VA Puget Sound, American Lake Psychology Postdoctoral Fellowship Program

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.

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
9
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.

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).

PTSD Evidence-Based Psychotherapy (EBP) Focus Area

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.

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.

Zeba S. Ahmad-Maldonado, PhD is the Program Manager for the Substance Treatment and Recovery (STAR) Program in the MH RRTP. She received her Ph.D. in Clinical Psychology from Seattle Pacific University, completing her doctoral internship at the Louis Stokes DVAMC in Cleveland, Ohio. She is licensed to practice in Washington state and is a Clinical Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington. Dr. Ahmad’s theoretical orientation is Cognitive Behavioral. Dr. Ahmad was certified in Cognitive Behavioral Therapy for Substance Use Disorders (CBT for SUD) through the VA in 2015. She is a trained consultant for the national CBT for SUD training program through the VA. At American Lake, Dr. Ahmad is the former Chair of the Diversity Committee, a Committee serving under the Training Committee. Dr. Ahmad has a special emphasis on diversity related issues.

Derek Anderson, PhD is a psychologist in the Rehabilitation Care Service. He obtained his PhD in Clinical Psychology from Ohio State University and is licensed in Washington state. He completed his doctoral internship at the Seattle VA and postdoctoral residency in Rehabilitation Psychology at the Seattle VA. Clinically, he is interested in adjustment to chronic disabilities and currently conducts brief outpatient neuropsychological assessments as well as provides individual and group psychotherapy. His intervention approaches are guided by empirically supported treatments, including Cognitive Behavioral Therapy (CBT), Behavioral Activation, Acceptance and Commitment Therapy (ACT), Motivational Interviewing (MI) and Problem-Solving Therapy techniques to promote mood management, pain management, and optimize response to disability within a rehabilitation setting. As for research, he is most broadly interested in examining response to chronic medical conditions or acquired disability among patients and their family members. His most recent research efforts have included examining mood and social support among patients with limb loss. Additionally, he has been serving as a study therapist for an ongoing grant-funded, multi-site, group intervention for chronic pain management.

Madison Bertolin, PhD is a clinical rehabilitation neuropsychologist in Rehabilitation Care Services, working primarily with the Blind Rehabilitation and Telerehabilitation teams. She earned her PhD in Clinical Psychology, with a specialization in Neuropsychology, from Saint Louis University. She subsequently completed a neuropsychology internship at the Southwest Consortium and postdoctoral fellowship in neuropsychology at the VA Puget Sound, Seattle division. She is licensed in Washington state. Her professional areas of expertise and clinical interests involve inpatient and outpatient neuropsychological assessment with a variety of rehabilitation populations, psychotherapeutic interventions for optimizing response to disability, and adaptation of rehabilitation psychology and neuropsychology services for telehealth.

Joshua Breitstein, PsyD is a psychologist in the Primary Care Mental Health Integration (PCMHI) Clinic. He attended The Georgia School of Professional Psychology, earning his PsyD in 2008. While attending his graduate program, he earned a 2-year Health Professions Scholarship in the United States Army. He completed internship and post-doctoral training at Madigan Army Medical Center where he was trained as a clinical psychologist with a specific emphasis on military psychology. He served on active duty from 2007 to 2011, completing one deployment to Iraq from 2010 to 2011 as the psychologist assigned to the 85th Combat Stress Control Detachment. Dr. Breitstein holds an active psychology license in Washington state. His theoretical orientation is cognitive behavioral within an interpersonal framework. Dr. Breitstein received advanced training in sleep medicine at Madigan Army Medical Center. He brings diversity experience working with active duty military populations across all branches of service. Dr. Breitstein clinical and research interest is in the area of sleep medicine. He enjoys mentoring and supervising interns providing trainees with a diverse understanding of military culture and its impact on cognition and behavior. Dr. Breitstein also enjoys training interns in various aspects of sleep medicine and applying these principles to treatment in a primary care setting.

