Organization of the Training Program

The MCG-Charlie Norwood Psychology Residency represents a truly collaborative effort in regard to federal and local institutional support in achieving the training objectives. Given the breadth and complexity of the training objectives it is not surprising that a total of 49 faculty/staff are needed and contributed to the enterprise with the average faculty time contribution being 5.8% (8 faculty contribute 10% or more of their time to the consortium training efforts). We have 22-core faculty who are very active in daily training and 27 affiliated faculty (17 M.D.s, one P.A., two Ph.D-R.N.s, and 6 Ph.D.s) who have less active roles. Although psychology faculty members apply a wide range of theoretical orientations in their clinical work and teaching, about half emphasize cognitive-behavioral approaches. All faculty are committed to treatments based on scientifically sound empirical foundations.

Our hospitals and clinics are large regional treatment and training centers with more than 800 combined in-patient beds and a multitude of specialty treatment programs and clinics. They are relatively new, well-equipped facilities with adequate space and provisions for Residents. Medical charts are fully paperless at the VA and at MCG. Both facilities offer excellent on-line access to research and clinical information.

The MCG-Charlie Norwood VAMC Psychology Residency organizes practicum activities and supervision around three four-month rotations, each designed to expose Residents to a wide variety of patients with all types of diagnoses at varying levels of acuity and to provide specialty training in an area of interest to the Resident. Also, throughout the year one day of the week is set aside for specialty track training, enabling a continuity of training experiences in the area of the Resident’s specialty interest. There are two rotations required of all Residents: (1) The General Practice Rotation – located primarily at the Uptown VA, and (2) the Medical Psychology General Practice Rotation – located at the Downtown VA and MCG sites.

Rotations

• The General Practice Rotation

At the Uptown VA Medical Center we have developed a broad-based clinical training experience designed to maximize both the range of patient diagnostic categories and the variety of clinical training experiences. During the 4-month General Practice Rotation, Residents will have opportunities for development of their psychological assessment skills (that includes personality, PTSD-specific, and Neurocognitive Assessment), training in crisis intervention, co-leadership of time-limited groups and weekly support groups, individual, couple, and family psychotherapy. Residents will gain experience in assessing and treating various mood, psychotic, and dementing conditions, as well as Posttraumatic Stress Disorder, adjustment to serious injury and substance abuse problems. The Residents will also take an active role in treatment planning as part of an interdisciplinary team. 

• The Medical Psychology Rotation

The Medical Psychology Rotation focuses on the delivery of psychological services in a medical-surgical hospital. The settings for the Medical Psychology rotation are in the Downtown (medical-surgical) Division of the VAMC, the Uptown VAMC, the Augusta Multiple Sclerosis (MS) Center, the Medical College of Georgia (MCG) Infectious Disease Clinic, and the MCG Children’s Medical Center. This rotation focuses on acquiring a knowledge base that will enable the psychology residents to apply fundamental psychological principles to health care settings, with a goal of training residents to function independently in interdisciplinary health care settings. Rotational requirements include:

1. blind rehabilitation services for returning active duty service men/women or the combination of behavioral medicine interventions with individuals experiencing chronic pain syndromes and assessment - follow-up of bariatric surgery candidates and/or individuals with eating disorders;
2. consultation with the Augusta Multiple Sclerosis (MS) Center – providing comprehensive interdisciplinary care for people of all ages with MS;
3. consultation with the MCG Children Medical Center - providing diagnostic and brief intervention services for the Children’s Medical Center;
4. clinical service for individuals living with HIV/AIDS in an interdisciplinary team providing consultation, rapid assessment, motivational interviewing, behavioral interventions, individual, family and group therapies in HIV and HIV related environments;
5. rehabilitation psychological services in the interdisciplinary Spinal Cord Injury Service..   

