For the 2019-2020 class, the MICHMED/VAAAHS Clinical Psychology Consortium will be recruiting 4 residents for the following positions (more than one position can be ranked per applicant):
- MICHMED-Adult (1 position available)
- VAAAHS-Adult (2 positions available)
- VAAAHS-Adult Women’s (1 position available)
Clinical Psychology Sections
Michigan Medicine (MICHMED) Clinical Adult Section
The MICHMED Clinical Adult Section provides outpatient assessment, consultation, and treatment services across the range of adult psychiatric disorders.
MICHMED consists of hospitals, health centers, and clinics owned and operated by the University. At its core is the Michigan Medicine Medical Center, a large, attractive inter-connected complex of contemporary buildings, located virtually in the center of Ann Arbor, a focal point of the city and the University campus. Major facilities consist of the University Hospital (UH), the Cancer and Geriatric Centers, and the Maternal and Child Health Center (MCHC), which is comprised of Mott Children’s Hospital, Von Voigtlander Women’s Hospital, and the Holden Neonatal Unit. The UM Hospitals have a total bed capacity of 809. The Michigan Medicine Medical Center provides more ambulatory patient care visits than any other academic medical center in the country, approximating 1.6 million annually. The East Ann Arbor Medical Campus, Kellogg Eye Center, Turner Geriatric Center, and the Ann Arbor Veterans Affairs Hospital and Health System are in close proximity. Adding to the University’s research capabilities in 2009, UM acquired the North Campus Research Complex—formerly the Pfizer property—which is close to the East Ann Arbor Medical Campus, and encompasses four parcels of land and 30 buildings. The acquisition added nearly two million square feet of sophisticated laboratory facilities and administrative space, along with furnishings.
Postdoctoral activities for Clinical Psychology Consortium residents take place primarily in the Department of Psychiatry’s Depression and Ambulatory Care Center within the Rachel Upjohn Building (~5 miles from the main Michigan Medicine Medical campus), a state-of-the-art facility located on the East Ann Arbor Medical Campus that was completed in 2006. This building includes over 39,000 net square feet (over 54,000 BGSF), and provides key new laboratories for current PHS-funded investigators, clinical investigation facilities and offices, educational facilities, and treatment clinics.
VAAAHS Clinical Adult Section
The VAAAHS Clinical Adult Section has a long history of evaluating and treating Veterans in acute and long-term care inpatient, outpatient, and rehabilitation settings.
The Ann Arbor VA Medical Center is located adjacent to the main Michigan Medicine Medical campus. The VAAAHS is a 105-bed general medical-surgical hospital, which includes an inpatient psychiatric unit, outpatient mental health clinics, substance abuse disorders treatment and extensive medical and other psychiatric outpatient and recovery services. The Community Living Center (CLC), specializing in short-term geriatric work, is attached to the VAAAHS. Community Based Outpatient Clinics (CBOCs) provide outpatient mental health services to Veterans in the VAAAHS catchment area but residing nearer to Jackson, Michigan; Flint, Michigan; and Toledo, Ohio. Mental Health facilities have been fully updated in the past few years. Offices for residents have modern support facilities, with full computer access to the University of Michigan information systems and library, as well as VAAAHS information systems.
Residents are provided with the opportunity to perform clinical supervision of predoctoral practicum students and interns. Additional supervision of undergraduate students who work with faculty and residents on a wide variety of research projects is also available. In addition, residents may also provide assistance in teaching seminars with faculty members. Residents also take part in an annual half-day supervision skills workshop.
Residents develop individualized training plans comprised of experiences selected by the resident in conjunction with their primary faculty advisor. Clinical experiences typically account for 50% of the resident’s experience and may be a combination of experiences at either the MICHMED or VAAAHS site from those described below. The following figure provides an overview of the clinical experiences at the two sites:
Michigan Medicine Clinical Rotations
Adult Anxiety and Depression Programs
The adult anxiety and depression programs provide individual and group CBT for patients with anxiety, depression, and comorbid disorders. Psychiatry residents receive training in CBT for anxiety disorders and depression, and psychology postdoctoral fellows, social work fellows, and practicum students may obtain supervised experience treating these disorders.