Cody L. Bullock, PhD, ABPP is a clinical psychologist in the PTSD Outpatient Clinic (POC). He received his PhD from Pacific Graduate School of Psychology at Palo Alto University, with an emphasis in Neuropsychological Assessment in 2011. He completed his doctoral internship at Heartland Behavioral Health Hospital through the Ohio Psychology Internship Program, and his postdoctoral residency through the San Francisco VA Medical Center, in the Rural Psychology Track. Dr. Bullock has been licensed since 2013, and specifically in Washington state since 2015. He has completed VA rollout trainings in MET, PE, WET, and CPT. He has enjoyed serving on a variety of workgroups with areas including staff education, review of risk management documentation, training committee, diversity mentorship, and psychology trainee clinical and psychological assessment supervision. His theoretical orientation is primarily CBT-based. He currently is also an Army Psychologist and a Major in the Army Reserves, having joined in 2016 and serving in a Unit whose mission is to provide Behavioral Health services in deployed environments. He has two areas of specialized training as an Army Psychologist – Aeromedical Psychology and SERE Psychology – and has had two deployments to the Middle East in 2019 and 2021 providing a wide range of Behavioral Health services and consultation. He obtained board certification in Clinical Psychology in 2023.

Melissa Caris, PhD is a psychologist in the Mental Health Clinic (MHC). She completed her PhD in Clinical Psychology at Seattle Pacific University, her doctoral internship at VA Puget Sound Health Care System, American Lake Division, and is licensed in Colorado. She has a MA in Marriage and Family Therapy from Whitworth University. She uses a combination of cognitive behavioral therapy and family systems theory to inform her clinical practice with individuals and couples.

Erik Clarke, PhD is a psychologist in the Pain Clinic and Team Lead for the Residential Functional Restoration Pain Program. He received his Ph.D. in Counseling Psychology from The University of Kansas in Lawrence, KS. He completed his doctoral internship at the St. Louis VAMC which included rotations in Pain Clinic, Spinal Cord Injury Unit, and PCMHI. He went on to complete a post-doctoral fellowship in Chronic Pain and PCMHI at VA Puget Sound Healthcare System at the American Lake campus in Tacoma, WA. He is licensed in Washington state since 2018. Dr. Clarke has training in evidence-based treatments for chronic pain and substance use disorder which include Acceptance and Commitment Therapy for chronic pain and Mindfulness Based Relapse Prevention. Other evidence-based practices of interest to Dr. Clarke include Motivational Interviewing and Pain Neuroscience Education. He currently serves as Co-research chair on the training committee.

Emily Cox-Martin, PhD is a clinical health psychologist and preceptor in the Primary Care Mental Health Integration Clinic. She received her PhD in clinical psychology with a focus in health psychology from Virginia Tech, and completed her pre-doctoral internship in behavioral medicine at the VA Boston Psychology Internship Training Program. Dr. Cox-Martin was a National Cancer Institute R25 Fellow at the University of Texas MD Anderson Cancer Center and completed clinical fellowship rotations in the Department of Pain Medicine and the Tobacco Treatment Center. Her theoretical orientation is primarily third wave cognitive behavioral therapy, ACT, mindfulness and compassion-based approaches, and existential therapies (e.g., Meaning Centered Therapy). She has advanced training in health behavior change, chronic pain management, psycho-oncology, and CBT-I. Her research interests include the application of mindfulness- and acceptance-based interventions for chronic and terminal medical conditions. She currently serves as an assessment supervisor and a member of the Training Committee.

Matthew Cook, PhD is a clinical psychologist in the residential substance treatment and recovery (STAR) program and serves as the preceptor for the MH RRTP focus area for postdoctoral residents. He received his PhD in Clinical Psychology from the University of Central Florida in Orlando, FL. He completed a pre-doctoral internship at the William S. Middleton Memorial Veterans Hospital in Madison, WI. He is licensed in the state of Washington. His theoretical orientation is primarily cognitive behavioral therapy and he has completed advanced training and certification in the treatment of Substance Use Disorders using CBT for SUD, and of PTSD using Cognitive Processing Therapy. His professional interests include residential treatment settings and the treatment of substance use disorders, PTSD, and complex comorbidities.

