> ![](media/image1.png){width="1.125in"
> height="1.4166666666666667in"}**Psychology Internship Program**

**Asheville VA Medical Center**\
Director of Psychology Training (116)

1100Tunnel Rd.

Asheville, NC 28805 ***\
**<http://www.asheville.va.gov/>*

**APPIC MATCH Number: 206611**

**Applications Due: November 30, 2008**

## Accreditation Status

The predoctoral internship at the **Asheville VA Medical Center** is not
yet accredited by the Commission on Accreditation of the American
Psychological Association.

An application for accreditation is in process, and a site visit is
expected by academic year 2010.

## Application & Selection Procedures 

**Overview**

The Asheville VAMC abides by all APA guidelines and requirements
regarding selection procedures. APA can be contacted at 750 First
Street, NE, Washington, DC, 20002-4242, or www.apa.org. The phone number
is (202) 336-5979 or (202) 336-5500. The Asheville VA Predoctoral
Psychology Internship Program participates in the APPIC Match for
predoctoral psychology internships.

An internet link to the current APPIC Match Policies is available at
<http://www.appic.org/about/2_3_5_about_policies_and_procedures_match.html>

The Asheville VA Medical Center Internship APPIC Match number is 206611.

The internship is new for the training year of 2008. As a new program,
we are not yet eligible for APA Accreditation but are in pursuit of this
accreditation. We are a member of APPIC.

**Eligibility**

All applicants for VA internships must be U.S. citizens enrolled in an
APA‑approved Ph.D. or Psy.D. program in clinical or counseling
psychology. To be considered for acceptance, a candidate must be
approved by his or her Director of Psychology Training as ready for
internship. All applicants must have completed three full years of
graduate study leading to the doctorate (less than three years may be
acceptable with special recommendation by the sponsoring university).
Graduate training will have included coursework and formally supervised
applied clinical training in the provision of psychological assessment
and psychotherapy. Applicants will have demonstrated 1) the ability to
apply assessment and intervention skills in applied settings, 2)
knowledge of and adherence to ethical guidelines, and 3) interpersonal
skills necessary for the practice of psychology.

The Asheville VA Psychology Internship Program requires documentation of
800 hours of practicum experience including 500 hours of direct clinical
experience. Practicum hours are specified by applicants on the AAPI and
should include a minimum of 300 hours of therapy, 200 hours of
assessment, and 300 hours of supervision. Experience gained outside of
the doctoral program can be considered if supervision was provided by a
licensed mental health professional. Projected hours can not be counted
in the 800 hour total

**Application Requests**

The Charles George (Asheville) VA Psychology Internship Program uses the
APPIC Application for Psychology Internships (AAPI) available at the
APPIC website ([www.aapic.org](http://www.aapic.org/)). Requests for a
brochure can be made by email to <CHRISTOPHER.SANMIGUEL@VA.GOV> , or by
mail at the address below.

**Applications**

Each applicant is required to submit a complete set of application
materials including the following:

-   Cover letter indicating intent to apply to the internship program
    and internship training interests,

-   Completed APPIC Application for Psychology Internships (AAPI),

-   Curriculum Vita,

-   Three letters of evaluation from individuals familiar with recent
    academic and clinical performance. At least one letter of evaluation
    should be from a clinical supervisor with direct knowledge of the
    applicant's clinical skills, and

-   Official transcripts of all graduate training.

All application materials should be collected by the applicant and
forwarded in [ONE PACKAGE]{.underline}. Copies of transcripts and
letters of reference should be enclosed in sealed envelopes with the
appropriate stamp or signature over each seal. All materials should be
sent to the address listed below and received no later than November 30.

Christopher L. San Miguel, Ph.D.\
Director of Psychology Training\
Asheville VA Medical Center (116)\
1100Tunnel Rd.\
Asheville, NC 28805

**Selection Process**

***EEO Guidelines* --** The Asheville VA Psychology Internship Program
adheres to Equal Employment Opportunity (EEO) guidelines in the
selection of intern applicants. Equal employment opportunity is the
requirement, based in both law and regulations, that agencies provide
employees a full opportunity to enter into, function in, and progress in
their careers based on their abilities and performance, rather than on
such non-merit factors as race, religion, sex, or age.

Providing equal opportunity requires a coordinated effort among faculty
supervisors, VA managers, EEO program officials, and HR
officials. Working together, they seek to ensure that all employees are
protected:

-   with the opportunity to compete fairly for positions for which they
    are qualified,

-   by receiving objective ratings based on their performance, and

-   from being subjected to personnel decisions based on non-merit
    factors.

In short, the objective of the EEO program is not to provide special or
unfair advantage to any groups or individuals, but rather, to ensure
that employees are not unfairly disadvantaged based on non-merit factors
that are outside their control. Please refer to
[http://www.va.gov/dmeeo](#application-selection-procedures) for further
EEO information.

***Application Reviews* --** All applications are screened for mandatory
requirements and program fit by the Director of Psychology Training
(DOT) or an Assistant Director of Psychology Training (ADOT).
Applications that appear to be a good match for our internship program
and meet mandatory requirements may be offered an interview.
Applications that do not meet the above requirements or do not appear to
be a good fit may be reviewed by additional members of the Psychology
Training Committee. Applicants that are not selected for interview
following the above reviews will be notified in writing by December
15^th^. Applicants selected for interviews will be contacted by the DOT
or ADOT to schedule an on site interview. Applicants unable to interview
in person may be offered a telephone interview at the discretion of the
Director of Psychology Training.

***Applicant Interviews* --** The Charles George VA Clinical Psychology
Internship Program establishes two interview dates, with an additional
alternate date to be used in the event of inclement weather. Interview
dates for 2009 are January 7 and 14, with January 21 as the alternate.
Applicants selected for interviews will be contacted by the DOT or
designated staff member to confirm an interview date. Applicants will
receive e-mail confirmation of the interview date, along with an
interview schedule, directions to the facility, and information on local
lodging. Applicants are given an overview of the training program by the
DOT, an introduction to all available faculty, and then are interviewed
individually by two faculty members. Applicants will have the
opportunity to spend time with the current interns, and receive a brief
tour of the facility. Applicants are encouraged to follow up with phone
calls to faculty if they have further questions following the completion
of the interview day.

***Applicant Ratings* --** Faculty members review applicant packets in
addition to completing in person interviews. Faculty members evaluate
clinical training, assessment training, clinical experience, assessment
experience, and letters of recommendation. Clinical training and
experience are rated based on breadth and depth, as well as consistency
with the program's generalist training philosophy. Assessment training
and experience are evaluated for the variety of assessment instruments,
number of instruments administered, and number of integrated reports
written. Experience with both objective and projective assessment is
preferred, either through training or experience. For both clinical and
assessment experience, supervised practicum experiences are given more
weight. Letters of recommendation are reviewed to determine applicants'
strengths and weaknesses, acceptance of and response to supervision,
demonstration of professional behaviors and ethical practice, and
personal characteristics indicative of successful internship completion.
These factors also are evaluated through the interview, in addition to
professional demeanor and interview style. Considerable weight is given
to how well the prospective intern's professional experience and career
goals match with the training philosophy and goals of the Charles George
VA Clinical Psychology Internship Program.

