt of the doctoral degree and successful completion of doctoral internship training as part of the doctoral degree, have acquired Profession-Wide Competencies in the context of service provision to adult patients, have received individual supervision with direct observation of their graduate and internship clinical work, and meet the eligibility requirements for VA employment (see https://www.psychologytraining.va.gov/eligibility.asp for further details).

Describe any other required minimum criteria used to screen applicants:

The Department of Veterans Affairs (VA) adheres to all Equal Employment Opportunity and Affirmative Action policies. As a Veterans Health Administration (VHA) Health Professions Trainee (HPT), you will receive a Federal appointment, and the following requirements will apply prior to that appointment

1. U.S. Citizenship. HPTs who receive a direct stipend (pay) must be U.S. citizens. Trainees who are not VA paid (without compensation-WOC) who are not U.S. citizens may be appointed and must provide current immigrant, non-immigrant or exchange visitor documents.
2. U.S. Social Security Number. All VA appointees must have a U.S. social security number (SSN) prior to beginning the pre-employment, on-boarding process at the VA.
3. Selective Service Registration. Male applicants born after 12/31/1959 must have registered for the Selective Service by age 26 to be eligible for U.S. government employment, including selection as a paid or WOC VA trainee. For additional information about the Selective Service System, and to register or to check your registration status visit https://www.sss.gov/. Anyone who was required to register but did not register before the age of 26 will need to apply for a Status Information Letter (SIL) and request a waiver. Waivers are rare and requests will be reviewed on a case by case basis by the VA Office of Human Resources Management. This process can take up to six months for a verdict.
4. Fingerprint Screening and Background Investigation. (Please read and carefully consider all of these criteria, even if you do not believe they apply to you). All HPTs will be fingerprinted and undergo screenings and background investigations. Additional details about the required background checks can be found at the following website: https://www.archives.gov/federal-register/codification/executive-order/10450.html
5. Drug Testing. Per Executive Order 12564, the VA strives to be a Drug-Free Workplace. HPTs are not drug-tested prior to appointment, however are subject to random drug testing throughout the entire VA appointment period. You will be asked to sign an acknowledgement form stating you are aware of this practice. See item 8 below. Further information about the VA’s efforts at a Drug-Free Workplace can be found at the following website: https://www.va.gov/OAA/docs/VHA_HPTsDrug-FreeWorkplaceOAA_HRA.pdf
6. Affiliation Agreement. To ensure shared responsibility between an academic program and the VA there must be a current and fully executed Academic Affiliation Agreement on file with the VHA Office of Academic Affiliations (OAA). The affiliation agreement delineates the duties of VA and the affiliated institution. Most APA-accredited doctoral programs have an agreement on file. More information about this document can be found at https://www.va.gov/oaa/affiliation-agreements.asp (see section on psychology internships). Post-degree programs typically will not have an affiliation agreement, as the HPT is no longer enrolled in an academic program and the program is VA sponsored.
7. TQCVL. To streamline on-boarding of HPTs, VHA Office of Academic Affiliations requires completion of a Trainee Qualifications and Credentials Verification Letter (TQCVL). An Educational Official at the Affiliate must complete and sign this letter. For post-graduate programs where an affiliate is not the program sponsor, this process must be completed by the VA Training Director. Your VA appointment cannot happen until the TQCVL is submitted and signed by senior leadership from the VA facility. For more information about this document, please visit https://www.va.gov/OAA/docs/2024TQCVLGuideFINALv6.pdf.
   1. Health Requirements. Among other things, the TQCVL confirms that you, the trainee, are fit to perform the essential functions (physical and mental) of the training program and immunized following current Center for Disease Control (CDC) guidelines and VHA policy. This protects you, other employees and patients while working in a healthcare facility. Required are annual tuberculosis screening, Hepatitis B vaccine as well as annual influenza vaccine. Declinations are EXTREMELY rare. If you decline the flu vaccine you will be required to wear a mask while in patient care areas of the VA.
   2. Primary source verification of all prior education and training is certified via the TQCVL. Training and Program Directors will be contacting the appropriate institutions to ensure you have the appropriate qualifications and credentials as required by the admission criteria of the training program in which you are enrolled.
8. Additional On-boarding Forms. Additional pre-employment forms include the Application for Health Professions Trainees (VA 10-2850D) and the Declaration for Federal Employment (OF 306). These documents and others are available online for review at https://www.va.gov/oaa/hpt-eligibility.asp. Falsifying any answer on these required Federal documents will result in the inability to appoint or immediate dismissal from the training program.
9. Proof of Identity per VA. VA on-boarding requires presentation of two source documents (IDs). Documents must be unexpired and names on both documents must match. For more information visit: https://www.oit.va.gov/programs/piv/_media/docs/IDMatrix.pdf

Additional information regarding eligibility requirements (with hyperlinks)

• Trainees receive term employee appointments and must meet eligibility requirements for appointment as outlined in VA Handbook 5005 Staffing, Part II, Section B. Appointment Requirements and Determinations. https://www.bing.com/search?q=va+handbook+5005&cvid=0c5f920392684f1daacd723a86804756&gs_lcrp=EgRlZGdlKgYIABBFGDkyBggAEEUYOdIBCDMxNzVqMGo0qAIAsAIB&FORM=ANAB01&PC=U531
• Selective Service website where the requirements, benefits and penalties of registering vs. not registering are outlined: https://www.sss.gov/about/

Additional information specific suitability information from Title 5 (referenced in VHA Handbook 5005 – hyperlinks included):

(b) Specific factors. In determining whether a person is suitable for Federal employment, only the following factors will be considered a basis for finding a person unsuitable and taking a suitability action:

1. Misconduct or negligence in employment;
2. Criminal or dishonest conduct;
3. Material, intentional false statement, or deception or fraud in examination or appointment;
4. Refusal to furnish testimony as required by § 5.4 of this chapter;
5. Alcohol abuse, without evidence of substantial rehabilitation, of a nature and duration that suggests that the applicant or appointee would be prevented from performing the duties of the position in question, or would constitute a direct threat to the property or safety of the applicant or appointee or others;
6. Illegal use of narcotics, drugs, or other controlled substances without evidence of substantial rehabilitation;
7. Knowing and willful engagement in acts or activities designed to overthrow the U.S. Government by force; and
8. Any statutory or regulatory bar which prevents the lawful employment of the person involved in the position in question.

(c) Additional considerations. OPM and agencies must consider any of the following additional considerations to the extent OPM or the relevant agency, in its sole discretion, deems any of them pertinent to the individual case:

1. The nature of the position for which the person is applying or in which the person is employed;
2. The nature and seriousness of the conduct;
3. The circumstances surrounding the conduct;
4. The recency of the conduct;
5. The age of the person involved at the time of the conduct;
6. Contributing societal conditions; and The absence or presence of rehabilitation or efforts toward rehabilitation.

Mission
Training provided through the American Lake Psychology Training Programs (Residency and Internship) supports the Mission of VA Puget Sound to “Honor America’s Veterans by providing exceptional and innovative care that improves their health and quality of life,” and the national VA Missions of patient care, education, research, and serving as back-up to the Department of Defense.

The Training Program has a specific mission, as captured in the following statement:
“It is the mission of the Psychology Postdoctoral Residency Training Programs at the American Lake Division of VA Puget Sound is to ensure that Veterans and others across the nation have continuing access to highly qualified, ethical, and professional psychological staff who possess advanced competencies in Clinical Psychology, Geropsychology, or Clinical Neuropsychology, who integrate science into their practice with sensitivity to and knowledge about the influence of ethnic, cultural, and individual differences on their psychological services.”

