Mission

The Clinical Psychology Residency Program at Womack Army Medical Center, is designed to prepare psychology residents to become highly competent providers of psychological services in support of individuals, families, and organizations within the United States Army. Training is based on a Practitioner-Scholar model that espouses the premise that specific training goals should be directly related to career outcomes. Therefore, we prepare residents for a dual career as professional Army Clinical Psychologists and as Military Officers. Training is guided by a competency model approach which focuses specifically on ensuring that all residents meet a minimum threshold expected of an independent and advanced specialty practitioner of clinical psychology across nine core and specialty-specific competency domains (described further below). By the end of training, residents are expected to meet eligibility criteria for board certification in Clinical Psychology.

Aims

The 12-month full time WAMC CPRP is designed to train residents to become independent, competent, and responsible providers of clinical psychology services. Training focuses primarily on adult mental health services in a military setting. Residents receive a breadth of experience to prepare them to function competently in a variety of clinical, military, and consultative settings, both within and outside of the military. Specific areas of evaluation across all training and supervision activities include the following identified level 1 advanced, and level 2 program-specific competencies:

Level 1 - Advanced Competency Areas 

• Integration of Science and Practice: As evidenced by the residents’ understanding of research, research methodology, techniques of data collection and analysis, biological bases of behavior, cognitive-affective bases of behavior, and development across the lifespan. Residents are expected to demonstrate respect for scientifically derived knowledge and to integrate this knowledge into all aspects of their clinical work to include selection of assessment tools and intervention techniques.
• Individual and Cultural Diversity: As evidenced by the residents’ awareness, sensitivity, and skills in working professionally with diverse individuals, groups and communities who represent various cultural and personal backgrounds and characteristics defined broadly and consistent with American Psychological Association (APA) policy. Residents are expected to demonstrate an awareness of and understanding of their own and others individual and cultural diversity (e.g., ethnicity, race, gender, age, etc...) and the impact of such on the professional relationship be that psychotherapeutic, consultative, evaluative, or supervisory.
• Ethical and Legal: As evidenced by demonstrated compliance with the current ethical principles and practice standards of the APA and the military, in addition to the current statutory and regulatory provisions applicable to professional practice as a military psychologist. Residents are expected to apply ethical concepts and demonstrate an awareness of legal issues regarding professional activities with individual, groups, and organizations.

Level 2 - Program Specific Competencies

• Assessment: As demonstrated by the residents’ ability to use a scientific base to thoroughly evaluate the person and/or military organization’s collective strengths and weaknesses in an ongoing and dynamic process that at times involves formal psychometrics. Assessment also includes the ability to accurately utilize the information obtained to formulate treatment/intervention plans, and the ability to communicate the relevant findings in an understandable and useful manner.
• Intervention: As demonstrated by the residents’ ability to use empirically supported modalities to effect change in individuals and/or organizations after a thorough and informed assessment has occurred.
• Supervision: As demonstrated by the residents’ ability to communicate their own knowledge in an instructive or didactic manner in order to shape the practice of junior officers or enlisted paraprofessionals within the military training environment.
• Communication and interpersonal skills: As demonstrated through the residents’ ability to relate to colleagues, patients, clients, subordinates, and others in a sensitive, professionally effective and self-aware manner.
• Consultation and interprofessional/interdisciplinary skills: As demonstrated by the residents’ ability to communicate professional opinions in a manner that engenders decision making and the implementation of those decisions across a broad range of consultees to include health professionals, commanders, and military units.
• Professional values, attitudes, and behaviors: As demonstrated through the residents’ awareness of relevant existing concerns within the field, their own interpersonal and intrapersonal skills in establishing their identity both as a professional psychologist and as an Army officer, their awareness of their own need to seek supervision, and their maturation as a military psychologist through training in military unique aspects of psychological service delivery and consultation.