The Charles George VA Clinical Psychology Internship Program faculty
prefers applicants who have their dissertation proposal approved by the
start of the internship.

***Applicant Rankings* --** Following applicant interviews, the
Psychology Training Committee meets to review applicants' ratings.
Applicants are ranked based on interview ratings, review of applicant
packets, and discussion among the Training Committee members. Applicants
are placed on a rank order list. Low-rated applicants may be eliminated
at this time. This ranking process usually requires two meetings before
a final ranking list is produced. The final rank list is submitted via
computer to National Matching Services (NMS).

The preceding criteria serve as general guidelines for rating and
ranking applicants. These guidelines are not inflexible and reviewers
must rely on professional judgment when evaluating applicants that do
not meet the standards noted above.

**Applicant Matching**

The Asheville VA Psychology Internship Program participates in the
Matching Program administered by National Matching Services Inc. (NMS)
on behalf of the Association of Psychology Postdoctoral and Internship
Centers (APPIC). Only those applicants who participate in the Match can
be matched to our internship program. All applicants must obtain an
applicant agreement package from NMS and register for the Match in order
to be eligible to match. Applicants can request an applicant agreement
package from NMS through their web site at
[http://www.natmatch.com/psychint/]{.underline} or by e-mail at:
<psychint@natmatch.com>.

The Asheville VA Psychology Internship submits a final rank list via
computer to National Matching Services (NMS). At the appointed time, the
list shown by NMS is verified by computer link. Applicant candidates are
advised of their status in the match according to the NMS program
schedule. Acceptances and notification procedures follow the Association
of Psychology Postdoctoral and Internship Centers (APPIC) Match
Policies. This internship site agrees to abide by the APPIC policy that
no person at this training facility will solicit, accept, or use any
ranking-related information from any intern applicant. On the designated
match day, NMS sends an e-mail to the program and to the applicants
indicating the final outcome of the match.

The Asheville VA Medical Center Internship APPIC Match number is
**206611**.

APPIC Match Policies are available on the APPIC web site:
[http://www.appic.org](http://www.appic.org/)

**Intern Appointment**

On match day, the DOT or ADOT calls each intern by telephone to confirm
that he or she has matched with our program. A letter of confirmation is
sent within 72 hours of notification. Each selected intern must respond
in writing that he or she accepts the appointment with the Charles
George VAMC Clinical Psychology Internship Program.

When these letters are received from the new intern, copies of the
application folders are sent to Human Resources Management Service
(HRMS), which will then begin the process of employment. The applicants
are required to complete an OF 612 (Optional Application for Federal
Employment) and to complete a physical exam.

The appointment to an intern position is contingent upon the
individual\'s application being cleared through a national data bank to
screen for possible ethical and legal violations. All interns must pass
employment screenings through the Department of Health and Human
Services, Office of Inspector General, List of Excluded Individuals and
the National Practitioner Health Care Integrity and Protection Data
Bank, as well as a fingerprint check, before the appointment becomes
official. An intern must also pass the pre-employment physical completed
by a VA hospital before he or she can begin the internship.

New interns also complete Online Cyber Security Awareness Training,
Privacy Training and sign the Rules of Behavior before arriving for
orientation. After all documentation is complete, interns will be ready
to start at the beginning of the pay period closest to the second week
of July.

***Psychology
Setting***![](media/image2.jpeg){width="2.6243055555555554in"
height="1.636111111111111in"}

The Charles George (Asheville) VAMC has been providing practicum
training to psychology students since 2005, and established a
predoctoral internship program in 2008. In addition to the psychology
training programs, there are 60 training affiliations between the
Medical Center and Academic Programs. The Asheville VAMC has an active
Surgical Residency Program in conjunction with Duke Medical School.
There are non-physician students representing a number of disciplines,
including Social Work, Nursing, Physician Assistant, Pharmacy, Dental,
Medical Technology, and Laboratory.

Within the Medical Center, psychology training is conducted in the
context of the Mental Health Service Line (MHSL), a multidisciplinary
department including professionals from the following disciplines:
psychology, psychiatry, social work, nursing, and addictions therapy.
The mission of the MHSL is to provide quality patient care, training and
research. The Director of Psychology Training and the Training Committee
administer psychology training activities.

Currently, there are ten doctoral level psychologist positions at the
Asheville VA, with clinical and research interests in PTSD, dual
diagnosis, primary care psychology, health psychology, military sexual
trauma, neuropsychology, end of life issues, geropsychology, and serious
mental illness. Psychology staff come from diverse academic backgrounds
and ascribe to a range of theoretical orientations including cognitive
behavioral, cognitive processing, analytical, experiential, depth
oriented, and gestalt. Internship faculty members hold faculty positions
at Western Carolina University and East Tennessee State University.

## Training Model and Program Philosophy

The Psychology Internship Training Program adheres to a generalist
training model, while emphasizing the importance of interprofessional
collaboration and the unique needs of a veteran population. Our faculty
seeks to prepare psychologists to work in teams with other disciplines
to plan, coordinate, and deliver excellent care that meets the needs of
the patients they serve. Psychology is a distinct discipline with skills
and expertise to contribute to veteran care. By working with other
disciplines, psychology interns learn to define their role and value the
role of other professionals in maximizing quality of care. The program
seeks to prepare psychologists to provide competent, compassionate care
based on ethical principles and to develop a broad range of skills in a
variety of inpatient, outpatient, and consultation settings. Throughout
the training year, the faculty works with interns to foster sensitivity
to veterans who have or experience mental and physical health problems
and to develop empirically based, thoughtful plans of approach to caring
for the veteran. The program approaches the intern as a mature learner
who is capable of working with the faculty in the development of
mutually derived learning objectives and a collegial relationship
between faculty and intern. Developmental approaches to supervision look
to assessment of current strengths and weaknesses and using this
awareness in the stages of professional development. As the internship
year progresses, the intensity of supervision will decrease as the
intern displays ever-growing independence.

While the main emphasis is on a generalist model, the program places
special emphasis on training psychologists to work with a veteran
population \-- developing the specific competencies for addressing many
of the needs unique to veterans and the VA setting. Training will
therefore include some particular emphasis on the diagnosis and
treatment of post-traumatic stress disorder, military sexual trauma,
integration of psychology within a primary care setting, as well as
inpatient treatment and crisis management.

Consistent with our training philosophy, the Asheville VA Medical Center
accepts interns from traditional scientist-practitioner graduate
programs as well as from practitioner-scholar graduate programs. Interns
matching with our program will have a strong commitment to training in a
generalist model and a desire to develop strong skills for working in
interprofessional settings. While interns may choose to specialize at a
later date, we believe that a generalist model provides a strong
foundation for later specialized practice.

## Program Goals & Objectives

The goals and objectives of our internship program reflect our
dedication to providing a broad training experience designed to prepare
interns for working in a variety of settings.

***Goal 1 -- Preparation of psychologists to practice in general
settings with a broad base of general skills.*** To accomplish this
goal, each intern will participate in three, four-month rotations in a
variety of generalist settings. Each intern will perform psychological
assessments and individual and group psychotherapy. Family psychotherapy
will be offered on a limited basis. Each intern will develop an
understanding of the scientific relevance of each assessment tool and
psychotherapeutic intervention. These intervention and assessment
opportunities are sequential, cumulative and graded in complexity.
Further, each will participate in staff education opportunities, weekly
seminars, and in assigned team meetings.

