Clinical Health Psychology Fellowship Program
Program Description: The Postdoctoral Fellowship in Clinical Health Psychology at Brooke Army Medical Center (BAMC) facilities is an intensive, 2-year training program designed to assist psychologists in acquiring advanced competencies and specialized training skills in clinical health psychology. The training curriculum provides an integrated program of study, using a practitioner-scholar model. The mission of the Clinical Health Psychology Fellowship is to provide advanced clinical and didactic training to support clinical excellence in health psychology through:
- Providing a foundation in evidenced-based practice with medical patients,
- Working to identify, respect and nurture the unique attributes of the Fellow,
- Fostering advanced clinical and empirical skills through mentorship and practice,
- Cultivating strong leadership abilities in the field of clinical health psychology
The overall aims of the program are to: (1) to provide training towards the development of specific skills relating to the unique application of Clinical Health Psychology within a military medical treatment facility, caring for service members and their families; (2) to prepare clinical psychologists for independent clinical health psychology practice at an advanced competency level; (3) to provide training in a professional development model that will prepare and support clinical psychologists in applying for ABPP certification in clinical health psychology; and (4) to foster the development of cultural competence in healthcare delivery. Training includes:
- Two years of full-time health psychology practice in the areas of assessment, conceptualization, communication, intervention, and professional and ethical conduct supervised by licensed clinical health psychologists.
- Experience in supervision and teaching health psychology principles to trainees (psychology interns, practicum students, medical residents).
- Respect for issues of diversity.
- Professional development as evidenced by continuing professional education and membership and participation in professional psychological organizations.
Below are the goals of the training program and the training objectives within each goal.
- Fellows learn to administer health psychology evaluations using a variety of data sources: interview, formal assessment tools, medical chart information and collateral data.
- Data from these sources is used in case conceptualization, using empirically supported formulations for clinical health populations.
- Fellows refine oral and written communication with patients and consultees, who are usually medical personnel.
- Fellows develop therapeutic relationships with patients in the context of brief interactions in medical clinics.
- Fellows develop skills in group and individual empirically supported treatments for medical patients with psychosocial issues.
- Fellows refine crisis management and consultation skills within a large medical center.
- Research/program Evaluation
- Fellows become skilled in measuring outcomes for clinical health group and individual treatments.
- Fellows become skilled in measuring outcomes for clinical program effectiveness.
- Fellows become familiar with measurement of administrative program outcomes.
- Fellows expand skills in producing and using science to inform health psychology.
- Professional Development
- Fellows set and monitor professional training goals.
- Fellows expand skills in supervision for clinical health assessment, intervention and consultation.
- Fellows develop their role as a civilian psychologist in a military setting.
- Fellows make progress towards independent clinical health employment.
- Fellows maintain the boundary between personal and professional.
- Fellows use supervision constructively.
- Ethics, Law and Diversity
- Fellows develop familiarity with hospital ethics.
- Fellows develop skills in the professional, ethical and legal practice of health psychology generally, and in the military medical center, specifically.
- Fellows practice ongoing professional skills of sensitivity to cultural and individual diversity with a special focus on role of the health psychologist.
Training settings: The Clinical Health Fellowship provides services at BAMC and rarely, Wilford Hall Ambulatory Surgical Center (WHASC). Fellows provide services to active duty military, their adult family members, military retirees and their family members. This is a diverse population with individuals from every ethnic group and geographic area in the US.
Training experiences: The Fellowship is divided into two years with Year I providing the foundation and development of skills required to advance to Year II. The first year begins with a focus on primary care health psychology practice, with consideration of the importance of developing consultative relationships with medical providers. The first year includes a 3-month major rotation in the Internal Medicine Clinic and a 3-month major rotation in OB/GYN Women's Health clinic. The fellow can choose a major rotation in specialty clinics, after the primary care experience has been met. During the first year, fellows will be expected to engage in 10-15 hours per week of direct patient care, either individual or group treatment. The second year focuses on specialty health psychology care and the development or expansion of consultative services in a specialty clinic (e.g., Hem/Onc, Amputees, Burn, GI, etc.). Didactics in both training years focus on understanding the psychological sequelae of medical illness and health psychology assessment and intervention. During the second year, fellows will provide 16-20 hours per week of direct patient care, individually or in a group format. Seminars in hypnosis, supervision for supervision and medical ethics are required experiences. Fellows have joint didactics with fellows from other BAMC fellowships on topics that apply broadly, e.g., evidence-based treatment, psychopharmacology, assessment/treatment of suicidal patients, various cultural diversity topics, etc. Opportunities to supervise pre-doctoral interns or practicum students are included in the training experience.
Year I - Training experiences include:
- Development of consultative and collaborative relationships with primary care providers.
- Assessment and short term, evidence-based treatment of patients referred by their primary care providers with a variety of medical disorders and associated psychological factors.
- Experience with case conceptualization and treatment-planning from a biopsychosocial model that examines the impact of medical conditions and treatments on the psychological functioning and well-being of patients.
- Provision of consultation to providers on multidisciplinary teams (physicians, nurses, case managers, PharmD, dietitian, diabetes educators, etc.) on a variety of clinical issues, including chronic disease management, treatment adherence, and mood and anxiety disorders complicating a medical diagnosis.
- Provision of formal and informal didactics to the providers of other disciplines on their team, while increasingly acting as the subject matter expert in health psychology.
