Ptsd evaluation and treatment | veterans affairs

PTSD EVALUATION AND TREATMENT Dr. Maura Pellowe | [email protected] Dr. McKenzie Kaubrys | [email protected] VA Bedford’s PTSD Psychology Residency Training Track provides

comprehensive training in PTSD assessment and evidence-based treatments for trauma-related disorders in Veterans. Trainees gain experience in providing Cognitive Processing Therapy (CPT),

Prolonged Exposure Therapy (PE), and other interventions to Veterans struggling with PTSD symptoms. Core training elements focus on evidence-based assessment, diagnosis, case

conceptualization, and treatment of PTSD and other trauma-related disorders. There are opportunities for program development, data collection and analysis for purposes of process

improvement, and outreach/education for staff and Veterans. The overarching goal of this track is to train psychologists in specialized PTSD services to promote recovery in Veterans who have

experienced trauma. Training within our PTSD Track offers residents a breadth of opportunities to provide individual, couples, and group psychotherapy as well as clinical assessment in our

Outpatient Mental Health Clinic (MHC). VA Bedford’s MHC is comprised of five inter-professional teams, affording residents collaborative contact with clinicians from psychology, nursing,

psychiatry, and social work. Within MHC, residents are afforded an opportunity to engage a variety of Veterans in episodic, evidence-based psychotherapy for PSTD and other presenting mental

health concerns. A range of psychological issues and severity are represented, including PTSD (combat and non-combat related), anxiety disorders, mood disorders, couples/family issues, and

disorders of addiction, personality disorders, and SMI. Individual psychotherapy is informed by an overall Veteran-centered and strengths-based approach to integrative therapy. Residents

will be expected to facilitate at least two PTSD-related treatment groups over the course of the year. Residents will also receive comprehensive training in Assessment and Diagnosis of PTSD

using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). On a clinical level, the MHC operates from an integrative psychotherapeutic orientation. In addition, a focus on strengths and

recovery from a psychosocial rehabilitation is embodied in the overall approach of the clinic. Within this larger integrative orientation, an appreciation of and training in specific

evidence-based psychotherapies (EBPs) is also a key component of training and practice within the program. Residents will have an opportunity to learn and implement EBPs for PTSD, including

Cognitive Processing Therapy and Prolonged Exposure Therapy. Residents are afforded significant opportunity to tailor their clinical work in accord with their interests. On an organizational

level, the principles and practices of effective inter-professional collaboration and practice is a key foundation of both the MHC and the larger hospital. Specific didactics, grand rounds,

and interdisciplinary dialogues support this hospital’s ongoing evolution to an inter-professional model. Residents are expected to conceptualize clinical cases broadly and from more than

one perspective, and they are similarly encouraged to implement interventions thoughtfully from relevant therapeutic schools to best meet the presented clinical needs of a Veteran.

Supervisors represent a range of theoretical and clinical expertise, including cognitive-behavioral, psychodynamic, humanistic, positive psychology, experiential, and transpersonal/integral

orientations. Many supervisors also work from third-wave cognitive-behavioral approaches that emphasize mindfulness and acceptance. Many staff members have expertise in the treatment of

PTSD, and a number of supervisors are trained in one or more EBPs for PTSD (primarily cognitive processing therapy and prolonged exposure), with both formal training and ongoing supervision

available in these modalities. Staff also have training in several other EBPs relevant to care of the Veteran population. LEARNING OBJECTIVES 1. Accurately conceptualize overall client

functioning from resident’s primary psychotherapeutic orientation. 2. Ability to conceptualize specific aspects of client functioning from other psychotherapeutic orientations. 3. Effective

implementation of interventions related to one’s primary orientation to facilitate client’s integration of new knowledge/skills into everyday functioning. 4. Effective implementation of

interventions related to other psychotherapeutic orientations to facilitate client’s integration of new knowledge/skills. 5. Ability to implement evidence-based practices, particularly those

for assessment and treatment of Post-Traumatic Stress Disorder. 6. Ability to empathically join with the client and elicit necessary cooperation. 7. Ability to recognize one’s overt as well

as subtle feelings as they arise within the psychotherapy. 8. Ability to respond effectively to the content (client’s thoughts, feelings, and behavior) of the psychotherapy. 9. Ability to

target and work toward specific goals in collaboration with the client. 10. Accurately diagnose according to DSM-5, with particular attention paid to differential diagnosis of Post-Truamatic

Stress Disorder. 11. Ability to incorporate client’s dynamics, functioning, and treatment readiness in order to determine  appropriate treatment considerations. 12. Ability to effectively

facilitate a psychotherapy group for treatment of Post-Traumatic Stress Disorder. 13. Ability and initiative to design and implement programmatic changes, particularly as related to

assessment and treatment of Post-Traumatic Stress Disorder. TARGET PROFESSIONAL EXPERIENCES 1. Carry a caseload of approximately 12-15 psychotherapy clients, providing about 14 hours/week of

individual treatment. At least half of one’s caseload will carry a diagnosis of Post-Traumatic Stress Disorder. 2. Co-facilitate an evidence-based psychotherapy group related to treatment

of Post-Traumatic Stress Disorder. 3. Collaborate with inter-professional trainees and faculty on an inter-professional MHC team to provide and promote Veteran-centered clinical care and

recovery. 4. Provide consultation and outreach to clinicians and professionals across the medical center as related to assessment and treatment of Post-Traumatic Stress Disorder. 5. Provide

outreach and education to Veterans with Post-Traumatic Stress Disorder. 6. Complete at least two formal assessments for Post-Traumatic Stress Disorder using the Clinician Administered PTSD

Scale for DSM-V. 7. Provide supervision to earlier-in-training psychology students. 8. Determine specific clinic/program needs and modifications, particularly as related to assessment and

treatment of Post-Traumatic Stress Disorder. 9. Design and initiate program development activities, in collaboration with administrative staff and supervisors affiliated with one’s subtrack.