Philosophy
It is our belief that excellence in health service psychology requires attention to ethics, diversity, science, and practice. The residency programs at American Lake value the integration of science and practice.

This value reflects our belief that the postdoctoral residency provides specific training in advanced competencies, as well as acculturation into a philosophy with which clinical and research problems are approached. This philosophy includes objectivity, openness to the available data, and a willingness to explore various hypotheses to understand and address specific clinical situations through research, as well as through study and training.

Within our postdoctoral programs, the integration of science into practice occurs under the supervision of psychologists in programs that have either service delivery or clinical research as a primary focus. Emphasis is placed on the acquisition of clinical skills, including the ability to evaluate psychiatric and
neuropsychological disorders objectively, to develop and implement treatment plans, and to evaluate the effectiveness of interventions. Seminars dealing with relevant clinical, research, and professional concerns occur throughout the training experience at the American Lake VA medical center and in the greater professional community.

Overview of the Training Programs
We are currently recruiting for three separate Focus Areas (Primary Care – Mental Health Integration Focus; PTSD Evidence-Based Psychotherapy Focus; Residential Treatment Focus) within the Clinical Psychology postdoctoral residency program at American Lake VA. We are not currently recruiting for the Neuropsychology or Geropsychology postdoctoral residency programs.

Each program has specific aims which reflect our belief that psychologists are defined both by specific training received and by the attitude with which clinical and research problems are approached. The program aims also support the VA’s broader mission of training psychologists competent and committed to practice in public service settings.

Clinical Psychology Program Aims
The postdoctoral residency in Clinical Psychology has three overarching goals:

1. Residents will be prepared for institutional practice in complex and comprehensive public service environments.
2. Residents will develop the full range of skills required for independent functioning as a clinical psychologist.
3. Residents will engage in the necessary training experiences while a resident to be eligible to sit for ABPP specialty certification in Clinical Psychology and/or another relevant ABPP specialty certification (e.g., Clinical, Behavioral and Cognitive Psychology).
    

Our residency programs are developed from the basic perspective that a health service psychologist should be broadly trained in accordance with the Profession-Wide Competencies defined by the APA during the course of graduate and doctoral residency training. Thus, we view the residency training experience as the time for advanced competency development and specialization training. To that end, residency training at American Lake is designed to provide individually tailored, collaborative, and advanced training in Clinical Psychology or Geropsychology.

Residents can expect to be exposed to a wide array of patients and problems over the course of the residency. Residents are expected to further develop already-acquired Level 1 (Core) Competencies, Level 2 (Program Specific) Competencies, and Level 3 (Speciality Specific) Competencies. The competencies for each of the three programs are listed below. Residents are also expected to have exposure to, and/or direct clinical experiences with patients that represent a cross-section of the diverse veterans served at VA Puget Sound’s American Lake Division and to acquire sensitivity to, and knowledge of, cultural differences, as well as other individual differences that influence the manner in which services are provided.

Clinical Psychology Program Competencies
The focus of the Clinical Psychology residency is on the acquisition of advanced and Level 1 and Level 2 Competencies, as applied to specific areas of focus (PTSD Evidence-Based Psychotherapy Focus, Residential Treatment Focus, and PCMHI Focus). Please see American Psychological Association,
Commission on Accreditation. 2015. Standards of Accreditation for Health Service Psychology. Retrieved from https://www.apa.org/ed/accreditation/standards-of-accreditation.pdf and the APA’s 2012 Competency Benchmark Revision for further elaboration on these competencies (https://www.apa.org/ed/graduate/benchmarks-evaluation-system).

Level 1 - Integration of Science and Practice: Understanding of research, research methodology, techniques of data collection and analysis, biological bases of behavior, cognitive-affective bases of behavior, and development across the lifespan. Respect for scientifically derived knowledge. Use of the scientific method to inform therapy and assessment practices. Generating research that contributes to the professional knowledge base and/or evaluates the effectiveness of various professional activities.

Level 1 - Individual and Cultural Diversity: Awareness, sensitivity and skills in working professionally with diverse individuals, groups, and communities who represent various cultural and personal background, and characteristics defined broadly and consistent with APA policy.

Level 1 - Ethics and Legal Standards: Application of ethical concepts and awareness of legal issues regarding professional activities with individuals, groups, and organizations.

Level 2 - Professional Values, Attitudes, and Behaviors: Behavior and comportment that reflect the values and attitudes of psychology.

Level 2 - Communication and Interpersonal Skills: Practice conducted with personal and professional self-awareness and reflection; with awareness of competencies; with appropriate self-care. Relate effectively and meaningfully with individuals, groups, and/or communities.

Level 2 - Intervention Skills: Interventions designed to alleviate suffering, and to promote health and well-being of individuals, groups, and/or organizations. Integration of research and clinical expertise in the context of patient factors.

Level 2 - Assessment Skills: Assessment and diagnosis of problems, capabilities, and issues associated with individuals, groups, and/or organizations.

Level 2 - Education: Knowledge of theories of learning and/or supervision. Evaluation of teaching practices and incorporates feedback to modify current and future teaching strategies.

Level 2 - Consultation and Interprofessional Skills: Knowledge of key issues and concepts in related disciplines. Identify and interact with professionals in multiple disciplines. The ability to provide expert guidance or professional assistance in response to a client’s needs or goals.

Fostering Belonging and Learning
The VA Puget Sound Psychology Training Committee is committed to creating a work environment characterized by fairness, acceptance and preparation for research and practice among our trainees and staff. We believe it is crucial to understand how various personal and societal facets shape an individual's life and experience, and how that can have a positive effect on our clinical practice. Our Psychology Training Program is thus dedicated to creating an environment focused on increasing the knowledge of, and competence around universal human issues. Our goal is to increase our trainees’ knowledge base (didactics, supervision discussions), self-reflection (mentorship program), and comprehensive clinical consideration and application (consultation group). We prioritize these opportunities as we believe that rich educational experiences are gained when we learn and work with people from various backgrounds and experiences. We hope you will join our program and welcome your participation in continuing to cultivate a workplace of community and belonging.

Resident Preparation

Incoming residents are required to have completed a doctoral degree in Clinical or Counseling Psychology from a program that is accredited by the APA CoA, CPA, and/or another VA recognized accrediting body (e.g., PCSAS). To be eligible to attend residency at American Lake, incoming residents must have adequate academic preparation, including receipt of the doctoral degree and successful completion of doctoral internship training as part of the doctoral degree, have acquired Profession-Wide Competencies in the context of service provision to adult patients, have received individual supervision with direct observation of their graduate and internship clinical work, and meet the eligibility requirements for VA employment. Applicants must meet the eligibility qualifications for psychology training within the Department of Veterans Affairs: https://www.psychologytraining.va.gov/eligibility.asp - these include, but are not limited to: U.S. Citizenship, completion of our application materials, completion of the doctoral degree by the time the internship begins. Note: All applicants who are U.S. citizens, required to register for the Selective Service, born after December 31, 1959, and who are not otherwise exempt, must show proof of Selective Service registration as part of their VA application. Acceptance of residents is contingent upon the results of a background check, TQCVL verifications (see XXXXXXXXXXX)   and possible drug screening. Residents are appointed as temporary employees of the Department of Veterans Affairs. As such, residents are subject to laws, policies, and guidelines posted for VA staff members. There are infrequent times in which this guidance can change during a training year which may create new requirements or responsibilities for residents. If employment requirements change during the course of a training year, residents will be notified of the change and impact as soon as possible and options provided. The Training Director will provide you with the information you need to understand the requirement and reasons for the requirement in a timely manner. Please note that the VA is a drug-free workplace (see XXXXXXX).