***Goal 2 -- Participation in interprofessional collaboration to deliver
comprehensive care.*** Toward this goal, each intern will participate in
multidisciplinary teams sharing their psychological expertise and
learning from other professions represented on the team in order to
improve the overall quality of patient care. Each will further develop
and articulate an understanding of his/her professional identity as a
psychologist.

***Goal 3 -- Define individual learning needs and professional goals.***
Toward this goal, each intern will work with supervisors to tailor
rotation experiences to fit longer-term professional goals. Each will
also work with supervisors to monitor progress in training objectives
and overall professional development. Interns will have a series of
graduated, sequential training experiences tailored to their training
needs, and designed to assist in development of competent clinical
skills and a strong professional identity.

***Goal 4 -- Foster the use of scientific inquiry and critical thinking
to integrate scientific knowledge into current practice.*** Toward this
goal, each intern will use skills of scientific inquiry when dealing
with practice situations. Each intern will apply empirically supported
treatment models and other traditional treatment approaches.

***Goal 5 -- Development of professional behavior and ethical
practice.*** Toward this goal, each intern is encouraged to develop a
strong professional identity that incorporates adherence to professional
ethics, a capacity for self-reflection and sensitivity to individual and
cultural differences.

***Training Requirements***

**Assessment**

Interns will be trained in assessment through a weekly seminar and the
application of assessment techniques in clinical settings utilizing the
most current literature in the area. Early in the internship year, the
emphasis is on the development and refinement of interview based
psychological assessment. This approach to patient care leads to a
better understanding of the individual as a person, his/her needs, a
tentative diagnosis, and plan for disposition. Interview skills will be
supplemented with training in objective, projective and
neuropsychological assessment techniques. As competence with these
measures is achieved, the focus will shift to the integration and
synthesis of interview and test data.

Finally, interns will refine the ability to write a report that provides
the synthesized product to both psychologist and non - psychologist
readers. This sharing leads to interns learning to consult with other
professionals with regard to increased understanding of the patient and
his/her needs across disciplines (interprofessional care). Emphasis is
also placed on understanding both the strengths and weaknesses of
psychological tests, and potentials for errors inherent in data obtained
from psychological tests. Throughout this developmental process, the
weekly Assessment Seminar will allow for sharing of knowledge and
monitoring of progress through intern presentations.

**Modalities of Treatment**

Our internship shares the Veterans Healthcare Administration's growing
emphasis on evidence-based interventions and the increasing
understanding of the value of various psychotherapeutic approaches
within the field of psychology. Interns will gain knowledge of, and
training in, the application of evidence-based psychotherapeutic
interventions. In addition, demonstrated understanding in appropriate
application in such skill areas as analytical, experiential and depth
oriented psychotherapies is an essential part in the development of
generalist psychologist skills.

The Psychotherapy/Professional Issues Seminar will challenge the intern
to examine relevant psychological literature and to apply this knowledge
to case studies in the seminar. Issues covered in the seminar include:
identifying which approaches work and for what reason; identifying the
most effective treatment approaches to use with specific diagnoses;
understanding of the therapeutic relationship; and addressing
personality factors and/or issues such as cognitive rigidity in
treatment planning. As the year progresses, the intern will play a more
active role in the seminar, and initially close supervision will become
more collegial. Interns also receive significant exposure on each
rotation to individual, group, and family psychotherapy modalities.

**Interprofessional Treatment Team Participation**

Treatment team membership and participation is an integral part of, and
is modeled on, each rotation. Participation is most structured and
defined on the inpatient rotation, with multidisciplinary treatment
rounds scheduled every day. As members of the team, interns contribute
to the decision-making process necessary for the overall benefit of the
patient from the treatment experience. On MH/PC Integration rotation,
interprofessional collaboration is the foundation of the integrated
unit. The intern, with modeling and supervision by the psychologist
supervisor, will participate in the mutual sharing, consultation and
collaboration among MH professionals and primary care providers that has
led to the success and popularity of this model. As interns participate
in the outpatient MH rotation, interdisciplinary treatment of patients
is quite typical. Patients may have a psychotherapist who is a
psychologist, a medication provider (psychiatrist, MH mid-level, or
primary care provider) and seek assistance from a non MH social worker.
Alternatively, a patient may be assigned to the Day Treatment Program
and still be seen by a psychologist for psychotherapy. In these varied
scenarios, there exists opportunities for confusion among various
providers and patients and the opportunity for everyone -- especially
patients -- to profit from interdisciplinary collaboration.

**Development of Professional Identity**

Over the course of the internship year, interns will develop a primary
professional identity as a psychologist through the development of
professional responsibility, sensitivity to professional appearance, and
understanding of professional roles. Interns learn to take on and carry
out professional responsibilities, display initiative in ensuring that
key tasks are accomplished, and responsibly and promptly complete their
assignments.

Conversely, interns gain awareness of the problems created by taking on
too many responsibilities, and learn to limit the load to the amount
that they can competently handle. Interns learn to recognize the
importance of appearance in their professional identity and the impact
that appearance can have on therapeutic transference. Interns learn to
act appropriately within the role of a professional, both as a
psychologist and as an employee of the Department of Veterans Affairs.
They become aware of and learn to recognize and observe appropriate
boundaries and conduct.

## Program Structure

**Orientation**

Psychology Interns begin the training year with a week of orientation.
They meet with all Psychology training faculty and visit all rotation
settings. This allows time to become familiar with the Medical Center,
various treatment activities, record keeping, personnel issues, and
procedures specific to the Mental Health Service Line. Interns commence
rotations at the end of this week.

**Training Plans and Evaluations**

The Director of Psychology Training and the Training Committee assist
each intern in the development of an individualized training plan.
Interns will have the opportunity to choose preferred rotations based on
their own professional interests, and on information gathered during
orientation. The Director of Psychology Training and the Training
Committee make final decisions regarding each intern's rotation
schedule, based on resource availability, and with every effort made to
grant intern requests.

The intern and Director of Psychology Training augment each intern's
training plan with additional assignments and choices of supervisors,
based primarily on the needs and interests of the intern. Throughout the
year, regular meetings of the interns, training director and training
supervisors are held to discuss progress, address any problems
encountered, and respond to training needs with evolutionary adaptations
of the training plan.

The Director of Psychology Training receives all written evaluations
from supervisors about the intern's progress and reviews all written
evaluations from the intern about his/her experience with supervisors.
The Director of Psychology Training summarizes these written evaluations
and writes the evaluative letters to each intern's graduate program. The
Director of Psychology Training is responsible for correspondence
between the internship program and the doctoral programs.

**Rotations**

The 12-month internship period is divided into three four-month
rotations. Each rotation involves approximately 24 hours each week in
the selected specialty area. The remaining 16 hours are devoted to
psychological assessments, training seminars, minor rotations,
supervision, and psychotherapy with individuals, families, or groups.