Daniel J. Fischer, PhD is the Program Manager in the PRRC. He is licensed in Washington state. Dr. Fischer received his PhD in Clinical Psychology from the University of New Mexico. He completed his doctoral internship at the VAPSCHCS, American Lake Division and his postdoctoral residency in the Center for Excellence in Substance Abuse Treatment and Education (CESATE) at VAPSHCS, Seattle Division. Dr. Fischer has received advanced training in the practice and education of MI and is a member of the Motivational Interviewing Network of Trainers (MINT). He is certified through the VA in CPT and is completing certification in IPT. His theoretical orientation is cognitive behavioral and he identifies as a generalist clinically. His professional interests include issues related to client engagement and retention as well as the training and dissemination of empirically based practices.

Amy Frers, PhD is a psychologist in the Pain Clinic. She completed her PhD in Clinical Health Psychology at the University of Colorado-Denver, her doctoral internship at VA Puget Sound, American Lake Division, and is licensed in the state of New York. She considers her theoretical orientation to be integrative and grounded in ACT and CBT. She also integrates compassion-focused therapy into her work and has special interest in helping patients with chronic pain modify health behaviors (e.g., tobacco cessation, diet). She is the lead psychologist for the functional restoration pain program, and she also provides individual and group psychotherapy in the Pain Clinic.

Sam Glovak, PhD is a psychologist in the Pain Clinic. She completed her PhD in Clinical Psychology at the University of Tennessee and her doctoral internship year at VA Puget Sound, American Lake Division. She was a Mood and Anxiety Disorders fellow at VA Puget Sound, Seattle, before returning to American Lake as staff. She is licensed in Washington state. Dr. Glovak has a trauma-informed, third-wave CBT theoretical orientation. She provides individual and group evidence-based psychotherapy for chronic pain and co-occurring mental health conditions. Her specialty area of interest is in the relationship between chronic pain and trauma-related concerns, and she most commonly delivers Acceptance and Commitment Therapy and Cognitive Processing Therapy. Dr. Glovak co-developed an ACT-informed Pain and PTSD group, which she runs regularly in the Pain Clinic.

Scott Hunt, PhD is a psychologist in the Psychiatric Assessment and Clinical Care (PACC) Unit. He received his PhD in Clinical Psychology from Fielding Graduate University. He completed both his doctoral internship and a postdoctoral research residency at the VAPSHCS, American Lake Division. Dr. Hunt’s clinical orientation is integrative and his clinical interests are in emergency mental health, psychodiagnostics, and assessment. His research at the VA has ranged from biomedical research in antidepressant augmentation to aspects of religiousness in marital quality. He is licensed in WA state.

Andrew Jeon, JD, PhD is a program manager in the American Lake Mental Health Clinic (MHC). Dr. Jeon received a Ph.D. in clinical psychology from the University of Nebraska – Lincoln. He completed his internship at VA Central Iowa Health Care System (Des Moines, IA) where he then worked on the Disruptive Behavior Committee (DBC), Employee Threat Assessment Team (ETAT), and Behavioral Health Interdisciplinary Program (BHIP). Dr. Jeon is a licensed psychologist in the state of Iowa. His theoretical orientation is primarily second-wave cognitive behavioral therapy with a specialty in anxiety disorders and exposure/response prevention.

Sarah Jones, PhD is a clinical psychologist in the Mental Health Clinic. She received her PhD in clinical psychology from the University of Nevada, Las Vegas. She completed her predoctoral internship at Mount Sinai St. Luke’s/Roosevelt Hospitals and a postdoctoral residency at a private practice specializing in sexual health. Dr. Jones’s theoretical orientation integrates primarily psychodynamic, interpersonal, and cognitive-behavioral approaches and her clinical interests include treatment of trauma and sexual wellness concerns. Dr. Jones is currently in process of becoming an AASECT Certified Sex Therapist.

