##### VA Palo Alto Health Care System

##### Posttraumatic Stress Disorder Emphasis Area Training

#### 

#### The PTSD post doctoral fellowship emphasis area is designed in parallel with the VHA Mental Health Strategic Plan and in recognition of the anticipated need for psychologists trained to provide the highest quality of care to OIF/OEF veterans with PTSD and associated disorders. As noted in the VHA Mental Strategic Plan, care for OIF/OEF veterans is among the highest priorities in the VA\'s mental health care system. Among the VA\'s goals for this population are to promote screening and treatment for PTSD with the ultimate aim of preventing chronicity and lasting impairment.

Since national standards defining competency in the treatment of PTSD do
not currently exist, the specific skills to be developed in the PTSD
emphasis area are derived from a review of number of relevant and
respected sources (for example, the NCPTSD website and the website of
the newly established APA Division 56 Trauma Psychology) as well as from
review of existing core competencies in PTSD postdoctoral fellowships
such as the VAPAHCS MIRECC fellowship in PTSD. The seven skill areas
specified are: 1) Core PTSD assessment modalities; 2) Assessment
modalities pertaining to disorders commonly co-morbid with PTSD
including TBI, substance abuse, and anxiety disorders; 3) Empirically
validated and supported treatments for PTSD, particularly Cognitive
Processing Therapy and Prolonged Exposure; 4) PTSD research and theory,
especially that pertaining to military/combat-related PTSD; 5) Military
culture and diversity issues in the presentation and treatment of PTSD;
6) Relevant developmental, characterological, and neurological factors
in the presentation of PTSD; and 7) Therapist self-care.

The Fellow\'s major, year-long rotation will occur in the VAPAHCS Trauma
Recovery Programs which are closely affiliated with the Clinical
Education Division of the National Center for PTSD and Stanford
University. A primary Psychology Preceptor will be selected from these
programs. The Fellow and his/her preceptor will determine which training
sites, additional rotations (such as in the Polytrauma Rehabilitation
Center and Women's Prevention, Outreach, and Education Center), and
research tasks the Fellow will pursue, based on an assessment of
competencies the Fellow already has acquired and the competencies in
which he/she has not yet had experience. Additionally, decisions
regarding additional rotations and the structure of the postdoctoral
fellowship year will be based on the Fellow\'s particular interests.

The treatment modalities utilized in the Men and Women\'s Trauma
Recovery Programs are empirically-supported whenever possible, and
consist primarily of cognitive-behavioral group based treatments in the
context of a therapeutic milieu. Recently hired staff will also allow
for the inclusion of individually-based treatment such as Prolonged
Exposure. Among the current groups/interventions offered in the VAPAHCS
Trauma Recovery Programs are: Cognitive Processing Therapy (CPT),
Seeking Safety, Panic Control Therapy modified for PTSD, Harm
Reduction/Motivational Enhancement; Emotion Regulation, and Acceptance
and Commitment Therapy. Additionally, in the PRC, the Fellow would have
the opportunity to provide individual therapy, cognitive rehabilitation,
neuropsychological screening for TBI, and family psychoeducation about
PTSD and TBI; in the WPOEC, treatment modalities include both individual
and group therapy. In the provision of services to OIF/OEF veterans with
PTSD, Fellows will work with an interdisciplinary team in each setting
which may include -- in addition to psychology -- nursing, social work,
recreational therapy, occupational therapy, physical therapy, internal
medicine, gynecology, and psychiatry, as well as trainees in each of
these areas.

Attaining competencies in the skill areas outlined above defines the
fellowship program emphasis area goals and objectives. The PTSD
Psychology Fellow will spend 50% time in clinical service, 30% time in
research, and 20% time attending didactics and providing teaching and
supervision. Fellows will be encouraged to define their research
activity in terms of involvement in projects already underway at
VAPAHCS. Current research projects include: Effectiveness of Screening
and Treatment of PTSD in SUD Treatment Settings, Gender and Medical
Needs of OIF/OEF Veterans with PTSD; Gender, Era, Attitudes, Resources
and Use of PTSD Care (GEAR UP); Prolonged Exposure Implementation
Research; and Sleep in PTSD/Panic.

