> ![](media/image1.png){width="1.125in"
> height="1.4166666666666667in"}**Psychology Postdoctoral Fellowship**
>
> **Director, Psychology Training Program (116B)**
>
> Department of Veterans Affairs Medical Center
>
> 1601 SW Archer Road
>
> Gainesville, Florida 32608-1197
>
> *(352) 374-6020*
>
> ***\
> **<http://www.northflorida.va.gov/>*
>
> **Application due date: December 15^th^, 2008**

## Accreditation Status

The postdoctoral fellowship at the **North Florida/South Georgia
Veterans Health** System is fully accredited by the Commission on
Accreditation of the American Psychological Association.\
The next site visit will be during the academic year 2013.

## Application & Selection Procedures 

**Eligibility Requirements**

Applicants must have completed all requirements of an APA-accredited
doctoral program in clinical or counseling psychology, including an
APA-accredited internship, prior to the fellowship start date.
Applicants are required to have a strong interest in geriatrics, PTSD,
or substance abuse issues and treatment with a long-term goal to provide
service and contribute to these areas in psychology.

***To apply, candidates should submit the following by December 15,
2008:***

-   a cover letter stating training, research, and career goals as well
    as the special emphasis area for which you are applying
    (Geropsychology or Substance Abuse)

-   a current vita, including anticipated graduation date

-   a copy of your APPIC internship application

-   a letter of recommendation from your internship training director,
    describing progress and anticipated completion date

-   a letter of recommendation from the dissertation chair describing
    progress on your dissertation and specifying your defense date (if
    applicable)

-   a letter of recommendation from someone knowledgeable about your
    work in the special emphasis area for which you are applying

-   transcripts of all graduate work

-   an abstract of your dissertation and a copy of another scholarly
    work

**Applications should be directed to:**

> ***Marianne Freeman, Ph.D.***
>
> Director, Psychology Training Program (116B)
>
> Department of Veterans Affairs Medical Center
>
> 1601 SW Archer Road
>
> Gainesville, Florida 32608-1197
>
> *(352) 374-6020*
>
> *E-mail: <mmarianne.freeman@va.gov>*

**Inquiries should be directed to:**

> Director of Training: [Marianne Freeman,
> Ph.D](mailto:marianne.freeman@va.gov).
>
> Preceptor for Substance Abuse Special Emphasis: [George Shorter,
> Ph.D.](mailto:george.shorter@va.gov)
>
> Preceptor for Geropsychology Special Emphasis: [Judy deMontmollin,
> Ph.D.](mailto:judy.demontmollin@va.gov)
>
> Preceptor for Posttraumatic Stress Disorder Special Emphasis: [Thomas
> Hundersmarck](mailto:thomas.hundersmarck2@va.gov), Ph.D.

All are available at the same address as Dr. Freeman or may be reached
by e-mail or by phone at 352-374-6020.

Fellow selection will be made by the voluntary uniform notification date
for VA post doctoral programs, which will be February 26, 2009.

## Psychology Setting

The Fellowship in Clinical Psychology at the North Florida/South Georgia
Veterans Health System began in 2004 and became APA accredited in 2006.
We offer three distinct emphasis areas each in geropsycyhology,
substance abuse, or post traumatic stress disorder. We have a variety of
additional rotations from which to chose in order to round out and
address fellows\' additional training needs and other areas of interest.

## We also offer an APA accredited Internship in Professional Psychololgy which has been accredited since 1981. The internship offers three generalist positions and one specialty position in geropsychology. Additonally, we offer practicum level training and have from 5-10 graduate students from the University of Florida as well as from other programs during a given year. Currently we have 35 psychologists on staff throughout our medical center\'s health care system, including six community based outpatient clinics (CBOCs). Our staff is well represented in all major areas of healthcare provision as well as serving on a variety of professional committees and boards, oftentimes in leadership positions. All staff have courtesy professor appointments with the University of Florida\'s Department of Clinical and Health Psychology, and two staff are dually-appointed to UF\'s Shands Hospital and the VA. Our medical center is affiliated with the University of Florida and Shands Hospital and as such, offers clincial training to a variety of disciplines including medicine, psychiatry, nursing, pharmacy, and social work. 

## Training Model & Program Philosophy

The overall mission of the Psychology Postdoctoral Training Program at
the NF/SGVHS is to prepare Fellows to practice autonomously as clinical
psychologists in a variety of clinical and academic settings and to
provide expertise in the areas of substance abuse treatment, PTSD, or
geriatrics. The postdoctoral program is designed to develop advanced
practice competencies and expertise based upon sound scholarly and
professional practice foundations. The training integrates clinical,
scientific, and ethical knowledge in the development of attitudes and
skills basic to clinical psychology. Therefore the philosophy of
training offered by the NF/SGVHS is best described as a
"practitioner-scholar" model. The training experiences have a strong
clinical focus. However, knowledge and use of empirically supported
processes and interventions are expected and encouraged in all aspects
of the program. Central to our training philosophy are the following
core values:

***Autonomy***. The postdoctoral training of psychologists should ensure
that the Fellows are able to make independent, clinically appropriate
decisions about the psychological services they provide to patients.
Fellows should also recognize that their ability to practice
autonomously reflects an understanding and awareness of when it is
appropriate to seek out consultation or supervision from a colleague. In
addition to possessing skills in psychodiagnosis, psychological
evaluation, psychotherapy, education, and research, the autonomous
psychologist is flexible and has personal resources that permit
generalization of skills to new situations.

***Supervision***. Just as it is important to receive high quality
supervision as a psychologist-in-training, it is equally important to
learn how to supervise others. Postdoctoral training should impart the
skills necessary to provide high quality supervision to the next
generation of psychologists.

***Expertise***. Postdoctoral training should provide the knowledge,
skills, and experience necessary to be an authority in an area of
special emphasis. At the conclusion of the training year, Fellows should
be able to pursue employment in their area of special emphasis and
should be recognized as subject-matter experts.

***Professionalism***. Postdoctoral Fellows should engage in activities
that further their development as a healthcare professional and that
solidify their professional identity within multi-professional treatment
settings. Fellows should demonstrate the ability to form and maintain
collegial relationships with members of their own and other professions.
We especially encourage a collegial relationship between psychology
staff and Fellows, in which the principal differences between teacher
and learner are breadth and depth of knowledge and experience. Fellows
should demonstrate healthy leadership skills. As a first step down this
road, Fellows should prepare themselves during the training year to take
the national psychology licensure examination.

***Diverse***. The NF/SGVHS provides services to diverse populations.
This healthcare system strives to create a therapeutic environment for
and to ensure the ethical treatment of patients with diverse backgrounds
and characteristics. Psychology training should be sensitive and
responsive to diverse cultural, ethnic, and special populations.
Postdoctoral Fellows should be able to extend their core understanding
of diversity issues to their area of special emphasis.

Over the last seven years, 36% of our interns have been from diverse
backgrounds specifically including racial, ethnic, and sexual
orientation diversity. This percentage does not include non-traditional
students, such as older students, veterans, or interns for whom
psychology is a second career. If those interns are accounted for, then
51% of our past interns could be considered diverse. The 2005 research
statistics from the Committee on Accreditation (COA) indicate that
internships nationally had an average of 24% ethnic minority intern
representation. We are striving to diversify our fellow classes as well.
Over the last four years 50% of our fellows have been women and one
fellow has been ethnically diverse. All fellows that have begun our
program have completed our program.

Currently 26% of our staff is representative of a variety of
diversities, including ethnic, racial, and sexual orientation
diversities. The 2005 research statistics from COA indicate that
training programs nationally had an average of 16% ethnic minority staff
representation. 55% of our staff are women and our staff also includes
three veterans (two women and one man.) We continue to be a growing
staff and look forward to the opportunity for additional
diversification.