Jennifer C. King, PhD is the co-occurring substance use/PTSD specialist at American Lake and serves as the liaison between the POC and ATC. She received her PhD in Clinical Psychology (with an emphasis in forensic psychology) from Palo Alto University and completed her doctoral internship at VA St. Louis Health Care System. She is licensed in Kansas. Her theoretical orientation is cognitive-behavioral with a particular focus in behavioral therapy. Dr. King completed the VA rollout training in Prolonged Exposure in 2015 and Written Exposure Therapy in 2020. Her professional interests include co-occurring substance use and PTSD in the Veteran population, Prolonged Exposure, “killing” and combat trauma specifically, harm reduction, and culturally-informed, inclusive care. Dr. King is the preceptor for the Behavioral and Cognitive Psychology postdoctoral residency track, as well as serves as the local EBP coordinator for American Lake.

Karen Kosky, PsyD is a clinical neuropsychologist in the Mental Health Service Line. She completed her doctoral degree in clinical psychology from Indiana University of Pennsylvania. She completed a neuropsychology-focused internship at the APA-accredited Missouri Health Sciences Psychology Consortium and a two year, APPCN-member postdoctoral fellowship in adult neuropsychology at the University of Missouri. Prior to coming to the American Lake VA, she worked at a group practice specializing in adult autism spectrum disorder assessments. She is licensed in Washington State.

Fiona Kurtz-Thornley, Ph.D., L.P. is a staff psychologist in the Addiction Treatment Center (ATC) at the American Lake VAHCS. She earned her degree in Clinical Psychology at Seattle Pacific University, and completed internship at American Lake. She also received postdoctoral training at the Seattle VA Center of Excellence in Substance Addiction Treatment and Education (CESATE). Her clinical focus is in the assessment and treatment of cooccurring disorders, particularly cooccurring SUDs and PTSD. She also has specialty knowledge and a background in the assessment of adult Attention Deficit/Hyperactivity Disorder (ADHD). She currently serves as an assessment supervisor and as a member of the Diversity Committee.

Gina Kuusisto, PhD is a staff psychologist on the Homeless Engagement & Recovery Opportunity (HERO) team in the MH RRTP. She received her PhD in clinical psychology from Seattle Pacific University with a focus on treating complex trauma and PTSD. She completed her internship at Louis Stokes Cleveland DVAMC and her postdoctoral residency in women’s residential trauma treatment at VA Palo Alto. Dr. Kuusisto has previously worked with Active Duty Military as a civilian psychologist at Madigan Army Medical Center. She has extensive training in the use of mindfulness-based and third-wave contextual-behavioral therapies to include DBT, ACT, and Compassion-Focused Therapy (CFT). She is also trained in several trauma-focused treatments to include: EMDR, PE, CPT, and WET. She is a former member of the Diversity Committee and Assessment Supervisory Team and continues to supervise at the intern, resident, and graduate psychologist levels. Dr. Kuusisto has special interests in program development and improvement, diversity, interpersonal process, and feminist psychotherapy. Dr. Kuusisto is licensed in WA state.

Jacob Manuel, PhD is a staff psychologist in Primary Care Mental Health (PCMHI). He graduated from Pacific University in Oregon with a Ph.D. in Clinical Psychology where his research involved the development and validation of a measure designed to assess barriers to treatment enactment in participants of mindfulness-based interventions. He was subsequently awarded NIH funding to further validate this measure on a sample of law enforcement officers undergoing mindfulness-based resilience training. He completed internship at the Southern Oregon VA and postdoctoral residency at American Lake in PCMHI. Currently, Dr. Manuel is implementing a mindfulness-based resilience training for primary care providers. His interests/areas of training also include: diversity issues in psychology, trauma-informed interventions, sleep disturbance/CBT-I, LGBTQ+ issues, third-wave behavioral treatments, and mindfulness-based interventions. Dr. Manuel is the preceptor for the PCMHI postdoctoral residency.

Jon T. Moore, PhD is a psychologist and the Program Director of the Workplace Violence Prevention Program and Chair of the Disruptive Behavior Committee. He received his PhD in counseling psychology from the University of Louisville. He completed his doctoral internship at the Cincinnati VAMC and continued his training in substance use and homeless rehabilitation as a postdoctoral resident at the VA Palo Alto. Clinically, Dr. Moore uses a Feedback-Informed Treatment framework with theoretical rationales that primarily stem from Emotion-Focused Therapy and interpersonal foundations. Dr. Moore researches dogmatic/biased thinking styles as well as secular and religious groups’ mental health and spirituality. Dr. Moore is currently using program evaluation data from residential programs to identify the mechanisms of change for Veterans. He has served as the Research Chair within the Training Committee and as an assessment supervisor. Dr. Moore is licensed in Washington state.