Supervised clinical experience must be enhanced by a foundation of didactic instruction. The Clinical Psychology Residency Program provides residents with more than 4 hours per week of formal seminars (averaged throughout the year). The required seminar time includes the didactic seminar series, which is offered weekly on Fridays from 8 a.m. - 12 p.m. in the Executive Conference Room. All didactics are organized around seminar series. The seminars provide a thorough and coherent examination of topics important to resident development. The didactic seminars provided are on the following topics:

• Supervision
• Ethics and Diversity
• Leadership & Consultation
• Advanced Topics:
  • Psychotherapy
  • Military Psychology
  • Diagnosis and Assessment
  • Risk Assessment

The program’s pedagogical philosophy presupposes that residents successfully completed internship and have the requisite theoretical knowledge and clinical skills which enable them to operate at a foundational or “entry level.” The seminar sequence of didactic instruction is designed to enhance and build on residents’ previous doctoral training by first providing initial orientation to the CPRP/military system/culture, and then by providing information critical for the beginning steps of professional development toward licensure and independent practice. Next, advanced knowledge in theory and treatment modalities is presented, including competency-specific content areas, and more general topics in clinical psychology. Where appropriate, some didactics will be offered to a combined class of residents and interns. These generally include didactics on ethics and diversity, or presentations by subject matter experts. Combined presentations are clearly identified as such on the didactic schedule.

Tremendous importance is placed on developing cultural sensitivity to diverse populations and utilizing cultural awareness in the professional practice of psychology. In fact, developing cultural competence is an ongoing process addressed systematically throughout our topical seminars as well as in supervisory sessions. Considerable attention is paid to cultural diversity and implications for working with and treating individuals different from one’s self.

Presentations

In conjunction with the formal seminar structure outlined above, the CPRP also provides robust opportunities for residents to develop competency in teaching and training. Residents take responsibility for designing and teaching the following monthly, bi-monthly, or quarterly didactic presentations:

Quarterly Presentations

• Two presentations to the Interns on topics to be assigned by the Program Director; these may reflect opportunities for development for the Resident, or teaching moments from which all trainees can benefit.
• One presentation on one of the Department of Defense/Veteran's Administration Clinical Practice Guidelines, to be presented to the interns
• One presentations on any topic in psychology topic that reflects an area of interest/expertise of the resident

Bi-monthly Presentations

• Offer behavioral health (BH) briefings for new Commanders and First Sergeants to Fort Liberty (occurs about once every two months).
• Other briefings as requested by the Officer In Charge or Instillation Director of Psychological Health.

Monthly presentations

• Residents also are responsible for providing monthly instruction to the Behavioral Health Specialist Technicians (68X) as part of their ongoing development.
• Residents may also be required to offer briefings on assigned topics to all providers in the Department of Behavioral Health as part of the Tuesday afternoon training stand-down.

Case Presentations

• Residents are also required to individually deliver two case presentations during the training year. Residents formally deliver these presentation before faculty members, and other clinical psychology residents and interns, using the format required by the American Board of Professional Psychology.
• Residents are required to choose cases that maximally demonstrate specific skill sets, such as detailed treatment interventions or in-depth psychometric assessment.

Other training opportunities

• Residents have access to day-long training events sponsored by the Department of Behavioral Health or the Department of Medical Education, giving them rich opportunities to enhance their professional knowledge. Residents are encouraged to present at local and national conferences.
• Residents must make arrangements well in advance if they wish to attend any relevant Womack Grand Round Conferences.

Examination for Professional Practice in Psychology Preparation

• During the first five months of the training year, time will be allocated on Fridays for Residents to prepare for the EPPP licensing exam.
• The WAMC CPRP will provide all residents with EPPP study materials.
• Residents will be expected to sit for the EPPP within the first five months of their postdoctoral residency training. Should a resident complete licensure prior to the completion of the first five months, the resident will utilize that allotted time for professional development activities and opportunities.

