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Bay Pines VA Healthcare System

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Center for Sexual Trauma Services Program - Psychology Postdoctoral Fellowship Training

Supervisor: Jessica Keith Ph.D.

1. Patient population: Female and male veterans, reservists, active duty personnel with PTSD secondary to sexual trauma (MST, CSA, ASA).  Patients seen in Residential or Outpatient setting.  Focus of the residential program is on patients who have been unable to resolve MST issues/symptoms by traditional outpatient care. Participants range in period of service from Korean Conflict through OIF/OEF/OND.  Currently we are seeing an increasing number of OIF/OEF/OND females, many of whom have experienced both MST and combat-related trauma.

2. Psychology's role in the setting: Program management, member of interdisciplinary treatment team, clinical services provider, supervision and training of psychology Interns and post doctoral Fellows.

3. Other professionals and trainees in the setting:  Psychiatrist, Nursing Staff, Social Workers, Recreational Therapists.

4. Nature of clinical services delivered:  Program utilizes evidence-based treatments such as core CBT modalities, Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), Acceptance and Commitment Therapy (ACT), Dialectic Behavioral Therapy skills, Seeking Safety, and Motivational Interviewing techniques.  Treatment consists of group and individual psychotherapy, psychoeducational classes, community meetings, and case management.

5. Fellow's role in the setting:  Fellow will have the role of Primary Mental Health Provider to a discrete number of patients and provide psychodiagnostic evaluations and psychosocial assessments, treatment plans, and discharge summaries. The Fellow will function as a member of the interdisciplinary treatment team and will assist with case conceptualization, treatment planning, provision of clinical services, and case management.  The Fellow will learn to conceptualize the effects of trauma from a variety of theoretical perspectives, including cognitive-behavioral approaches.  Fellow will have the opportunity to co-facilitate and individually lead therapy groups and conduct individual CPT and PE and become familiar with a variety of leading therapeutic technologies (PE, CPT, ACT, DBT Skills, and Seeking Safety).  Fellow will have the opportunity to provide supervision to Psychology Interns and participate in the annual MST training offered for MST providers nationwide.

6. Supervision:  Fellow is provided with a minimum of one-hour weekly individual supervision as well as ongoing opportunity for in-vivo supervision within the therapeutic community via group therapy, the community milieu, and treatment team meetings.

7. Didactics:  Attendance of annual MST training for clinical providers and occasional in-service trainings by clinical staff.

CSTS is a nationally recognized program that focuses exclusively on the treatment of sexual trauma.  The program opened in 2000 on an Innovative Programs grant and was the first residential program in the country to focus solely on women with MST.  The CSTS program is the recipient of the HERA Award and was designated as a center for excellence as a part of the Women's Program.

The rotation offers a setting where the Fellow can develop, refine, and expand clinical skills. The clinical population is complex, with the majority of patients presenting with co-morbid disorders and multiple traumatic events that include military sexual trauma, childhood sexual trauma, and other adult sexual and physical abuse.  The complexity of patients and the intensity of the program ensure that Fellows acquire the in-depth experience necessary for the acquisition of expertise in working with PTSD.  Fellows will acquire and practice EBT interventions and learn to function effectively on an interdisciplinary treatment team in the treatment of chronic and/or complex PTSD.

The CSTS program is structured so that patients without prior PTSD treatment are provided with education regarding effects of PTSD and taught basic coping skills.  The program also specifically focuses on treating sexual trauma with exposure based modalities (PE, CPT) while managing the thoughts, feelings, and physiological symptoms that these interventions evoke.