Jared Mull, PsyD is a clinical psychologist in the PTSD Outpatient Clinic (POC). He received his PsyD from Pacific University in Oregon and is licensed in the state of Washington. He completed his internship at the Alaska VA Healthcare System in Anchorage Alaska. He has completed national roll-out trainings in Cognitive Processing Therapy (CPT) and Motivational Interviewing (MI). His interests include providing evidenced-based psychotherapies for the treatment of PTSD, and while his main theoretical orientation is CBT, has occasionally been accused of entertaining Acceptance and Commitment Therapy.

Sarah Noonan, PhD is a clinical neuropsychologist in Rehabilitation Care Services, working primarily within the Center for Polytrauma Care. She earned her PhD in Clinical Psychology, with a specialization in Neuropsychology, from the San Diego State University/University of California, San Diego joint doctoral program. She completed her internship and postdoctoral residency within the VA Boston Healthcare System, where she received advanced clinical training in neuropsychological assessment, cognitive rehabilitation, and evidence-based treatments for PTSD, and conducted research within the Boston Attention and Learning Laboratory and the VA Boston Neuroimaging Research Center. She is licensed in Washington state. Her professional interests include mTBI/concussion diagnosis and treatment in combat Veterans, holistic cognitive interventions, and neuroplasticity.

Samantha Overstreet, PhD is a psychologist in the Psychosocial Rehabilitation and Recovery Center (PRRC). She received her Ph.D. in Clinical Psychology from The University of Tulsa in Tulsa, OK. She completed her doctoral internship at the Hunter Holmes McGuire VAMC in Richmond, VA in their Serious Mental Illness Across the Lifespan track. She went on to complete a post-doctoral fellowship in Psychosocial Rehabilitation and LGBT Healthcare at VA Connecticut Healthcare System in West Haven, CT. She is licensed in Rhode Island since 2017. Dr. Overstreet’s theoretical orientation integrates cognitive-behavioral and third-wave modalities, and she is a strong proponent of the recovery model. She has training in evidence-based treatments for serious mental illness, and is a VA-certified provider of Social Skills Training for Schizophrenia. Dr. Overstreet’s professional interests include recovery-oriented systems change, personality assessment, and diversity issues, particularly LGBTQ advocacy. She currently serves as an assessment supervisor and as a member of the Diversity Committee.

David L. Pressman, PhD is the Acting Chief of Psychology for VA Puget Sound & Team Leader of the Seattle Division’s PTSD Outpatient Clinic (POC). He received his PhD in Clinical Psychology from Columbia University-Teachers College in 2007. He completed his internship at Montefiore Medical Center in the Bronx. Prior to arriving at the VA, Dr. Pressman worked at Madigan Army Medical Center on Joint Base Lewis-McChord. Dr. Pressman previously served as the PTSD-SUD Specialist for the Seattle Division of VA Puget Sound. He is a licensed psychologist in the State of Washington.

Larry D. Pruitt, PhD is the Director of Suicide Prevention at both the American Lake and Seattle divisions of VA Puget Sound. He received his PhD in Clinical Psychology from the University of Nevada, Reno. He completed his doctoral internship at the VA Sierra Nevada Medical Center and his postdoctoral fellowship at the University of Washington’s Center for Anxiety and Traumatic Stress. He is a Licensed Clinical Psychologist in Washington State and an Associate Clinical Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington. His theoretical orientation is primarily behavioral. Dr. Pruitt has served as a member of the Military Suicide Research Consortium, the Joint DOD/VA Strategic Decision Team in response to Executive Order 13822, The Department of Defense’s Suicide Prevention and Risk Reduction Committee, and the 2019 update to the VA/DoD Clinical Practice Guidelines for the Identification and Management of Suicide Risk. Dr. Pruitt co-chairs the VA Puget Sound Suicide Risk Reduction Committee.