Although the medical center serves a predominately adult male
population, there is an increasing number of female veterans using VA
facilities (13% nationwide). Our Medical Center has a Women\'s Health
Clinic which has been open since October 1999. This clinic address the
medical and mental health needs of female veterans. The Psychology
Service in particular has developed several groups and outreach programs
for women veterans such as the Women Veterans Support Group.
Additionally, Dr. Courtney Stahl is the Military Sexual Trauma
Coordinator (MST) for our medical center in addition to being the
psychologist assigned to the Women\'s Clinic.

***Ethics***. Training of psychologists should ensure that the
fundamentals of ethical practice are understood and followed. Fellows
should be able to extrapolate their understanding of ethics to their
area of special emphasis and should be conversant with applicable laws
and policies. We believe that an autonomous psychologist maintains the
highest ethical standards and exercises critical thinking and sound
judgment in the provision of all psychological services.

## Program Goals & Objectives

**Training Competencies and Objectives**

Our training program is organized around seven core competencies. Each
rotation and training experience has identified specific objectives
associated with these seven competencies. The core competencies compose
the clinical and professional skills we believe provide the foundation
for a solid, effective, professional psychologist. Specific objectives
for these core competencies will be presented in the descriptions of the
special emphasis areas.

***Competency 1. Assessment and Diagnosis:*** Postdoctoral Fellows shall
demonstrate competency in conducting psychological evaluations that
integrate patient biopsychosocial history, interview data, and a variety
of psychological tests to provide accurate diagnoses and to make useful
treatment/intervention recommendations.

***Competency 2. Intervention:*** Postdoctoral Fellows shall demonstrate
competency in conducting individual and group psychotherapy and
psychological interventions across a variety of problems and populations
and, in particular, in their area of special emphasis. They shall review
and integrate relevant scholarly literature to assist in clinical
problem solving.

***Competency 3. Consultation and Communication:*** Fellows shall
demonstrate competency in professional consultation with clients and
colleagues in relation to an identified problem area or program that
would benefit from psychological expertise. Psychological consultation
is an explicit intervention process that is based on principles and
procedures found within psychology and related disciplines.
Psychological consultation focuses on the needs of individuals, groups,
programs, or organizations.

***Competency 4. Professional and Ethical Behavior:*** Postdoctoral
Fellows shall demonstrate competency in their ability to use sound
professional judgment and shall have the capability to function
autonomously and responsibly as practicing psychologists. They are aware
of their strengths and limitations, as well as the need for consultation
and continued professional development.

***Competency 5. Human Diversity:*** Postdoctoral Fellows shall become
aware of cultural and individual diversity and shall integrate this
awareness in all spheres of their psychological practice.

***Competency 6. Practitioner-Scholar Model/Scholarly Inquiry:***
Postdoctoral Fellows shall demonstrate critical thinking about relevant
theoretical and scientific literature and apply this thinking to their
clinical and research work.

***Competency 7.*** Supervision and Teaching Skills: Fellows will
develop competence and confidence in providing supervision including the
following skills: ability to communicate expectations, ability to
establish and maintain a professional and respectful relationship with
supervisee, ability to deliver and receive constructive feedback, and
ability to monitor progress of supervisee and effectiveness of
supervisor. Fellows will develop professional-level presentation skills
in a variety of contexts.

## 

## Program Structure

The Geropsychology postdoctoral fellow spends the first six months of
their training year immersed in their special emphasis area. The second
six months are divided into two three-month rotations designed to
broaden their experience by expanding training into other areas.

The Substance Abuse and PTSD emphasis area fellows spend the entire year
half-time in their respective emphasis areas. The other time is split
between two or more other training areas of their choice.

Please see the TRAINING ROTATIONS section for a description of the
respective emphasis area rotations as well as a description of the
optional training rotations.

***Teaching Method/Supervision***

While Fellows are expected to accept as much professional responsibility
as their current knowledge and skills will allow, all clinical work is
reviewed and supervised by licensed staff psychologists. Clinical
responsibilities are assigned to Fellows with their learning goals in
mind. While the service needs of the treatment units are important, they
are a secondary criterion for assignment of clinical activities.
Selection of training experiences and assignment of clinical
responsibilities are made with the active participation of the Fellow.
At the beginning of each rotation, the Fellow and rotation supervisor,
in consultation with the Post-Doctoral Training Committee, identify the
training goals and negotiate a contract specifying the rotation
activities that will maximize the achievement of these goals. Fellows
begin their training year and rotations as co-therapists/observers with
the supervising psychologist. Once the Fellow has learned the relevant
skills, s/he will provide services independently, with at least two
hours of face-to-face supervision. Supervisors request audiotapes of
therapy sessions in order to provide feedback on therapy skills and to
contribute to case conceptualization. For assessments, supervisors
review all aspects of the assessment process and co-sign the final
reports. Fellows are also involved in the decision-making processes
affecting the administration of the training program. Fellows serve as
members of the Psychology Training Committee and vote on matters of
programmatic significance with the exception of decisions relating to
specific Fellows.

***Additional Learning Activities***

Fellows will complete a year-long project related to their area of
special emphasis. This project may take the form of a research project,
a grant proposal, a literature review and/or meta analysis, or a newly
designed treatment program. Fellows may design and conduct their own
project that is different from those listed previously, subject to the
approval of the Training Committee. The Fellows will present their
project toward the end of the training year to Psychology Service staff
and trainees and to staff associated with their special emphasis area.

In addition, Fellows will present at least two case conferences or
special topic presentations during the training year to Psychology staff
and trainees. Fellows will participate in rotation-specific training
opportunities (e.g., grand rounds) on a biweekly basis and in relevant
Psychology Service continuing education programs. Finally, Fellows will
participate in a monthly meeting with the Post-Doctoral Training
Committee which consists of the Director of Training, the three emphasis
area Preceptors, and the Chief of Psychology Service. This meeting
serves to facilitate professional development and fellows take turns
presenting related articles for discussion among the committee members.
Fellows will also be expected to attend the monthly Psychology Service
Staff Meeting and the monthly Psychology Service Training Committee
meeting.

***Competency Evaluations***

A basic goal of the postdoctoral fellowship program is to promote the
professional development of the Fellows in each of the core competency
areas so that they are ready to assume autonomous practice as a licensed
professional psychologist. Competency evaluations will be completed by
supervisors in the core competencies that are relevant to their specific
rotation. The rating periods will be at 6, 9, and 12 months. To
successfully complete the postdoctoral program, Fellows must demonstrate
proficiency in each of the objectives for their special emphasis area by
achieving ratings of at least a \"3\" in all areas of evaluation.

***Program Evaluation***

The Psychology Training Program is committed to program assessment and
quality improvement. Informal, continuous program evaluation is
conducted in the monthly Training Committee Meetings that are attended
by the training staff, interns, and Fellows. Fellows are encouraged to
discuss issues, concerns, and suggestions for improvement throughout the
year with their supervisors and the Training Director. Supervisors and
Fellows complete formal evaluations of one another and the training
experiences at 6, 9, and 12 months. These evaluations focus on the
attainment of each of the seven goals as relevant to the particular
rotation. The Fellows will also complete a comprehensive year-end
evaluation of the fellowship program. Graduates of the fellowship
program are surveyed one year after completion to obtain feedback and
suggestions for improvement. The training staff thoroughly review the
Fellows' evaluations and ensure that recommendations for improvement are
seriously considered and implemented when appropriate. The Training
Director spearheads the quality improvement activities of the
postdoctoral program. She attends the APPIC training conferences and
other relevant conferences to stay abreast of the cutting edge issues in
psychology training. Ideas for improvement obtained from the conferences
are shared with the training staff and integrated into the training
program. In addition to local program evaluation, the postdoctoral
fellowship program will be regularly evaluated by national professional
and accrediting bodies such as APPIC and the Committee on Accreditation
for APA.

Fellows receive at least 2 hours of individual supervision and 2 hours
of group supervision weekly. Program evaluations from the last four
fellow classes indicate that fellows typically receive between 5-6 hours
of supervision weekly.