The majority of the resident’s time is spent in one of the Embedded Behavioral Health Clinics of the Department of Behavioral Health. Residents spend three days per week at their assigned EBH, working alongside providers in that setting. Most of the training and clinical experiences will be performed at the EBH. Time is dedicated in the resident schedule for the development of competency’ in Consultation and Interprofessional/ Interdisciplinary Skills. Residents spend Thursdays and Fridays together at the Womack Health Support Center where they will have opportunities to engage in layered supervision, socialize with each other and with other trainees, attend didactics, study for the EPPP, or engage in a mini-rotation of choice. Examples of typical weekly templates may be found as Appendix A of this Handbook. Residents spend nine (9) months on the Advanced Adult Outpatient/BHO Rotation, and, if eligible, three (3) months on one of current three elective rotations. Details of each rotation are described below.

Advanced Adult Outpatient/Behavioral Health Officer Rotation

The Advanced Adult Outpatient/BHO Rotation provides ample opportunity for residents to practice and obtain supervision in both more traditional psychological assessment, intervention, and consultative skills, as well as in advanced military-specific evaluations (such as 706 Sanity Board evaluations). Residents continue also to focus on enhancing their competence in functioning independently as Military Officers. In order to accomplish this dual goal, residents are embedded one of the EBH Clinics, which allows them a degree of independence of functioning while remaining under the supervision of an onsite training supervisor. Residents are supervised by both civilian and military supervisors.

On the Advanced Adult Outpatient/BHO Rotation, residents receive supervision on a broad range of clinical and consultative psychological services in a multidisciplinary outpatient clinic. Core clinical activities include didactics in psychological assessment, psychotherapy, health psychology applications, ethics, and military-specific topics. Residents are assigned training supervisors who are responsible for supervision of all core activities and who provide oversight of other adjunct supervisory activities. The primary goal for the resident on the Advanced Adult Outpatient/BHO Rotation is to continually demonstrate ongoing professional development in the Level 1 and Level 2 advanced and program-specific competencies outlined earlier. On this rotation, residents will have opportunities to work alongside a Behavioral Health Officer as well as the Clinic Officer in Charge in order to gain in-depth exposure to and experiences with unit and clinic briefings, administrative meetings, and leadership and consultation activities.

Upon successful completion of the Advanced Adult Outpatient/BHO Rotation, residents may request to participate in one of four elective rotations described below. All elective rotations run for four days per week for three months of the training year. Residents first submit a rank-ordered list of preferences for elective rotations. The Program Director will attempt to match residents to their preferred rotations. Should interest exceed availability for a particular elective rotation, the Program Director will first allow residents the option of revising their preferences. In the event that competing residents are in equally good standing and have been receiving positive evaluations from their supervisors, a random number generator will be employed to impartially decide any remaining conflict in preferences.

Sample WAMC Clinical Psychology Residency Program Rotation Schedule

Click on the image to download a 508-compliant version.

Elective 1: Advanced Operational Rotation

Option I: In general, the Operational Psychology rotation consists of four days a week for three months of training and experiences related to supporting the psychological needs of a military Special Operations Unit or organization such as a Special Forces, Civil Affairs, or Psychological Operations unit. Residents build skills in occupational selection and assessment, teaching/instruction, command consultation and leadership development. During this elective rotation, residents provide psychological support to Leader Development programs and schools such as Special Forces Sniper School, Civil Affairs and Psychological Operations training exercises as well as Adaptive Thinking and Leadership programs. Supervision in these areas and other command consultation services (i.e., presenting cases to a selection board) occurs. In addition, residents participate in other clinical activities to include routine psychological evaluations, research with the Army Research Institute, and didactics in performance psychology. Residents are supervised onsite by a team of Operational Psychologists. The primary goal for the resident on this rotation is to continually demonstrate ongoing professional development in all Level 1 and any relevant Level 2 areas of clinical competence.