Tracks

Residents select one specialty training track in which the training will occur during a 4-month rotation and each Wednesday of the week (for the entire year). When applying via APPIC, Residents will see and select from four Track choices:

• Health Behavior Track
• Child and Family Track
• Medical Psychology HIV/AIDS Track
• Psychology of Women Track

Once accepted, Residents who applied for the Health Behavior Track will have the opportunity to specialize further within this Track by selecting one of four subspecialties:

Health Behavior Track subspecialties:

• Chronic Pain, Neuropsychology and Spinal Cord Injury
• Trauma/PTSD
• PTSD/Women’s Issues
• Rehabilitation Psychology

Thus, we have seven different specialty training options:

1. Child and Family
2. Health Behavior- pain/neuro/spinal cord
3. Health Behavior - Trauma/PTSD
4. Health Behavior – PTSD/Women’s Issues
5. Rehabilitation Psychology
6. Medical Psychology-HIV/AIDS specialization
7. Psychology of Women.

Depending upon funding availability we select one Resident for the Child and Family track, one Resident for the Medical Psychology HIV/AIDS Track, one Resident for the Psychology of Women Track, and three Residents for the Health Behavior Track. Residents may apply for any or all of the four tracks on their APPIC match forms.

• The Child and Family Track.  This track provides specialty training in preparing  professional psychologists to provide services for children and their families who represent diverse populations in regard to socioeconomic, cultural, racial and ethnic characteristics. This track makes use of the following educational components: (A) Providing assessment and treatment services in the MCG Outpatient Psychiatry Clinic and the Children’s Medical Center; (B) Participation in weekly Child, Adolescent, and Family Psychiatry interdisciplinary intakes and follow-up clinics; (C) The family therapy seminar involving didactics, live supervision, and the use of an interdisciplinary reflecting team; (D) The Child Psychiatry Consultation-Liaison Service that entails consultative services for the MCG Children’s Medical Center and pediatric liaison services for pediatric specialty clinics; (E) Pediatric neuropsychological assessment training.

•  Health Behavior Track

A. Health Behavior Track - Chronic Pain, Neuropsychology and Spinal Cord Injury Specialization.  This track provides specialty training in the delivery of psychological services (including chronic pain assessment and treatment, and neuropsychological assessment) to patients in a general medical-surgical hospital and clinics and a Center for Spinal Cord Injury. This track makes use of the following educational components: (1) Consultative services in the VAMC and Center for Spinal Cord injury. (2) Leading groups in the management of chronic illness/pain. (3) Interdisciplinary treatment planning in the Center for Spinal Cord Injury. (4) Neuropsychological assessment training. (5) Resident presentations on behavioral medicine issues to VAMC staff and MCG trainees. (6) Behavioral medicine and rehabilitation psychology didactics.

B. Health Behavior Track -Trauma Specialization. This track provides specialty training in the assessment and treatment of patients with many varieties of post-trauma symptoms. The Resident will gain experience with childhood trauma, chronic trauma, male and female sexual trauma, and combat trauma spanning a range from Vietnam veterans with long-standing PTSD to active duty Iraq soldiers with acute stress disorders. Some of these patients will have complex, co-occurring Axis I and Axis II psychopathology. Some will also have medical problems associated with their trauma symptoms such as substance abuse, HIV/AIDS, traumatic brain injuries, spinal cord injuries, hypertension, diabetes, hepatitis or dementias.  In the context of an interdisciplinary health care team, residents will do inpatient crisis stabilization, diagnostic assessments, psychoeducational groups, brief psychotherapy, group therapy and individual therapy.

C. Health Behavior Track –PTSD/Women’s Issues. The PTSD/Women’s track optional experience provides specialty training in the effects of trauma upon adult women ranging in age from 20-65. In addition the experience provides an opportunity to address gender differences in PTSD. The provision of services across settings emphasizes women’s psychological, social, cultural, and developmental issues.

D. Health Behavior Track – Rehabilitation Psychology. The Rehabilitation Psychology Specialization trains residents to provide psychological services in a medical rehabilitation setting as members of a multidisciplinary team. In the context of the Department of Veteran Affair’s TBI/Polytrauma, Active Duty, Blind, Medical, Spinal Cord, and Rehabilitation Units, the patients served during this specialization experience have typically suffered from some type of traumatic or acquired injuries or physical illness that impairs their physical, emotional and/or cognitive functioning. Training includes the development of skills pertaining to psychological assessments including the assessment of brain injury, provision of empirically supported psychological treatment interventions of the emotional, behavioral, and cognitive sequelae associated with a wide range of medical conditions, and consultation and education for providers and families regarding the psychological sequelae of a broad range of illnesses and physical impairments.