## Training Experiences (Rotations & Seminars)

**SUBSTANCE ABUSE EMPHASIS AREA:**

The NF/SGVHS supports several levels of care in an interdisciplinary
approach to the treatment of veterans with substance abuse problems.
Available to veterans in a 52-county rural and urban catchment area is
an array of services, including intensive hospital based detoxification,
ambulatory detoxification, residential care, transitional housing
program, dual diagnosis residential care, and a full range of outpatient
services including vocational rehabilitation. This continuum of care
takes place in a variety of milieus in several different locations,
including the Malcom Randall VA Medical Center in Gainesville, the Lake
City VA Medical Center, and the outpatient SATP facility in the
Gainesville community. Fellows may participate in activities in all the
aforementioned locations. The structure for the year is to work in the
emphasis area half-time for the entire training year. The other
half-time can be divided into two three-month mini-rotations in several
different treatment areas, such as Primary Care, PTSD, Pain Psychology,
etc. Please see section on additional training rotations for more
information.

The special emphasis in substance abuse provides an extensive training
experience in the assessment and treatment of substance abuse and
provides the opportunity to function as part of several
interdisciplinary teams including (but not limited to) psychologists,
psychiatrists, social workers, addiction therapists, and nurses. The
teams provide continuity of care by following a panel of patients across
program elements. This training will prepare Fellows to assume clinical,
academic, and/or administrative leadership positions wherever they may
continue their clinical careers.

Fellows will spend the majority of their time sharpening their skills in
understanding the process of addiction, psychosocial factors associated
with addiction, assessment techniques, diagnostic measures and issues,
detoxification protocols, and psychopharmacology. In addition, they will
be very much involved in treatment models associated with residential
programs including motivational enhancement therapy, group
psychotherapy, family therapy and issues of co-dependency and enabling,
cognitive behavioral methods of relapse prevention, basic social skill
training, milieu therapy and appropriate referral. Fellows will be
provided with supervisory experience in individual psychotherapies
associated with substance abusers (e.g., network therapy and
motivational enhancement as well as co-therapeutic 12-step and other
programs).

**Training sites include:**

**1. Substance Abuse Treatment Program (SATP)**

This program is comprised of an inpatient detoxification program, an
extensive community-based outpatient program, a community-based
residential program, and a Compensated Work therapy/Transitional
Residence program. This array of services is offered in Gainesville.

*Supervisor: George Shorter, Ph.D.*

**2. Psychiatric Residential Rehabilitation Treatment Program (PRRTP)**

The PRRTP is a residential rehabilitation program focusing on veterans
diagnosed with both an Axis I disorder (most often a mood or thought
disorder) concomitant with a substance abuse disorder. Most veterans
admitted to PRRTP stay for a period of 12-14 consecutive weeks, and
Fellows will be involved in providing individual case management guided
by an interdisciplinary treatment team, didactic psychoeducational
classes, traditional process-oriented group therapy, behavior-oriented
group therapy, process-oriented experiential groups, relaxation
training, and relapse prevention training. They will also learn about
leisure skills education, nutrition education, social skills training,
role-playing groups, spirituality groups, medical education, medication
management, and self-help groups specific to dual diagnosis. This
program is offered at the Lake City VA Medical Center.

*Supervisor: Gavin Shoal, Ph.D.*

**3. PTSD/Substance Abuse Treatment Track (PSATT)**

The PSATT is an outpatient integrated treatment track for veterans who
have a dual diagnosis of PTSD (secondary to combat, sexual assault,
physical assault, POW captivity, or motor vehicle accident) and
substance abuse/dependence. Fellows will receive training in
psychological assessment and testing, addiction education, relapse
prevention, coping skills training, 12-step programs, relaxation
response training, and PTSD-trauma education which has a special
emphasis on how the two disorders overlap, affect one another, and
compromise recovery efforts.

*Supervisor: Tom Hundersmarck, Ph.D.;*

***Below are the specific objectives for the Substance Abuse Emphasis
Area:***

> ***Assessment and Diagnosis:***

-   Diagnosis and classification of substance disorders and substance
    induced disorders, including an understanding of the American
    Society of Addiction Medicine (ASAM) placement criteria and the
    Addiction Severity Index (ASI).

-   Protocols for co-morbid psychiatric disorders, neuro-cognitive
    function/impairment, and personality disorders.

-   The physical, intellectual, behavioral, and emotional concomitants
    of acute alcohol/drug impairment.

-   Assessment of co-dependency and the enabling of addiction

-   Assessments of relapse potential, high-risk issues, substance use
    inventories, and readiness to change.

> ***Intervention:***

-   Specific modalities of treatment in which the Fellow may gain
    experience include Motivational Enhancement Therapy (MET),
    cognitive-behavioral group therapies, Network Therapy, relapse
    prevention, process-oriented group psychotherapy, psycho-educational
    group treatment, addiction education, coping skills, communication
    skills, problem solving skills, family and marital therapies, Mutual
    Help Therapies, therapeutic communities, pharmacotherapeutics, EEG
    biofeedback, and vocational rehabilitation.

> ***Consultation and Communication:***

-   Learn roles of specific treatment team members and the knowledge and
    skills of specific disciplines as applied to substance abuse
    treatment.

-   Distinguish appropriate from inappropriate consults and educate
    referral sources.

-   Develop problem-solving strategies with referring staff.

-   Write reports in a clear, concise manner and communicate results to
    referring clinicians.

-   Learn when to refer for appropriate treatment.

> ***Professional and Ethical Behavior:***

-   Demonstrates understanding of the APA Ethical Principles and Code of
    Conduct and HIPAA.

-   Interacts appropriately with all team members, colleagues, and
    supervisors.

-   Demonstrates ability to assume responsibility for key patient care
    tasks.

-   Begins the process of obtaining licensure for the independent
    practice of psychology.

> ***Human Diversity:***

-   Demonstrates understanding of the impact of individual differences
    and cultural diversity on substance abuse treatment.

-   Integrates the above knowledge into the development and
    implementation of a treatment plan for substance abusing veterans.

> ***Practitioner-Scholar Model:***

-   Seeks out relevant sources of information related to substance abuse
    treatment and applies to assessments and interventions. Presents at
    least once to interns and staff on information learned from this
    endeavor.

-   Designs and conducts one project during the training year. Examples
    of successful projects include designing and conducting research,
    conducting a literature review and meta-analysis, or designing and
    implementing a new treatment group. Fellows are encouraged to be
    creative and may submit other ideas for their project for approval
    by the Training Committee.

> ***Supervision and Teaching Skills:***

-   Provides supervision on at least three cases throughout the year
    under the supervision of a staff psychologist.

-   Supervises at least one intern/graduate student working in substance
    abuse.

-   Attends monthly professional development meetings with postdoctoral
    subcommittee and completes readings as assigned.

-   Discusses supervision with their supervisors throughout the year
    (supervision of supervision).

-   Makes at least two presentations to staff and peers during the year.

**GEROPSYCHOLOGY EMPHASIS AREA**

The Gainesville division at the NF/SGVHS was designated in December 1983
as a Geriatric Research, Education, and Clinical Center (GRECC) site
charged with focusing on state-of-the-art clinical care and innovative
research to meet the needs of the aging veteran. The GRECC funds two
positions each year for gerontology-focused training of one predoctoral
psychology intern and one post doctoral psychology fellow.

The GRECC program is closely affiliated with the Center for
Gerontological Studies at the University of Florida, which offers a wide
range of didactic experiences that reflect the true multidisciplinary
nature of this organization. Academicians and clinicians with widely
diverse interests enjoy the opportunity to study together in this
setting and address issues related to aging. In addition to the above,
the Geriatric and Extended Care Service has been a model of
interdisciplinary teamwork for over 20 years. It is an essential site
for the training of health professionals from the University of Florida
and Santa Fe Community College locally and from a variety of colleges
and universities across the country. Trainees from psychology, medicine,
psychiatry, pharmacy, neurology, speech, and rehabilitation medicine
draw upon the expertise in geriatrics at the NF/SGVHS while engaging in
their clinical, research, and teaching activities.