Hannah Reas, PhD is a staff psychologist in the PTSD Outpatient Clinic (POC) at VA Puget Sound Healthcare System, American Lake Division. She completed her postdoctoral fellowship in Behavioral and Cognitive EBP Treatments for PTSD at American Lake, where she also completed her pre-doctoral internship. She has a Master of Arts degree with an emphasis in Marriage and Family Therapy from Pepperdine University and received her PhD in Clinical Psychology from Seattle Pacific University. Her theoretical orientation is primarily cognitive-behavioral and trauma-focused (PE, CPT). Additional clinical interests include provision of evidence-based psychotherapies for PTSD via telehealth. Her research interests include military trauma (MST, combat), moral injury, understanding the effects of the sociopolitical climate on mental health outcomes, and the intersection between substance misuse and PTSD. Dr. Reas is a member of the Diversity Committee and hopes to continue providing trauma-informed & culturally sensitive care to the Veterans we serve.

Greg Reger, PhD is the Deputy Associate Chief of Staff for the Mental Health Service at VAPSHCS and an Associate Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine. He received his PhD in Clinical Psychology from Fuller Theological Seminary in 2004 and completed his psychology internship at Walter Reed Army Medical Center. He is an Army Veteran and deployed to Iraq in 2005 in support of Operation Iraqi Freedom. Dr. Reger spent 5 years as a civilian employee with the Department of Defense (DoD) leading teams designing and evaluating technology in support of psychological health. His research has focused on the development and evaluation of virtual reality, mobile applications, and other innovative technologies for psychological purposes. He is currently funded to evaluate a virtual reality patient to support provider training in motivational interviewing. Dr. Reger also led the VA/DoD team that designed the PE Coach mobile application and was recently funded to conduct a pilot trial of patient preferences for PE Coach and the impact of the app on clinically relevant outcomes.

Troy Robison, PhD is a psychologist in the Addictions Treatment Center (ATC). He completed his PhD in Clinical Psychology at Ohio University, his doctoral internship at the Cincinnati VA Medical Center, and is licensed in the state of Washington. His approach to psychotherapy is primarily humanistic, with specific interests in mindfulness-based interventions and the incorporation of neurobiology into psychological treatments for addiction. He also provides Behavioral Couples Therapy for SUD and gambling addiction treatment in the ATC.

Marissa Rudolph, Ph.D. is the Program Manager for the VA Puget Sound Mental Health Intensive Outpatient Program (MH IOP). She earned her Ph.D. in Clinical Psychology from Seattle Pacific University. She completed her predoctoral internship at Louis Stokes Cleveland VA Medical Center and postdoctoral fellowship in Women’s Trauma at VA Long Beach Health Care System. Dr. Rudolph is licensed in Washington State and her theoretical orientation is primarily cognitive-behavioral. She is trained in Comprehensive Dialectical Behavior Therapy, Prolonged Exposure, Cognitive Processing Therapy, Written Exposure Therapy, Imagery Rehearsal Therapy, CBT for Insomnia, and the DBT PE protocol. Her professional interests include emotion dysregulation, military sexual trauma, women’s mental health, innovative approaches to the delivery of evidence-based treatments for PTSD, and program evaluation.

Orlando Sánchez, PhD is a clinical neuropsychologist in the MHC. He attended Seattle Pacific University and completed his doctoral internship at the University of Miami/Jackson Memorial Hospital where clinical interests focused on neuropsychological assessment and neurorehabilitation of patients with varied neurologic injuries, particularly TBI and CVA/strokes. He completed postdoctoral fellowships in neuropsychology at the Truman VA Medical Center and Minneapolis VA Health Care System with emphasis in: TBI via a national DoD-DVA longitudinal treatment and research program, CVA/stroke, geriatrics – including the Memory Disorders Clinic through GRECC, and polytrauma. He has been licensed in the state of Washington since 2018. Clinical interests include cross-cultural neuropsychology, particularly assessment and treatment pertaining to indigenous peoples of the Americas (North, Central, and South America), cultural competency, and neurorehabilitation. Research/scholarly interests include cultural competency training, acculturation, TBI/PTSD, and health disparities.

