Trauma Risk and Resiliency Program
Training model and philosophy: The BAMC Postdoctoral Fellowship in Trauma, Risk, and Resiliency (TRR) is guided by the scientist-practitioner model. The program offers expanded clinical training and research opportunities with diverse populations, with special emphasis on active duty military, military retirees, and family members. The intent of this Fellowship is to provide advanced clinical training associated with reduction of adverse biopsychosocial outcomes of trauma. The Fellowship emphasizes the psychological, psychiatric and social factors associated with prevention, management and recovery from trauma. Best clinical practices are supported by clinical research to promote optimization and advancement of the three essential concentrations: resilience enhancement, risk management, and trauma care.
The training program consists of a Fellowship Director, Primary Supervisors, Mentors, and Site Supervisors. The Fellowship Director maintains primary responsibility for the TRR Fellowship including administration, recruitment and program evaluation. The Primary Supervisors function in the two focal areas: Clinical Practice and Clinical Research. The roles of Mentors and Site Supervisors are outlined below. Fellows are encouraged and expected to actively participate in the development of their training plans.
Primary Supervision: Each Fellow is assigned two Primary Supervisors, one for the Clinical Practice domain and the other for the Clinical Research domain, for the duration of the 2-year training program. Primary Supervisors (PS) are principally responsible for the design, implementation, and performance evaluation of the Fellow's training experiences. PS will meet weekly to review and explore the Fellow's progress and development. PS provide oral feedback monthly and written summary feedback quarterly. A semi-annual and annual progress evaluation are reviewed with Fellows and commentary documented before submission to the TRR Fellowship Director. Fellows may also receive supervision from sites that are used to develop focal skills and knowledge. PS coordinate on-site supervision.
Mentorship: The TRR Fellowship recognizes the importance of professional development and addresses this in part through a mentoring program designed to enhance clinical acumen and develop clinical research skills. Each Fellow is required to maintain a journal during the course of their experience to document special interests/concerns, novel circumstances, and issues related to their ongoing professional development. Mentorship will occur bi-weekly with the goal of offering ways to stimulate and integrate the Fellow's development. Mentors do not function as part of the evaluative system and the content of mentorship remains privileged except in circumstances of consent or identification of reasonable risk to Fellow or Program by Mentor. In the case of programmatic risk, the Mentor is required to first seek Fellow's permission to release information. If this fails, the Mentor will only release the minimal information needed to allow for risk mitigation.
Professional development is also addressed through participation in supervision, training, and joint didactics with DBM post-doctoral psychology Fellows.
Site Supervisors: Site Supervisors have the responsibility for providing advanced clinical or clinical research skills and knowledge in accordance with the Fellow's approved training. Site Supervisors maintain principal case or research responsibility.
Fellowship Experience: The TRR Fellowship is divided into two phases. Year I is focused on providing the foundation and development of advanced clinical skills and knowledge required to procure independent professional status as a health care provider. Some of these clinical experiences involve assignments to specific clinics and/or other departments within the hospital or other treatment facilities. By the end of Year I, Fellows will be able to demonstrate advanced clinical skills in treatments for posttraumatic stress reactions and management of psychological factors associated with trauma. Fellows will work in a variety of practice settings where they will receive advanced training in Prolonged Exposure Therapy and Continuous Processing, and participate in clinical research using these treatment modalities. Fellows may also elect to train in other treatment areas such as the use of virtual reality exposure therapy, the reduction of secondary trauma for children of wounded service members, special applications in primary prevention, consultation, and/ or rehabilitation issues.
The emphasis during Year II is on research. The Fellow will be asked to demonstrate mastery in the following areas:
- Display knowledge and skills associated with grant procurement and management;
- Design, implement or conduct clinical research supporting trauma and resiliency;
- Promote advancement of the scientific community's awareness of Psychological Resilience and Recovery through publications and presentations; and,
- Demonstrate capacity to conduct Psychological Resilience and Recovery Program Evaluation.
NOTE: Fellows will be expected to identify research topics by the middle to the end of Year I.
TRR Associated Factors: The TRR Fellowship includes special challenges such as a diverse population, multi-disciplinary care planning, and the potential delivery of services to a population under marked distress. As a result, organizational and management skills are necessary for addressing both clinical and research demands. Therefore, in addition to the acquisition of Core Skills and Knowledge, Fellows will also be evaluated on TRR Associated Factors (AF) that are judged to influence their effectiveness as advanced practitioners. These include interpersonal skills; ethical judgment; cultural sensitivity and diversity; effectiveness within military, research and academic environments; and supervision/management skills. These factors will be promoted through supervision, mentoring, readings and didactics.
- TRR Fellows are required to participate in weekly TRR didactics that include focal clinical and clinical research topics as well as in joint didactics shared by all Department of Behavioral Medicine Fellows.
- TRR Fellows are required to complete after-hours on-call in compliance with Department of Behavioral Medicine schedule. Year I Fellows will go on call with their Supervisor, and Year II Fellows will manage call independently with Supervisor back-up.
- Fellows must be U.S. citizens. 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. The second year Fellow will be paid at the GS12 level, if licensed and determined to be in good standing.
- TRR Fellows participate in relevant extramural training or professional associations.
TRR Fellowship Table
|Core Skills||Core Knowledge|
Consultation and Training Skills
Consultation and Training Knowledge
Clinical Research Skills
Clinical Research Knowledge
For further information, please check the Fellowship Brochure.
To contact the Fellowship Director: Phone (210)292-2730; Fax (210)292-5077.
7800 IH-10 West, Suite 300
San Antonio, TX 78230