Extended care programs serve the aging and/or chronically ill veterans
who may be homebound, in institutional care, or primary care and who
range in age from 40 to greater than 100 years of age. Diagnostic
categories include dementia, stroke, cardiovascular disease, congestive
heart failure, malignancy, renal failure and a variety of other chronic
illnesses most often occurring as multiple medical conditions. Inpatient
programs include Nursing Home Care (240 beds), Geriatric Evaluation and
Management (26 beds, configured as part of the 240 nursing home beds),
Inpatient Hospice, and Palliative Care (four beds at the Gainesville
division and 20 beds at the Lake City division). Outpatient programs
include Home Care (Home Based Primary Care, Home Health Aide,
Intermittent Skilled Care, and Hospice); Tech Care Coordination (Rural
Home Care and Chronic Pain); Geriatric Primary Care; Geriatric Specialty
Care; Palliative Care; and a Gait and Balance Clinic. In addition to the
provision of clinical care, Geriatrics and Extended Care Service is also
integrally involved in numerous education and research initiatives.

The special emphasis in geropsychology provides an invaluable
opportunity to address and resolve the unique difficulties presented by
an aging veteran population. Fellows will develop skills in assessing
and treating dementia and other cognitive impairments, pain, maladaptive
personality traits/disorders, and caregiver stress. There will be a
focus on cognitive-behavioral therapy, interpersonal psychotherapy,
behavioral management, and case management techniques. Fellows will
conduct their work in an interdisciplinary team setting that will allow
them to interact with other trainees and preceptors from other
disciplines. Fellows will also engage in staff consultation with their
team and with other groups of health professionals and administrators.
The overall goal of this special emphasis area is to train professional
psychologists with specialized skills and information pertinent to
geropsychology so that they may assume clinical, academic, and/or
administrative leadership roles in geriatrics.

**Objectives for this training experience:**

> ***Assessment and Diagnosis:***

-   Differentiation between various forms of dementia and cognitive
    impairment, using data from cognitive tests and interviews, and
    identification of medical conditions and medications that may
    negatively impact a patient's cognitive abilities.

-   Identification of distinct psychiatric conditions and their
    presentations in older adults (e.g., dementia vs. depression)

-   Assessment of patient's ability to make medical and financial
    decisions.

> ***Intervention***:

-   Effective case conceptualization and development of appropriate
    treatment plans.

-   Implementation of various psychological interventions targeting
    issues relevant to aging, including individual psychotherapy, group
    psychotherapy, and couples/family psychotherapy.

> ***Consultation and Communication:***

-   Development of consultation liaison skills in working with
    interdisciplinary treatment teams.

-   Communicate team interventions and planning to family members,
    significant others, and/or caregivers.

> ***Professional and Ethical Behavior:***

-   Knowledge of and sensitivity to ethical and legal issues associated
    with working with older adults.

-   Demonstrates understanding of the APA Ethical Principles and Code of
    Conduct and HIPAA.

-   Begins the process of obtaining licensure for the independent
    practice of psychology.

***Human Diversity:***

-   Recognition of the impact of cultural and/or individual differences
    in the assessment and treatment of older adults.

***Practitioner-Scholar Model:***

-   Seeks out relevant sources of information related to geriatrics and
    applies to assessments and interventions. Presents at least once to
    interns and staff on information learned from this endeavor.

-   Designs and conducts one project during the training year. Examples
    of successful projects include designing and conducting research,
    developing a grant proposal, conducting a literature review and
    meta-analysis, or designing and implementing a new treatment group.
    Fellows are encouraged to be creative and may submit other ideas for
    their project for approval by the Training Committee.

> ***Supervision and Teaching Skills:***

-   Provides supervision on at least three cases throughout the year
    under the supervision of a staff psychologist.

-   Supervises at least one intern/graduate student working in
    geriatrics.

-   Attends monthly professional development meetings with post-doctoral
    subcommittee and completes readings as assigned.

-   Discusses supervision with their supervisors throughout the year
    (supervision of supervision).

-   Makes at least two presentations to staff and peers during the year.

**Training Rotations -** Fellows work full-time in geropsychology in
some combination of the rotations described below for six months. The
next six months can be divided into two three month rotations. Please
see additional rotation descriptions for rotation options for the second
six months.

***1. Malcom Randall VA Medical Center Geropsychology.*** This rotation
includes opportunities to work with a variety of interdisciplinary teams
that provide treatment services to geriatric patients: the Geriatric
Evaluation and Management Unit (GEM), the Palliative Care Unit, and the
Primary Care Geriatric Clinic. The GEM is designed to provide
comprehensive interdisciplinary assessment, treatment, preventive, and
restorative/rehabilitative care to geriatric veterans who have sustained
a loss in physical functioning which places them at risk for
institutionalization. The Palliative Care Unit was established to
enhance the life of patients who are facing serious, life-limiting and
terminal illnesses. An interdisciplinary team helps to relieve the
veteran's suffering by controlling pain and other symptoms and by
managing the veteran's physical, psychological, social, and spiritual
needs. The Primary Care Geriatric Clinic brings together various
disciplines to formalize the provision of outpatient primary care
geriatric services. This clinic focuses on older (usually over the age
of 70), frail veterans with multiple medical problems.

Fellows will divide their time among these three training sites, with
the GEM and the Palliative Care Unit forming the backbone of their
geriatric training. In this rotation, Fellows will spend the majority of
their time initially in the GEM and the Palliative Care Unit. As their
skills in these settings improve and their practice becomes more
autonomous (approximately three months into this rotation), they will
reduce the amount of time they devote to these settings and spend the
majority of their time in the Primary Care Geriatric Clinic.
Nevertheless, Fellows will continue to spend at least a portion of their
time in the GEM and the Palliative Care Units throughout the training
year. The remainder of the Fellow's time will be spent in didactics and
consultation with other professionals. Fellows will conduct cognitive
screenings and psychological assessments, as appropriate, and they will
engage in short-term individual, marital, and family psychotherapy. They
will be responsible for responding to consults from Geriatric Primary
Care, and they will develop a caseload of five long-term psychotherapy
cases that they will follow throughout the training year. Beginning in
the second half of this rotation, Fellows will supervise, in conjunction
with the geropsychologist, the psychology interns who choose geriatrics
as a training experience. They will also interact closely with the
Geropsychiatry Fellow and will have the opportunity to provide
in-service training sessions and community support groups.

*Supervisor: Judy deMontmollin, Ph.D.*

***2. Hospice/Palliative Care and Geropsychology.*** The Extended Care
Service at the Lake City VAMC consists of five separate units with a
total of approximately 200 geriatric beds. The units\' specialties
include dementia specialty care, rehabilitation and restorative care,
intensive skilled nursing/medical management, institutionalized
long-term care (disabled and/or chronically ill), and hospice/palliative
care (terminally ill). Various units also provide inpatient respite beds
for short-term caregiver breaks.

This training experience affords the opportunity to participate as a
member of an interdisciplinary treatment team, which includes
representatives from Nursing, Medicine, Social Work, Physical Therapy,
Dietetics, and Pharmacy. Interns/fellows will attend didactic rounds
with residents/interns from these other disciplines present. Psychology
provides consultation for referral sources with services ranging from
evaluation to behavioral management or psychotherapy. There are also
opportunities to work with family members, caregivers, and staff
members. This interaction is an important component of working on the
hospice/palliative care unit. With our diverse population,
interns/fellows can tailor the training experience to their interests or
needs.

> ***Fellows/interns who complete this training experience will be able
> to:***

-   Perform evaluations of dementia and age-related cognitive decline,
    becoming familiar with the prevailing diagnostic nomenclature and
    specific diagnostic criteria.

-   Establish rapport and maintain a therapeutic alliance with older
    adults in individual or group psychotherapy.

-   Gain factual and experiential information about certain life events
    that typically occur in later life.

-   Understand aging individuals in the context of social structures, as
    social contexts define and shape the lives of older people.

