I. Eligibility for Residency
The Clinical Psychology Residency Program (CPRP) can accommodate up to six students per academic year. The primary mechanism of fills is the DDEAMC Clinical Psychology Internship Program (CPIP); graduating interns may “opt-in” to the CPRP. Periodically and based on needs of the Army, a resident may be accepted a) as a PCS by an Officer having graduated internship at another Army CPIP, or b) as an Active Duty direct accession of an already licensed psychologist. In the latter case, the Residency will serve as a “train-up” to orient the psychologist to military-specific psychological practice. Pre-doctoral requirements are expected to be complete by December 1 to be eligible for the Residency Program, which typically starts on or about January 2.
II. Program Overview
The intent of the CPRP is to produce autonomous general scientist-practitioner psychologists capable of managing common challenges in both military and civilian practice while developing professional identity as a psychologist. Training focuses on mastery of traditional clinical skills in therapy, assessment, and consultation, building upon skills developed during the internship year, with specific focus on application to a military environment and with a military population. Although residents have the opportunity to spend time in a specialty area of interest, such as neuropsychological assessment within a traumatic brain injury population and primary care psychology, the intent of such specialty experience is to further enhance overall competencies within a generalist framework. Residents are trained to provide clinical and consultation services that are supported by scientific evidence and conducted within a sound theoretical framework. Special emphasis is placed on developing the ability to provide effective, efficient clinical services to a large and diverse population of active duty service members, retirees and family members.
Residents are supervised in various aspects of service delivery during the CPRP. There is particular emphasis placed on supervision of empirically validated interventions for the treatment of various psychopathology; assessment skills (to include diagnostic and risk assessments and military-specific psychological assessments); consultation; teaching; and supervision. Residents’ skills are refined during the training year to ensure they are adequately training in providing services to a diverse Active Duty military population. The CPRP strives to create a therapeutic environment for, and ensure ethical treatment of, patients with diverse backgrounds and characteristics. While residents provide some direct services to military family members and retirees during various rotations, the predominant population served is the active duty military population. Residents can reasonably expect to be assigned to a military unit immediately following the training year; thus, familiarity with the active duty population is highly important.
III. Training Structure and Organization
The CPRP is part of the Behavioral Health Care Line within the Dwight D. Eisenhower Army Medical Center (DDEAMC) organizational and command structure; the program also falls under the Medical Center’s Graduate Medical Education Committee (GMEC). The Program Director is a voting member of the GMEC. The CPRP abides by appropriate GMEC Standard Operating Procedures (SOPs) to include Due Process and Grievance Procedures, which are included in a later section of the Handbook.
The CPRP is divided into (4) 3-month clinical rotations and a longitudinal training experience within the Outpatient Behavioral Health Service (OBHS). A formal written evaluation is completed by a doctoral-level psychologist supervisor at the end of each rotation.
Required clinical rotations are:
- Advanced Military Psychology: The Resident enhances skills initially developed during the internship year, particularly those associated with military-specific evaluations to include personnel selection for certain Department of the Army duty positions, Security Evaluations, and command-directed mental health evaluations. Residents conduct additional evaluations to develop this important skill set, and develop additional expertise with appropriate Army Regulations to include AR 40-501 (Standards of Medical Fitness) and AR 635-200 (Active Duty Enlisted Administrative Separations), and Army Medical Command (MEDCOM) policies. Residents on the Advanced Military Psychology Rotation develop professional identity and autonomy in part by providing supervision (under staff umbrella supervision) to interns conducting military-specific evaluations and by conducting various briefings for post leaders.
- Family Medicine/Primary Care Psychology: The Resident develops skills in the psychological assessment and intervention of common behavioral health problems experienced by patients and families throughout the lifespan. Residents learn the skill of focused, brief interventions and work collaboratively with other health care professionals in a primary care setting to provide continuity of care using a biopsychosocial model. The curriculum for training residents in primary care psychology is distinguished by its immersion in hands-on care of Family Medicine patients by shadowing, direct supervision, and interdisciplinary collaboration; its provision of opportunities to work with a variety medical professionals; and its attention to experiences involving continuity of care within a systems perspective, both within the Medical Center and in the greater Augusta community.
- Combat and Operational Resilience (Fort Campbell, Kentucky): The Resident focuses on an advanced practice and clinical care experience in an Army outpatient mental health setting with a primarily combat arms population. Residents receive mentoring in the behavioral health support of combat operations. Experiences will include assignments in Fort Campbell’s Soldier Readiness and Resiliency Service (SRRS) which includes the High Interest Program (post-hospitalization treatment for suicidal/homicidal ideations, psychosis, and other severe pathology) and the Soldier Readiness Program. There will also be opportunities for experience with Brigade-based behavioral health services. The rotation provides hands-on experience with life in a Brigade footprint, the unique Behavioral Health needs of front-line combat arms Soldiers, and the Embedded Behavioral Health model being implemented in combat brigade elements.
- Elective Rotation: The Resident chooses one of 3 elective options.
