Minneapolis VA Health Care System
Psychology Postdoctoral Residency - Neuropsychology Overview
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Program Overview - Clinical Neuropsychology
The clinical neuropsychology postdoctoral training program at the Minneapolis VAHCS was accredited by the Committee on Accreditation of the American Psychological Association in July 2011 (through academic year 2018).
The Houston Conference Guidelines provide standards by which specialized training in clinical neuropsychology is established. All general programmatic guidelines are met by our program, including (1) the presence of a board certified neuropsychologist on faculty, (2) two years full-time training, (3) provision of training at formally affiliated and proximal training sites with on-site direct clinical supervision, (4) training in allied health specialties (e.g., behavioral neurology, psychiatry), (5) interaction with other residents outside the immediate program, and (6) a program structure that assures that residents spend a significant percentage of time in clinical service, clinical research and educational training that is proportional to the residents' needs. Furthermore, our program meets all specific content areas identified in the Houston Conference Guidelines. The following is a review of exit criteria established by the Houston Conference Guidelines, with reference to program activities that accomplish those criteria.
- Advanced skill in the neuropsychological evaluation, treatment and consultation to patients and professionals sufficient to practice on an independent basis. Residents develop advanced skills in these areas through core neuropsychology rotations as well as elective rotations requiring increasing autonomy and knowledge of special populations and/or particular syndromes. Interdisciplinary consultation is integral to virtually all of these clinical experiences. For instance, residents assist in triaging consultation requests and clarify with physicians and other referral sources specific referral questions to be addressed through neuropsychological evaluation. Residents are also encouraged to provide occasional lectures to medical trainees and residents (e.g., assessment of mild traumatic brain injury). Formal didactics occurring throughout the two-year training period focus both on building a strong neuropsychological knowledge base, and exposing the Resident to the latest in scientific advances in our field.
- Advanced understanding of brain-behavior relationships. Residents obtain an advanced understanding of brain-behavior relationships through clinical and didactic activities. Clinically, they receive training and close supervision in the neuropsychological evaluation of outpatients and inpatients presenting with varied neurologic injuries or other forms of brain involvement. (e.g., Neuropsychology Consults, Geriatric Research Education and Clinical Center [GRECC], Spinal Cord Injury & Disorders Center [SCI/D], Polytrauma Rehabilitation Center [PRC]). Didactic activities include regular participation in a weekly Neuropsychology Seminar, regular brain cutting observations through the Minneapolis VAHCS morgue, and various medical rounds (e.g., Mental Health Grand Rounds) led by staff and medical trainees.
- Scholarly activity, e.g., submission of a study or literature review for publication, presentation, submission of a grant proposal or outcome assessment/ Residents are required to participate in scholarly activity, which might include the preparation of a scholarly paper or literature review, participation in ongoing research programs, or development of an independent, mentored scholarly project. Residents' scholarly activity receives mentorship from faculty, in line with the residents' research focus.
- A formal evaluation of competency in the exit criteria 1 through 3 shall occur in the residency program. Tri-yearly formal evaluations assess whether residents are successfully progressing towards meeting the exit criteria.
- Eligibility for state or provincial licensure or certification for the independent practice of psychology. Upon completion of the program, residents are eligible for licensure to independently practice psychology in the state of Minnesota.
- Eligibility for board certification in clinical neuropsychology by the American Board of Professional Psychology. Residents are also eligible for American Board of Professional Psychology specialty certification in clinical neuropsychology upon successful completion of the training program.
