Behavioral Medicine Rotations

Availability: Major and Minor Rotation

Location: Murfreesboro Campus

Supervisor: Natalie Heidelberg, Ph.D. and Sharon Gordon, Psy.D.

Setting: The intern will be able to work with older veterans in a variety of settings for assessment and intervention services. Veterans seen on this rotation reside on the Community Living Centers at this VAMC. The Community Living Centers provide comprehensive, interdisciplinary care to veterans requiring short-term rehabilitative care and long-term skilled nursing care, including dementia related care. Within hospice, there are sixteen total beds (12 hospice and 4 palliative care). The patients have a variety of terminal or chronic illnesses including cancer, liver failure, failure to thrive, congestive heart failure, and various other diseases. Most have co-morbid psychiatric conditions such as substance abuse, depression and PTSD. The majority of the patients encountered on this rotation are in the geriatric age group.

What Interns Will Do: Interns will complete diagnostic interviews, brief cognitive assessments, capacity assessments, individual and group therapy, and assist in the development of positive contingency plans with veterans. There are also opportunities available to work with family members, such as co-facilitating the caregiver support group or providing REACH VA interventions.

Availability: Major rotation only

Location: Nashville Campus

Supervisor: Saundra Saporiti, Psy.D.

Setting:

The psychologist on the liver, heart, stem cell, and kidney transplantation services is an integral part of the transplant teams at this regional academic transplant center, which operates in conjunction with Vanderbilt University Medical Center. Psychological evaluations of potential transplant candidates and their support person(s) are performed. These evaluations involve a diagnostic interview, cognitive and personality assessment, and a collateral interview. The psychologist formulates specific recommendations regarding suitability for transplantation, and possible interventions or behavioral markers which should be met before the candidate is listed. Follow-up in regard to the patient’s progress in meeting intervention goals is an ongoing part of the evaluation. Results of the evaluation are presented in an interdisciplinary team meeting involving psychologists, transplant physicians, transplant surgeons, nurses, and social workers. Candidacy for transplant is decided at these meetings. In addition to evaluation, psychological interventions (psychotherapy and support groups) are provided for pre- and post-transplant patients and their families/support persons.

What Interns Will Do: The intern will perform psychological evaluations of potential transplant candidates and their support person(s). A goal of this rotation is the objective assessment of the risk of noncompliance, including relapse to smoking and substances of abuse, presence of dysfunctional family systems, presence of psychopathology, and cognitive impairment, any of which might be a barrier to successful transplantation. The intern must learn to communicate and report to non-mental health professionals clearly, both orally and in writing, and to work closely with medical center staff from a variety of disciplines. The intern and the staff psychologist attend team meetings together and are jointly involved in all aspects of the rotation. In addition, the intern will attend the Liver Support Group for pre- and post-transplant patients, as well as provide psychotherapy to pre- and post-transplant patients, as needed.

Availability: Major rotation only

Supervisor: Eun Ha Kim, Ph.D. (Nashville Campus); Whitney Pierce, Psy.D. (Murfreesboro Campus)  

Setting:  The psychologist on this rotation functions as a member of the interdisciplinary Pain Management Team through the Pain Clinic. The central focus of this rotation is assessment and brief interventions for patients with chronic pain conditions.  Assessment: These evaluations involve a diagnostic interview; cognitive, substance, functional, and personality assessment; and, when possible, a collateral interview.  The psychologist formulates specific recommendations regarding suitability for invasive pain management procedures, and possible interventions or behavioral markers which should be addressed before the candidate is considered a candidate for implantable pain management devices (e.g. neurostimulator, intrathecal medication pump). Follow-up in regard to the patient’s progress in meeting intervention goals is an ongoing part of the evaluation process when appropriate.  Intervention: From a Behavioral Medicine perspective,  the focus is on brief psychological interventions that facilitate self-management of pain (e.g. sleep management, use of pacing, relaxation strategies). In addition, appropriate Veterans may be trained in adjunct interventions that directly aid in reduction in physical and mental distress (e.g. biofeedback, hypnosis). The results of the evaluation and treatment recommendations are communicated to the team via a variety of formal and informal avenues.  In addition to evaluation, other services available to Pain Clinic patients and their families include individual, group, telemental health, and education.

What Interns Will Do:  The intern and the staff psychologist attend Pain Management Team meetings together and are jointly involved in all aspects of the rotation.  A goal of this rotation is the objective assessment of current functioning, available support and coping resources, potential co-morbid psychopathology, possible substance abuse, and cognitive impairment, any of which might be a barrier to full benefit of medical and psychological interventions.  The intern must learn to communicate and report to non-mental health professionals clearly, both verbally and in writing, and to work closely with medical center staff from a variety of disciplines.  In addition, the intern will attend the quarterly TVHS Pain Management Committee, as well as provide psychotherapy to Pain Clinic patients, as needed.  Interns interested in a Minor rotation experience will be expected to focus on one aspects of this rotation (for example, either the Pain Rehab group, individual implementation of the CBT-CP protocol, or biofeedback).

Availability: Major or Minor rotation, depending upon location

Location: Murfressboro Campus and Charlotte Ave./Meharry Campus

Supervisors: Ashely Barroquillo, Psy.D (Murfreesboro Campus). and Chelsea Rothschild, Ph.D. (Nashville Campus); Rhonda Venable, Ph.D. (Nashville- Charlotte Ave./Meharry annex)

Setting:  Primary Care Clinic. The PC-MHI psychologist consults with the Patient Aligned Care Teams that include a physician, a registered nurse, a licensed practice nurse, and a medical support assistant. There are opportunities to also gain exposure working with a psychiatric nurse practitioner and serve as a member of an interdisciplinary team. The PC-MHI psychologist often collaborates with other consultants within primary care in addition to the PACT team to include pharmacy and social work.

What Interns Will Do:  The intern on this rotation functions as a psychologist within the primary care setting. The central focus of this rotation is to obtain experience as a functioning member of the PC-MHI team. The intern and the staff psychologist are jointly involved in all aspects of the rotation.  Goals of this rotation are to establish skills in brief assessment, conduct brief interviews, deliver targeted brief psychological interventions, and assess veterans’ current levels of functioning and the possible impacts of co-morbid psychological disorders on physical and emotional health. The intern will develop skills regarding clear, concise verbal and/or written communication to medical providers and staff regarding patient care.