In the PTSD emphasis area, the Fellow\'s major, year-long rotation will
occur in the VAPAHCS Trauma Recovery Programs (formerly known as the
NCPTSD Men\'s Residential Rehabilitation Program and the Women\'s Trauma
Recovery Program). The Men\'s Trauma Recovery Program has a bed capacity
of 40 and the Women\'s Trauma Recovery Program has a bed capacity of 10.
Both programs serve a nationwide catchment area and treat all types of
military trauma and complex cases with multiple medical and psychiatric
co-morbidities, utilizing a range of interdisciplinary staff to do so.
The programs are designed to be 60 -- 90 days in length. In FY2006,
OIF/OEF returnees comprised 17.9% of the men patients who were admitted,
and 22.6% of the women patients who were admitted.

Additional PTSD settings include the Polytrauma Rehabilitation Center
(PRC) which allows the Fellow to have experience in working with
patients with acute stress/PTSD as well as TBI and other injuries
requiring physical rehabilitation; and the Women's Prevention, Outreach,
and Education Center (WPOEC) which allows the Fellow to work with female
patients with trauma histories in both outpatient mental health and
primary care settings. The Fellow will also have the opportunity to work
with researchers in the NCPTSD Clinical Education Division on new or
ongoing research (selected current projects noted in Specific Skills
section).

The actual **training plan** for the PTSD Fellow will be developed with
the assistance of a Primary Preceptor who will help plan the fellow\'s
over-all program, ensure sufficient depth and breath of experience and,
plan which of the PTSD faculty will serve as supervisors during the
fellowship year. The Training plan will specify in which of the many
possible training venues the Fellow will have comprehensive rotations
with options of mini-rotations. The aim is to ensure attainment of
general clinical competencies as well as to provide experience in each
of the emphasis area-specific competencies.

**Men's Trauma Recovery Program (Buildings 351 and 352, MPD)**

**Supervisors: Dorene Loew, Ph.D.**

> **Robert Jenkins, Ph.D.**
>
> **Jean Cooney, Ph.D.**
>
> **Jennifer Alvarez, Ph.D.**

**1. Patient population:** Men (veteran, reservist, active duty) with
military-related PTSD. Our program treats men who have experienced a
wide range of traumatic experiences, including but not limited to war
zone and combat-related trauma and military sexual trauma (MST). We are
seeing an increasing number of OIF/OEF veteran and active-duty military
personnel.

**2. Psychology's role in the setting:** Program Attending, member of
interdisciplinary treatment team, clinical services provider.

**3. Other professionals and trainees in the setting:** Psychiatrists,
Nursing Staff, Social Workers, Readjustment Counselors, OIF/OEF case
manager, Recreational Therapists, Education and Research Specialists.

**4. Nature of clinical services delivered:** This rotation emphasizes
evidence-based treatments such as Cognitive Processing Therapy for
trauma and Acceptance and Commitment Therapy, and Motivation
Enhancement/Problem Area Review Group. Residential treatment occurs
within a therapeutic community model via cognitively behaviorally-based
group therapies, psychoeducational classes, case management, and
medical/medication management.

**5. Distinctions between Men\'s and Women\'s Trauma Recovery
Programs:** Both the Men\'s and Women\'s programs function under the
broader range of Trauma Recovery Programs at the Palo Alto VA Health
Care System and as such are very similar in their clinical missions.
However, the Women\'s Trauma Recovery Programs currently treats a
greater proportion of patients with Military Sexual Trauma and,
conversely, the Men\'s Programs treats a greater number of patients with
combat-related trauma. Additionally regarding key differences, the
women\'s program carries a smaller daily census and admits by cohort
whereas the men\'s program admits patients on a rolling basis. This has
implications for the structure and implementation of groups and the
conduct of the therapeutic milieu.