Psychology Service staff supervisors for the Neuropsychology specialty include: Drs. Anderson (ABPP), Clason, Cipri, Doane, Lamberty (ABPP), Miller Seelye, Sim (ABPP), Van Voorst (ABPP) and Yamada
The philosophy of our clinical neuropsychology training program is based on a scientist-practitioner model. Our program endorses the view that good clinical practice is based on the science of psychology. In turn, the science of psychology is influenced by the experience of working with complex patients. As a consequence, our approach to training encourages clinical practice that is evidence-based and consistent with the current state of scientific knowledge. At the same time, we acknowledge the considerable complexities of patients in this setting and the limitations of our empirical base. We aim to produce psychologists who are capable of contributing to the profession by investigating clinically relevant questions through their own clinical research. While individual residents may ultimately develop careers that emphasize one aspect of the scientist-practitioner model more than the other, our expectation is that clinicians will practice from a scientific basis and that scientists will practice with a strong and informed clinical sensibility.
Combining science with practice can take on several forms depending upon the training goals of the resident. For residents that are more clinically focused, between 15-25% research time is provided to complete a scholarly project that is commensurate with the release time allotted. For residents who are more research or academically oriented, up to 49% research time is provided to complete research project(s) that are commensurate with the release time allotted. Residents may take advantage of collaborating with several of the very productive clinical researchers on staff. A wide range of projects and content areas are available including work relating to neuropsychological and personality assessment measures, assessment of outcomes in rehabilitation programming, interventions/treatment trials with veteran populations, and several funded and ongoing projects aimed at assessment and treatment of veterans returning from ongoing conflicts. Regardless of focus, all residents are expected to develop a strong working knowledge of the scientific literature pertaining to assessment and intervention and all clinical activities should be guided by this knowledge base.
Our training model also emphasizes self-directed development. In addition to developing core clinical psychological skills, which build upon the skill base attained through their pre-doctoral training and residency, we encourage greater reliance on self as the resident develops his or her professional identity as a psychologist. This includes attention to advancing development of core skills such as: assessment, treatment interventions and psychotherapy, consultation and multi-disciplinary teamwork, research and scientific inquiry, supervision and teaching, ethics, and cross-cultural and diversity sensitivity. With this approach, residents will be prepared to leave their residency well-prepared to function successfully as an independent scientist practitioner
In addition, the residency training model also emphasizes breadth with depth. We expect that the postdoctoral resident will demonstrate a high degree of initiative and independence in working towards achieving his/her training goals and in meeting the complex medical and psychological needs of our veterans. Training is sufficiently broad to build on the generalized foundation of the knowledge, skills, and proficiencies that define clinical psychology, and of sufficient depth to develop more focused competence and expertise in a specific area of focus, chosen by the resident.
The primary focus of the residency year is training. Delivery of patient care is an essential vehicle through which training occurs, but is secondary to the educational mission of the residency. Toward this end, postdocs are encouraged to plan their residency experiences in a manner that maximizes their individual training goals (for example, residents help choose their own placements in order to meet their individual training needs).
Sensitivity to Diversity: Our training program is sensitive to individual differences and diversity and is predicated on the idea that psychology practice is improved when we develop a broader and more compassionate view of what it is to be human -- including human variations and differences. Our practice is improved further as we better understand the complex forces that influence a person's psychological development, including cultural, social and political factors. For these reasons, professional growth requires that the training experiences offer opportunities for trainees to expand beyond their vision of the world and learn to understand the perspective of others. When this occurs, our practice can be more responsive to the needs of individuals and less constrained by our biases. For these various reasons, the internship and residency programs place high value on attracting a diverse group of trainees and on maintaining an awareness of diversity issues during the training year.
Culture and Diversity Training Program Philosophy:
Cultural Awareness: While the skill of gathering cultural knowledge is a key component of cultural competency, cultural awareness and sensitivity are at the heart of the cultural competency experiential process. For this reason, the Minneapolis VAHCS places high value and focus on cultural awareness training, both as a valued perspective and demonstrable skill. In addition, our goal is to avoid any further perpetuation of the consumer model of cultural and diversity training where psychology trainees learn cultural information (content-based didactics with facts about diverse groups) without being challenged to demonstrate an understanding of how their personal attitudes and biases affect how they understand and interact with individuals who are different from themselves. Our objective here is twofold: a) foster and/or promote a perspective that values cultural awareness, and b) assist trainees in refining the life-long skill of self-examination and self-awareness. To this end, our training program includes awareness training through a variety of means provoking self-reflection.
