Psychology Internship Program Southeast Louisiana Veterans Health Care System



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Training Experiences



Clinical Rotations

Within many rotations, an area of responsibility is performing compensation and pension evaluations for veterans applying for service-connected disability status. On average, an intern completes approximately one examination per week.


Ambulatory Mental Health (AMH)

Supervisors:  Shannon Hartley, Ph.D

Working within the framework of the Mental Health Clinic, multidisciplinary staff provides comprehensive mental health services to veterans suffering such mental disorders as anxiety and mood disorders, personality disorders, adjustment disorder, and psychotic disorders. Interns will conduct evaluations for new veterans coming into the VA to seek treatment.  These evaluations will emphasize the development of the intern’s ability to formulate diagnostic impressions and treatment plans.  Additionally, interns will administer psychological assessments with veterans requiring diagnostic clarification.  For both evaluations and assessments, report writing skills will be developed throughout the rotation.  Interns will also be assigned short-term individual therapy cases within this rotation. Attempts will be made to accommodate interns’ interests and areas of growth. If interested, interns will have the opportunity to develop time-limited group therapies in a subject of expertise.


Health Psychology and Behavioral Medicine

Supervisor:  Karen Slaton, Ph.D

In health psychology and behavioral medicine, interns function as consultants on the psychosocial and behavioral aspects of disease expression, control, and prevention in addition to providing brief, solution focused behavioral health treatment for adjustment issues and less severe mental illness.  With potential involvement among several outpatient clinics, the Southeast Louisiana Veterans Health Care System offers opportunities for applying principles of health psychology and behavioral medicine in primary and specialty health care service delivery.  Interns share responsibilities for providing acute and extended treatments for a wide range of emotional and behavioral complications of disease, medical and surgical procedures, hospitalization, and associated family crises.  The module encompasses:



  • Primary Care Mental Health Integration

    • Brief solution focused treatment for depression, anxiety and adjustment issues

    • Health coaching for health promotion and disease prevention utilizing motivational interviewing

    • Treatment of chronic pain in primary care setting

  • Assessment of patients prior to solid organ transplants, interferon treatment, bariatric surgery, and implantation of dorsal column stimulators

  • Group treatment for pain management, weight control and smoking cessation

  • Assessment and treatment of veterans with chronic illness

  • Behavioral treatment experiences include:

    • Cognitive restructuring therapies (pain control, insomnia, adherence)

    • Clinical Hypnosis (pain control)

    • Relaxation training(meditation, yoga)

  • Consultation and interprofessional treatment planning with primary care and specialty medical care providers

  • Training emphasis is directed toward functioning within a multidisciplinary medical treatment team in primary care and surgery (anesthesia pain clinic).

Community Based Outpatient Clinics: Primary Care Behavioral Health

Supervisor in LaPlace: Michele Carroll, Psy.D.

Supervisor in Slidell:Sheila Corrigan, Ph.D.

This rotation will emphasize development of skills needed to integrate psychological services within interdisciplinary treatment teams in medical contexts.

Major components of this rotation include brief evaluation and treatment of clinical and health psychology problems;


  • Triage decision-making to prioritize service delivery; consultation and collaboration with primary care providers for psychological and medical management

  • Psychological assessment, individual and group psychotherapy

  • Referral to specialty mental health programs, and coordination of care with the onsite psychiatrist/mental health staff

Interns have the opportunity to take part in leading empirically based treatment groups on topics such as sleep, pain, mastering emotions, and other chronic medical ailments. On this rotation, interns will gain experience working with problems that have psychological origins (mood, anxiety, substance abuse, sleep, adjustment, and anger management).  In addition, interns will have the opportunity to develop skills in promoting healthy behaviors (i.e. physical activity) and help patients resolve other medically-related problems (i.e. pain management, treatment adherence, coping with illness, and disease management). 
Evidence Based Psychotherapy for PTSD & Related Disorders

Supervisor:   C. Laurel Franklin, Ph.D.

Students working with Dr. Franklin in the Evidence Based Psychotherapy rotation will have an opportunity to gain training and experience in treating PTSD and Subthreshold PTSD with Prolonged Exposure (PE) or Cognitive Processing Therapy (CPT). Students will receive intensive training in the EBP of choice and carry up to three cases in the General PTSD clinic. Group supervision for PE therapy is a requirement if that therapy is chosen. Engaging in research or program development is encouraged under this rotation. In addition to EBP cases, interns will:



  • Carry short-term CBT cases for PTSD-related symptoms

  • Conduct individual sessions of CBT for insomnia

  • Conduct individual sessions of Imagery Rehearsal Therapy (IRT) for reoccurring posttraumatic nightmares

  • Conduct PTSD treatment intakes, including administering the Clinician Administered PTSD Scale (CAPS) for DSM-5

  • Engage in biofeedback for anxiety reduction, if desired.