Each intern will be required to complete at least one outpatient
rotation and one inpatient rotation, and a third rotation chosen based
on interest and desired specialization.

The objectives of the rotations are deemed to be consistent with the
philosophy of the training program. They were also developed in
consideration of the unique contributions that psychologists make within
a medical center setting. In determining whether the Charles George VA
Medical Center will be an appropriate training site, applicants for
internship are encouraged to assess their training needs in terms of the
following:

-   Career goals and interests

-   Preferences for the training rotations offered

-   Training needs as assessed or required by his/her graduate program

-   Strengths and weaknesses identified in previous clinical training

The excellent resources of the internship, the high supervisor/intern
ratio, the training philosophy, and the environment of a medical center
committed to interprofessional collaboration and training excellence,
ensure each intern an opportunity for maximum professional growth.

**Seminars**

Interns participate in two core weekly seminars throughout the training
year.

**The assessment seminar** covers the fundamentals of psychological
assessment, encompassing intellectual, personality, and cognitive
factors. Interns meet weekly to discuss their own assessment cases, and
to receive training from experienced psychometricians in specific
aspects of psychodiagnostic assessment.

**The professional development seminar** is more clinically focused,
providing training in essential core subjects, and a changing list of
elective topics designed to meet each year's current training needs. It
covers advances in the treatment of veterans, psychotherapeutic
techniques, ethical issues, current issues in the field of psychology,
and sensitivity to culturally diverse populations. Medical center
faculty and outside consultants present this seminar. In addition to
this regularly scheduled weekly seminar, interns will have the
opportunity to participate in a wide variety of seminars and workshops
offered by the VA, or in collaboration with local training facilities.

The seminar schedule includes time for case presentations by the
interns, at mid-year and again at the end of the internship. Interns
will have the experience of sharing their case conceptualization and
treatment plan with the training staff, both for the purpose of
receiving feedback and opportunities for professional growth, and for
gaining experience in case consultation and formulation.

**Supervision**

Rotation supervision is based on a developmental model, taking into
account that interns are mature learners who, throughout the internship
year, are expected to perform with increasing degrees of independence.
The internship provides for open and ongoing contact between supervisors
and interns. Interns function as colleagues in the mental health
service, with daily access to supervisors and other professionals.

At least two hours of scheduled, formal individual supervision is
provided each week by rotation and/or individual psychotherapy
supervisors. Individual, formal supervision of assessment work is
provided weekly by assessment supervisors. This is in addition to intern
participation in the assessment seminar. One hour of group supervision
is provided by the Director of Psychology Training on a weekly basis.

Less formal supervision occurs during seminars and case conferences, and
is regularly provided by psychologists supervising interns in group or
family psychotherapy, or psychoeducation. Supervision by professionals
from other disciplines will be arranged when desired and appropriate.

Interns will receive training in supervision. This training will be
offered through the seminars, readings and may include "supervised
supervision" of psychology graduate students in the psychology practicum
program.

**Evaluations**

Supervisors, on a continuing basis, provide formal and informal feedback
on each individual's performance as an intern. The rotation supervisor
provides formal written evaluations at the mid-point and conclusion of
the four-month rotation period. Interns review these written evaluations
and are asked to indicate either agreement or disagreement with the
evaluation and sign it. An intern may request a copy of the evaluation.
These written evaluations are given to the Director of Psychology
Training/Asst. Director of Psychology Training. In addition, Individual
Psychotherapy Supervisors and the Assessment Supervisor provide written
evaluations at the middle of the year and again at the end of the year.

Supervisors also provide verbal feedback of each intern's performance to
the training committee, which reviews intern progress on a monthly
basis. The Director of Psychology Training keeps minutes of the meeting.
Rotation supervisors meet with interns for a minimum of two hours per
week, one hour of which must be formal individual supervision.
Individual Psychotherapy supervision is provided for one hour per week.
Assessment supervision is provided on an ongoing basis. It should also
be noted that supervisors (including the Training Director) may also
provide supervisory feedback and evaluation on a less formal basis when
appropriate or necessary. A written copy of this feedback may be
provided to the intern and/or filed in the intern's records at the
discretion of the supervisor, Director of Psychology Training and the
committee.

The Director of Psychology Training integrates all supervisor feedback
into formal written evaluations for the intern's graduate program at the
middle of the year and at the conclusion of the internship. The Director
of Psychology Training meets with each intern, provides the intern with
a copy of this evaluation, and discusses the intern's progress and
perceptions of the training program. If an intern's graduate program
requires additional feedback or has its own forms, he or she should
inform the Director of Psychology Training, who will make every effort
to accommodate these requirements.

Interns are asked to complete a feedback form about each rotation and
supervisor at the end of each four-month rotation period. In order to
continually monitor and improve the quality of the Internship Program,
these feedback forms will ordinarily be discussed by the intern and
supervisor at those points. Under certain circumstances, feedback may be
withheld until the end of the rotation or even the Internship year to
protect Interns from concerns of retribution.

Interns also provide feedback about the training program at the end of
the internship year to the Training Director. Interns are asked to raise
any acute concerns or problems to the Training Director. If there are
concerns about the Training Director, those issues are to be brought up
with the Lead Psychologist.

## Training Experiences (Rotations & Seminars)

**INTERNSHIP MAJOR ROTATIONS**

**Inpatient Rotations:**

### ***Inpatient Mental Health Rotation***

(Supervisor: Dr. Horn)

The Inpatient Mental Health Team is comprised of a psychologist,
psychiatrists, clinical social workers, nurses, and specialists in
chemical dependence addressing a wide range of psychiatric disorders
through various clinical modalities. Interns will participate in
objective, projective and neuropsychological assessment, group
psychotherapy and multidisciplinary case management rounds. The
interprofessional approach emphasized in the inpatient unit allows
interns to gain exposure and knowledge regarding pharmacotherapy and
comorbid medical conditions that often present with serious mental
illnesses. Interns may elect to participate in and learn requisite
mental heath recovery skills utilized in the partnership between the
Inpatient program and the Mental Health Intensive Case Management
program (MHICM). Individualized learning experiences may be developed
for interns with interest in substance dependence treatment through the
substance abuse residential treatment program (SARRTP).

### *Community Living Center (Geriatric/Hospice) Rotation*

(Supervisor: Dr. Bringle)

The Community Living Center houses long-term care residents, short-term
patients for rehabilitation and hospice patients. The psychologist is
part of an interdisciplinary team that includes physicians, mid-level
providers (PA, NP), social workers and rehabilitation staff (e.g., PT,
OT, Nutritionists). Interns will receive training in psychodiagnostic
assessment, brief cognitive screening, capacity evaluations and the
interface between medical diagnoses and psychological symptoms. Interns
will also be exposed to issues specific to a geriatric population such
as dementia, delirium as well as issues specific to the end of life.
There are opportunities for brief consultative services, work with
families, time-limited psychotherapy and group work with an emphasis on
empirically supported techniques.