Preparation for Licensure
The programs prepare residents to meet licensure requirements for Washington State https://doh.wa.gov/licenses-permits-and-certificates/professions-new-renew-or-update/psychologist/licensing-requirements. If you have plans to practice in a particular jurisdiction outside of Washington, please contact that jurisdiction’s licensing board to seek clarification. Licensing information can be found via the Association of State and Provincial Psychology Boards (ASPPB) at https://asppb.net/.
 

Holidays and Leave: See OAA national policies, as well as the Office of Personnel Management website (http://www.opm.gov) for full information on leave and benefits for VA personnel. Residents usually receive 11 annual federal holidays. (On occasion, not all 11 holidays fall within a training year; e.g., federal employees are not paid for a holiday that falls on the first day of work, which can impact the total stipend slightly as well). In addition, residents accrue 4 hours of sick leave and 4 hours of annual leave for each full two week pay period as a resident, for a total of 104 hours of each during the year. Information can also be found on the OPM website (under Pay & Leave, Work Schedules) about alternative work schedules to accommodate religious observations not coinciding with federal holidays.
Authorized Absence: According to VA Handbook 5011, Part III, Chapter 2, Section 12, employees, including trainees, may be given authorized absence without charge to leave when the activity is considered to be of substantial benefit to VA in accomplishing its general mission or one of its specific functions, such as education and training (e.g., licensure exam, conference presentation). Requests for Authorized Absence are reviewed on a case by case basis by the Training Directors.
Family Leave and Support: Although trainees are not eligible for the Federal Medical Leave Act (FMLA), our program is happy to support trainees through the birth or adoption of a child during their residency year. Current and past trainees have opted to take leave without pay to be home with a new family member and extend their training year accordingly to still complete the requirements of the residency. Trainees at American Lake will be offered accommodations related to lactation while at work in accord with the Patient Protection and Affordable Care Act revised the Fair Labor Standards Act. It is unlikely that a trainee would be paid for time extended beyond the initial training year, due to the nature of the year-long employment contracts associated with VA trainee status.

Privacy: We will collect no personal information about you when you visit our website.

Due Process: Impairment and grievance procedures are consistent with VA Human Resource regulations.

Benefits: Residency appointments in the Clinical and Geropsychology programs are for 2080 hours, which is full-time for a one-year period. VA residents are eligible for health insurance (for self, spouses, and legal dependents) and for life insurance, just as are regular employees.

Liability Protection for Trainees: When providing professional services at a VA healthcare facility, VA sponsored trainees acting within the scope of their educational programs are protected from personal liability under the Federal Employees Liability Reform and Tort Compensation Act 28, U.S.C.2679 (b)-(d).

Facility and Training Resources
As the American Lake Psychology training programs enjoy a long history of providing excellent training (at the doctoral internship level), it is well-integrated into the VA Puget Sound and VISN 20 Northwest Network training infrastructure. The full resources of VA Puget Sound, affiliated with the University of Washington, are available to residents in our programs. The Psychology Training Program at American Lake has had some didactic training exchanges with Joint Base Lewis McChord, as well as the Seattle Division of the VA Puget Sound Health Care System, and VA Community Based Outpatient Clinics. The Center for Education and Development at VA Puget Sound oversees all academic and continuing education activities for our facility, which includes over 1,600 academic trainees and more than 2,700 employees. There are two branch libraries as well as our medical media services.
In addition to the interprofessional core clinical staff and faculty, residents also receive support from administrative staff. The Mental Health Service at American Lake has allocated necessary clinical space and equipment to ensure high quality training in the service of veterans' healthcare. State of the art equipment made available for the training programs include computers for staff, phones, video teleconference, FAX machines, and copy machines. The medical record is completely computerized at this facility, so appropriate training and ongoing resources for using it effectively is available, as are a full selection of psychological assessment materials.

Scholarly Activity (Research/QI)
While the primary focus of our postdoctoral residency programs is the development of advanced and/or specialized Level 1, Level 2, and (if applicable) Level 3 Competencies, the residency programs at American Lake value the scientific method and scholarly productivity. As such, a portion of the training experience is focused on psychological research. Residents will develop a research project at the outset of the training year, in consultation with the Training Directors and Research Lead. We define research broadly and recognize three categories of research. These include traditional research (e.g., RCTs, empirical projects requiring IRB review, generalization is expected), utilizing an implementation science (IS) framework to ask systems-based questions to evaluate models of care, and utilizing program evaluation and quality assessment/improvement (QA/QI) frameworks to illustrate clinical service challenges, opportunities, and potential solutions. Thus, a resident research project may take several forms, to include the following:

• Participate in an ongoing research project (e.g., Mental Health Research, GRECC)
• Conduct a meta-analysis in an area of the resident’s interest
• Complete a literature review and research methods section for relevant research that could be conducted here or taken to with the resident to their next professional position
• Complete a grant proposal
• Complete an IS project to assess a systems level question
• Complete a QA/QI project to assess a clinic/program level question
• Conduct an approved research project based off an open dataset (e.g., Pew Research Center, General Social Survey, etc.)

Residents may allocate up to 4 hours per week for research/QI over the course of the training program. Factors which may affect the amount of time a particular residency may allocate to research could include:
the requirements of the specific residency program; the scope of the project; and/or the training goals of the resident. This is collaboratively agreed upon at the outset of the training program with the preceptor and is delineated in the Individual Training Plan for each resident. Residents must complete a research product (e.g., poster, presentation, or manuscript submission; grant submission; or, IS or QA/QI report) by early July and present their final project at the end-of-year psychology training retreat.
 

Service
Residents are asked to assist in the development and administration of the Training Programs by participating in committees and activities. These opportunities include, but are not limited to, service on the Training Committee, service on the Education and Didactic Committee, co-facilitation of the Cultural Competency Consultation group, and/or assistance with development of orientation and training week for incoming residents.

Licensure Exam Preparation Time
While the primary focus of our residency programs is the development of advanced and/or specialized Level 1, Level 2, and (if applicable) Level 3 Competencies, the residency programs at American Lake aim to prepare trainees for licensure. To that end, a portion of the training experience can be focused on licensure exam preparation.

Residents may allocate up to 4 hours per week for licensure exam preparation for the first six months of the training program. This is collaboratively agreed upon at the outset of the training program with the preceptor and is delineated (e.g., number of hours, date for exam) in the Individual Training Plan (ITP). Residents who formally block time into their schedules for EPPP study are expected to sit for the exam during the course of the residency program.

Provision of Education
Residents are expected to engage in the education of others and there are many opportunities to do so. These opportunities may include, but are not limited to, education to service recipients and their family members in clinical placements, presentation to peers and junior peers (e.g., internship didactic series, integrated postdoctoral didactic series), presentations to Psychology Service (e.g., Intern Didactic, Faculty Didactic, Training Day, etc.), presentations to other professionals within or outside of VA Puget Sound (e.g., clinical team meetings, leadership team briefings, UW Grand Rounds, Madigan continuing education series), outreach to community groups, consultation to interprofessional staff and/or trainees, and/or supervised peer supervision of junior psychology trainees. The advanced, specialized, and individually determined plan for education provision are described in the ITP.
 