- Leading a disease management group (e.g., IBS, diabetes stress management, weight management).
- Provision of supervision to practicum students or interns, as well as didactic training on specific areas of practice, such as psychological services to primary care patients, or to patients seen in a specialty clinic, e.g., GI disorders, chronic pain issues, or cardiac disease sequelae.
- Completion of a short rotation with the Inpatient/Hospitalist medical teams, seeing patients on the ICUs and wards.
- Experience in several rotations in specialty clinics of their choice (e.g., Cardiology, GI, Pain Clinic, Hem/Onc, Burn). These experiences give the fellow an opportunity to see what specialty clinics are available to develop a full-year experience in the second year.
Year II- Training experiences include:
- Fellows choose a specialty clinic in which to spend at least 3 days per week in practice in their second year. Health psychologists are highly valued at SAMMC and physicians and other providers are very receptive to having an advanced practice trainee working in their clinic. Fellows attend didactics with the specialty clinic fellows, are mentored by a clinic staff member who guides them on a literature review of the field and shadow providers as they see their patients in clinic or perform procedures. Fellows are supervised by a health psychology faculty as well.
- Fellows are required to develop and execute a project that demonstrates the application of science to the practice
of health psychology.
- writing a grant;
- writing a study protocol and presenting it to the hospital's IRB, collecting data, analyzing and writing up the results;
- joining an existing study but writing an original proposal to address the data, or collecting new data, analyzing and writing up the results;
- performing a program evaluation of an existing program;
- creating a new program that will directly benefit patients or that will enhance or improve care in the Department of Behavioral Medicine or in the clinic where the fellow is practicing and using outcome measures to evaluate, or
- writing a detailed, publishable-quality literature review.
Faculty: The Clinical Health core faculty consists of 7 health psychologists who are all embedded in primary care or these specialty clinics: Pain, Cardiology and Hematology/Oncology. All faculty members have considerable experience in their specialty fields. The San Antonio Military Medical Center (SAMMC) Department of Behavioral Medicine supports an APA-accredited internship, as well as several other postdoctoral Fellowships. Fellows in these other training programs are also involved in joint
Stipend and benefits: Fellows are term Government Service (GS) federal employees and will be eligible for federal benefits. The first year Fellow is paid at the GS-11 level, with locality adjustment. There exists the opportunity for second year Fellows to be paid at the GS-12 level, if licensed and determined to be in good standing, however, this does not occur immediately upon completion of requirements. Go to this URL to determine the salary: http://www.opm.gov/oca/09tables/indexGS.asp. Select "Complete set of locality pay tables" and then select "Locality pay area of rest of U.S." G.S. positions include generous annual and sick leave, federal holidays, low cost healthcare plans and enrollment in the G.S. pension and employee/employer-funded retirement savings plan.
Qualifications: Applicants must be U.S. citizens. Applicants must be from an APA-accredited graduate program and have completed an APA-accredited internship. Applicants must have completed all requirements for graduation before starting the Fellowship. Ideal candidates will have some coursework in brain-behavior relationships and practica experiences with a health psychology population. Additionally, applicants are expected to have completed at least one major rotation in their internship in assessment/treatment of individuals for whom medical illness is a primary concern.
Preference will be given to applications meeting the above criteria. Any offer for Fellowship is contingent upon achieving all requirements for graduation prior to the start of the Fellowship.
Accreditation: The Fellowship is APA-accredited. For information concerning the accreditation status of this program, please contact the Commission on Accreditation of the American Psychological Association: Telephone 202-336-5979, at the American Psychological Association, 750 First Street, N. E., Washington, DC. 20002-4242; web address: www.apa.org/ed/accreditation
Applications: The United States government is a non-discriminatory, affirmative action employer. Federal law prohibits discrimination on the basis of age, sex, race, creed, color, religion, handicap or national origin.
All Fellowships are civilian programs. Although the setting is a military medical center, Fellows are under no obligation to join the military upon completion of training.
There is no formal application form for any of the Fellowship programs. Application materials may be submitted directly to the Fellowship Director of the Fellowship. Applications will be accepted until the Fellowship vacancy is filled. Applicants must send the following materials to the address listed below:
- A letter of interest
- A copy of official transcripts (including undergraduate for Clinical Health)
- Graduate transcripts listing courses, grades and degrees
- A curriculum vita
- Three sealed letters of recommendation
Send the above to:
Fellowship Director, Clinical Health Psychology
Dept. of Behavioral Medicine
San Antonio Military Medical Center
3551 Roger Brooke Drive
Fort Sam Houston, TX, 78234
For further information about each Fellowship program, please contact the Fellowship Director:
Clinical Health Psychology:
Phone: (210) 916-5962
Fax: (210) 808-2559.
Or contact the Program Coordinator, Department of Behavioral Medicine:
Phone: (210) 808-2561
Fax: (210) 808-2559.
Applications will be accepted for the Clinical Health Fellowship until 31 January for the same year or until vacancy filled.
Interviews: The faculty of the Clinical Health Psychology Fellowship are happy to offer in-person or telephone interviews to eligible applicants. Before scheduling the interview, we ask that the applicant’s doctoral program director send a letter to the fellowship director with the date scheduled for the applicant’s dissertation defense (if not already complete). This is important to ensure that all doctoral requirements are met in time to start the fellowship in the month of September.