### ***Substance Abuse Treatment/Mental Health (Co-occurring Diagnoses) Rotation***

(Supervisor: to be announced)

Treatment for veterans recovering from substance abuse disorders and
co-occurring mental health issues is offered through inpatient,
aftercare, and outpatient programs. The Substance Abuse Residential
Rehabilitation Treatment Program (SARRTP) is a 28-day program offering
milieu therapy, cognitive behavioral therapy and 12-step groups.
Following discharge, veterans participate in aftercare groups, and have
access to assistance with employment and housing. Outpatient treatment
is also offered on an outpatient basis through the Mental Health Center.
The Charles George VA Medical Center is proud to be able to offer this
rotation for the first time in the 2009-2010 academic year. A
psychologist specializing in substance abuse and co-occurring diagnoses
has been selected by the facility, and is expected to join the staff by
December of 2008. This person will provide services to patients through
both the inpatient and outpatient programs, and will provide training
and supervision to psychology interns.

The psychologist is part of an interprofessional team that includes a
physician, a mid-level provider (PA), addiction therapists and social
workers. Interns will receive training in assessment of addiction, and
in empirically supported treatment for addiction, including specialized
treatment of addiction with co-occurring PTSD. Interns will also gain
experience in addressing safety, relationship, and quality of life
issues, all of which are affected by addiction and recovery. There are
opportunities for brief consultative services, work with families,
time-limited psychotherapy and group work with an emphasis on
empirically supported techniques.

### ***Primary Care Integration (Health Psychology) Rotation***

(Supervisor: Dr. Urbaniak)

The PCI rotation includes opportunities to work in a MH consultative
capacity and as a mental health professional integrated into a Primary
Care setting. The Mental Health Consult Team (MHCT) is a
multidisciplinary mental health outpatient service made up of
psychologists, psychiatrists, and mid-level providers (PA, NP). The
psychologists involved with the MHCT are imbedded within the medical
center's Primary Care teams, encouraging interprofessional
collaboration. The psychiatrists and nurse practitioner serve in a
consultative capacity for Primary Care, the Emergency Department (ED),
and Medical and Surgical Services. Primary Care team psychologists also
provide the ED and medical services psychological coverage on an as
needed basis. An intern on this rotation will liaison with primary care
providers regarding the psychological needs of veterans and provide
comprehensive assessment and treatment for veterans and their
families. They will have the opportunity to closely interface with
psychiatric providers on the team. Interns will receive consultation
requests, complete initial intakes and some formal psychological
testing, support mental health assessment in the Emergency Department,
provide feedback and consultation to other team members, and maintain an
ongoing caseload of short-term/crisis intervention outpatient
psychotherapy/health psychology patients.

An intern can expect to deal with psychological issues (e.g., anxiety,
depression) that may exacerbate medical conditions, as well as to help
patients with the psychological sequelae of medical problems such as
hypertension, hepatitis C, cancer, diabetes, coronary artery disease,
chronic obstructive pulmonary disease, etc. An intern on this rotation
may also gain specialized knowledge and skill in the areas of chronic
pain, sexual health, neuropsychology screening and other specialized
areas within health psychology often present within the Primary Care
setting. Educational opportunities include assigned readings and
organizational meetings with in-service presentations.

## Outpatient Rotation:

(Supervisors: Drs. Bringle, Lardieri, Marlow, Purvis, and San Miguel,
Ms. Stewart)

***The Mental Health Outpatient Clinic*** is staffed by a
multidisciplinary team composed of psychologists, psychiatrists,
clinical social workers, a nurse counselor, a physician assistant, a
nurse practitioner and specialists in vocational rehabilitation. Interns
will receive training and supervision in objective and projective
personality assessment, individual psychotherapy, and group
psychotherapy. Family psychotherapy is offered on a limited basis.
Interns will have an opportunity to receive training in the provision of
empirically supported individual therapy modalities. Interns may provide
psychoeducation through the Life Abilities Program; a series of courses
designed at this medical center and now considered a best practice model
by the VHA. Current topics addressed include Stress Management, Anger
Management, PTSD Basics, Managing Worry and Anxiety, Managing
Depression, and Relationship Basics.

Within the Outpatient Rotation, the intern may choose to specialize in
working with one of several patient populations served at the Charles
George VAMC, who have specific treatment issues and needs. Interns are
also encouraged to talk with supervisors and the Director of Psychology
Training about professional interests, and may have the opportunity to
develop their own specialization, in addition to those listed below.

### *Specializations within the Outpatient Rotation:*

> **Combat Trauma and PTSD** (Supervisors: Drs. Purvis and San Miguel):
> The PTSD Consultation Team provides coordination of services for
> veterans who have experienced trauma, before, during, or after their
> military service. Intern will be provided specialized training in the
> etiology and treatment of PTSD, and will have opportunities to provide
> individual, group, and family therapies to survivors of combat trauma.
> In addition to traditional mental health services, training
> opportunities may exist within the OEF/OIF evening group and family
> therapy program.
>
> **Military Sexual Trauma** (Supervisor: Dr. Marlow): The VA has
> identified military sexual trauma as a serious issue, and provides
> outreach and treatment to all veterans, male and female, who report
> having been victims of sexual assault or harassment while serving in
> the military. Interns who choose a minor rotation in treatment of MST
> will be provided with specialized training in the history, experience,
> and impact of MST, and will be exposed to the most current research on
> the subject. They will be given opportunities to provide consultation,
> psychoeducation, individual psychotherapy, and group psychotherapy to
> survivors of sexual assault and trauma.
>
> **Severely Mentally Ill** (Supervisor: Dr. Huddleston): Interns may
> elect to participate in outpatient Mental Health Intensive Case
> Management (MHICM), serving the seriously mentally ill in their
> community. Interns also have the opportunity to provide group therapy
> and psychoeducation to severely mentally ill patients and their
> families, and to participate in the Mental Health Consumer Council,
> which acts as a liaison/advisory entity between the hospital and
> consumers of mental health care.
>
> **Women Vets** (Supervisors: Drs. Marlow and Huddleston): The VA is in
> the process of expanding its services for female veterans, as the
> number of returning female veterans continues to increase. Interns
> will have an exciting opportunity to learn about the unique needs of
> female veterans, to provide individual and group therapy to women who
> have served in the military, and to take part in development of new
> programs in psychoeducation and psychotherapy, tailored to the needs
> of female veterans.
>
> **Geriatrics** (Supervisor: Dr. Bringle): Home Based Primary Care
> offers unique opportunities to provide psychological services to
> veterans in the community. The HBPC psychologist functions within an
> interdisciplinary team comprised of physicians, mid-level providers
> (NP, PA), social worker and occupational therapists. Interns will
> conduct cognitive evaluations, provide consultative services and have
> some opportunities to conduct time-limited psychotherapy with an
> emphasis on empirically supported techniques. The population served by
> HBPC is primarily older adults. There may be opportunities for interns
> to conduct capacity evaluations, treat caregiver burden and facilitate
> family meetings.

**Seminars**

Interns participate in two core weekly seminars throughout the training
year.

**The assessment seminar** covers the fundamentals of psychological
assessment, encompassing intellectual, personality, and cognitive
factors. Interns meet weekly to discuss their own assessment cases, and
to receive training from experienced psychometricians in specific
aspects of psychodiagnostic assessment.