Seminars and Educational Offerings
Education is an integral part of the training year, with a variety of opportunities available throughout the training year. Residents play an important role in shaping these didactic and other educational experiences by completing evaluation forms, participating in an end-of-year review with the Training Director(s), and active involvement with the Psychology Training Committee.
Clinical Psychology Program residents must complete at least 104 hours of learning activities during the training year. This can be met through participation in required Resident Didactic Series presentations, optional Wednesday Faculty Didactic Series presentations, required residency-specific training opportunities as detailed in each program description, as well as other didactic presentations that are individually tailored with their preceptors to meet training goals as delineated on each trainee’s ITP.  Please refer to the program-specific descriptions in this brochure for an overview of required didactic offerings for the Clinical Psychology and Geropsychology programs. Optional didactic offerings are available at American Lake, the Seattle Division, Madigan Army Medical Center, Joint Base Lewis-McChord, and at outside professional meetings.

Resident Didactic Series
The Tuesday Resident Didactic Series is a training experience comprised of topics in the areas of professional development, administrative, clinical issues in psychology, culture and psychology, and clinical research. This series is a collaborative experience for residents in all three residency programs. This is a required training activity, occurring once per month.

Faculty/Psychology Service Didactic Series
The Wednesday Faculty Didactic Series is arranged for all psychologists in the American Lake Psychology Service. It is optional for all residents to attend. Residents are required to provide at least one didactic to the psychology department during their training year. Topics presented by residents are done so with their supervisor’s and the Training Committee’s approval.

UW Psychiatry Grand Rounds
Grand Rounds is a Department of Psychiatry & Behavioral Sciences Continuing Medical Education program, which consists of a series of educational lectures. Presenters at the Grand Rounds include both Department faculty and speakers from other institutions around the country. Grand Rounds typically occurs twice per month (generally every other Friday from 1300 to 1400). Attendance is optional.
A yearly schedule, as well as access to the live telecast may be accessed at: https://psychiatry.uw.edu/training-workforce-development/grand-rounds/.

Madigan Workshop Opportunities
The American Lake Psychology Training Programs enjoy a strong training relationship with Madigan Army Medical Center, located at nearby Joint Base Lewis-McChord. American Lake residents are occasionally invited to join active duty Army psychology interns’ and residents’ educational and training experiences over the course of the training year. Participation in these events is optional.

Other Off-Site Training Opportunities
Additional off-site training opportunities are available over the course of the training year through the University of Washington, the Seattle Division of VA Puget Sound, Western State Hospital, and other local trainings/experiences. In addition, residents are encouraged to participate in unsponsored training and academic experiences, such as the APA annual conference and Washington State Psychological Association. These events may be approved for Administrative Leave on a limited case-by-case basis.

With the approval of the Training Director and the resident’s supervisor(s), Administrative Leave can be granted to residents wishing to attend non-VA professional meetings and workshops relevant to the practice of psychology (see the leave policy section of this manual for further details). Time devoted to such meetings or workshops outside normal VA hours is not compensable.

Resident Lunch
While the VA authorizes 30 minutes for lunch, the training program supports one 60-minute lunch per week to be aside for residents to meet and share concerns about issues of mutual interest. Residents are to be released from competing activities during this meeting time. The Psychology Training Committee strongly encourages residents to meet together; however, participation in the resident lunch meeting is optional.

VHA Mandatory Training for Trainees (MTT)
The MTT course includes all content necessary for trainees to practice safely and effectively in VA. Please go to the following website, which will direct you to the TMS portal, to complete: https://www.va.gov/oaa/mandatory-training.asp. This is required prior to beginning residency training.

Supervision
Formal supervision (i.e., scheduled face-to-face individual contact) is provided for at least two hours per week. Overall responsibility and coordination of supervision is provided by each program/focus area preceptor in collaboration with the primary clinical supervisor and the resident.

Supervisors vary in their theoretical orientation and supervisory style. Each, however, is committed to providing a meaningful training experience, with the supervisory process being central to that experience. Each supervisor provides supervision using the Competency Based Supervision framework (Falendar & Shafranske, 2004) that aligns with the APA Board of Educational Affairs (BEA) Guidelines for Clinical Supervision in Health Service Psychology https://www.apa.org/about/policy/guidelines-supervision.pdf. A resident individual training plan (ITP) is developed between the resident and preceptor at the beginning of the year, addressing the baseline competency of the resident, training goals, career goals and outlining training activities that will meet goals and training needs. A formal, regularly scheduled (i.e., quarterly) discussion between the resident and preceptor addresses progress in meeting specified goals and allows for mid-course corrections as needed.

In some settings, residents also have the opportunity to develop supervision skills by participating in tiered supervision of psychology interns. The residency program is committed to providing training and supervised experience using competency-based supervision with interns from our APA-accredited internship program. Tiered supervision and consultation opportunities are designed to address the specific training needs identified in each resident’s ITP, targeting the development of competence in specific supervision skills.

Evaluation
Each primary supervisor provides regular, formal evaluations of the resident’s performance (i.e., quarterly for first year residents, semi-annually for second year residents). These evaluations are based not only upon the Level 1, Level 2, and (if applicable) Level 3 Competencies, but also upon the achievement of the agreed upon goals and professional performance expectations that comprise the ITP. The preceptor, in collaboration with the primary clinic supervisor, integrate evaluative feedback from other supervisor(s) involved in the resident’s training (e.g., secondary clinical supervisor, research project mentor). These evaluations are discussed by the supervisor and/or preceptor and resident. Evaluations are retained after the residency is completed and may provide a basis for letters of recommendation.

The resident provides an evaluation of the training experience at regularly scheduled intervals (i.e., quarterly for first year residents, semi-annually for second year residents). Further, at the end of the training program, the resident provides an overall evaluation of the residency experience. Both interim and final evaluations provided by the residents assist the programs in their self-assessment process.

Supervisory staff meet monthly in the Psychology Supervisors’ Meeting to review resident progress as well as to discuss general issues related to the training program. Training staff and residents meet monthly or as needed to discuss policy concerns and evaluation procedures.

Requirements for Completion:
Consistent with APA CoA expectations, we have identified clear minimum levels of achievement for successful completion of each of our postdoctoral residency programs:

In order for residents to successfully complete the program they must:

• By the final evaluation/end of the training program, obtain ratings of “7” in all of the Competency Ratings areas on Supervisor Evaluation(s)
• Not be found to have engaged in any ethical, legal, or conduct violations
• Complete a scholarly activity product (e.g. poster)
• Deliver all signed evaluations and training logs (ITP, supervision contracts, quarterly evaluations, log of residency activities [hours, didactic], and final residency feedback).

Focus Area Preceptor: Emily Cox-Martin, Ph.D.
VA Puget Sound Healthcare System, American Lake Division (A-116-MHS-PC)
9600 SW Veterans Drive
Tacoma, WA 98493
Telephone:
Email: emily.cox-martin@va.gov

Overview
The goal of the Primary Care Mental Health Integration Focus Area (PCMHI) is to prepare residents to function as scientist-practitioner Health Service Psychologists with advanced training in integrated behavioral health in primary care. Residents working in this Focus Area provide behavioral health services as a member of an interprofessional team, particularly targeting empirically-supported psychological principles for a variety of mental and behavioral health conditions. The Focus Area includes an emphasis on the attitudes, knowledge, and skills in the area of PCMHI. To support competency in PCMHI, clinical work operates in tandem with opportunities for teaching, administrative, research, leadership, and supervisory experiences. The resident will train in PCMHI for approximately 80% of their time and may elect to spend up to twenty percent of their time in another relevant clinical setting associated with the resident’s training goals.

Number of Residents: One

Length of Training: One year

Goals
Postdoctoral education and training are designed to promote an advanced level of competence as a health service Psychologist with a focus in interprofessional collaborative care.

