The postdoctoral training program at the Minneapolis VAMC has been fully accredited by the Committee on Accreditation of the American Psychological Association since 2001 (the next site visit will be during the academic year 2013). The program is a member of Association of Psychology Postdoctoral and Fellowship Centers (APPIC) and abides by its guidelines.

Training Philosophy and Model

The philosophy of our program is scientist-practitioner. Our program endorses the view that good clinical practice is based on the science of psychology. In turn, the science of psychology is influenced by the experience of working with real patients. As a consequence, our approach to training encourages clinical practice that is evidence-based and consistent with the current state of scientific knowledge. At the same time, we acknowledge the complexities of real patients and the limitations of our empirical base. We aim to produce psychologists who are capable of contributing to the profession by investigating clinically relevant questions through their own clinical research. While individual residents may ultimately develop careers that emphasize one aspect of the scientist-practitioner model more than the other, our expectation is that clinicians will practice from a scientific basis and that scientists will practice with a clinical sensibility.

Generalist Training is an important foundation for professional competence. Our program is based on the view that a psychologist must be broadly competent before she or he can become a skillful specialist. We believe that residents are best trained by strengthening their generalist skills across a broad spectrum of practice and by deepening their skill set in emphasis area(s) of their choice. This is best accomplished in relationship with mentor(s) who are a role models and accomplished scientist-practioners in the area(s) of emphasis selected by the resident. The training model for the postdoctoral training program at the Minneapolis VAMC therefore has four key components: (1) combining science with practice, (2) learning through mentoring relationships with staff, (3) self-directed development, and (4) training that combines breadth with depth.

Combining science with practice can take on several forms depending upon the training goals of the resident. For residents that are more clinically focused, between 15-25% research time is provided to complete a scholarly project that is commensurate with the release time allotted. For residents who are more research or academically oriented, up to 49% research time is provided to complete research project(s) that are commensurate with the release time allotted. Since completing original data collection projects can be challenging within the confines of a 12 month training program, residents typically take advantage of collaborating with several of our very productive clinical researchers on staff. Regardless of focus, all residents are expected to develop a strong working knowledge of the scientific literature pertaining to assessment and intervention and all clinical activities should be guided by this knowledge base.

Mentorship is characterized by close, collegial consultation with at least one psychologist specializing in the resident’s primary area of interest. Mentors will model the integration of scientific work with clinical practice, while fostering the further development of those skills in the resident. The mentor(s) also will assist the resident with becoming a self-supervisor and with taking responsibility as one of the principle designers of his/her learning.

Our training model also emphasizes self-directed development. In addition to developing core clinical psychological skills, which build upon the skill base attained through their pre-doctoral training and residency, we encourage greater reliance on self as the resident develops his/her professional identity as a psychologist. This includes attention to advancing development of core skills such as: assessment, treatment interventions and psychotherapy, consultation and multi-disciplinary teamwork, research and scientific inquiry, supervision and teaching, ethics, and cross-cultural and diversity sensitivity. With this approach, residents will be prepared to leave their training year well prepared to function successfully as an independent science/practitioner.

In addition, the residency training model also emphasizes breadth with depth. We expect that the postdoctoral resident will demonstrate a high degree of initiative and independence to better serve the increasingly complex medical and psychological needs of our veterans. Training is sufficiently broad to build on the generalized foundation of the knowledge, skills, and proficiencies that define clinical psychology, and of sufficient depth to develop specialized expertise and training in a specific area of emphasis, chosen by the resident.

The primary focus of the residency year is training. Delivery of patient care is an essential vehicle through which training occurs, but is secondary to the educational mission of the internship. Toward this end, postdocs are encouraged to plan their residency experiences in a manner that maximizes their individual training goals (for example, residents choose their own placements in order to meet their individual training needs).

Our training program is sensitive to individual differences and diversity and is predicated on the idea that psychology practice is improved when we develop a broader and more compassionate view of what it is to be human -- including human variations and differences. Our practice is improved further as we better understand the complex forces that influence a person's psychological development, including cultural, social and political factors. For these reasons, professional growth requires that the training experiences offer opportunities for interns to expand beyond their vision of the world and learn to understand the perspective of others. When this occurs, our practice can be more responsive to the needs of individuals and less constrained by our biases. For these various reasons, the residency places high value on attracting a diverse group of interns and on maintaining an awareness of diversity issues during the internship year.

Rehabilitation Psychology (Polytrauma):
The unique nature of polytrauma injuries creates the need for an interdisciplinary polytrauma program to handle the medical, psychological, rehabilitation, and prosthetic needs of these individuals. Our Polytrauma Rehabilitation Center provides both inpatient and outpatient services including a new transitional day treatment program using an interdisciplinary team consisting of physicians, rehabilitation therapists (occupational, physical, and recreation therapists), speech pathologists, neuropsychologists, psychologists, social workers, and other disciplines, with access to the full range of medical and support services within the hospital to meet the patient’s needs. The nature of these injuries requires flexible, innovative treatment approaches. The polytrauma rehabilitation environment is fast-paced and exciting, with immense opportunity to contribute to this burgeoning field.

Residents participate in psychotherapeutic and behavioral interventions, neuropsychological evaluations, ward rounds, interdisciplinary treatment team meetings, and family conferences. Residents will also participate in providing interventions to family members, who often stay in a special residence on our grounds during their loved one’s inpatient rehabilitation. Residents also participate in scholarly research activities and the Polytrauma Rehabilitation Center provides a wide range of research opportunities. These include research in pathophysiological and microstructural changes post-TBI (i.e., evoked related potentials, diffusion tensor imaging), assessment of impaired consciousness, neuropsychological predictors of rehabilitation outcome, quality of life, and community reintegration.