**The professional development seminar** is more clinically focused,
providing training in essential core subjects, and a changing list of
elective topics designed to meet each year's current training needs. It
covers advances in the treatment of veterans, psychotherapeutic
techniques, ethical issues, current issues in the field of psychology,
and sensitivity to culturally diverse populations. Medical center
faculty and outside consultants present this seminar. In addition to
this regularly scheduled weekly seminar, interns will have the
opportunity to participate in a wide variety of seminars and workshops
offered by the VA, or in collaboration with local training facilities.

The seminar schedule includes time for case presentations by the
interns, at mid-year and again at the end of the internship. Interns
will have the experience of sharing their case conceptualization and
treatment plan with the training staff, both for the purpose of
receiving feedback and opportunities for professional growth, and for
gaining experience in case consultation and formulation.

## Requirements for Completion

Interns are expected to progress along a continuum of competence during
the internship year in the areas of assessment, clinical interventions,
consultation, supervision, and professional development. To maintain
good standing, interns actively participate in clinical assignments, are
receptive to and responsive to supervision, and demonstrate ethical and
professionally appropriate behaviors. Interns in good standing
demonstrate punctuality, are receptive to clinical assignments, complete
clinical responsibilities and documentation in a timely manner,
recognize professional limitations, and seek supervisory assistance as
needed.

Early in the internship year, and early on specific rotations, interns
are expected to need fairly close supervision, including observation
under certain circumstances. Interns are expected to become more
autonomous in their professional activities over the course of each
rotation, and across the internship training year. By the end of the
internship year, interns are expected to be able to function
independently or with minimal supervision in a number of core
professional areas. These include the ability to understand referral
questions; select, administer, and interpret appropriate evaluation
instruments; conduct diagnostic interviews; clearly communicate findings
in writing and in person; apply psychotherapeutic techniques; display
sensitivity to issues of diversity; and maintain high ethical and
professional standards. In more specialized areas, such as
neuropsychology, increased competence is expected, but interns are not
expected to practice independently or with minimal supervision by the
end of the training year.

Interns are evaluated at various points in time during the internship
year. Interns must maintain adequate performance in core areas to remain
in good standing. Interns who do not maintain this minimal level of
competence will be placed on probation, and a remediation program
initiated.

## Facility and Training Resources

The Mental Health Clinic at the Asheville VA completed an expansion in
2008, to include individual offices for psychology interns. Intern
offices are equipped with voice recording equipment for supervisory
purposes, and video recording equipment is available in the facility as
well. Interns also have access to additional space as needed on
inpatient units, outpatient clinics including Primary Care, and testing
areas. All offices include state of the art computer equipment, with
access to the hospital network, and Windows-based software including
computerized patient record system (CPRS), VA Vista, and Office-based
applications. Internet and intranet LAN connectivity are provided. The
Asheville VA maintains a medical library on station, as well as having
sharing agreements with local universities. VA maintains a wide lending
library for access to computerized journal articles. Interns receive
needed clerical and administrative support and assistance through the
Mental Health Clinic staff, as well as through the Medical Center staff
if needed to complete clinical duties elsewhere in the hospital. The
Mental Health Service Line employs five full-time
clerical/administrative staff within the Mental Health Clinic, and
additional clerical/administrative staff in free-standing programs such
as SARRTP.

## Administrative Policies and Procedures

**Personal Information**

*Our privacy policy is clear: we will collect no personal information
about you when you visit our Website.*

In the supervision of interns, the faculty believes that an intern's
awareness and use of self are important professional tools for
facilitating interpersonal interactions. We believe that forming a
positive working alliance is an indispensable ingredient in any helping
relationship. We encourage interns to explore and understand those
qualities and characteristics that they bring to each interpersonal
encounter. We want interns to recognize, improve, and employ personal
qualities that will assist them in forming effective working
relationships with patients, peers, faculty, staff, and other members of
the community. This aspect of supervision is evaluative and educational
in nature.

The faculty is committed to promoting intern development, respecting
intern privacy, and avoiding the misuse of power that can accompany dual
roles. Towards these ends, the faculty supervisors respect the ability
of interns to choose what personal information is appropriate for
disclosure to faculty. There are exceptions to this general rule. In
some situations, it is necessary for faculty to evaluate or obtain
assistance for interns whose personal problems prevent them from
performing their training activities or professional duties in a
competent manner or whose behavior may pose a threat to self or others.
In these situations, the faculty may ask for personal information in
order to make a responsible decision. In so doing, the faculty members
will follow guidelines for remediation and due process described in the
program manual. Although the faculty recognizes that interns may need or
benefit from psychotherapy, supervisors do not establish therapy
relationships with interns, or for that matter, anyone with whom such an
arrangement would constitute a dual relationship.

**Due Process**

***Performance Deficits* --** One of the goals of internship is for
interns to identify and work on gaps and deficits in their knowledge,
skills, and experience. The internship program helps interns identify
such areas through supervisory evaluations. The internship provides
opportunities for improving knowledge and skills through didactic
presentations and clinical rotations. It is expected that interns will
make sufficient improvement in these areas so that they will be able to
meet the Performance Standards listed previously. Interns must meet
these standards in order to graduate from and obtain official credit for
completing the predoctoral internship. In almost all cases, the process
of supervisory evaluations and feedback meetings by the training
committee ensures that interns receive adequate training and supervision
to achieve satisfactory levels of performance.

If a problem or deficit is identified to be of significant seriousness
to the extent that the intern would not be able to graduate from the
internship program, this problem must be brought to the attention of the
Director of Psychology Training and the training committee as quickly as
possible. It is the ethical responsibility of interns and supervisors to
bring such issues to the Director of Psychology Training and training
committee if there is reasonable suspicion of a problem. If an intern is
not aware of a deficit, he or she cannot remediate it. If the problem
area or deficit is serious, the training committee will meet to decide
if the Intern will be placed on probation (see below). If a supervisor
gives an intern a "Needs Remedial Work" rating on a formal evaluation,
either mid-rotation or end of rotation, this will automatically result
in the intern being placed on probation. An intern can also be placed on
probationary status for significant or repeated instances of unethical,
illegal, or unprofessional behavior. It must also be noted that flagrant
ethical and/or legal violations may result in an intern being
immediately terminated from the Internship.

***Probation* --** As noted above, if an Intern receives a "Needs
Remedial Work" rating on a mid or final rotation evaluation or a mid
year individual therapy or assessment supervisor evaluation, the intern
is automatically placed on probation. In addition, if the Director of
Psychology Training/ Asst. Director of Psychology Training, a supervisor
or intern becomes aware of a serious deficit or unprofessional conduct
on the part of an intern that would create doubts or questions about
their ability to satisfactorily meet the Performance Standards for
successful completion of the internship, this issue must be brought
before the training committee. The training committee will carefully
evaluate the situation, speak with the intern and his or her
supervisors, and review any written material relevant to the issue
including evaluations or clinical work. The training committee may
request information in writing from the intern and supervisors.

***Pursuant to anticipation of application to APPIC Membership, this
program adheres with the following three provisions:***

1.  APPIC members are required to provide due process for doctoral
    interns,

2.  Internships are permitted to create their own due process procedures
    for both academic and disciplinary decisions, consistent with their
    particular institutional requirements, and

3.  Public institutions must provide a level of due process which meets
    constitutional standards as follows:

    -   Regarding academic decisions, gives interns notice of the
        internship's academic rules and of any academic deficiencies.
        While a hearing may be provided, it is not required.