Dale E. Smith, PhD is the Program Manager of the POC. He received his doctorate in social psychology from the University of Florida and completed the University of Washington’s Respecialization Postdoctoral Training Program in Clinical Psychology. He completed his doctoral internship in the Psychiatry and Behavioral Sciences Department at the University of Washington School of Medicine, and has been licensed in Washington since 1992. He has held faculty positions at the University of Florida, the American University, and the University of Washington prior to his clinical licensure and has held a number of administrative positions since assuming the role of the program director of the specialized outpatient PTSD clinic at American Lake. He is also the lead mentor for the VISN 20 PTSD Mentoring Program. Dr. Smith’s diversity interests include how beliefs are shaped by sociopolitical cultures within and across time, and his professional interests include the psychology of trauma. He is also interested in the delivery of patient care and treatment outcomes.

Rosamond Smith, PhD is a psychologist and the Program Director of the Primary Care Mental Health Integration (PCMHI) clinic. She received her M.S. in Counseling Psychology from The University of Southern Mississippi and her Ph.D. in Counseling Psychology from the University of Louisville. She completed her doctoral internship at VA Puget Sound – American Lake, and her post-doctoral fellowship at the Center for Excellence in Substance Abuse Treatment and Education (CESATE) at VA Puget Sound – Seattle, where she focused on dual-diagnosis treatment of PTSD/SUD. She has been licensed in Washington state since 2019. Dr. Smith conceptualizes veterans from a relational gestalt theoretical orientation, which is humanistic, existential, holistic, emotion-focused, phenomenological, process-experiential, strengths-focused, and intentionally relational/interpersonal. Her graduate training programs were heavily CBT and MI focused, and she frequently uses these and other empirically supported treatments within the relational gestalt framework. Dr. Smith is a VA-certified provider of Cognitive Processing Therapy and Cognitive Behavioral Therapy for Insomnia, and is VA trained in Whole Health and Prolonged Exposure for Primary Care. Other professional interests include treatment of grief, work centered on personal and community values, and challenging oppressive systems through therapy and professional development. She currently serves as the facilitator for the Clinical and Professional Development Group and as a member of the Diversity Committee.

Jason Stolee, PhD is the Psychology Training Director for VA Puget Sound Health Care System – American Lake Division, and also works in the Mental Health Clinic. He completed his doctorate degree in clinical psychology at the Rosemead School of Psychology, Biola University, and his internship and postdoctoral residency at Madigan Army Medical Center. He served within the Active Duty Army for four years, including one deployment to Iraq, and then worked as a civilian staff psychologist and associate training director at Madigan Army Medical Center prior to joining the staff at American Lake in 2021. Dr. Stolee’s professional interests are in the areas of exposure treatment for PTSD, insomnia, and cultural humility. He is a licensed psychologist in the state of Washington.

Amanda Ernst Wood, PhD is a Mental Health Research psychologist a VAPSHCS and a Clinical Associate Professor with the Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine. Dr. Wood received her PhD in Clinical Psychology from the Graduate School of Psychology at Fuller Theological Seminary. She completed her doctoral internship at the VAPSHCS, American Lake Division, and her postdoctoral residency in Chronic Mental Illness and Neuropsychology at the University of Washington/VAPSHCS. She is currently licensed in the state of Washington. Dr. Wood’s research interests include pharmacogenetics, provider burnout, and the treatment substance abuse, depression, and PTSD.

Elisia Yanasak, PhD is the Program Manager of the ATC at VAPSHCS, American Lake Division. She received her PhD at the University of Houston in 2002. She completed her doctoral internship at VAPSHCS, American Lake Division. She completed her postdoctoral residency in the interdisciplinary treatment of substance abuse at the Center of Excellence in Substance Abuse Treatment at VAPSHCS, Seattle Division. She has been licensed in Washington state since 2004. Her theoretical orientation is primarily cognitive behavioral. Her clinical interests include the treatment of male and female Veterans diagnosed with substance use and comorbid psychiatric disorders. Her research interests include Evidence Based Treatment of SUDs.