Psychology staff supervisors for the Rehabilitation (polytrauma) emphasis area include: Drs. Blahnik Collins , Lamberty , Lundgren, McGuire, Simm, and Wickie-Cohen.

Neuropsychology:
Training in neuropsychology focuses on brain-behavior relationships and represents a combination of clinical psychology and behavioral neurology. It involves the integration of data derived from multiple sources to assist in the evaluation and treatment of the functional deficits stemming from either congenital or acquired impairment of brain functions. Through didactic and experiential training, residents will gain proficiencies in various neuropsychological assessment techniques and instruments, interpretation of test results, and report-writing; selected methods of intervention for problems arising directly from and/or secondary to impaired brain function; and psychiatric and neurological diagnostic skill. Training will expand residents’ existing knowledge base of neuro-anatomy, neuropathology, and related neurosciences as well as focus on the further development of consultation/liaison skills in a variety of patient populations. Clinical activities will include neuropsychological screening and assessment; provision of feedback to patient, family, and referral sources; participation in interdisciplinary team patient care meetings; and direct intervention utilizing neuropsychological principles, including patient and/or family psychotherapy and/or education. Residents will have the opportunity to obtain more in-depth training in such areas as the assessment and neuro-rehabilitation of traumatic brain injury through a national DoD-DVA (Department of Defense-Department of Veterans Affairs) longitudinal treatment and research program; cerebrovascular disease; geriatrics, including the Memory Disorders Clinic through GRECC; the inpatient and transition polytrauma programs, chemical dependence; and the neuropsychology of schizophrenia.

Opportunities for supervision of graduate level trainees will be available under the guidance of postdoctoral program supervisors. The resident also will participate in research and/or other scholarly academic activity related to neuropsychology either through collaboration with ongoing research programs or through independent research projects approved by the program supervisor, mentors, and training committee. This project should culminate in the submission of such work for professional presentation or publication.

*** The Neuropsychology Emphasis within our accredited clinical psychology postdoctoral residency does not meet the full post doc requirements for neuropsychology specialty since this accredited program is for only one year. However, upon successful completion of the first year, residents in the neuropsychology emphasis area enter a second year of training that will consist of more emphasis on research, supervision, didactic instruction and generally more focused training in clinical neuropsychology. The second year of training in clinical neuropsychology is not a part of our APA-accredited postdoctoral residency program, and it is not independently accredited. However, the first and second years, taken together, satisfy Houston Conference Guidelines for specialization in clinical neuropsychology (Houston Conference Policy Statement, 1998). We are planning on applying for Specialty accreditation for what will be a two year postdoctoral residency in clinical neuropsychology in 2010. Given the two year nature of this position we recruit for it eveyy other year. The next recruiting cycle will be in the Fall/Winter of 2009/2010 for the 2010/2011 training year.

Psychology Service staff supervisors for the Neuropsychology emphasis include: Drs. Bares, Lamberty , Lundgren (ABPP), Nelson (ABPP), Simm, and Wickie-Cohen.

Serious Mental Illness:
Training in serious mental illness focuses on the use of scientific innovations and theory in the treatment of psychopathology to enhance quality of life. Training emphasizes the multifaceted nature of complex mental disorders and includes, but is not limited to, assessment of critical aspects of individuals’ mental illness and the study, development, and application of empirically-supported interventions for those with severe mental disorders. Assessment training will be centered on measuring psychopathology, personality, substance use behavior, relevant cognitive functions, and social and community functioning, along with other factors. Associated factors may include exposure to combat and other traumatic experiences and circumstances associated with aging. Interventions training focuses on empirically supported treatments that target the effects of psychopathology on quality of life, address complexities of common co-morbid conditions (e.g., alcohol dependence), and consider the role of cognitive deficits in those with severe mental disorders.

The program emphasizes the treatment and study of severe mental disorders. Residents will develop the following proficiencies: reliable and valid assessment of severe psychopathology and personality disorders, disorder-relevant cognitive functions, and factors associated with vulnerability, exacerbation, and relapse of severe and persistent mental disorders; skilled use of outcome and/or intervention research methodology; and competent implementation of an empirically-supported intervention (e.g., dialectical behavior therapy, cognitive-behavior therapy, exposure therapy, family education/intervention) for individuals with severe mental disorders.

Residents are given opportunities for intensive clinical and scholarly work in a variety of content areas in psychopathology. For example, residents may pursue study of short-term psychodynamic therapies, addictions interventions, projective assessments, family interventions, behaviorally-based interventions for anxiety disorders (including PTSD), questionnaire-based assessment of malingering and psychopathology, biological bases of seasonal affective disorder, cognitive functioning in schizophrenia, markers of genetic vulnerability for severe mental disorders, or cognitive remediation therapies. Opportunities for supervision of graduate-level trainees will be available under the guidance of postdoctoral program supervisors.

Psychology Service staff supervisors for the Serious Mental Disorders emphasis include: Drs. Arbisi Bares, Erbes, Hegeman, Hoffman-Konn, Isenhart, Kattar, Neinow, Perry, Sponheim, Peterson, Polusny, Siegel, Silversmith, Sponheim, Waden, Wagner.

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