**6. Fellow's role in the setting:** Each fellow will function as an
important member of an interdisciplinary team and will assist with case
conceptualization, treatment planning, case management, and the
provision of clinical services. Fellows' role in group therapy will be
commensurate with comfort level and experience, with the opportunity to
co-facilitate and individually lead therapy groups and psychoeducational
classes. This setting encourages evidenced-based treatments and applied
research, and has a reputation for clinical innovation. Fellows will
have the opportunity to provide individual or group supervision to
psychology interns and practicum students.

**7. Amount/type of supervision:** At least one hour per week of
individual supervision, and many opportunities for in-vivo supervision
within the therapeutic community.

**8. Didactics in the setting:** Participation in the Clinical Training
Program developed by the National Center's Education Division and
Clinical Laboratory, weekly fellow seminar, occasional in-service
trainings (on related topics by clinical staff and invited experts).

**9. Pace:** Fellows will be expected to write brief group and case
management process notes within 24 hours of providing these services.
Fellows will assist with the completion of psychosocial assessments,
integrated summaries, master treatment plans, and discharge summaries.

This rotation is an ideal training site for trainees interested in
developing and expanding their clinical skills. The Men's Trauma
Recovery Program (MTRP) is affiliated with the National Center for Post
Traumatic Stress Disorder and is the first and longest-standing
residential treatment program for men with PTSD. Many of our patients
have experienced multiple traumatic events and have comorbid psychiatric
diagnoses. The clinical complexity of our population and the program
intensity ensure that trainees acquire solid skills in working with
PTSD, in particular group therapy skills as well as the ability to
function effectively on an interdisciplinary treatment team.

The program is structured as a therapeutic community wherein patients
are taught basic coping, interpersonal, problem solving, and affect
management skills in group settings. They are provided psychoeducation
regarding the various effects of PTSD and have the option to participate
in Cognitive Processing Therapy where they learn to challenge beliefs
associated with traumatic memories while managing the thoughts,
feelings, and physiological symptoms this evokes. The program has
established a reputation for innovation, wherein cutting edge therapies
are thoughtfully applied and assessed. Trainees at the MTRP have the
opportunity to:

> Learn to function as part of an experienced, interdisciplinary team in
> the treatment of complex PTSD.
>
> Learn to conceptualize the effects of trauma from a variety of
> theoretical perspectives, including cognitive-behavioral and systemic
> approaches.
>
> Become adept at working with men who present with Axis II
> characteristics.
>
> Become familiar with leading therapeutic technologies in the treatment
> of trauma, including Acceptance and Commitment Therapy (ACT) and
> Cognitive Processing Therapy (CPT).
>
> Develop group therapy skills, as well as milieu interventions.
>
> Develop PTSD assessment and report writing skills.

**Women's Trauma Recovery Program (Building 350, MPD)**

**Supervisor: Jean Cooney, Ph.D.**

**1. Patient population:** Women (veteran, reservist, active duty) with
military-related PTSD. Our program treats women who have experienced a
wide range of traumatic experiences, including war zone and
combat-related trauma, military sexual trauma (MST), and traumatic
experiences that may have occurred pre-and postmilitary service. We are
seeing an increasing number of OIF/OEF women, many of whom have
experienced both MST and combat-related trauma.

**2. Psychology's role in the setting:** Program Attending, member of
interdisciplinary treatment team, clinical services provider.

**3. Other professionals and trainees in the setting:** Psychiatrists,
Nursing Staff, Social Workers, Clinical Specialists, OIF/OEF case
manager, Recreational Therapists, Education and Research Specialists.

**4. Nature of clinical services delivered:** This rotation emphasizes
evidence-based treatments such as Cognitive Processing Therapy for
trauma, Acceptance and Commitment Therapy, Functional Analytic
Psychotherapy, and Seeking Safety. Residential treatment occurs within a
therapeutic community model via group therapies, psychoeducational
classes, trauma exposure groups, and case management.