At the conclusion of the residency, residents will be expected to demonstrate advanced competence in the following areas, consistent with the Clinical Psychology residency program expectations:

• Development of advanced skill in the Level 1 competencies of Integration of Science and Practice, Individual and Cultural Diversity, and Ethics and Legal Matters;
• Development of advanced skill in the Level 2 competencies of Professional Attitudes, Values, and Behaviors; Interpersonal and Communication Skills; Intervention; Assessment; Education and Teaching; and, Interprofessional and Consultation Skills

As applied to the following PCMHI Focus Area skills:

• Development of advanced skills in the practice of brief psychological and behavioral interventions within a collaborative, team-based, patient-centered care environment;
• Development of advanced understanding of biopsychosocial model of etiology, experience of illness, and treatment of disease;
• Development of a professional identity as a Clinical or Counseling Psychologist with an emphasis in providing integrated, collaborative care in a primary care setting;
• Preparation for state or provincial licensure or certification for the independent practice of psychology;
• Preparation for requirements for board certification in Clinical Psychology and/or Counseling Psychology by the American Board of Professional Psychology.

Clinical Settings

Primary Care-Mental Health Integration
The function of PCMHI is co-located, collaborative care to support primary care in their mission to provide healthcare for the broad population of Veterans. PCMHI serves to identify and treat common mental and behavioral health conditions of mild to moderate severity. Due to American Lake’s proximity to Joint-Base Lewis-McChord, PCMHI is often the first mental health contact for Veterans who recently separated from the military. PCMHI also triages individuals with moderate to severe mental health conditions to assist in treatment engagement with the specialty mental health teams.

To support the open-access initiative of VHA, all PCMHI psychologists, psychiatrists, and social workers participate in the same-day access clinic to provide immediate mental health care for non-emergent concerns. This includes providing in-room, telephone, and online consultation for primary care providers, Veterans, and their family members. This also includes conducting focused functional assessments to assist Veteran’s with their primary mental health needs. Common presenting problems include: Posttraumatic stress disorder, insomnia, depression, various anxiety disorders, nightmares, chronic pain, suicide ideation, and the military-to-civilian transition.

With PCMHI’s mission to treat the Veteran population, brief episodes of care (e.g., 4-sessions, 20-minutes per session) utilize evidence-based psychotherapies (e.g., Behavioral Activation, Cognitive-Behavior Therapy for Insomnia, Acceptance and Commitment Therapy, Prolonged Exposure – Primary Care) to target empirically-supported psychological principles. Clinicians routinely utilize measurement-based care to monitor treatment progress to increase the accuracy of case conceptualizations and adapt treatment modalities on-the-fly. We value trainees with flexibility, professional communication skills, good customer service, and an appetite for baked goods.

Elective Opportunities
Residents will have the opportunity to operate in clinics beyond the core PCMHI clinic. Listed below are primary care programs in which the Resident may elect to receive additional training. In addition to the clinics below (dependent on logistical feasibility), residents may also elect to train in the outpatient mental health clinics (e.g., Mental Health Clinic, PTSD Outpatient Clinic, Addictions Treatment Clinic) to obtain more in-depth training in specific treatment modalities or disorders.

Chronic Pain Management: The resident collaborates with primary care teams regarding patient recovery goals and biopsychosocial treatments for chronic pain management. The resident may lead brief CBT and ACT based groups for chronic pain. The resident may also complete a minor training experience through the comprehensive pain clinic with outpatient and residential functional restoration program through the Pain Service Line.

Women’s Health Clinic (WHC): The resident may collaborate with primary care teams in the WHC to provide behavioral services in this setting, including same-day access consultation and functional assessments, collaboration with WHC interprofessional staff, facilitation of groups and provision of brief individual treatment.

Role of the Resident

The resident’s duties in PCMHI revolve around three emphases throughout the residency training year, including: 1) developing strong, collaborative interprofessional working relationships, 2) increasing the utilization of behavioral health services by primary care teams and among veterans; and 3) improving veterans’ biopsychosocial health using brief, evidence-based interventions targeting health behavior change.

The resident receives training in the use of brief evidence-based treatments within a primary care setting. Training is available in many evidence-based psychotherapies, including Cognitive-Behavioral Therapy, Acceptance and Commitment Therapy, and Motivational Interviewing. Targeting core psychological principles through process-based interventions will be emphasized (e.g., Hayes & Hoffman, 2019). Residents will further develop their case formulation ability to rapidly identify psychological processes initiating and maintaining psychological disorders.

As a valued member of the PCMHI team, the resident may also participate in administrative, research, or quality improvement projects. Quality improvement and research opportunities are widely available and strongly encouraged. If interested, the resident may opt to receive additional training from local PCMHI leadership to develop communication skills for health systems management and process improvement with stakeholders from multiple VA services (e.g., general medicine, outpatient mental health).

Teaching Methods
There are several methods that are used to train the PCMHI resident, and they include:

Didactics: As mentioned previously, Clinical Psychology Program residents must complete at least 104 hours of learning activities during the year, which may include didactics, case conferences or other learning experiences beyond clinical and supervision requirements. This may include required and optional didactics individually tailored, in collaboration with their preceptor. Didactic training may occur via online trainings, webinars, in-person lectures, experiential trainings, and/or case conferences and may include some of the optional offerings listed below.

• Required Didactics:
  Primary Care Focus Area Seminar Series – approximately 40 hours over the course of the training year, to be determined based on resident’s individual learning needs;
• American Lake Division Postdoctoral Residency Didactic Series – one to four hours per month, to be determined collaboratively with each residency class;
• Additionally, the resident will be expected to participate in PCMHI Competency training, and upon completion will be eligible for Competency Certification in PCMHI.

Optional Didactics:

• University of Washington/DOD/VA Tele-pain conference – one hour per week
• PC-MHI Monthly Education Conference Call – one hour per month
• National Measurement Based Care in Mental Health series – one hour per month

Mentorship: As preceptor, Dr. Manuel operates as the administrative head for the PCMHI Focus Area of the clinical psychology postdoctoral program. The task of the preceptor is to aid the resident in evaluating individual training needs and interests, and to develop an individualized training plan (ITP) based on those needs and the training program’s competency areas. In addition, the preceptor provides professional mentoring to the resident at least monthly, with an eye toward the resident’s overall progress through the residency program.

Supervision: Determination of a primary clinical supervisor in both PCMHI and in any minor rotation is a collaborative process with the resident that takes into account training needs and preferences. Supervision may occur by any of the licensed psychologists within PCMHI (see below). Additional consultants on rotation include our two embedded psychiatrists, two clinical social workers, and four nurse care managers.

The resident will receive individual supervision where PCMHI, clinical, career development, teaching, and scholarly activity are addressed. The resident will have opportunities to work closely with professionals from other disciplines with different areas of expertise. The resident will have opportunities to directly observe licensed independent practitioners, including psychologists, psychiatrists, nurse practitioners, medical staff, and social workers. Residents may also have the opportunity to provide tiered supervision to psychology interns, utilizing a competency-based supervision framework.

Scholarly Activity, Research, and Program Development

As this focus area is oriented towards scientist-practitioner values, involvement in programmatic development and evaluation is considered an important component of the PCMHI Focus Area. The resident will be encouraged to identify research, quality improvement, or quality assurance activities that would expand their current skill set. There are a wide range of opportunities available to the resident that include: participation in ongoing research studies, participation in ongoing quality improvement projects, data analysis, preparing papers and presentations, interfacing with the local IRB, etc. Previous residency projects include: implementing a primary care provider burnout prevention program; development of local operating procedures to improve transfer of care between PCMHI, outpatient mental health, and primary care; and behavioral medicine education for primary care and PCMHI. Time allocation for research will be determined in collaboration with the preceptor, and will be up to 4 hours per week.