    -   Regarding disciplinary decisions, gives interns notice of the
        charges and details of the hearing so that the intern is
        afforded an opportunity to respond, explain and defend. Hearings
        are required, but need not be like formal courtroom proceedings.

The Asheville VA Medical Center Psychology Training Program affords the
opportunity for a hearing to interns facing probation and/or expulsion.
The right to a hearing is not required when there is a situation that
could cause danger if the intern were afforded the hearing. The hearing
is informal to the extent that there is "...no requirement for a
transcript or for the presence of attorneys" (APPIC, 1996). The hearing
will be scheduled by the Director of Psychology Training to occur before
members of the training committee. All members of the committee need not
be present.

In instances where concern is expressed about an intern's performance
without an unsatisfactory rating from an intern's supervisor, the
training committee will decide by majority vote of a quorum present
whether the intern does have a serious enough deficit or problem that
would jeopardize his or her ability to successfully complete the
internship. An intern on probation cannot graduate or successfully
complete the internship until the intern has been removed from
probationary status.

When an intern is placed on probationary status, the intern will meet
with the training committee, the Director of Psychology Training, and
the intern's supervisors to devise a learning contract to remediate the
intern's deficits. In situations where someone other than the intern's
direct supervisors has raised a concern, that party may be consulted as
a part of the process. Such a problem and its remediation would take
priority over the intern's preference for training rotations and
experiences.

***The learning contract will consist of part or all of the
following:***

-   additional training experiences,

-   immediate changes in the intern's rotation responsibilities, if
    necessary,

-   a system for frequent feedback (at least once per month) on the
    intern's progress and performance to the Director of Psychology
    Training and the training committee,

-   standards for meeting minimal levels of proficiencies in the problem
    areas or deficits,

-   opportunities for training and remediation that clearly and
    concretely address the areas of concern,

-   input from the intern's individual psychotherapy supervisors and/or
    assessment supervisor when appropriate.

Once this contract has been devised and accepted by the intern
(acceptance is preferred but not required), the Director of Psychology
Training, the intern's supervisors and the Training Committee will be
notified and given regular updates. The burden of demonstrating that the
problem/deficit has been adequately remediated will be on the intern
once he or she is placed on probation. The intern must achieve the goals
set by the contract in order to be considered for removal from
probation.

If an intern is placed on probationary statues, the Director of
Psychology Training will notify the intern's Training Director at his or
her graduate program. The learning contract will also be sent to the
intern's graduate program. The Director of Psychology Training of the
Asheville VAMC Internship Program will provide regular updates to the
intern's graduate program Training Director regarding the intern's
status and progress in writing (including email), verbally or both.

***Removal from Probation* --** Supervisors responsible for
implementation of the learning contract will provide written and verbal
feedback to the training committee on a regular basis, at least monthly.
When the supervisors and Training Director believe that the intern has
satisfactorily addressed and remediated the problems and deficits, and
met all the goals established in the learning contract, the Director of
Psychology Training will formally propose that the training committee
consider removing the intern from probationary status. An intern is
removed from probation by a majority vote of the training committee
present for this vote, assuming a quorum is present. Removal officially
indicates that the intern's performance is at an appropriate level to
receive credit for the Internship. An intern can only graduate from and
successfully complete the internship if they are not on probationary
status.

***Termination from Internship* --** If a intern is on probation and the
supervisors and Training Director do not believe that the intern is
achieving satisfactory progress toward acceptable levels of performance,
or believe that the intern has not been able to remediate the problem or
deficit, the training committee may have to consider alternatives such
as partial credit for internship and/or early termination from the
internship program. Similarly, if the intern does not cooperate with
devising a remediation program or refuses to cooperate with this
process, termination will be considered by the Training Committee.

An intern cannot graduate from the program if they receive an
unsatisfactory rating on a final rotation evaluation. Such a rating
means the intern has failed the rotation, which is considered a required
course for graduation. If the intern is not already on probation, the
intern will be on probation immediately and automatically, without a
vote by the training committee. The training committee will meet as soon
as possible to consider options such as devising a learning contract to
address the specified deficits, extending the internship past the
contracted one year period (without additional pay), termination from
the internship, or giving the intern partial credit for the internship
year. The training committee cannot reverse a supervisor's rating or
give an intern credit for a failed rotation.

The training committee may also consider terminating an intern from the
predoctoral program for significant or repeated instances of illegal,
unethical, or unprofessional behavior. If the situation is serious
enough, the committee may choose to terminate the intern without giving
the intern an opportunity for remediation. In all of the situations
described above, the training committee will decide on the ultimate
disposition of the intern. Since the intern will technically be on
probation in all of these situations, the outcome for the intern must be
agreed to by a majority of the training committee. It is preferable that
the Director of Psychology Training and the intern involved cooperate in
order to present the training committee with a plan that would be to the
advantage of all parties.

In all of these situations, the Director of Psychology Training will be
in intensive communication with the intern's graduate program Training
Director so that he or she may be involved in the process. If the
training committee votes to terminate the intern or provide only partial
credit for the internship, the Director of Psychology Training will meet
with the intern and talk to the graduate program Training Director in
order to come up with an appropriate plan for the intern's future
course.

***Illegal, Unethical, or Unprofessional Behavior* --** If a supervisor
or fellow intern believes that an intern has engaged in significant or
repeated instances of illegal, unethical, or unprofessional behavior, he
or she is required to report these concerns to the Training Director.
The Training Director will investigate the situation and report findings
to the training committee. The training committee may place the intern
on probation by majority vote, and for very serious problems,
immediately terminate the intern from the internship program by a
majority vote. Interns are responsible for and will be held to all of
the appropriate ethical guidelines and professional laws established by
the Department of Veterans Affairs, the Medical Center, Mental Health
Service, the American Psychological Association, and the North Carolina
Psychology Board.

## Training Staff

***Christopher L. San Miguel*** earned his Ph.D. in Clinical Psychology
from the University of Houston in 1976. He completed his predoctoral
internship at the Houston, TX VAMC. He is licensed in North Carolina. He
graduated from the VISN6 Leadership Development Institute Program (LDI)
in 2006. Dr. San Miguel is the Director of Psychology Training. His
primary clinical interests are in individual and group psychotherapy,
and psychoeducation. His clinical orientation is primarily in
cognitive-behavioral psychotherapeutic interventions. He treats veterans
with Posttraumatic Stress Disorder, other anxiety and affective
disorders (including Bipolar Disorder), dual diagnoses (co-morbid mental
and substance illnesses) and with primary psychotic disorders. He offers
significant time to administration of the Psychology Practicum and
Internship Programs and supervision through the Mental Health Outpatient
Rotation. He is an Adjunct Associate Professor of Psychology at Western
Carolina University. 

