Provide description of Externship: The psychology externship program of the Veterans Affairs' New York Harbor Healthcare System's Brooklyn campus provides students with a clinically intense learning experience that includes individual and group psychotherapy as well as seminars and experiential group experiences. Veterans at our facility are coping with a wide variety of difficulties including substance abuse, posttraumatic stress disorder, grief and loss, depression, anxiety, personality disorders, family relationships, anger management, and chronic pain.
General information about externship site: Our externship program, has been mutually positive experience for both externs and staff. It encourages professional growth and hopes to provide externs with a training experience that enables them to discover their own as a clinician. Major extern responsibilities include individual psychotherapy and group psychotherapy. Externs have weekly individual supervision with a clinical psychologist and also participate in a supervision group in which they are supervised on their group psychotherapy experiences. They also participate in an extern process group. In addition, externs attend Mental Health department Grand Rounds and may participate in other seminars as well. The externship year runs from September through May and is two days per week with Friday being a required day for the Brooklyn campus positions. Some clinic assignments require attendance on other days. Possible clinic area assignments include the following:
Primary Care Psychology: Primary Care-Mental Health has become the main gateway through which veterans access mental health treatment within the Brooklyn VA Medical Center. As such, psychology externs working in this rotation will be exposed to a wide range of presenting problems and clinical demographics. Veterans range in age from 20s-90s and often present with clinically complex, interrelated problems such as combat-related PTSD, difficulties in adjustment to serious medical conditions and marital/family & life stage issues. Externs are provided with a well-rounded clinical experience that includes conducting short-term and long-term individual psychotherapy, group psychotherapy and psychological evaluations. In addition, externs are full participants in a weekly triage meeting with the primary care-mental health psychologists where case dispositions are discussed; adding to the intensive supervision and support of this rotation.
PTSD Clinic: Externs in this clinic have an opportunity to work with male and female veterans across the life-span, diagnosed with PTSD and other trauma related mental health issues as the result of combat stressors. Externs will carry a caseload of veterans that they will see for individual therapy as well as facilitate a PTSD group.
Psychology Outpatient Rotation: On this rotation we focus on giving the extern wide exposure to and experience with veterans who are having a wide array of difficulties described in the Overview section. This includes combat and non -combat veterans across the life span including those returning from recent and current conflicts. The extern conducts intakes, meets to decide clinical disposition, and provides individual psychotherapy to this outpatient population. When possible the extern will also co-lead a Vietnam Combat PTSD group psychotherapy session with another extern.
Military Sexual Trauma (MST): Externs in this rotation will primarily work with male and female veterans diagnosed with PTSD and other related mental health problems as a result of sexual trauma which took place during military service. The extern conducts intakes and carries a caseload of veterans with MST whom they will see for individual therapy. Externs will also get to participate in the annual MST Clothesline Project, where clinical staff work with survivors who are invited to decorate a T-shirt depicting their recovery process. For the group therapy experience on this rotation, the extern will co-facilitate with an Intern a one-hour dynamically-oriented process group for veterans diagnosed with hepatitis C. Group offers exposure to a broad array of psychological issues related to the diagnosis of hepatitis C, such as adjustment to major medical illness and treatment, maintaining recovery from alcohol/drug abuse, and forming healthy relationships.
Psychosocial Rehabilitation and Recovery Center (PRRC): Externs assigned to this service have the opportunity to provide a full range of psychological services in a milieu therapy program to veterans who require intensive mental health treatment. There are approximately 30-35 veterans enrolled in the program at any given time who suffer from a wide range of mental health problems, including combat-related PTSD, schizophrenia and other psychotic disorders, major depressive disorder, bipolar disorder, anxiety disorders, and personality disorders. Many of our veterans also have co-morbid medical problems. They attend the program Mondays through Fridays from 8:30am-2pm. Externs on this rotation are involved in conducting initial screenings and assessments, carrying a caseload of veterans that they will see for individual psychotherapy, co-facilitating and leading groups (both psychoeducational groups and therapy groups), and possibly working with couples and families. Externs on this rotation will have the opportunity to work on an interdisciplinary team with psychologists, social workers, a psychiatric nurse, a psychiatrist, and a creative arts therapist. Externs will learn about the recovery model of care and, specifically, how to build upon each veteran's strengths and work collaboratively to establish treatment goals.