**5. Fellow's role in the setting:** Each fellow will function as an
important member of an interdisciplinary team and will assist with case
conceptualization, treatment planning, case management, and the
provision of clinical services. Fellows' role in group therapy will be
commensurate with comfort level and experience, with the opportunity to
co-facilitate and individually lead therapy groups and psychoeducational
classes. This setting encourages evidenced-based treatments and applied
research, and has a reputation for clinical innovation. Fellows will
have the opportunity to provide individual or group supervision to
psychology interns and practicum students.

**6. Amount/type of supervision:** At least one hour per week of
individual supervision, and many opportunities for in-vivo supervision
within the therapeutic community (e.g., group therapy, milieu, team
meetings)**.** Group therapy is also possible depending on cohort size
and interests.

**7. Didactics in the setting:** Participation in the Clinical Training
Program developed by the National Center's Education Division and
Clinical Laboratory, weekly fellow seminar, occasional in-service
trainings (on related topics by clinical staff and invited experts).

**8. Pace:** Fellows will be expected to write brief group and case
management process notes within 24 hours of providing these services.
Fellows will assist with the completion of psychosocial assessments,
master treatment plans, and discharge summaries.

This rotation is an ideal training site for trainees interested in
developing and expanding their clinical skills. A cornerstone of the VA
Palo Alto Health Care System [Women's Mental Health
Center](http://www.womenvetsptsd.va.gov/), the Women's Trauma Recovery
Program (WTRP) is the first and longest-standing residential treatment
program for women with PTSD, and 80% of our patients come to us from
out-of-state. Many have experienced multiple traumatic events, including
both military and childhood sexual trauma. The clinical complexity of
our population and the program intensity ensures that trainees acquire
solid skills in working with PTSD, in particular group therapy skills as
well as their ability to function effectively on an interdisciplinary
treatment team.

The program is structured as a therapeutic community wherein patients
are taught basic coping, interpersonal, problem solving, and affect
management skills in group settings. They are provided psychoeducation
regarding the various effects of PTSD, and are guided via Cognitive
Processing Therapy to head into traumatic memories while managing the
thoughts, feelings, and physiological symptoms this evokes. The program
has established a reputation for innovation, a program in which cutting
edge therapies are thoughtfully applied and assessed. Trainees at the
WTRP have the opportunity to:

> Learn to function as part of an experienced, interdisciplinary team in
> the treatment of complex PTSD.
>
> Learn to conceptualize the effects of trauma from a variety of
> theoretical perspectives, including cognitive-behavioral and systemic
> approaches.
>
> Become adept at working with women who present with Axis II
> characteristics.
>
> Become familiar with leading therapeutic technologies in the treatment
> of trauma, including Acceptance and Commitment Therapy (ACT), Seeking
> Safety, Functional Psychoanalytic Therapy (FAP), and Cognitive
> Processing Therapy (CPT).
>
> Develop group therapy skills, as well as milieu interventions.
>
> Develop PTSD assessment and report writing skills.

**Acceptance and Commitment Therapy (Mini-Rotation)**

**Available at both the Men's and Women's Trauma Recovery Programs**

**Supervisors: Robyn Walser, Ph.D.**

**David Rogers, LCSW**

Acceptance and Commitment Therapy (ACT) is a behaviorally based
intervention designed to address avoidance of internal experiences such
as negative thoughts, emotions and sensations while also focusing on
making powerful life enhancing choices that are consistent with personal
values. ACT demonstrates the role that language plays in human suffering
and specifically undermines this role with experiential exercises,
mindfulness practice, use of metaphor and focus on defining values. ACT
is a manual-based intervention that can be applied with a number of
populations. The mini-rotation will provide a combination of didactic
and supervised clinical experience in the use of ACT with PTSD patients
at the National Center for PTSD and with patients from the Mental Health
Clinic, Menlo Park.

**Posttraumatic Stress Disorder Clinical Team** **(PCT)**

**Supervisor: Gretchen K. Lindner, Ph.D.**

1.  **Patient population:** Men and women (veterans, reservists, active
    duty personnel) with PTSD, many of whom have additional comorbid
    diagnoses. The PCT provides assessment and psychotherapy to
    individuals with a wide range of traumatic experiences, including
    combat trauma, training accidents, military sexual trauma, and
    childhood trauma. A significant number of our patients are returning
    veterans from Operation Iraqi Freedom (OIF) and Operation Enduring
    Freedom (OEF).