  • Attending EBP Journal Club once per month

  • Review journal articles submitted for peer-review from a variety of psychology and psychiatric journals.

  • Co-lead the Korean War Support group



General PTSD

Supervisor:  Michelle Hamilton, Ph.D, Madeline Uddo, Ph.D

Students working with Dr. Hamilton and Dr. Uddo will work with veterans with PTSD and Subthreshold PTSD related to military service.  Students working with Dr.’s Hamilton and Uddo will conduct PTSD intake evaluations and possibly compensation and pension evaluations.  Students may opt to receive training in Acceptance and Commitment Therapy with Dr. Hamilton.  They may also opt to participate in Mind Body Medicine Skills Groups.  Interns will co-lead a relationship module in the Trauma, Recovery, and Wellness Program with Dr. Hamilton.




Military Sexual Trauma

Supervisor: Lisa-Ann Cuccurullo, Psy.D.

Training experiences are provided in the assessment and treatment of military sexual trauma (MST) in both female and male veterans.  This rotation includes intake assessment (clinical interview and psychometric evaluation), individual psychotherapy, and group psychotherapy.  In assessment, there is an emphasis on case conceptualization, differential diagnostic formulation, identification of therapeutic targets and the prioritization of these targets for intervention. In treatment, there is an emphasis is placed on Evidenced-Based Psychotherapies (EBP’s). Trainees can select instruction in Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), or Prolonged Exposure (PE).  Training in all therapies includes: didactics, readings, and supervised clinical application with veterans. 



ACT: Interns are able to co-facilitate an ACT group, have individual ACT patients, and co-facilitate a Mindfulness group.

DBT: Interns are able to conduct individual DBT, conduct DBT program psychological assessments, and co-facilitate a Mindfulness group.

PE: Interns are able to attend a weekly PE consultation group, maintain a caseload of PE patients, and have supervision based on audio tapes of PE sessions.

The intern may wish to engage in other experience such as: scholarly writing and research, ad hoc journal review with supervisor, and learning the Imagery Rehearsal Training for recurrent nightmares and the Clinician Administered PTSD Scale (CAPS).


Neuropsychology

Supervisor: John Mendoza, Ph.D.

The SLVHCS neuropsychologist collaborates with other health care professionals in the diagnosis and management of known or suspected neurological syndromes.

This includes:


  • Providing diagnostic assessments to rule out non-neuropathological factors that might account for, or contribute to, the presenting complaints

  • Offer descriptions of cognitive-behavioral impairments associated with brain injury or compromise, define residual assets

  • Outline patient management strategies

  • Encourage adaptive skills necessary for normal daily living

Interns learn to apply specialized psychological and neuropsychological techniques in the evaluation and management of patients referred by Mental Health, Substance Abuse, Neurology, and Ambulatory Care Clinics. In addition, the SLVHCS is currently engaged in the routine assessment of traumatic brain injury in veterans returning from the Middle East. Standardized neuropsychological tests, mental status examinations, behavioral observation and assessment, and selected experimental procedures are used to define specific behavioral, cognitive, perceptual, and sensorimotor deficits. Following a process-oriented approach, qualitative and hierarchical analyses of test performance and behavioral deficits are emphasized. Formal neuropsychological testing is complemented by traditional psychological assessment, including use of individual and family interviews and objective personality measures to assess emotional and behavioral problems which often accompany brain injury and impact negatively on rehabilitation efforts, self-image, and/or social adjustment. There are opportunities for interns to provide individual and family consultations, and render specialized forms of treatment interventions such as cognitive retraining. Options are also available for applied clinical research in neuropsychology.
OEF/OIF/OND: Trauma

Supervisor:   Julie Arseneau, Ph.D.

Embedded within the PTSD Clinical Team, the OEF/OIF/OND Program provides trainees an opportunity to work with post-9/11 combat veterans along the spectrum of post-deployment and post-trauma reactions.  The rotation emphasizes the development of critical skills in the diagnosis and treatment of PTSD, with intervention typically being provided in a time-limited, individual modality.  Interns may elect supervised experience using Prolonged Exposure or Cognitive Processing Therapy for PTSD, though a range of therapeutic approaches with demonstrated effectiveness (e.g., psychodynamic, interpersonal, cognitive, behavioral) is supported and encouraged.  Other components of the training experience include attention to the engagement of OEF/OIF/OND veterans, provision of psychoeducation, and enhancement of treatment motivation and participation.

Supplemental experiences vary in availability, and according to trainee interest, skills, and need.  These may include: program evaluation and development, scholarly writing projects, participation in multidisciplinary team meetings, and group therapies.
Psychosocial Rehabilitation (PSR)

Supervisor: Baris Konur, Psy.D.