Option II (proposed): In general, this Advanced Operational Psychology rotation will consist of three days a week for three months of training and experiences supervised by the Operational Command Psychologists. One goal of this advanced rotation will be to expose residents to performance enhancement testing and feedback which is vital to this population. Residents will be part of the Psychological Performance and Enhancement Program and provide individual feedback to operators during the key leader engagement phase of training, as well as being part of each group’s holistic operator assessments. Residents will be involved in program development, designed to improve readiness, and will receive advanced training in operational consultation, development and implementation of psychoeducation, and operational leader professional development. Residents will also have the opportunity to be part of the ongoing research into the impact of repeat blast exposure on operators at 1st Special Forces Command. Residents will be supervised onsite by a team of Operational Command Psychologists. The primary goal for the resident on this rotation is to continually demonstrate ongoing professional development in all Level 1 and any relevant Level 2 areas of clinical competence.

**To be eligible for an Advanced Operational Rotation, the resident must have successfully completed a Special Warfare Center and School Operational Rotation at the Internship level.**

Elective 2: Inpatient Psychiatry Rotation

In general, the Inpatient Psychiatry rotation consists of four days a week for three months on the inpatient psychiatry unit of the hospital, where residents conduct comprehensive psychological assessments and offer individual and group psychotherapy treatment to military service members or civilian patients requiring inpatient care. Residents work closely with the hospital’s Behavioral Health Consultation and Liaison Service, and provide competency evaluations where required. This rotation is intended to allow residents exposure to more severe forms of psychopathology. Residents are supervised onsite by a licensed clinical psychologist. The primary goal for the resident on this rotation is to continually demonstrate ongoing professional development in all Level 1 and any relevant Level 2 areas of clinical competence.

Elective 3: Pain/Behavioral Medicine Rotation

In general, the Pain/Behavioral Medicine rotation consists of four days a week for three months of training and experiences at the Womack Interdisciplinary Pain Management Center, the Womack Health Support Center, and the Robinson Clinic Primary Care Clinic. Residents on the Pain/Behavioral Medicine rotation will primarily provide interventions to patients with chronic pain and medical diagnoses (e.g., headaches or tinnitus). Training opportunities include treating patients who have a medical and/or pain diagnosis in which hyper-sympathetic arousal appears to be an aspect of the pathology. Most of these diagnoses will be treated using biofeedback assisted self-regulation. Residents will have the opportunity to work with multidisciplinary teams in several medical specialty clinics. In addition, they will receive training and experience in conducting pre-surgical evaluations for bariatric surgery candidates, spinal cord stimulation evaluations, and pre-surgical transgender evaluations. Finally, residents will receive training and experience in the use of evidence-based scripted hypnosis interventions in the treatment of chronic pain and inflammatory bowel syndrome.

**To be eligible for this option, the resident must have successfully completed the Primary Care Rotation at the Internship level.**

Elective 4: Clinical Research Rotation

In general, residents on this rotation are given four days a week for three months to develop and conduct research on a clinical area of interest, with a military population. Residents have the option of participating in one of the ongoing research projects developed by any of the operational psychologists on the faculty. Residents also have the option of developing or taking leadership of any of the Professional Improvement projects being conducted within the Department of Behavioral Health. Residents seeking to develop an independent project must start planning to do so well before the start of the elective. If necessary, residents may also need to complete training on the trusted standard in research, ethics, compliance, and safety training offered by The Collaborative Institutional Training Initiative Program. If necessary, residents may also seek consultation from Womack’s Department of Clinical Research. Supervision of this rotation is provided by a licensed clinical psychologist with clinical interest in the chosen domain. The primary goal for residents on this rotation is to continually demonstrate ongoing professional development in all Level 1 and any relevant Level 2 areas of clinical competence.

Elective 5: Child and Adolescent Family Behavioral Health

In general, residents on this rotation are given four days a week for three months gaining clinical experience in support of child and dependent population. This rotation includes participation in the robust 15-week dialectical Behavioral Therapy group for teenagers and their caregivers. Residents on this rotation strive to build a caseload of up to 8 – 10 individual clients a week. Residents will learn common treatment intervention for this population to include Cognitive Behavioral Therapy, Parent Child Interactive Therapy, Trauma Focused Cognitive Behavioral Therapy, Behavior Training, etc.

Embedded throughout the residency program’s rotations, didactics, and training opportunities.