2.  **Psychology's role in the setting:** Psychologists are an integral
    part of the interdisciplinary treatment team, working closely with
    the PCT social worker and recreational therapist. Psychologists also
    work closely with the Mental Health Clinic staff, coordinating care
    with case managers, nursing staff, and psychiatrists. The
    psychologists\' primary role is direct service provision, offering
    veterans individual and group psychotherapies for PTSD. We also
    provide PTSD assessment and staff consultation.

3.  **Other professionals and trainees in the setting:** Psychology
    interns, psychology practicum students, psychiatry residents, social
    workers, nurses, and psychiatrists.

4.  **Nature of clinical services delivered:** The PCT places an
    emphasis on empirically-supported treatments for PTSD, but
    integrates treatment interventions from a variety of modalities.
    There are opportunities to provide individual psychotherapy (e.g.,
    Prolonged Exposure, Cognitive Processing Therapy,
    Skill-Building/CBT, Acceptance and Commitment Therapy) and group
    psychotherapy (e.g., PTSD Education, OIF/OEF Readjustment, Seeking
    Safety). The PCT also completes thorough PTSD assessments (e.g.,
    CAPS) and aids in treatment planning. Fellows will also provide
    consultation to MHC and Substance Abuse Program staff.

5.  **Fellow's role in the setting:** Fellows will have the opportunity
    to provide both individual and group psychotherapies. Depending on
    level of interest and skill, fellows can choose to start a
    PTSD-relevant group of interest to them. Fellows are also involved
    in the triage, assessment, and treatment planning of PCT patients.
    Participation in team meetings and didactic trainings is also part
    of this rotation. Fellows may have the opportunity to provide
    individual or group supervision to psychology interns and practicum
    students.

6.  **Amount/type of supervision:** At least one hour of individual
    supervision will be provided and fellows will participate in one
    hour of group supervision with other psychology trainees. In
    addition, there are ample opportunities for in-vivo supervision
    through co-leading groups, as well as live and videotaped
    supervision. The supervisor works from an integrated perspective,
    examining CBT, interpersonal, systemic, and psychodynamic factors.

7.  **Pace:** The PCT clinic has a steady workload. Expectations around
    number of assessments, individual clients, and groups per week will
    be set collaboratively at the start of the rotation (based on
    fellow\'s interests and skills). Fellows will be expected to write
    individual, group, and assessment notes in a timely and professional
    manner. Given the emotional intensity of some of the psychotherapies
    provided (e.g., prolonged exposure) there is also a strong emphasis
    on self-care.

This rotation is a great fit for anyone who is interested in gaining
initial or additional expertise in the outpatient treatment of PTSD and
its associated features. The PCT rotation aims to help you build
foundational knowledge of PTSD, as well as an understanding of the
triaging, assessment, case conceptualization, case management, and
multidisciplinary treatment of veterans with PTSD. We help to build
these skills by providing you with opportunities to conduct thorough
PTSD assessments; to conduct individual psychotherapy; to co-lead
psychotherapy groups/classes; to participate in team meetings and
didactic presentations; to take part in individual and group
supervision; and to function as an integral part of a multidisciplinary
team. Additionally, you will be exposed to numerous evidence-based
treatments, including Prolonged Exposure, Cognitive Processing Therapy,
Seeking Safety, CBT for PTSD, and Acceptance and Commitment Therapy.
There are also opportunities for program development, as we are
continuing to assess and adjust our approach to treating veterans with
PTSD, based on new research findings, feedback from veterans, and
increasing experience with OIF/OEF veterans.