- Additional 3-month rotation in Advanced Military Psychology
- Additional 3-month rotation in Family Medicine/Primary Care Psychology
- Elective 3-month rotation in Traumatic Brain Injury (TBI)/Neuroscience and Rehabilitation
- The TBI Rotation occurs primarily in the Neuroscience and Rehabilitation Center and emphasizes post-doctoral level neuropsychological training in the evaluation and management of brain injury in a garrison setting. Residents receive instruction on neuropsychological screening instruments commonly employed by Neuropsychology and available in the psychology deployment toolkit, and are instructed on how to appreciate biomedical contributions to clinical problems including cognitive and emotional status.
- Training is accomplished by increased familiarization with military and civilian brain injury populations; fostering enhanced skill with a variety of clinical instruments and tools that are routinely employed during the evaluation of patients claiming head injury including approaches that may be amenable for application down range; and further refinement of clinical interviewing, report writing, and neurobehavioral feedback skills. Residents also participate in a variety of ongoing didactics including: Review and discussion of landmark and contemporary articles, audio and video teleconferences, TBI Clinic Journal Club and Hospital Grand Rounds.
Outpatient Behavioral Health Service (OBHS): Residents operating in the DDEAMC footprint maintain a panel of long-term psychotherapy patients through the Outpatient Behavioral Health Service. Focus will be on providing evidenced-based treatment for Soldiers with a range of Axis I psychiatric disorders, particularly those secondary to deployment. Residents will engage specific treatment protocols to include Prolonged Exposure and Cognitive Processing Therapy for PTSD/Anxiety. Residents enhance already acquired skills in intake and diagnostic evaluation, risk assessment, crisis intervention, consultation, and individual and group psychotherapy. Residents further develop expertise in assessment by completing one - two psychological assessments per week utilizing various psychometric instruments to include the Personality Assessment Inventory, MMPI-2, MCMI-III, and Clinician Administered Scale for PTSD (CAPS). Focus of such assessments is on selection of appropriate psychological tests, integration of data, DSM diagnosis, writing professional reports, consultation, and making practical recommendations to referral sources. Residents complete nine total months of the OBHS experience, which may be interrupted by the Fort Campbell out-rotation (e.g., 6/3 or 3/6).
Research Requirements: Residents participate in a research endeavor under the guidance and supervision of a member of the Faculty. It is understood that it is extremely difficult, within the other obligations of the residency, to initiate a research protocol, gain IRB approval, collect and analyze data, and complete a manuscript within a one-year time frame. Therefore, residents may opt to work with a staff member on an ongoing project, develop a research prospectus and initiate the IRB process for another student or staff member to continue at a later time, or to continue a previously initiated research protocol/program. Regardless of the mechanism, each student will enter into a contract outlining the agreed upon contribution with the supervising faculty member and is expected to fulfill the outlined requirements. A goal of each student should be to have (at least) co-authorship of a professional publication or presentation at a national conference.
Didactics/Training: Residents will complete no fewer than two hours of structured learning activities or didactics per week. Activities are typically scheduled on Friday afternoon and follow a Brown Bag format. Faculty members and residents share responsibility for the presentations; residents responsible for facilitating discussions should demonstrate subject matter expertise reflective of a licensed, doctoral-level psychologist. Topics vary and are generally resident-driven, but have included topics in Military Ethics, Advanced Issues in Treatment and Assessment of PTSD, Changes with the DSM-V, Military History and Culture, Patient-Centered Medical Home, History of Combat Trauma, and Embedded Behavioral Health. The training is often conducted from a Problem-Based Learning or Reflective Practice model.
- Residents attend one- to two-day workshops (approximately every two months) from Distinguished Visiting Lecturers. Recent DVLs have included Jeffrey Younggren (Ethics), Paula Domenici (Prolonged Exposure Therapy for PTSD), David Rudd (Suicide/Risk Assessment), Dr. John Kurtz (Personality Assessment Inventory), and Commander Carrie Kennedy (Traumatic Brain Injury and Blast Concussions).
- Residents attend the one-week long Army Medical Department (AMEDD) Center and School Combat and Operational Stress Control Course in San Antonio, Texas (per funding availability; this is a centrally funded course so attendance may be dependent on financial and seat availability, however to date all residents have been able to attend).
Professional Licensure: Residents are expected to earn professional licensure during the Residency Year. Although they may obtain licensure in their state of choice, most opt to license in Alabama, Arizona, or Washington due to licensing requirements regarding overall clinical hours, including post-doctoral hours, in these respective states. Active Duty officers fall under federal guidelines and can practice with a valid license in any State. The Program Director encourages all Residents to obtain licensure by April 1 of the training year, and historically, assignment preferences go to Residents who obtain licensure as early as possible. Note, once licensed a Resident does not receive clinical privileges in the Medical Center, and he/she continues to progress in the Residency under appropriate supervision. Thus, he/she may continue to count supervised clinical hours which can (based on relevant state requirements) be used if he/she opts to seek licensure in another state at a later time.