This rotation will emphasize development of skills needed to provide psychological services to a population with serious mental illness (SMI).

Major components of this rotation include evaluation and treatment of clinical and psychosocial problems both within an outpatient clinical setting and out in the community;


  • Collaborate and work hand-in-hand with the Mental Health Intensive Case Management (MHICM) team

  • Outreach to Veterans with SMI that are lost to care via the SMI Re-Engage Program

  • Collaborate and consult with community providers and other stakeholders

  • Provide group psychoeducation as part of the Psychosocial Recovery Program

  • Provide education to staff and community stakeholders on SMI, Veteran issues, and other relevant topics

Interns have the opportunity to take part in promoting recovery principles and providing mental health care outside of a traditional outpatient setting.  The rotation is highly customizable and allows the intern a large amount of flexibility in what services are provided depending on interests.  In addition, interns are provided the opportunity to participate in activities that are outside of what is commonly thought of as “VA psychologist” activities.  As this rotation is set within a community based outpatient clinic, interns will also gain experience working with problems that have biopsychosocial origins (mood, anxiety, substance abuse, sleep, adjustment, life stressors, medical conditions, pain, and anger management). 

PTSD & Substance Use

Supervisor: Joseph Vigil, Ph.D., Jessica Walton, Ph.D

This rotation will provide interns with exposure to integrated treatment of the often co-morbid Posttraumatic Stress Disorder and substance use disorders (PTSD/SUD).  Along with providing evidence-based integrated treatment to this population, interns will also serve as members of and consultants to the PTSD team and the Substance Abuse Treatment Program (SATP) and will have the opportunity to work with providers from others disciplines (Psychologists, Psychiatrists, Social Workers, Addiction Therapists, Counselors, and Vocational Rehabilitation workers), usually aiding in the identification of co-morbidity coordination of care, treatment planning, and provision of services.


Research 

Interns may select up to the equivalent of approximately six hours per week for research. Under some circumstances, interns may split research training with clinical rotation assignments. Emphasis is placed on development and implementation of an advanced curriculum that will promote intern skills and experiences in clinically relevant research.  Specifics of the research module may vary widely to reflect the diversity of ongoing research programs and opportunities available to interns.  In addition to the potential research opportunities afforded within clinical rotation settings, a number of formal research programs underway at the SLVHCS may provide opportunities for research experience.  The following projects represent a selected but non-exhaustive sample of ongoing investigations in which interns may become involved.  Projects not listed in this description may also become available to interested interns by the beginning of the next training year.


In the PTSD Program, ongoing research projects led by Dr. Laurel Franklin include using teleconferencing to deliver CBT for Insomnia; a study differentiating shame and guilt in veterans seeking treatment for PTSD; a validation of a measure of posttraumatic nightmares; and examination of treatment readiness in patients presenting for PTSD treatment.   Dr. Sautter, in the Family Program, is investigating ways to use couple-based interventions to engage OEF/OIF veterans into evidence-based PTSD treatments.  Dr. Constans, ACOS of Research, is currently involved in studies involving cognitive biases modification.  
In addition, it is possible that fellows may conduct their own research projects, possibly through a MIRECC pilot grant, or without funding source.  Supervision of these activities would be conducted by psychologists in the emphasis area of the project and concurrence by the preceptor.
Telemental Health: PTSD and trauma

Supervisor: Amanda S. Vaught, Psy.D.

With telemental health becoming the wave of future, the office of VA mental health has placed a great deal of time and attention to this area of practice. Interns working with Dr. Vaught will have an opportunity to learn evidence based assessment and treatment of Veterans who present from varying eras, with a wide variety of presenting traumas and comorbid issues (Vietnam, OEF/OIF/OND, Military Sexual Trauma, dual-diagnosis, etc.). As such, interns will be trained in the diagnosis of PTSD using the CAPS as well as trained in the treatment of PTSD/Trauma using Cognitive Processing Therapy (CPT) and/or Prolonged exposure therapy (PE), via telemental health. Opportunities to begin or lead a CPT group using this interface may also available. A strong emphasis will be placed on the creation and maintenance of the therapeutic alliance while using these treatment modalities on this rotation. Similarly, interns will gain experience navigating, collaborating, and developing relationships with multiple treatment teams and administrative staff from various CBOCs within the Southeast Louisiana Veterans Health Care System. Interns will further learn the administrative, ethical, and logistical issues that emerge while doing therapy via computer-based interface. Finally, if available, Dr. Vaught will include interns on administrative or program development projects as this is an essential feature to successful practice in telemental health.


Substance Abuse Treatment Program

Supervisor:  Mercedes Carswell, Ph.D.