-   Utilize specific techniques for working with the elderly who
    experience emotional suffering and dysfunction secondary to
    dementia.

-   Conceptualize cases for treatment planning and attainment of
    therapeutic goals.

Supervisory Psychologists: Paul Bessette, Ph.D.; Merle Miller, Ph.D.

**PTSD EMPHASIS AREA**

The special emphasis in PTSD provides an extensive training experience
in the assessment and treatment of PTSD and provides the opportunity to
function as part of an interdisciplinary outpatient team including (but
not limited to) PTSD psychologists, psychiatrists, social workers, and
advanced practice nurses. The team provides care for veterans with PTSD
from military, non-military, and sexual trauma. The team also provides
care for patients presenting with mild to moderate traumatic brain
injury (TBI) and PTSD. Coordination of care with the NF/SG Veterans
Health System TBI Team as well as Substance Abuse and other care teams
is done routinely. This training will prepare Fellows to assume
clinical, academic, and/or administrative leadership positions wherever
they may continue their clinical careers. Below are the specific
objectives for this training experience.

> **Assessment and Diagnosis:**

-   Proficient psychological evaluations with full integration of the
    patient\'s biopsychosocial and biomedical history, psychopathology
    issues, psychopharmacological issues, life span developmental
    issues, clinical diagnostic interview data, and a variety of
    psychological tests to provide accurate diagnoses and to make useful
    treatment intervention recommendations based on the best research
    evidence.

-   Accurate diagnosis of PTSD and other related disorders, particularly
    depression and substance abuse.

-   Proficient assessment of neurocognitive functional impairments due
    to mild traumatic: brain injury with a DSM differential diagnosis
    for patients with both mild traumatic brain injury and PTSD
    symptoms.

-   Proficient use of PTSD assessment inventories with best research
    evidence.

-   Accurate assessment of personality disorder.

-   Intervention:

-   Skilled use treatment interventions with the best research evidence
    for efficacy for patients with Acute Stress Disorder and
    Posttraumatic Stress Disorder.

-   Skilled treatment intervention with patients with PTSD and TBI.

-   Proficient use of protocols for Acute Stress Disorder and co-morbid
    psychiatric disorders.

-   Implementation of psychoeducational strategies and relaxation
    response training strategies that are supported by the best
    available research evidence.

-   Implementation of cognitive processing therapies, cognitive
    behavioral individual and group therapies, substance abuse and
    relapse prevention strategies, cognitive remediation strategies,
    family, marital and couples therapy strategies, and exposure based
    therapies that have the best available research support.

> ***Consultation and Communication:***

-   Developed knowledge of roles of treatment team members and
    understanding of their knowledge base and skills.

-   Distinguish appropriate from inappropriate consults and educate
    referral sources.

-   Development of problem-solving strategies with referring staff.

-   Proficient skill in report writing that is clear, concise, and
    communicate effectively clinical data to referring clinicians.

-   Understanding of when to refer for appropriate treatment.

-   Effective interaction with members of the Substance Abuse Treatment
    Team (Psychiatry) and the Traumatic Brain Injury Clinic
    (Rehabilitation Medicine).

-   Understanding of models of supervision and models of
    interdisciplinary team functioning.

> ***Professional and Ethical Behavior:***

-   Demonstrated understanding of the APA Ethical Principles and Code of
    Conduct and HIPPA.

-   Appropriate interactions with all team members, colleagues,
    supervisors, and patients.

-   Demonstrated ability to assume responsibility for key patient care
    tasks.

-   Commence the process of obtaining licensure for the independent
    practice of psychology.

-   Appropriate response to, and resolution of, any ethical problems
    that arise in their clinical practice.

> ***Human Diversity:***

-   Demonstrated understanding of the impact of diversity issues such
    as: individual differences (sociocultural, ethnic, and
    socioeconomic), gender, sexuality and physical/cognitive/mental
    dysfunction on PTSD treatment.

-   Effective integration of this knowledge into the development and
    implementation of a treatment plan for PTSD patients.

> ***Practitioner-Scholar Model:***

-   Effective use of relevant sources of information related to the
    specialty area and application of that knowledge to assessments and
    interventions.

-   Sharing with interns and staff of North Florida/South Georgia
    Veterans Health System relevant information learned through review
    of relevant sources in the PTSD specialty area.

-   Design and conduct one project during the training year.

> ***Supervision and Teaching Skills:***

-   Provision of supervision to an intern or a practicum student on at
    least three cases throughout the year under the supervision of the
    preceptor.

-   Supervision of at least one intern working in the specialty area.

-   Maintain ongoing discussion of supervision issues with the Preceptor
    throughout the year.

-   Participation in monthly professional development meetings with
    postdoctoral subcommittee and completion of readings as assigned.

**Rotations**

***1. The PTSD Clinical Team (Gainesville and Lake City divisions).***
There are two PTSD Clinical Teams serving NF/SGVHS, one located in Lake
City, and the other in Gainesville. The Lake City PCT was initiated in
February of 2007 and consists of a full-time psychiatrist, psychologist,
and an advanced practice nurse. The Gainesville division PCT has been
operating for over 17 years and has a full-time psychiatrist, two
psychologists, a social worker, and a half-time nurse practitioner. In
FY 06, the Gainesville PCT responded to 430 consults, generating 1100
visits for medication management, 1811 individual therapy visits, and
3431 group therapy visits for male and female veterans who served in
combat zones from all eras, as well as veterans with trauma from other
sources such as sexual assault, accidents, and natural disasters. Close
clinical coordination of care occurs on a weekly basis through care
coordination meetings with other service providers, including providers
in the TBI Clinic and the Substance Abuse Treatment Team. One member of
the PCT is designated to provide dual diagnosis services.

The PTSD Fellow will provide 24 hours per week of services within the
PCT setting as the major rotation (12 months in duration) and 12 hours
per week in two selected minor rotation (each 6 months in duration) over
the course of a training year. The major and minor rotations will be
completed concurrently throughout the year. The Fellow will provide a
range of services in the PCT setting in concert with training goals
outlined above.

*Supervisors:Thomas Hundersmarck, Ph.D., PCT Coordinator; Ronda Jordan,
Psy.D. Gainesville Division; Julia Tesch, Psy.D., Lake City Division.*

***2. The Traumatic Brain Injury Clinic.*** The TBI Clinic is designed
to provide same day services for veterans with positive indications for
TBI. These services include but are not limited to TBI evaluation,
neuropsychological testing, and PTSD assessment. The clinic provides
ongoing neurocognitive intervention and therapy, as needed. While most
of these clinic veterans served in Iraq or Afghanistan, veterans from
other eras are also provided this range of services. Close clinical
coordination of care occurs on a weekly basis mediated through care
meetings with representatives of the TBI and PCT teams. A
neuropsychologist and a PCT psychologist provide full-time services to
this TBI clinic. The PTSD Fellow will work with these individuals to
provide differential diagnostic assessment and treatment services. The
PTSD Fellow will learn to administer or refine existing skills with a
variety of standard neuropsychological assessment instruments within an
ongoing clinical context. Clinical practice will be supplemented with
didactic experiences that will include neuropsychology, neurology, and
psychiatry grand rounds. The PTSD Fellow will gain diagnostic skill in
determining appropriate diagnosis and treatment with post-TBI patients
who frequently present with symptoms overlapping with other co-morbid
disorders such as PTSD and other mood disorders. The Fellow will
interact and coordinate care in a multidisciplinary environment with
members of Physical Medicine and Rehabilitation.

*Supervisory Psychologists: Jason Demery, PhD.; Thomas Hundersmarck,
Ph.D.*

**ADDITIONAL TRAINING ROTATIONS -** these are the optional rotations
fellows may select from to round out their training year during the time
they are not solely assigned to their respective emphasis areas

***The SATT Team.*** The NF/SGVHS supports several levels of care in an
interdisciplinary approach to the treatment of veterans with substance
abuse problems, including: intensive hospital based detoxification,
ambulatory detoxification, residential care, transitional housing
program, dual diagnosis residential care, and a full range of outpatient
services including vocational rehabilitation. Primarily, Fellows will
participate in activities at our Gainesville location; however Fellows
who choose to seek experience with dually diagnosed patients may also
choose to spend some of their time working in our Lake City location;
both locations have supervising psychologists.