• Medical Psychology -HIV/AIDS Track.  This track provides specialty training in preparing professional psychologists to provide services in interdisciplinary environments for individuals and families infected and affected by HIV/AIDS. This track makes use of the following educational components: (A) Clinical service in an interdisciplinary team providing consultation, rapid assessment, motivational interviewing, behavioral interventions, individual, family and group therapies in HIV and HIV related environments including the MCG Infectious Disease Clinic and MCG Outpatient Psychiatry. (B) Provision of psychological assessment and care for patients with substance abuse, neuropsychological disorders, and pain disorders. (C) The development of clinical skills relevant to issues of psychology of women, palliative care, and behavioral medicine.

• Psychology of Women Track.  This track provides specialty training in the recognition of psychological, social, and cultural issues unique to women and the provision of culturally competent psychological services to women from diverse socioeconomic, cultural, racial, and ethnic populations. Residents work at the MCG Outpatient Clinic and the VA Medical Center conducting intake evaluations, psychological assessment, and individual psychotherapy with women presenting with a broad range of problems including depression, anxiety, eating disorders, PTSD/sexual trauma, chronic illness/pain, reproductive issues/ infertility, developmental issues, and borderline personality disorder. Group psychotherapy opportunities include, DBT Skills Training Group, CBT for sexual abuse survivors, chronic illness/chronic pain group, and an eating disorders group. Residents are provided training experience in consultation/liaison services to the OB/GYN department’s OB clinic for women with high-risk pregnancies.

Seminars / Grand Rounds / Workshops

Three year-long seminars, departmental grand rounds, and workshops are provided that provide training in core clinical competencies but also explicitly address training in:  (a) scientifically-minded practice in which knowledge of numerous and varied concepts, principles, and empirical findings are integrated with an understanding of the unique attributes of an individual case; (b) skills in being reflective in clinical practice; (c) basic understanding of medical contexts that include familiarity with common medical terms and tests/procedures and appreciation of the varied assumptions and practice habits and potential contributions to health care of common health care disciplines (e.g., physicians and nurses); and  (d) the development of core professional roles and perspectives on the practice of psychology (including consideration of ethical and cultural competence issues).
 
Research

All residents are required to devote at least 4 hours a week to an academic/ research project in order to maintain their skill set for scientific thinking and research implementation and writing – encouraging residents to stay abreast if not lead the way in the development of evidence-based practices in the field of mental health care. 

Outreach Educational and Prevention Teams

Residents are required to participate in Outreach Educational and Prevention Teams designed to provide mental health education for consumers and providers in mental health and medically underserved areas in the Region 2 of the Georgia’s MHMRSA system. Servicing at least two of the community mental health centers in Region 2, these psychology faculty and resident teams will provide half-day workshops on issues of prevention and treatment of mental health disorders based on the needs of the community mental health consumers and providers.

The MCG-Charlie Norwood VAMC Psychology Residency requires that the following standards be met by the completion of the Residency:

• Completion of 2080 hours of training. Georgia requires 2000 hours of residency training and the VA requires 2080 hours of residency training; we routinely provide 2100 or more. Required rotations are expected to be completed with no more than one week of vacation and one week of sick time per 4 months. If a resident misses more than two weeks of a 4-month rotation block, the amount of time must be made up. The residency will be a minimum of 48 weeks. Stipends will be paid to the end of the residency year.  If makeup time is needed, it will be completed without remuneration.
• A minimum of 800 hours of direct clinical services. Direct clinical services includes all patient-specific clinical activities which encompasses individual, family, and group psychotherapy, consultations, psychological assessments (including test report writing), and therapy/assessment documentation. 
• Competency-based evaluations indicating that the Resident’s performance on each of the rotations is rated as “competent to implement interventions independently with supervision and review.”
• Competency-based evaluations indicating that the Resident’s performance in the Diagnostic/Treatment, Psychotherapy Process, and Professional Issues Seminars is rated as “competent to implement interventions independently with supervision and review.”
• Must have appropriately completed all medical record documentation.
• Must complete at least one research project that has a good chance of becoming a journal submission in which the Resident is an author or co-author.

Diplomas are awarded after all requirements are met.