In addition to the listed rotation requirements, during the training year, residents are expected to make every effort to attend Aeromedical Psychology Training (3-week course hosted at Fort Novosel, AL), Combat Operation Stress Control, and Traumatic Event Management.

Supported via research project or through departmental initiatives, when available.

Residents are expected to participate in weekly professional development-specific didactics as well as any institutional and departmental opportunities, as made availability. Attendance at professional workshops, seminars and conferences is also encouraged and supported, as is feasible.

• Womack Army Medical Center

Application Procedures

Active-Duty Applicants

• Interested active-duty applicants should speak with their Internship Program Director as early in the internship training year as possible to notify them of the intent to apply to Womack’s CPRP.
• All active-duty applicants must submit the Post-Internship Assignment Preference Memorandum to the Psychology Consultant, Office of the Surgeon General no later than June 1st of that training year.
• Active-duty applicants requiring a Permanent Change of Station to attend CPRP at Womack AMC will need the approval of the OTSG Psychology Consultant prior to applying.
• Current active-duty applicants must also provide the following:
  • Copy of current Solider Talent Profile
  • Copies of all completed supervisor evaluation forms from internship
  • Copy of the most recent Army Combat Fitness Test score card

Civilian Applicants

Military Entry Requirements

• Civilian applicants must be able to meet the medical and administrative requirements to serve as an active duty officer in the U.S. Army Medical Service Corps.
• Applicants are required to contact an Army Health Care Recruiter as soon as possible during your application process to assist with this process via the Army Recruiting website or 1-888-550-ARMY (2769).

Application Information

• Civilian applicants interested in applying to the Womack Clinical Psychology Residency Program must have completed an APA-accredited Clinical Psychology Internship Program and have completed all doctoral degree requirements by December 1 of the year preceding the start of the CPRP. Particularly strong candidates demonstrate excellent academic records, excellent organizational skills, flexibility, and are quick to adapt and learn in order to be successful in demonstrating the program’s aims and competencies.
• If accepted, interested applicants will become Active Duty Army psychologists and will incur a service obligation upon commissioning.
  

Each resident expected to pass the Examination for Professional Practice in Psychology licensing exam by the completion of their residency year. The WAMC CPRP will provide all residents with EPPP study materials. Residents will be expected to sit for the EPPP within the first five months of their postdoctoral residency training.

Available, and embedded in all rotations as well as within didactic trainings. Available, and embedded in all rotations as well as within didactic trainings.

• Child and Adolescent Psychology
• Gender and Affirmative Care Services
• Aeromedical Psychology
• Operational Psychology

Although not a program requirement, residents are encouraged and supported in seeking a mentor. If interested, a list of doctoral-level psychologists who have volunteered for the position can be provided. The program will strive to ensure that no mentor will serve in a supervisory role over their protégé during the residency year, although mentors may provide instruction and teaching. In the event the resident requests a mentor who will be assigned as his or her supervisor during the course of residency, a conversation about the dual nature of these relationships will occur and the resident will have the freedom to terminate the mentorship relationship and seek a different mentor. This is intended to be a non-evaluative relationship. Mentors are considered faculty in the program.

• Focus on wellness: Wellness discussion is incorporated throughout program activities. Individual and group supervision provides dedicated time for supervisors to check in with their residents about how they are doing personally, and if they need additional support.
• Group supervision: Group supervision also offers an opportunity for residents to provide peer feedback to each other about wellness or concerns related to performance or burnout
• Program Director check-ins: The PD regularly checks in with each resident and has a more focused discussion about wellness and burnout during a quarterly counseling session.
• Chief Resident: Provides feedback about how the cohort is doing and can provide anonymous feedback or concerns from individual residents or the cohort to the Program Director. The Chief Resident also provides peer support to their cohort throughout the year.
• Opportunities and Resources: Residents are afforded various opportunities throughout the year to attend wellness-based events including team building activities on their respective rotations. Residents receive information about wellness resources available to them, as well as how to access behavioral health and medical services if needed.