***Lawrence Lardieri*** earned his Ph.D. in Clinical Psychology from
Georgia State University in 2000. He completed his predoctoral
internship at the VA Gulf Coast Veterans HCS and his Postdoctoral
Fellowship (Serious and Persistent Mental Illness) at the Houston, TX
VAMC. He is licensed in North Carolina. Dr. Lardieri performs
individual, couples and group psychotherapy, psychological assessment,
and PTSD assessment screenings. He serves as the Lead Psychologist for
the MHSL and Coordinator of the Professional Issues / Psychotherapy
Seminar for the practicum and internship programs. His areas of interest
include psychotherapeutic literature/research, decision making in
psychotherapy, Analytical Psychology, Experiential Psychotherapy and
Depth Oriented Brief Psychotherapy. He serves as an Adjunct Assistant
Professor for Western Carolina University, and he offers supervision in
psychotherapy and seminar participation/coordination through the Mental
Health Outpatient Rotation.

***Joshua Bringle*** earned his Ph.D. in Clinical Psychology from the
University of Massachusetts, Amherst in 2006. He completed his
predoctoral internship at the Boston Consortium in Clinical Psychology
(VA Boston Healthcare System, Brockton, MA and Harvard Medical School).
He completed his Postdoctoral Fellowship in Palliative Care at the Bronx
VAMC (GRECC), and joined the Asheville VAMC in 2007. He is licensed in
North Carolina as a psychologist. During his Fellowship, he provided
psychological assessment and brief individual and family psychotherapy
with inpatients, and psychological consultation on medical units for
veterans with serious, chronic medical conditions. Dr. Bringle is a
member of the interdisciplinary staff assigned to the Home Based Primary
Care Program (HBPC) and the Community Living Center (CLC). He offers
intern supervision through the Inpatient and Outpatient Rotations with a
focus on geriatric psychology. He also is a seminar participant. He
serves as an Adjunct Assistant Professor for Western Carolina
University.

***Arthur Horn*** earned his Ph.D. in Clinical Psychology from the
Georgia State University in 1987. He completed his predoctoral
internship at the Tuskegee VAMC. He is licensed in North Carolina. His
primary clinical interests are in personality assessment and the
treatment of Native American Veterans. He has significant formal
training in the Rorschach Technique and Gestalt Psychotherapy. As the
psychologist assigned to the Inpatient Psychiatric Unit, Dr. Horn is
active in the multidisciplinary assessment and disposition, and
psychotherapeutic treatment of patients with diagnoses that include
Adjustment Disorders, Bipolar Disorders, Schizophrenia Spectrum
Disorders, PTSD and Organic Brain Disorders. He offers supervision
through the Inpatient Mental Health Rotation, and Assessment Seminar
Co-Coordination. His research interest is in personality assessment, he
serves as the Chair of the VAMC Research Committee, and he has two
research projects in process. He serves as an Adjunct Assistant
Professor for Western Carolina University.

***Elizabeth N. Huddleston*** earned her Psy.D. in Clinical Psychology
from the Florida Institute of Technology in 1998. She completed her
predoctoral internship at Broughton Hospital in Morganton, NC, and is
licensed in North Carolina. A recent addition to the psychology faculty,
she has served as the Psychology Department Director and Internship
Training Director (APA -- Accredited Program) at Broughton Hospital. Dr.
Huddleston is the Local Recovery Coordinator for the VAMC and an
Assistant Director of Psychology Training. She offers supervision in
psychotherapy and serves as a role model/ mentor for women professionals
who are in training as well as for those interns interested in the
pursuit of administrative careers. She is pending a faculty position at
Western Carolina University.

***E. Lynn Marlow*** earned her Ph.D. in Counseling Psychology from
Virginia Commonwealth University in 1985. She completed her predoctoral
internship at the Elmcrest Psychiatric Institute in Portland, CT, and
she is licensed in North Carolina. She is an Assistant Director of
Psychology Training. As the Military Sexual Trauma (MST) Coordinator,
Dr. Marlow conducts assessments and psychotherapeutic interventions for
female and male veteran patients who have suffered sexual trauma,
whether inflicted in civilian life or military service. Her areas of
interest include trauma recovery, interpersonal theory, dissociative
disorders, women's issues, and the development and therapeutic uses of
creativity. She offers supervision through the Outpatient Mental Health
Clinic Rotation, and seminar participation. She serves as an Adjunct
Assistant Professor for Western Carolina University.

***Bruce Purvis*** earned his Ph.D. in Clinical Psychology from the
University of Southern Mississippi in 1993. He completed his predoctoral
internship at the Gulfport, MS VAMC. He is licensed in Alabama. He
graduated from the VISN6 Leadership Development Institute Program (LDI)
in 2007. Dr. Purvis is the Coordinator of the PTSD Clinical Team, and
specializes in the treatment of veterans with Posttraumatic Stress
Disorder, with co-morbid anxiety and/or affective disorders. His primary
clinical interests are in individual, group and couples psychotherapy,
and his clinical orientation is primarily cognitive-behavioral
psychotherapeutic interventions. He offers psychotherapy group
supervision through the Outpatient/Mental Health Clinic Rotation, and
seminar participation. He serves as an Adjunct Assistant Professor for
Western Carolina University.

***Geoffrey Urbaniak*** earned his Ph.D. in Clinical-Community
Psychology from the University of South Carolina in 2005. He completed
his predoctoral internship at the Boston Consortium (Boston VAMC and
Boston University) and his postdoctoral fellowship at Broughton Hospital
(State Mental Health Hospital for North Carolina). He is licensed in
North Carolina. He recently served as an internship supervisor with
Broughton Hospital. Dr. Urbaniak is the psychologist for the Mental
Health Consult Team, where he sees veteran patients upon referral from
the Primary Care Teams and the Emergency Department. As a member of the
multidisciplinary team (psychologist, psychiatrist and nurse
practitioner) he is responsible for diagnostic interviews, test based
assessments and dispositions, including short-term treatment or
referral. His clinical interests include psychological and
neuropsychological assessment, short-term psychotherapy, severe and
persistent mental illness, and human sexuality. He is an adjunct faculty
member for the psychology internship program at Broughton Hospital and
serves as an Adjunct Assistant Professor for Western Carolina
University. He offers intern supervision through the MH/PC Integration
Rotation, and serves as the Co-Coordinator for the Assessment Seminar.

## Trainees

**2008-09**

Both of our initial class interns are from Nova Southeastern University.

## Local Information

The Charles George VAMC is located in the beautiful mountains of Western
North Carolina. Year round sports activities, arts and music are
plentiful in Asheville. Aside from local and regionally influenced arts,
the city has a symphony orchestra, a ballet, and fine theater. Diversity
is well-represented in Asheville's culture and residents. Many websites
can help you become familiar with Asheville, including
www.asheville.com, www.mountainx.com, and at the official Asheville
tourism site, www.exploreasheville.com. The Asheville Chamber of
Commerce can be found at www.ashevillechamber.org.

Along with the natural beauty, the area possesses a greatly respected
hub for healthcare, and offers, through Mission Hospitals, one of the
finest centers for cardiothoracic and cardiovascular surgery, diabetes,
and orthopedics. The University of North Carolina at Asheville boasts a
ranking as one of the finest liberal arts universities, and publications
cite Warren Wilson College to be the "greenest" college on the East
Coast. There is a highly regarded family practice residency program
offered in Asheville through the Mountain Area Health Education Center.