**National Center for Post Traumatic Stress Disorder**

**Dissemination and Training Division (Building 334, MPD)**

Supervisors:

  ----- -----------------------------------------------------------------
        **Eve Carlson, Ph.D.**

        **Kent Drescher, Ph.D.**

        **Afsoon Eftekhari, Ph.D.**

        **Rachel Kimerling, Ph.D., Director, Military Sexual Trauma
        Support Team**

        **Eric Kuhn, Ph.D.**

        **Craig Rosen, Ph.D., Acting Deputy Director, NCPTSD
        Dissemination and Training Division**

        **Josef Ruzek, Ph.D., Acting Director, NCPTSD Dissemination and
        Training Division**

        **Pamela Swales, Ph.D.**

        **Robyn Walser, Ph.D.**

        **Steve Woodward, Ph.D., Director, PTSD Sleep Laboratory**
  ----- -----------------------------------------------------------------

**1. Patient population:** Vietnam veterans comprise the majority of VA
PTSD patients nationwide, but projects also include Iraq and Afghanistan
veterans, veterans exposed to military sexual trauma, and veterans of
WWII, Korea, and the first Gulf War. Ongoing research is also conducted
on hospital patients with traumatic injuries and family members of
gravely injured hospital patients.

**2. Psychology\'s role:** NCPTSD educators, many of whom are
psychologists, play a nationwide leadership role in disseminating
state-of-the-art treatments for PTSD, including two national VA
initiatives to train clinicians in evidence-based treatments, a
mentoring program for heads of PTSD clinics, and video and web-based
trainings for clinicians and web-based educational materials for trauma
survivors. NCPTSD researchers, most of whom are psychologists conduct
evaluations of VA mental health services, clinical intervention trials,
assessment development studies, biological research, and neuroimaging
studies.

**3. Other professionals and trainees:** Psychiatry, Research, Social
Work, Public Health, Psychology Practicum Students.

**4. Nature of clinical services delivered:** Limited clinical services
are delivered as part of specific research trials.

**5. Fellow\'s role:** The training needs and interests of the fellow
define the mix of disseminaton and research activities. Fellows
interested in dissemination work with National Center education staff to
develop PTSD-related educational products and services with potential
for wide dissemination, or to take on a significant role in an ongoing
dissemination project. Fellows interested in research work with a mentor
to develop and implement a research project related to one of NCPTSD's
ongoing studies. Research fellows are expected to develop a report of
their project that is suitable for presentation at a scientific
conference and/or publication in a peer-reviewed journal. Fellows may
also have an opportunity to participate in delivery of interventions in
ongoing clinical trials.

**6. Amount/type of supervision:** One or two mentors are assigned to
each fellow. Supervision will be as needed, typically involving several
face-to-face meetings per week.

**7. Pace:** The goal of completing a research project or education
project from conception to write up within six months requires skillful
time management. Rotation supervisors help the fellow develop a rotation
plan.

The National Center for Post Traumatic Stress Disorder
([NCPTSD](http://www.ncptsd.va.gov/ncmain/about/divisions/education_div/index.html))
is a congressionally mandated consortium whose goal is to advance
understanding of trauma and its consequences. The Dissemination and
Training Division at the Palo Alto VAPAHCS, Menlo Park Division is one
of seven National Center divisions located at five sites. The others are
located in Boston (Behavioral Science Division and Women's Health
Sciences Division), Honolulu (Pacific Islands Division), West Haven
(Evaluation Division and Clinical Neurosciences Division) and White
River Junction, Vermont (Executive Division).

Fellows may participate in ongoing research choosing from a variety of
research opportunities. These include ongoing studies evaluate VA
policies related to screening, detection and treatment of PTSD, military
sexual trauma, and other deployment-related health conditions, clinical
trials of psychosocial interventions, psychometric instrument
development, novel assessment methods development, laboratory and
ambulatory psychophysiological studies, laboratory and ambulatory sleep
studies, neuroimaging, longitudinal studies of the course of PTSD, and
systems of care for recent trauma survivors. Cognitive, affective,
psychobiologic and spiritual domains of PTSD are under investigation, as
are related health service delivery issues.

