Postdoctoral Residency in Clinical Psychology

The VA New York Harbor Healthcare System offers a postdoctoral residency in clinical psychology with an emphasis in clinical health psychology and interprofessional training in primary care.   Beginning with the 2013-2014 training year, this program implemented a new and innovative component to its training model that emphasizes clinical and didactic interprofessional training opportunities involving psychology, social work, and medicine trainees working collaboratively. This one-year postdoctoral residency program embraces a practitioner-scholar philosophy, with a strong emphasis on clinical practice that is informed by scientific inquiry, critical thinking, and active, collaborative learning.  The integration of science and practice is emphasized in all facets of the program, including clinical training assignments, supervision, and didactics.   Providing care in a large metropolitan, multicultura,l and multiethnic environment, the program strongly emphasizes and values multicultural competence, and is infused into all aspects of the resident’s training experience.   Residents work closely with supervisors to immerse in the clinical environment and culture, increase clinical and professional skills, and develop a sequence of assignments based upon training priorities and the residents’ particular interests and goals. 

Primary care mental health integration serves as the locus for the majority of the resident’s training, which consists of a combination of year-long assignments and rotations lasting from two to five months. Responsibilities include evaluation and assessment, individual and group therapies, team participation and consultations, behavioral consultations and shared medical visits with medical providers, didactics, teaching and supervision, and a year-long residency project.  By the end of the training year, residents are expected to demonstrate competence at the level of an independent, early career psychologist in several areas including: 1) psychological assessment, diagnosis, and intervention; 2) consultation, program evaluation, supervision, and/or training; 3) strategies for scholarly inquiry; 4) organization, management, and administrative issues; 5) professional conduct and ethics; and 6) cultural and individual diversity. 

Residents affiliate with at least one “PACT” (Patient Aligned Care Team), which is the designation for a treatment team within the patient-centered medical home model implemented throughout primary care. The PACTs operate within primary care, women’s clinic, and the OIF/OEF Unit (for veterans who served in the Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq). Residents consult with the care team and respond to patient mental health issues as they arise (e.g., discussion in team meetings, curbside informal consultation, brief “same day” or full evaluation, or short and longer term psychological intervention).  They also participate in behavioral consultations, wherein a behavioral health provider sits in with a medical provider (usually a medical resident) and patient to jointly address issues such as lack of adherence or self-care, communication problems, poor understanding or comprehension, and psychosocial barriers affecting the patient’s medical care.   Residents carry a caseload of short-term individual therapy cases from primary care or specialty clinics addressing such problems as depression, anxiety, adjustment to illness, psychosocial stressors accompanying medical disorders, modifying unhealthy habits or behaviors, and chronic pain with an additional option to treat one to two longer-term psychotherapy cases. Treatment emphasizes evidence-based modalities including cognitive-behavioral therapy (CBT), problem-solving treatment, motivational interviewing/enhancement and substance abuse intervention, specialized CBT for chronic pain, and biofeedback. Residents also complete an intensive two month rotation in consultation-liaison psychiatry, lead and/or supervise a variety of groups (e.g., mindfulness/relaxation, MOVE! weight management, chronic pain), and complete an independent research project.