Core Training Faculty
Please see the Psychology Service Faculty section of this brochure for full biographies of the core training faculty for this Focus Area of the Clinical Psychology postdoctoral residency program.

Joshua Breitstein, Psy.D. is a psychologist in the Primary Care Mental Health clinic.

Emily Cox-Martin, Ph.D. is a psychologist in the Primary Care Mental Health clinic, and serves as the PCMHI postdoctoral residency preceptor.

Caitlin Goodin-Phillips, Psy.D. is a psychologist in the Primary Care Mental Health clinic.

Jacob Manuel, PhD. is a psychologist in the Primary Care Mental Health clinic.

Focus Area Preceptor: Matthew Cook, Ph.D.

Psychologist, Substance Treatment and Recovery (STAR) Program
VA Puget Sound Health Care System, American Lake Division
9600 Veterans Drive SW
Tacoma, WA 98493
Phone:
Email: matthew.cook4@va.gov

Overview
The goal of this focus area within the Clinical Residency Program is to prepare residents to function as independent Health Service Psychologists, with a focus on advanced competence in the specialized residential mental health treatment of Veterans. The postdoctoral resident will spend the year training in the Mental Health Residential Rehabilitation Treatment Program (MH RRTP). The MH RRTP is comprised of four specialty treatment programs located at the American Lake campus in Tacoma, WA. These programs include 1) SUD (Substance Treatment and Recovery Program [STAR]), 2) DCHV (Homeless Engagement & Recovery Opportunity Program [HERO]), 3) PTSD (Veterans Intensive PTSD Program [VIP]) and 4) Compensated Work Therapy – Transitional Residence (CWT-TR). Residents training during the 2026-2027 training year are anticipated to work with the HERO and STAR Programs. As of the writing of this document, VIP is not available for training purposes.

The postdoctoral training year with MH RRTP will emphasize the unique aspects of working within an interdisciplinary residential mental health treatment environment and its ongoing processes. The resident will engage in consultation, care coordination, collaboration, and intervention within an interprofessional treatment team consisting of medical and nursing staff, peer support specialists, psychologists, psychiatrists, social workers, and recreation therapists. Further, the postdoctoral resident will develop and hone the following foundational skillset: navigating the balance between individual patient needs and the needs of the larger milieu; identification of roles and dialectics within an interdisciplinary team and the honing of vital communication skills; time management and prioritization in a complex and fast-paced environment; and collaborative behavior management and treatment planning. The residential mental health postdoctoral resident will learn about the recovery and Whole Health models within the residential setting and will be involved in milieu-based programming throughout the year, to include participation in Community Meetings, clinical huddles, and Residential Advisory Committee.

The MH RRTP provides high-quality residential rehabilitation and treatment services for Veterans who may have complex substance use, mental health, medical, and vocational concerns. The MH RRTP identifies and addresses goals of rehabilitation, recovery, maintenance of health, improved quality of life, and community integration. Treatment goals and interventions vary based upon the program in which Veterans are admitted and range from one month to one year of intensive treatment. Regarding specific areas of focus within the residential setting, the postdoctoral fellow will gain specialized experience in the treatment of Substance Use Disorders (SUDs) and psychosocial stressors (e.g., chronic housing instability; financial strain, employment instability, lack of social support, legal stressors). The resident will have opportunities for applied learning related to evidence-based practice with SUD and complex medical, psychiatric, and psychosocial needs. There will be opportunities for the resident to provide co-occurring individual evidence-based treatment with Veterans diagnosed with Posttraumatic Stress Disorder (PTSD) admitted to the STAR Program. Further, the resident will engage in trauma-informed treatment and may also have the opportunity for trauma-focused treatment as part of the HERO Program, depending on clinical need.

Length of training: One year

Number of Residents: One

Goals
The training year will be crafted to provide advanced competency as a Clinical or Counseling Psychologist with a focus in working with Veterans with SUD and/or complex comorbidities and psychosocial stressors (e.g., PTSD, Personality Disorders, housing instability, legal stressors). We aim to make applicants competitive for a staff position in the VA setting.

At the conclusion of training, residents will be expected to demonstrate advanced competence in the following areas, consistent with the Clinical Psychology residency program expectations:

• Development of advanced skill in the Level 1 competencies of Integration of Science and Practice, Individual and Cultural Diversity, and Ethics and Legal Matters
• Development of advanced skill in the Level 2 competencies of Professional Attitudes, Values, and Behaviors; Interpersonal and Communication Skills; Intervention; Assessment; Education and Teaching; and Interprofessional and Consultation Skills

As applied to the following Residential Treatment Focus Area skills:

• Selection and delivery of services within a residential treatment environment
• Consideration of benefits and challenges of providing services within a therapeutic milieu
• Attention to increasing knowledge of DEI, to include cultural case conceptualization, intersectionality and cultural humility
• Selection and delivery of appropriate evidence based and/or theory-driven interventions from a patient-focused perspective to treat SUD, complex comorbidities, and psychosocial stressors
• Advanced skill in delivering time-limited treatment
• Conduct psychodiagnostic assessment (including both clinical assessment and personality assessment)
• Provision of interprofessional consultation and engagement in collaborative interdisciplinary relationships
• Demonstrate advanced knowledge of the interaction between SUD, other mental health diagnoses (e.g. PTSD, Major Depressive Disorder), and psychosocial stressors (e.g., housing instability, legal stressors)
• Successfully complete a quality improvement, program development, or research project demonstrating knowledge of Measurement-Based Care
• Design and delivery of behavioral interventions to create a therapeutic community
   

Additionally, residents may have the opportunity to obtain VA equivalency training in CBT for SUD. Residents may also have the opportunity to provide tiered supervision to psychology interns, utilizing a competency-based supervision framework. Opportunities to work with psychologists in leadership positions may also be available, based on specific training goals.

Clinical Opportunities and Composition of the Training Year

The resident spends approximately two weeks at the start of the year immersing themselves in the MH RRTP treatment environment. The primary clinical placements will be in the STAR and HERO Programs. Residents will spend approximately five and a half months in each program, based on training needs. Residents will also participate in year-long residential milieu programming (e.g, facilitating Resident Advisory Committee meetings, attending Community Meetings) to gain advanced experience with the nuances of working within a residential treatment environment.

Homeless Engagement & Recovery Opportunity (HERO) Program:

The HERO Program is a residential program lasting approximately six to 12 months, serving any Veteran experiencing housing instability, often via the pathway of multiple-trauma exposure and secondary substance use. As a part of the interdisciplinary team, postdoctoral residents will primarily participate in the facilitation of group therapy in addition to individual therapy and case management. Veterans present with clinical concerns to include complex, often transgenerational or race-based trauma in addition to MST and combat trauma, a range of substance and process addictions, recent incarceration and legal stressors, and medical complexities. In line with the VA Whole Health Model, the HERO Program acknowledges that Veterans often experience unstable housing as a biproduct of many factors; therefore, to assist Veterans in finding secure and stable housing, HERO also works to address the long-term needs of the Veteran to reduce return to housing instability. This includes an emphasis on community reintegration and building increased social support. HERO works in collaboration with many other services to include housing, vocation, and voluntary services. Treatment programming is anchored in evidence-based and Veteran-centered intervention. Some of these interventions include DBT Skills, ACT, CBT, mindfulness-based interventions (e.g., Mindfulness-Based Relapse Prevention; Compassion Focused Therapy), Sleep Hygiene, and Social Skills Training. All interventions will be rooted in the recovery model approach to care. Finally, postdoctoral residents will have a unique opportunity to offer long-term therapy to HERO Veterans.