The SATT uses a biopsychosocial model of addictive behaviors that
accommodates a developmental framework, with patients moving from one
type of service to another depending upon their individual needs and
treatment goals. The Fellow will refine their knowledge of substance use
disorders, criteria, and course of recovery and will conduct a range of
treatment service that includes individual and group treatment along
with case management activities. The Fellow will demonstrate knowledge
of the rehabilitation process while working in an interdisciplinary team
environment.

*Supervisory Psychologists: George Shorter, Ph.D., Gavin Shoal, Ph.D.*

***Primary Care and Medical Psychology.*** These two Psychology programs
offer psychological services to Medical and Surgical inpatients and
outpatients and their families on a consultation-liaison basis.
Currently, consultations are completed on inpatient wards, intensive
care units, the dialysis unit, six Primary Care Clinics, medical
surgical specialty clinics, and the Mental Health Clinic.

A Fellow will have the opportunity to observe and participate in an
interdisciplinary team approach to patient care. Particular learning
experiences, in addition to psychological evaluation and treatment, will
include interacting with patients and their families, filling the role
of liaison between patient and caregiver or family member, and generally
facilitating the patient\'s adjustment to the treatment regimen and
adopting a more healthful lifestyle. Both short-term and extended
interventions may be utilized with individuals, couples, or families.
Biofeedback is among the treatment modalities employed, and it is
available on a selective basis through referral and screening.

Other aspects of the program include weekly attendance at meetings with
interdisciplinary staff members focused on providing support services
for patients and their family members on Medical, Surgical, and
Cardiothoracic Intensive Care Units, particularly as the patient\'s stay
on the unit is of longer-than-usual duration. Trainees will attend
monthly interdisciplinary meetings with staff members in Primary Care,
and meetings with hospital or clinic staff groups are conducted upon
request. either ad hoc to address matters of acute concern or on a
regular schedule in the interest of providing support, improving
communication, and enhancing team identity and cohesion.

Other program features include a Stop Smoking Clinic treating
outpatients and employees with nicotine use disorders. Stop Smoking
Clinics are now active in the Ocala, Leesburg, Lecanto, and Villages
CBOCs as well as at the Gainesville VAMC. Inpatient consultation
designed to provide palliative management of nicotine use problems
acutely is also offered.

Psychologists working in this program also perform preoperative
evaluations of candidates for organ transplantation. Currently, these
psychosocial assessments are being conducted with veterans requiring
bone marrow, kidney, heart, lung, and liver transplants. In addition,
staff performs screening evaluations with veterans undergoing treatment
for Hepatitis C. The Fellow will conduct evaluations preceding
medical/surgical procedures and convey results both verbally and in
written reports. In addition, the Fellow will participate in the
interdisciplinary approach to health care, spanning the range from
prophylaxis to providing care in terminal illness. In this process, the
Fellow will acquire familiarity with science-based and other
professional literature pertinent to health psychology topics, receiving
materials from the supervisor and contributing readings of interest.
Supervisory Psychologists: Linda Feldthausen, Ph.D.; Julius Gylys, Ph.D.

***CBOC Primary Care Experience***

For this rotation in Community Based Outpatient Clinic (CBOC) Primary
Care Psychology, fellows learn how to adapt traditional clinical and
health psychology services for the primary care setting. Typical
clinical activities include brief evaluation and treatment of clinical
and health psychology problems; consultation and collaboration with
primary care practitioners for psychological and medical management; use
of print and media for intervention and education; individual and group
treatment formats; coordination of care with the onsite social worker;
and triage decision making to prioritize service delivery. Fellows will
also gain exposure to a rapidly developing modality of 21st Century
healthcare, the use of live video-teleconferencing for the delivery of
clinical services. Common presenting problems include psychological
ones, such as affective, mood, somatoform, and adjustment disorders;
health behavior change ones, such as smoking cessation, physical
activity, and weight management; and medically related ones, such as
pain management, coping with illness, treatment adherence, and
practitioner-patient communication. Throughout the training experience,
fellows can choose to emphasize particular patient populations or
particular presenting problems as availability allows. In this context,
fellows also have the opportunity to make a continuing education
presentation to clinic providers or to develop a clinical intervention
involving a special interest area. A significant activity for fellows in
this training experience is the supervision of both interns and graduate
students.

*Supervisory Psychologists: Psychologists assigned to each CBOC.*

***Mental Health Clinic***

The Mental Health Clinic training experience offers fellows experiences
in group and/or individual psychotherapy. Fellows have the opportunity
to co-lead ongoing groups, as well as begin new groups. Some examples of
ongoing groups include the Creative Living Group; Interpersonal Men's
Group; Korean War Veterans Group, and Fundamentals Group (for
individuals with thought disorders). Fellows may elect to begin a new
group, as well. If interested, fellows may continue to co-lead and/or
lead any of these groups as a year-long or longer term experience.
Fellows can also follow individual therapy cases through the MHC.

*Supervisory Psychologists: Marianne R. Freeman, Ph.D.; Khalil Sakalla,
Ph.D.*

***Clinical Neuropsychology and TBI Team***

The rotation offers fellows the opportunity to participate in the
evaluation and treatment of patients demonstrating diverse neurological
disorders. Fellows will learn to administer a variety of standard
neuropsychological assessment instruments within an ongoing clinical
context. Clinical practice will be supplemented with didactic
experiences that will include neuropsychology, neurology, and psychiatry
grand rounds. Interdisciplinary approaches will be stressed so that
psychology fellows can expect to collaborate with nurses, physicians,
and rehabilitation professionals. Fellows can use this training
experience to gain new skills in neuropsychological assessment or as an
experience to polish, refine, and gain more autonomy if they have
already had significant training in this area.

> ***Fellows who complete this rotation will be able to:***

-   Design and conduct neuropsychological interviews

-   Develop a syndrome analysis, process approach to neuropsychological
    assessment

-   Demonstrate familiarity with the administration and scoring of a
    wide variety of commonly employed neuropsychological assessment
    instruments

-   Demonstrate knowledge of neuropsychological evaluation and treatment

-   Write comprehensive neuropsychological reports addressed to diverse
    referral sources

*Supervisory Psychologists: Carmen Fernandez, Psy.D.; Jason Demery,
Ph.D.*

***PTSD and Anxiety Disorders Team***

The PTSD Clinical Team and Anxiety Recovery Clinic (PCT/ARC) provides
outpatient services to both male and female veterans. The PCT/ARC
program assists veterans in overcoming the debilitating symptoms of PTSD
(from traumas including combat, sexual assault, physical assault, POW
captivity or motor vehicle accident) and other Anxiety Disorders
(including Panic Disorder, Phobia and Generalized Anxiety Disorder).
Additionally, veterans treated in this program typically carry comorbid
diagnoses of mood disorders and substance abuse disorders.

The coordinator of the program is a psychologist and the PCT/ARC staff
is an interdisciplinary team composed of members from Psychology,
Psychiatry, Nursing, and Social Work Services.

The fellow becomes a member of the team and has an opportunity to
broaden skills in psychological assessment, symptom conceptualization,
differential diagnosis and treatment. The team believes strongly in
developing a collaborative partnership with the veterans in the program
to assist them through a series of progressive stages that culminates in
the reduction or elimination of their symptoms. Group, individual and
family therapies are employed.

Specific responsibilities for the fellow include co-facilitating
psychoeducational and exposure-based group therapies that are designed
to improve social skills, better manage stress-related symptoms and
eventually to reduce or eliminate the source of the specific Anxiety
Disorder. Interested fellows may also gain experience in such areas as
program evaluation, staff training, research and external consultation
with inpatient and outpatient mental health facilities.