Cultural Sensitivity: Like cultural awareness, cultural sensitivity requires a change in attitude. Cultural sensitivity is a highly complex interpersonal process that leads to a perspective where one genuinely values and respects diverse worldviews. This attitude embodies openness and flexibility when working with individuals from diverse backgrounds. While cultural awareness forms the initial foundation of cultural competency (i.e., becoming conscious of personal cultural values, beliefs, and perceptions), cultural sensitivity is the catalyst or experiential process where one becomes simultaneously a) aware of our personal worldview, b) aware of our patient’s worldview, and c) willing/able to foster a therapeutic alliance where both perspectives are harmoniously integrated in assessment and treatment. From a demonstrable skills perspective, we believe that cultural sensitivity relies on several skills including the skill of self-reflection (i.e., awareness) and effective gathering of cultural knowledge.
The Geriatric Research Education and Clinical Center (GRECC) is comprised of a multidisciplinary team of experts specialized in assessing and treating disorders associated with aging and memory loss. Within the GRECC, neuropsychological assessment is often requested to assist with differential diagnosis between normal aging and progressive memory or cognitive difficulty. Common referral inquiries include questions of Mild Cognitive Impairment, Alzheimer's disease, Frontotemporal dementia, vascular dementia, Lewy body dementia, Parkinson's disease, primary progressive aphasia and corticobasal degeneration, among others.
Opportunities for supervision of graduate level trainees will be available under the guidance of postdoctoral program supervisors. The resident also will participate in research and/or other scholarly academic activity related to neuropsychology either through collaboration with ongoing research programs or through independent research projects approved by the program supervisor, mentors, and training committee. This project should culminate in the submission of such work for professional presentation or publication. Graduating residents will possess the requisite skills to bring research and clinical literatures to bear on their applied work, and to communicate their own scholarly endeavors and interests to other mental health practitioners. Subsumed under this overarching goal are the following training goals:
Consistent with our overall aims, training is expressed in the following competencies (which are consistent with the Houston Conference Guidelines as stated above):
- Research - Residents will demonstrate the ability to critically evaluate and disseminate research or other scholarly activities at the local (including the host institution), regional, or national level.
- Ethical and Legal Standards - Residents will demonstrate the ability to respond professionally in increasingly complex situations with a greater degree of independence across levels of training including knowledge and in accordance with the APA Code and relevant laws, regulations, rules, policies, standards and guidelines.
- Individual and Cultural Diversity - Residents will demonstrate ability to conduct all professional activities with sensitivity to human diversity, including the ability to deliver high quality services to an increasingly diverse population. Residents demonstrate knowledge, awareness, sensitivity, and skills when working with diverse individual, as well as with communities that embody a variety of cultural and personal background and characteristics.
- Professional Values and Attitudes - Residents will demonstrate maturing professional identities and a sense of themselves as a "Psychologist" and awareness of and receptivity to areas needing further development.
- Communication and Interpersonal Skills - Residents will demonstrate effective communication skills and the ability to form and maintain successful professional relationships.
- Assessment - Residents will develop competence in advanced evidence-based neuropsychological assessment with a variety of diagnoses, problems, and needs.
- Intervention - Residents will develop competence in the provision of evidence-based interventions for adults with a variety of diagnoses, problems, and needs. Residents will select and implement these interventions from a range of therapeutic orientations, techniques, and approaches.
- Supervision - Residents will demonstrate knowledge of evidence-based supervision models and practices and apply this knowledge in direct or simulated practice.
- Consultation and Interprofessional Skills - Residents will develop competence in the intentional collaboration of professionals in health service psychology with other individuals or groups.