Substance Treatment and Recovery (STAR): The Substance Treatment and Recovery (STAR) Residential Treatment Program serves Veterans who are struggling to attain their goals related to recovery for substance use. Providers in the STAR Program utilize several specialized treatment modalities including Motivational Interviewing, CBT for SUD, Acceptance and Commitment Therapy, CBT, DBT Skills, and mindfulness. Additionally, Veterans with co-occurring PTSD/SUD concerns can participate in Written Exposure Therapy during their admission. The primary modality is group treatment but also includes individual therapy and case management. STAR Program providers frequently collaborate with other VA services including medical providers for withdrawal management purposes, housing programs, work therapy programs, medical services, other local MH RRTPs, and additional VA programs for Veterans requiring longer term stabilization. In addition to obtaining experience with brief group and individual evidenced based treatments for SUDs, residents would have unique opportunities to consult and collaborate with medical providers about withdrawal management procedures and medication assisted therapies to best meet a Veteran’s needs. In addition to clinical interventions, the resident will have opportunities for completing psychological assessments. A successful resident would serve as a fully functioning treatment team member and engage in this flexible treatment environment. In addition to clinical work, there are numerous administrative opportunities to include participation in program development, quality improvement projects, and facilitating team aspects of care. An interested resident has the opportunity to work with Dr. Ahmad, a national VA consultant for CBT for SUD, to complete equivalency training to be a VA provider for this treatment.

Assessment: Residents are expected to integrate psychological personality and diagnostic assessment into their ongoing practice of therapy, as clinically appropriate. Assessment opportunities will be an integral part of residents’ work with patients, and opportunities for additional training and experience in this area will be available.

Teaching Methods
There are several methods that are used to train the Residential Treatment Focus Area Resident. They include:

Didactics: As mentioned previously, Clinical Psychology Program residents must complete at least 104 hours of learning activities during the year, which may include didactics, case conferences or other learning experiences beyond clinical and supervision requirements. Residents must present a didactic to the Psychology Department for the Wednesday Psychology Faculty Didactic Series. In addition, residents must attend – and may present – other didactic presentations that are individually tailored, in collaboration with their preceptor, to meet their training goals as delineated on their Individual Training Plan. Thus, within this Focus Area, didactic trainings are designed to provide the resident with advanced knowledge of SUD, homelessness, PTSD, complex comorbidities, and other psychosocial stressors within a residential treatment environment, and to prepare the resident for employment and licensure. The didactic training may occur via online trainings, webinars, in-person lectures, journal clubs, experiential trainings, and/or case conferences and may include some of the optional offerings listed below. Didactic trainings are individually tailored with the resident during the course of the training year; thus, some of the optional offerings below could be required for any given resident depending on needs.

Required Didactics:

• Residential, SUD, and PTSD focused didactics based on training goals of resident–to be determined based on individual learning needs
• Domiciliary Education Series – 1 hour per quarter
• American Lake Division Resident Didactic Series-approximately one hour per month

Optional Didactic Examples:

• VISN 20 MIRECC Didactics – one to two hours per month
• VISN 20 SUD Program Call - one hour per month
• Wednesday Psychology Faculty Didactic Series (3rd and 4th Wednesday of each month)

Mentorship: Dr. Cook provides leadership for the MH RRTP Focus Area of clinical postdoctoral program, as the preceptor. The task of the preceptor is to aid the resident in evaluating individual training needs and interests, and to develop an individualized training plan (ITP) based on those needs and the training program’s competency areas. In addition, the preceptor provides professional mentoring to the resident at least monthly, with an eye toward the resident’s overall progress through the residency program.

Supervision: Residents will receive at least two hours of individual, face to face supervision weekly. Staff members will also offer additional consultation and support as needed. Supervisors’ practices represent a variety of theoretical orientations and supervision approaches, yet all supervision will utilize competence-based supervision strategies to help residents meet their goals and competence requirements. Both summative and ongoing formative feedback will be given in accordance with written postdoctoral policies. Group supervision may also be offered in addition to individual supervision requirements, as available and appropriate.

Scholarly Activity, Research, and Program Development

The Clinical Psychology postdoctoral residency program embraces the relationship between science and practice and recognizes that it takes many forms for VA psychologists. Thus, opportunities for program evaluation and research mirror this diversity within the MH RRTP focus area. Residents are required to work with staff psychologists to engage in quality improvement and measurement or join with ongoing research projects, as available. Residents are expected to complete a quality improvement or research-based product by the end of the training year. Time allocation for research will be determined in collaboration with the preceptor, and will be up to 4 hours per week.

Core training faculty
Please see the Psychology Service Faculty section of this brochure for full biographies of the core training faculty for this Focus Area of the Clinical Psychology postdoctoral residency program.

Zeba S. Ahmad-Maldonado, Ph.D. is the Program Manager for the STAR Program and a clinical psychologist.

Matthew Cook, Ph.D., is a clinical psychologist in the STAR Program and preceptor for the MH RRTP focus area.

Gina Kuusisto, Ph.D. is a clinical psychologist in the HERO program.

Focus Area Preceptor: Jennifer King, PhD
VA Puget Sound Healthcare System, American Lake Division (116a)
9600 SW Veterans Drive
Tacoma, WA 98493
Telephone:
Email: jennifer.king11@va.gov

Overview
The goal of the PTSD Evidence-Based Psychotherapy (EBP) Focus Area in the Clinical Psychology program is to prepare residents to function as independent Health Service psychologists with advanced and specialized skills in Clinical Psychology with a focus on the delivery of evidence-based psychotherapies for PTSD. This residency provides clinical, didactic, and academic training to develop advanced knowledge of the etiology, comorbidities, and assessment and treatment of trauma-related disorders, including PTSD. This Focus Area integrates clinical work along with opportunities for teaching, administrative, research, and supervisory experiences within the context of outpatient PTSD treatment in the PTSD Outpatient Clinic (POC). We value trainees who are eager to participate on our team and be part of our professional community. The program requires that all residents engage in direct service delivery for at least a third of their time in training (at minimum), which averages to 13 hours per week.

Number of Residents: One

Length of Training: One year

Goals
Postdoctoral education and training are designed to promote an advanced level of competence as a Health Service Psychologist with focus on PTSD and the evidence-based psychotherapies used to treat it.

At the conclusion of the residency, residents will be expected to demonstrate advanced competence in the following areas, consistent with the Clinical Psychology residency program expectations:

• Development of advanced skill in the Level 1 competencies of Integration of Science and Practice, Individual and Cultural Diversity, and Ethics and Legal Matters;
• Development of advanced skill in the Level 2 competencies of Professional Attitudes, Values, and Behaviors; Interpersonal and Communication Skills; Intervention; Assessment; Education and Teaching; and, Interprofessional and Consultation Skills

As applied to the following PTSD EBP skills:

• Development of advanced understanding of cognitive-behavioral theories and application (specifically Prolonged Exposure [PE], Cognitive Processing Therapy [CPT], and Written Exposure Therapy [WET]);
• Development of advanced understanding of PTSD and trauma-related disorders, including Military Sexual Trauma (MST);
• Development of a professional identity as a Health Service Psychologist with specialized expertise in PTSD, especially as applied to the assessment and treatment of PTSD using trauma-focused EBPs;
• Scholarly activity, e.g., submission of a study or literature review for publication, presentation, submission of a grant proposal, quality improvement project, or outcome assessment;
• Preparation for state or provincial licensure, or certification for the independent practice of psychology