Fellows may participate in a broad range of dissemination and training
initiatives. Current dissemination/implementation activities of the
Education Division include two nationwide initiatives to train VA
clinicians in Prolonged Exposure and in Acceptance and Commitment
Therapy, development of video and web-based training materials for VA
and military clinicians, patient education and self-help materials for
military personnel and civilians exposed to trauma, and training
military chaplains and mental health staff in PTSD care.

Trainees at the NCPTSD have the opportunity to:

-   Learn to conceptualize the after-effects of trauma from a variety of
    theoretical perspectives---primarily cognitive-behavioral,
    biological, and spiritual;

-   Gain an understanding of factors that influence implementation of
    best care practices for PTSD in a national treatment system;

-   Learn about effective means of disseminating and training clinicians
    in PTSD treatments.

-   Gain further exposure to PTSD clinical research; and/or,

-   Gain experience in evaluating quality of care for PTSD.

NCPTSD has strong collaborative relationships with several other
clinical and research programs at the Palo Alto VA, including the Men's
Trauma Recovery Program, the Women's Trauma Recovery Program, the
Sierra-Pacific Mental Illness Research, Education and Clinical Center
(MIRECC), the Center for Health Care Evaluation (CHCE), the Program
Evaluation and Resource Center (PERC), and the Health Economics Research
Center (HERC).

**NC - PTSD -- Research on Women and Gender (Building 334, MPD)**

**Supervisor: Rachel Kimerling, Ph.D.**

1.  **Patient population:** Study participants are Veteran and civilian
    men and women exposed to traumatic stressors

2.  **Psychology's role:** Psychologists working in research settings
    collaborate with clinicians, policy-makers and administrators in an
    effort to better understand and treat posttraumatic stress among men
    and women.

3.  **Other professionals and trainees in the setting:** Trainees can
    expect to collaborate with other VA research and clinical staff.
    There is significant collaboration with the Women's Mental Health
    Center and other VA clinics. Trainees may also benefit from
    consultation with epidemiologists, statisticians, and other
    professionals who collaborate with the research team.

4.  **Nature of clinical services delivered:** No direct clinical
    services are delivered.

5.  **Fellow's role in the setting:** In consultation with supervisor,
    fellows develop and implement a research project that is part of an
    ongoing study. This project is expected to include participation in
    preparation of a presentation at a scientific conference and/or
    publication in a peer-reviewed journal.

6.  **Amount/type of supervision**: Fellows can expect to work closely
    and collaboratively with the supervisor. Supervision includes
    participation in group research meetings and individual,
    face-to-face supervision on a weekly basis. Additional meetings with
    the supervisor are scheduled as-needed.

7.  **Didactics in the setting:** Fellows have the opportunity to
    participate in NC-PTSD seminars and the interdisciplinary PTSD and
    Health Services Research-in-progress group. The fellow and
    supervisor will select readings together that are tailored to the
    research project.

8.  **Pace:** The research project will be structured so that it can be
    completed during the rotation. The supervisor will assist the fellow
    in developing a plan for the rotation that helps the fellow best
    meet their training needs and goals.

General topics of current research projects include:

-   The epidemiology of PTSD among civilian women

-   Issues of sexual assault and intimate partner violence as they
    pertain to welfare and other social policies

-   Screening for PTSD in clinical settings

-   Gender differences in PTSD among Veterans

-   How to address interactions among gender, ethnicity, and
    socio-economic status in providing services to individuals with PTSD

    This rotation is an ideal opportunity to complement the clinical
    skills gained on fellowship with clinically relevant research
    experience. This rotation may be especially interesting to
    individuals considering an academic career in psychology. Fellows
    may learn skills including qualitative and quantitative research
    design, psychometrics, project administration, data analysis, and
    statistical programming in SPSS, SAS, and/or Stata. Fellows also
    will receive mentoring on professional development as a
    scientist-practitioner, e.g., using clinical experiences in the
    formulation of research questions, scientific writing, including
    journal articles and grant proposals. Individuals interested in this
    rotation are encouraged to contact the supervisor prior to the start
    of the rotation.

This document was last reviewed on 9/29/2008 by Jeanette Hsu.