> ***Rotation Goals and Objectives:***

-   Discuss and apply research findings in assessment,
    conceptualization, diagnosis and psychotherapy.

-   Complete rotation and acquire hours of direct patient contact and
    supervision.

-   Produce a comprehensive, integrated written report on each
    assessment.

-   Serve as a co-facilitator in at least one fundamental
    psychoeducational group that meets 1 time per week for 90 minutes.

-   Serve as a co-facilitator in at least one relaxation and dialectic
    behavioral therapy group that meets 1 time per week for 90 minutes.

-   Serve as a co-facilitator in at least one exposure-based
    psychotherapy group that meets 1 time per week for 90 minutes.

-   Provide individual or family therapy to at least 2 veterans who are
    being seen in the PCT/ARC program.

-   Actively participate in case conceptualization and treatment
    planning performed in the weekly PCT/ARC treatment team meeting.

-   During supervision, discuss 2 ethical dilemmas in therapy.

-   Attend supervision as scheduled and participate fully; Supervise
    interns when available.

-   Meet deadlines for completion of required work.

-   Develop awareness of how PTSD interacts with individual differences
    in ethnicity, lifestyle, gender, and age-related factors.

-   During supervision, discuss diversity awareness related to PTSD.

-   Work with diverse veterans in the program.

-   Work with diverse staff members in coordinating care for veterans in
    the program.

*Supervisory Psychologists:Tom Hundersmarck, Ph.D.; Ronda Jordan,
Psy.D.*

***Behavioral Family Therapy (FaMHeLP)***

The Family Mental Health Learning Program (FaMHeLP) is a new program
that was developed as part of the VA's mental-health initiative. FaMHeLP
provides outpatient treatment for veterans who are seriously mentally
ill by; helping their families understand mental health and
mental-health treatment, helping the families learn how to support the
veteran's recovery process, and connecting families to community-based
mental-health resources. Primary experiences of this rotation will
include family assessment, family psychoeducation, and didactic /
self-study of individual and family systems issues that are relevant to
individuals with severe mental illness and their family members.

> ***Fellows who complete this rotation will be able to:***

-   Identify family systems issues relevant to recovery from severe
    mental illness.

-   Identify issues relevant to the treatment of Schizophrenia, Bipolar
    Disorder and Severe Depression.

-   Demonstrate increased competency in family assessment.

-   Demonstrate increased competency in family psychoeducation.

*Supervising Psychologist: Jennifer W. Adkins, Ph.D.*

***Pain Psychology Rotation***

The Pain Psychology rotation offers cognitive-behavioral pain management
services to veterans experiencing chronic pain. Services include
comprehensive intake/assessment and group and/or individual treatment.
Fellows can participate in the Pain Psychology rotation as a partial
three-month or six-month rotation, with the following goals and
objectives which can be tailored to address an intern\'s specific
training plan.

***Rotation Goals and Objectives:***

***Assessment and Diagnostic Competency.*** To broaden fellows\'
development of pain psychology assessment skills, including
administration and interpretation of data from clinical interviews,
record reviews, and psychometric instruments; to enhance ability to
identify psychological contributions to chronic pain symptomatology; to
formulate appropriate treatment plans; and to provide timely and
informative feedback to referral sources.

-   Complete at least six individual intake evaluations, which include
    data from clinical interviews, record reviews, and psychometric
    instruments.

-   Begin rotation by watching at least two clinical intake interviews
    conducted by the supervisor; conduct at least two intake interviews
    in presence of supervisor; progressing to conduct five to six intake
    interviews independently.

-   Intervention Competency: To foster fellows\' development of group,
    individual, and psychoeducational skills

-   Co-facilitate the weekly Pain Coping Skills Group, a group for
    patients with chronic pain who are interested in learning new coping
    techniques. Begin by watching the supervisor facilitate for the
    first several groups and progress to being the primary planner for
    group topics and the leader of group discussions.

-   Conduct individual cognitive-behavioral therapy as appropriate with
    negotiated number of individuals.

***Consultation and Communication Competency:*** To increase fellows\'
experience and skills in working with multidisciplinary teams and
referral sources.

-   Present assessment results/recommendations to the attending
    physician, residents, and fellows in the Anesthesia Pain Clinic and
    communicate with other referral sources through personal
    interaction, e-mail, or by identified signer.

-   Develop a brief and effective writing style with an emphasis on
    diagnostic issues and influence of psychological factors on the
    patient\'s pain condition.

-   Professional and Ethical Behavior: To enhance fellows\' ability to
    apply ethical decision-making processes, and to exhibit professional
    and ethical behavior in clinical work.

-   Discuss at least two ethical dilemmas during the rotation.

-   Discuss during supervision the intern\'s professional development
    and presentation in the areas of consultation, team meetings, and
    therapy.

-   Human Diversity: To promote the intern\'s application of research
    knowledge and understanding of and sensitivity to issues related to
    individual differences and cultural diversity.

-   Discuss two diversity issues over the course of the rotation.

-   Discuss individual differences and cultural diversity issues related
    to pain and pain management.

-   Work with diverse patients in both assessment and therapy.

-   Work with diverse staff.

-   Engage in ongoing reflection during supervision about how well they
    respect, are aware of, and are able to deal effectively with
    individual and cultural differences.

-   Practitioner-Scholar Model/Scholarly Inquiry: To promote the
    intern\'s ability to seek out and apply both new and classic
    knowledge and research to their assessment and intervention work and
    to their professional development.

-   Read and discuss at least two readings from the supervisor and
    discuss the applicability of the information to at least one
    assessment, group, or therapy case.

-   If possible, participate in the weekly pain research meeting in the
    Center for Pain Research at the University of Florida.

-   If interested, observe and/or participate in the supervisor\'s
    ongoing pain research projects during the rotation.

-   Discuss the importance of utilizing empirically validated methods
    and treatments in *psychological management of chronic pain*

*Supervisory Psychologist: Roger Fillingim, Ph.D.*

There are also at least two new rotations in the process of development,
including Home Based Primary Care and a Domiciliary program for homeless
veterans.

##  Requirements for Completion & Electives

Fellows are expected to achieve ratings of at least \"3\" on all
evaluation forms throughout the year, indicating that they are
performing in a manner consistent with their current level of training.
This allows for some variability with respect to training in areas in
which they have considerable past experience and well as new areas, in
which they may have little or no experience.

Fellows are expected to abide by the APA ethical principles and relevant
Florida Rules and Laws.

Fellows are expected to complete their special projects and have made
two professional presentations.

## Facility and Training Resources

The North Florida/South Georgia Veterans Health System Psychology
Fellowship Program has a number of training resources available both
intramurally and through the auspices of the University of Florida.
Psychology Service has four full-time administrative positions to assist
in providing clerical and technical support to Psychology Service and
the fellowship program. All fellows have their own private offices where
they see patients. Each office has a telephone and an individual
Windows-based personal computer for in-office use.

Both the Lake City and the Gainesville VA Medical Centers maintain their
own professional libraries, which are open to the fellows, as is the
220,000 volume medical library at the J. Hillis Miller Health Center,
which receives 2,000 periodicals. The University of Florida\'s libraries
contain a total of 2.6 million bound volumes, which are available for
reference. Literature searches and regional interlibrary loan services
are also available through the VA medical library. Both audiotape and
videotape capabilities are available through Psychology Service and the
Medical Media Service. A videotape and audiotape library is also
maintained. Most commonly used intelligence, personality, achievement,
vocational, and neuropsychological tests are available in our test file.
Some are also available in an automated administration and
interpretation package. The Psychology Service maintains computer-based
biofeedback equipment, including electroencephalographic,
electromyographic, electrodermal, thermal, and multi-channel acquisition
and coordination units. Windows-based computers with word processing,
database, and statistical software are available. A computerized patient
database permits patient scheduling, as well as retrieval of medical and
biographic information.

.