Clinical Settings

PTSD Outpatient Clinic (POC): The POC is a specialized outpatient clinic that provides evidence-based, trauma-focused treatment to Veterans who struggle with PTSD as a result of their military service. Treatment in the POC is behavioral and cognitive, time-limited, and evidence-based. Such evidence-based, PTSD-focused interventions may occur within a group or individual format, depending on the intervention.
For Veterans ready to engage in trauma-focused therapy, treatments that have been scientifically shown to be effective, such as Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy (PE), and Written Exposure Therapy (WET), are available; these are often referred to as the POC trauma-focused interventions.
The POC recognizes that many Veterans who struggle with PTSD may not be ready to directly address the traumas they experienced. Therefore, treatment is available for Veterans who do not yet feel ready to address their trauma experiences, but who recognize that a goal of their program involvement is to work toward engaging in a trauma-focused therapy; this is often referred to as the POC non-trauma-focused intervention. The POC has one non-trauma-focused intervention: a 3-week PTSD 101 group where Veterans can learn more about the disorder of PTSD and the trauma-focused interventions used to treat it.
Aftercare is also available to help Veterans maintain treatment gains and to pursue further engagement in life. All of the aftercare services are available outside the POC in other VA clinics or the community.
The overarching goal of the POC is to assist Veterans in their recovery from the disabling and distressing consequences of their condition. For some Veterans, this may be remission of PTSD, for others it may be a lessening in the symptoms with which they struggle, while for other Veterans it may be seeking to improve the quality of their lives in spite of having PTSD. For all Veterans who enter into treatment, the objective of the clinic is the same: to assist Veterans in their efforts to change and to have a more meaningful life.
 

The Role of the Resident
Resident duties in the POC are to provide individual, time-limited, trauma-focused interventions (i.e., PTSD EBPs, such as PE and CPT), as well as conduct two 90-minute intakes per week and one 60-minute intake every other week, and to engage in collaborative treatment planning with Veterans. Comprehensive psychodiagnostic assessment may be required for Veterans with complex symptom presentations. A resident may also be asked to help develop tailored services for the unique needs of Veterans, such as designing assessment batteries or intake procedures, or facilitating a specialized group offering. Residents will coordinate care with other members of the Veteran’s interdisciplinary care team, including medical staff, rehabilitation specialists, and family members, as necessary.

While on the POC rotation, the resident functions as the primary therapist for the Veterans on their caseload. We aim to ensure that residents are competent in CPT, PE, and WET, and are able to offer all three interventions to their patients. The Veterans served by the POC often present with a variety of co-morbid disorders and psychosocial issues that necessitate interventions that complement trauma-focused treatment. In addition to individual psychotherapy, residents are expected to co-facilitate at least one group. Residents are important members of the POC team, participating fully in administrative and case consultation meetings. Residents will also have the opportunity to engage in administrative projects, research tasks, and may have supervisory experiences with interns. Our goal is to help support the resident in gaining professional skills and competencies for full-time staff psychology positions in VA.

Teaching Methods
There are several methods that are used to train the PTSD EBP Resident. They include:

Didactics: In addition to participation in the monthly general seminar attended by all residents, the PTSD program offers a number of specialty specific didactics. As mentioned previously, Clinical Psychology Program residents must complete at least 104 hours of learning activities during the year, which may include didactics, case conferences or other learning experiences beyond clinical and supervision requirements. In addition, residents must attend other didactic presentations that are individually-tailored, in collaboration with their preceptor, to meet their training goals as delineated on their Individual Training Plan (ITP). Thus, within the Focus Area, PTSD psychology didactic trainings are designed to provide the resident with advanced knowledge of PTSD and the EBPs used to treat it. The didactic training may occur via online trainings, webinars, lectures, experiential trainings, and/or case conferences, and may include some of the optional offerings listed below. Didactic trainings are individually-tailored with the resident during the course of the training year; thus, some of the optional offerings listed below could be required for any given resident depending on training needs.

Required Didactics:

• PTSD EBP Seminar Series – approximately 40 hours over the course of the training year, to be determined based on resident’s individual learning needs;
• American Lake Division Postdoctoral Residency Didactic Series – one hour per month

Optional Didactics:

• University of Washington, Psychiatry Grand Rounds – two hours per month (1st and 3rd Fridays at 1200;
• National Center for PTSD Didactic Series – one hour per month (3rd Wednesday at 1100);
• VA National Military Sexual Trauma (MST) Didactic Series – one and a half hours per month (1st Thursday at 0900);
• VA NW MIRECC (VISN 20) Didactic Series – two hours per month (1st and 3rd Wednesdays at 1200).

Mentorship: Dr. King provides leadership for the PTSD EBP Focus Area of the Clinical Psychology postdoctoral program, as the preceptor. The task of the preceptor is to aid the resident in evaluating individual training needs and interests, and to develop an ITP based on those needs and the training program’s competency areas. In addition, the preceptor provides professional mentoring to the resident at least monthly, with an eye toward the resident’s overall progress through the residency program.

Supervision: The determination of a primary clinical supervisor in POC is a collaborative process with the resident that takes into account training needs and preferences. The licensed psychologists who may supervise the resident per WA State law include Drs. Bullock, King, Mull, Reas, and Smith.

The resident will receive individual supervision where PTSD assessment and treatment using PTSD-specific EBPs, clinical, career development, teaching, and scholarly activity are addressed (with a minimum of two hours of individual supervision being provided each week). The resident may also have the opportunity to supervise other trainees under the guidance of clinical staff, when feasible. In addition, the resident will have opportunities to work closely with professionals from other disciplines with different areas of expertise. Residents have opportunities to directly observe licensed staff psychologists in practice. For example, residents will observe licensed psychologists conduct intakes, other evaluations, or engage in other clinical or professional activities, and may co‐lead a group with staff.

Scholarly Activity, Research, and Program Development
Involvement in evaluation that embodies the integration of science and practice is an important component of the PTSD EBP Focus Area. The resident will be required to identify research or evaluation activities that would expand their current skill set. There are a wide range of opportunities available to the resident that include: participation in ongoing studies, participation in ongoing quality improvement projects, data analysis, preparing papers and presentations, interfacing with the local IRB, etc. Areas of ongoing evaluation include: program improvement within the POC and collaborating on ongoing projects with researchers outside of the POC. Residents are encouraged to participate and take the lead in program improvement and development projects. These projects allow the POC to continuously evaluate its programs and offerings, incorporate new evidence-based interventions, and keep clinical programs current and responsive to Veteran needs/preferences. Time allocation for research will be determined in consultation with the preceptor, but will consist of no more than 4 hours per week.

Core Training Faculty
Please see the Psychology Service Faculty section of this brochure for full biographies of the core training faculty for this Focus Area of the Clinical Psychology postdoctoral residency program.

Cody L. Bullock, Ph.D. is a Clinical Psychologist in the PTSD Outpatient Clinic at the American Lake Division.

Jennifer C. King, Ph.D. is the POC’s co-occurring substance use/PTSD specialist and serves as the liaison between the POC and Addiction Treatment Center (ATC). She is a Clinical Psychologist and the preceptor for this residency Focus Area. Dr. King is also the EBP Coordinator for VA Puget Sound.

Jared Mull, Psy.D. is a Clinical Psychologist in the PTSD Outpatient Clinic at the American Lake Division.

Hannah Reas, Ph.D. is a Clinical Psychologist in the PTSD Outpatient Clinic at the American Lake Division.

Dale E. Smith, Ph.D. is the longest standing member of the POC and has served as its Clinic Manager since its inception in September 1991 when it was first established as a Substance Use/PTSD Clinical Team.

Erin Verdi, PhD is a Clinical Psychologist in the PTSD Outpatient Clinic at the American Lake Division.

Sherry Yelland, Ph.D. is a Clinical Psychologist in the PTSD Outpatient Clinic at the American Lake Division.