The SLVHCS SATP provides outpatient services for veterans with substance use disorders. The program maintains a 12-Step emphasis but incorporates cognitive-behavioral and motivational principles. Community resources (e.g., AA/NA, Celebrate Recovery) provide additional support. The majority of veterans in SATP meet diagnostic criteria for another psychiatric disorder, including mood disorders, anxiety disorders (particularly PTSD), psychotic disorders, and personality disorders. Therefore, there is a heavy emphasis on dual diagnosis during the rotation. Interns will become a member of a multidisciplinary treatment team consisting of professionals in psychiatry, social work, nursing, and addiction therapy. The primary treatment modality in SATP is group therapy which allows interns an opportunity to co-lead/lead multiple groups including:



  • Intensive Outpatient (IOP)

  • Motivational enhancement

  • Relapse prevention

  • Anger management

Interns may also provide individual psychotherapy, conduct psychological assessments, and offer consultation for treatment and discharge planning. Opportunities to assist in ongoing program development are available.
Additional Training Experinces: available to trainees, however not as formal rotations:
Couple and Family Interventions

Supervisor: Frederic Sautter, Ph.D.

Students may work with Dr. Sautter to learn basic couple therapy skills while also learning to conduct a couple-based PTSD treatment. Teaching will be conducted within the context of a family long-term case format treating three couples over the course of a year. The first month consists of didactics and supervision involve review of videotapes of couple sessions. Training includes conducting couple therapy using clinical video technology.


Suicide Prevention:

Supervisor:William Hill, Psy.D

The Suicide Prevention office works closely with mental health and primary care providers to coordinate care for Veterans deemed high risk for suicide. This includes managing the high risk list to ensure that Veterans are being seen within the high risk protocol guidelines; and consulting with providers on complex cases where suicide risk is a concern. In addition, the Suicide Prevention office accepts crisis calls and responds to consults placed by the National Veterans Crisis Line. Suicide Prevention acts as consultants with hospital management on mental health protocols and procedures related to suicide prevention and investigates reports of patient suicides. Interns will learn from the VA’s nationally recognized “best practices” in suicide prevention, working alongside the suicide prevention staff with veterans determined to be at high risk for suicide. Interns generally will be seeing clients with another provider in the room and this rotation comes with extensive supervision due to the nature of high risk clientele. Interns may also participate in researching and completing a root cause analysis of aggregate patient suicides for VA leadership.


Didactics:

General In-serviceTraining:

Psychology interns are provided an ongoing series of weekly presentations on areas of assessment and treatment interest. Presenters include VA and academically affiliated psychologists and psychiatrists, psychology interns, and fellows.Some of the topics from past didactics include, CBT for Insomnia, Psychotropic medication, CAPS training, Licensure, Board Certification, and Professional Identity, Somatization, Suicide in the VA community, Private Practice, ACT training,and Attachment Theory. Participation in the in-service component of the internship is required to help maximize intern exposure to the expertise of mental health professionals within the VA and community.


Presentations:

Each intern makes a minimum of two presentations during the training year. The focus of the presentations are:



  • A clinical scholarship presentation on a research topic

  • A presentation on current issues in diversity and multicultural psychology


Assessment Training:

The SLVHCS internship believes that psychological assessment is a core competency of the applied psychologist. Our interns participate in a weekly assessment didactic series as a part of the training program. Over the course of the didactic series, interns receive instruction from staff psychologists on the fundamental aspects of psychological testing as well as supervised training in the administration, scoring, interpretation, and presentation of tests commonly utilized by practicing psychologists. Interns are required to complete at least two comprehensive, integrated assessment reports as a part of the assessment didactics.  They will present one of these assessment cases as part of the didactic.



Multicultural Training:

All interns participate for a minimum of 3-4 months in a weekly seminar course on multiethnic/multicultural psychiatric practice, offered at the Tulane University School of Medicine. This inservice is both for interns from Tulane and from SLVHCS. Topic areas include, Undoing Racism, Diversity in Clinical Practice, Diversity in Research, Working with Diverse Populations, and Becoming Culturally Competent.


Professional Identity and Development:

Interns attend 3-4 months of weekly seminars in the area of Professional Identity and Development. These are held in conjunction with the Tulane University School of Medicine Internship program. Examples of topic areas include, CV Preparation, Negotiating Contracts/Business Issues, Academic Mentoring, Supervision, Forensic Assessment, and Developing a Research Career.


Ethics:

Interns attend 3-4 months of weekly seminars at the Tulane University School of Medicine in the area of Ethics. Examples of topic areas include, Psychotherapy, Children and Families, Testing and Research, and Legal Cases.


Additional Didactics:

Interns are also encouraged to attend lectures, seminars, and case conferences offered by affiliated medical schools and community groups and to participate in annual scientific meetings. During each year, the Training Program also attempts to offer specially scheduled presentations, workshops, and seminars for trainees and staff by nationally known scientist practitioners in psychology and related disciplines.


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