## Administrative Policies and Procedures

**Stipend, Hours, and Leave**

The fellowship is full-time for a year beginning the first workday on or
after July 1 and ending June 30 or the closest work day the following
year. However, we recognize that internships have a variety of ending
dates which do not always coincide with ours and we are flexible about
the fellowship start date to accommodate later internship end dates.
Fellows are expected to complete 2080 hours of supervised experience
within the year.

The stipend for the program is \$41,079 for the year, paid biweekly.
Benefits include 13 vacation days, 13 sick days, 10 federal holidays, up
to 10 days of approved educational or professional leave, and health
insurance. Malpractice coverage is provided under the Federal Tort
Claims Act. Additionally, fellows are able to utilize AA for workshops
and presentations with advanced supervisory approval.

Some Fellows elect to work more than 40 hours; however, if a fellow\'s
supervisor is not on site, the fellow may not engage in any clinical
activities.

To ensure fellows\' rights of due process, Psychology Service has
enacted Memorandum Number 116B-2: Complaints and Grievance Procedures
Initiated by Trainees and Memorandum 116B-15: Remediation of Problematic
Performance, Due Process, and Grievance Procedures. This policy
statement defines the actions that both fellows and the Training
Committee must take should problems be identified in the fellow\'s
performance. This policy is provided to all fellows during orientation
week (or by request) and is discussed with them to ensure that they
understand their rights. Fellows\' complaints and/or difficulties with
supervisors are subject to the same procedures. A copy of same is
included in the Fellow Handbook fellows receive at the outset of the
training year.

## Core Training Staff

***Jeffrey Burk, Ph.D.,*** Chief, Psychology Service

University/Date of Degree: University of Missouri---Columbia, 1987

Clinical/Research Interests: Psychology administration; clinical
training

***Marianne Freeman, Ph.D.,*** Director of Training

University/Date of Degree: Nova Southeastern University, 1992

Clinical/Research Interests: Clinical training; psychotherapy, thought
disorders

***Judy deMontmollin, Ph.D.,*** Geropsychology Preceptor

University/Date of Degree: University of Florida, 1977

Clinical/Research Interests: Geropsychology

***Linda Feldthausen, Ph.D.***

University/Date of Degree: University of Florida, 2003

Clinical/Research Interests: Medical psychology; palliative care; weight
management; sexual trauma; EMDR

***Julius Gylys, Ph.D.***

University/Date of Degree: Ohio University, 2000

Clinical/Research Interests: Primary Care psychology; rural health

***Thomas Hundersmarck, Ph.D.***

University/Date of Degree: Temple University, 1991

Clinical/Research Interests: PTSD; personality disorders; family and
couples therapy; substance abuse disorders

***Ronda R. Jordan, Psy.D.***

University/Date of Degree: Florida Institute of Technology, 2006

Clinical/Research Interests: PTSD/Substance abuse

***Courtney Stahl, Psy.D.***

University/Date of Degree: Indiana State University, 2004

Clinical/Research Interests: PTSD; military sexual trauma; Women\'s
Clinic

***George Shorter, Ph.D.,*** Substance Abuse Preceptor

University/Date of Degree: Auburn University, 2001

Clinical/Research Interests: Dual diagnosis; work therapy

***Gavin Shoal, PH.D.***

University/Date of Degree: University of Kentucky, 2005

Clinical/Research Interests: Substance abuse disorders; substance abuse
etiology; PTSD; health psychology

**Additional Supervisors**

***Paul R. Bessette, Ph.D.***

University/Date of Degree: University of Southern Mississippi, 1995

Clinical/Research Interests: Psychological assessment, psychotherapy,
geriatrics/hospice.

***Jason Burns, Ph.D.***

University/Date of Degree: University of Florida, 2003

Clinical/Research Interests: Primary Care Psychology

***Jason A. Demery, Ph.D.***

University/Date of Degree: University of Florida, 2004

Clinical/Research Interests: Neuropsychology; traumatic brain injury;
stroke; cognitive neurorehabilitation; psychotherapy

***Roger Fillingim, Ph.D.***

University/Date of Degree: University of Alabama (Birmingham), 1990

Clinical/Research Interests: Chronic pain

***Khalil Sakalla, Ph.D.***

University/Date of Degree: University of North Dakota\--Grand Forks,
2004

Clinical/Research Interests: Psychotherapy; geropsychology

***Kaki York-Ward, PH.D.***

University of Southern Mississippi, 2006

Home Based Primary Care Psychology; Cardiac psychophysiology;
Mindfulness

**Clerical Staff**

***DEBRA STACEY***

Secretary

***JACKIE WELLINGTON***

Office Automation Assistant

***OSCAR MERCADO-PAGAN***

Program Support Clerk, TBI

***JACK MCKENZIE***

Program Support Clerk, PCT

***Trainees***

***2008-2009 Fellowship Class***

Malinda Trujillo, Ph.D. - VA Los Angeles Ambulatory Care Center;
Colorado State University

Heather Manor, Psy.D. - Louis Stokes Cleveland VA Medical Center; Nova
Southeastern University

Lisa Christman, Ph.D. - Miami VA Medical Center; Fuller Theological
Seminary

***2007-2008 Fellowship Class***

Heath Gordon, Ph.D. - NF/SG Veterans Health System; West Virginia
University

Jason Pickren, Psy.D. - NF/SG Veterans Health System; Nova Southeastern
University

***2006-2007 Fellowship Class***

Krisha Frassrand, Psy.D. - NF/SG Veterans Health System; Florida
Institute of Technology

Ronda Jordon, Psy.D. - Illiana Veterans Health System; Florida Institute
of Technology

***2005-2006 Fellowship Class***

Gavin Shoal, Ph.D. - Cincinnati VA Medical Center; University of
Kentucky

Debra Gleason, Ph.D. - James H. Quillen VA Medical Center; University of
Tennessee

***2004-2005 Fellowship Class***

Courtney Stahl, Psy.D. - NF/SG Veterans Health System; Indiana State
University

Khalil Sakalla, Ph.D. - NF/SG Veterans Health System; University of
North Dakota

## Local Information

The North Florida/South Georgia Veterans Health System is headquartered
at the Malcom Randall VA Medical Center in Gainesville and is located
adjacent to the University of Florida, an institution of more than
35,000 students.

The North Florida/South Georgia Veterans Health System is affiliated
with the J. Hillis Miller Health Center at the University of Florida,
located directly across the street. This complex consists of the Shands
Teaching Hospital and the Colleges of Dentistry, Health Professions,
Medicine, Nursing, Pharmacy, and Veterinary Medicine. All VA programs
are administered by the Director, Associate Director, and Chief of Staff
and are coordinated jointly with the University of Florida\'s Vice
President for Health Affairs and the appropriate colleges and faculty.

The Malcom Randall VA Medical Center is situated among the gentle hills
of North Central Florida in a scenic, tree-canopied community of 100,000
residents. Located midway between the Atlantic Ocean and the Gulf of
Mexico, Gainesville has a relatively mild climate suitable for
year-round enjoyment of sports and its varied lakes and recreation
facilities. Interestingly, Gainesville has more bicycle paths than any
other city in the United States. Gainesville is serviced by air, bus,
and train lines. Gulf- and Atlantic-coast attractions are within a
two-hour drive of the medical center. These include Orlando attractions,
such as Disney World, Universal Studios, and Sea World. Also nearby are
Busch Gardens and Cypress Gardens. The larger metropolitan areas of
Tampa, St. Petersburg, Orlando, and Jacksonville are equally accessible.

Culturally, Gainesville is enhanced by the University of Florida and the
Center for the Performing Arts. Entertainers who have performed in
Gainesville recently have run the gamut from Matchbox Twenty, Lenny
Kravitz, Smashmouth, and the Rolling Stones to Ray Romano, Elton John,
and Bill Cosby to nationally renowned symphonies and Broadway plays.
Gainesville also supports a nationally known art festival, a community
band, a civic chorus, the University symphony, and dance groups. The
Florida Museum of Natural History, the Samuel P. Harn Museum of Art, and
a number of excellent theater groups which includes the Hippodrome State
Theater provide considerable diversity.