Substance Abuse Residential Rehabilitation Treatment Program (SARRTP): 15 West is a 21 day substance abuse residential rehabilitation treatment program for men and women comprised of 22 beds. Our program is designed to treat the mental health and substance abuse needs in a collaborative, interdisciplinary environment with a focus on harm reduction. While in the program, residents participate in skills based and psychoeducational groups, and individual therapy. Veterans in this program present with a wide range of mental health needs including combat PTSD, Military Sexual Trauma, severe mental illness, bipolar disorder, anxiety disorder, and major depression. All activities offered provide opportunities to focus on and explore underlying personal experiences which may influence recovery and ongoing substance abuse. Through these activities veterans develop healthy coping strategies which can prevent future relapses. Externs on this rotation have the opportunity to work within an inpatient residential treatment setting and are collaborating members of our multidisciplinary treatment team. Externs are expected to co-facilitate/facilitate skills based (DBT, CBT, social skills), psychoeducation (Anger Management, healthy relationships), and process groups as well as meet with veterans individually as needed for supportive psychotherapy. Externs will gain experience working with veterans presenting with history of substance abuse, complex trauma, and urgent psychosocial stressors which have prevented them from achieving their treatment goals.
Director of the Program: Jessica Esposito, Ph.D.
Training director, (degree): Shalini Sehgal, Psy.D.
externship (in months): most rotations require 8-9 months (with option to extend); some require 12 months
Start Date: September 3, 2019
End Date: May 22, 2020 (with option to extend)
How many hours a week are expected of extern?:
minimum of 16 hours per week (some clinics may require additional hours)
Specialty tracks: Primary Care Psychology, PTSD, PRRC, SARRTP, MST, Outpatient Clinic, St. Alban's (see above for more information)
# of externs to be accepted for 2019-20: 11
Minimum level of readiness (any prior experiences or level of training required for applicants: Any
Do you provide a stipend? No If so how much?: N/A
When do you expect to begin interviews? (Applications can be submitted no earlier than Jan 22): Individual supervisors associated with each clinical rotation will call to schedule interviews after January 30, 2019
Interview process (provide information about interview process- time frame, how decisions are made) Also, do you conduct individual and/or group interviews; case presentation, other information?: 45-60 minute individual interviews with supervision for clinical rotation extern requested interest in; at varies for each supervisor; interviewers are scheduled throughout the entire application period until March 4,2019
What application materials are required (i.e., cv, transcript, how many reference letters, case summary, test report, other?: Cover letter, CV, transcript, two letters of recommendation
Intervention and Assessment:
Intervention training experiences offered: Estimate average number of individual patients that students will carry; estimate number of groups and other types of interventions. Offer description: Students will each carry 1 group; Individual caseload varies between 6-8 cases (including intakes); Interventions used vary depending on rotation and supervisor
Assessment training experiences commonly offered: No assessment training formally offered
Estimate hours/week of individual supervision: Minimum of 1 hour per week
Estimated hours/week of group supervision: Minimum of 1.5 hours per week
Estimated hour/week of didactics: Minimum of 3 hours per month
Estimated co-therapy hours with supervisors: Varies depending upon rotation and supervisor
Context of didactics (seminars, Grand Rounds): Grand
Rounds and quarterly seminars
Estimated informal open door "curbside" supervision: Varies depending upon rotation and supervisor
Describe direct supervision: Varies depending upon rotation and supervisor
Specify if observation occurs during intervention, assessment, consultation (audio, video, live in person (in treatment room, one-way mirror, live video stream): Varies depending upon rotation and supervisor
If you have only one extern, would you be to have the extern participate in a peer support consortium with other sites- live or "SKYPE"?: N/A
Is the agency readily accessible through public transportation?: Yes
Wheelchair accessible: Yes
Are home visits required as part of the trainee's duties?: No
Is a transportation stipend provided?: No