Behavioral Sleep Medicine (BSM) Clinic
The BSM Clinic conducts initial consultations and follow-up visits (individual and group therapy modalities) for adults 18 years of age and older with sleep disorders amenable to evidence-based sleep treatments (e.g., CBT for insomnia). The primary referrals to the BSM clinic are for insomnia, hypnotic discontinuation, circadian rhythm sleep-wake disorders, and adherence to medical regimens (e.g., Continuous Positive Airway Pressure, CPAP). Many initial consultations are conducted in a multidisciplinary context, where clinical psychologists work side-by-side with sleep medicine physicians. Residents are additionally encouraged to rotate through other UMHS sleep-related clinics, including the General Sleep Disorders, Pediatric Sleep Clinic, and Alternatives to CPAP Clinic, where they gain exposure to various medical specialties involved in the care of patients with sleep disorders. (e.g., Neurology, Pulmonology, Pediatrics, Otolaryngologoly, Oral and Maxillofacial Surgery).
Early Psychosis (PREP) Clinic
The PREP Clinic conducts initial consultations and early interventions for adolescents and young adults 14 years of age and older presenting with early psychosis or symptoms suggestive of increased risk for developing a psychotic disorder (attenuated psychosis syndrome or “prodromal” psychosis). We are the only early psychosis clinic in southeast Michigan. Our treatment focuses on evidence-based psychosocial interventions, including individual CBT for psychosis (CBTp), family psychoeducation, case management, and group therapy. Medication treatments are also available when appropriate. We are a multidisciplinary team consisting of clinicians and researchers from multiple disciplines, including clinical psychologists, psychiatrists, and social workers. Residents have the opportunities to learn and provide specialized assessments and individual, family, and group interventions for this young population. Residents are also encouraged to participate in local educational outreach activities to help promote early detection and intervention on campus and in the community.
University of Michigan Addiction Treatment Service (UMATS)
The University of Michigan Addiction Treatment Service is an outpatient substance use disorder treatment center located in the Department of Psychiatry, Rachel Upjohn Building. In addition to psychiatric services (medication management, outpatient detoxification, and opioid substitution treatment), psychotherapy services include intensive outpatient programming, aftercare groups, dual diagnosis groups, family/couple’s therapy, individual therapy, treatment for healthcare professionals, and a blended motivational interviewing/psychoeducational group. Residents will work collaboratively in our interdisciplinary team of psychiatrists, social workers, psychologists, and certified addiction nurses to treat patients with substance use or dual diagnoses. Residents will conduct individual and group therapies and have the opportunity to receive specialized training in Motivational Interviewing and Behavioral Couple’s Therapy, in addition to cognitive behavioral approaches.
Women and Infants Mental Health Clinic
The WIMHC is an outpatient clinic in the Department of Psychiatry in the University of Michigan Health System. Our clinic is staffed by a multidisciplinary team of psychiatrists, nurse-practitioners, psychologists, and social workers. Trainees on the team include psychology practicum students, psychiatry residents, and social work interns and fellows. As a tertiary care clinic, we specialize in assessment and treatment of mental health conditions in women, primarily during pregnancy, postpartum, and other times of hormonal change (e.g., perimenopause). We also offer dyadic-based psychotherapy services for mothers and their infants and young children. As one of very few clinics in Michigan that specialize in perinatal mental health, we serve a diverse population, often with medical and psychiatric comorbidities. As part of this rotation, postdoctoral fellows complete a mentorship in Interpersonal Psychotherapy.
VA Ann Arbor Healthcare System Clinical Rotations
The health psychology offerings emphasize functional assessments and brief interventions for patients presenting in ambulatory care settings. Exposure to Interprofessional practice and the “medical home” model are important elements in learning. The resident can gain experience with chronic pain management, MOVE! Weight Management and other patient education programs, and tobacco cessation services with some additional options. Working with the Pain Clinic and Primary Care (and Brent Coy, Ph.D.), the resident can learn to provide comprehensive, bio-psychosocial assessments and provide integrated CBT-based chronic pain management services. Residents can be integral part of the MOVE! Weight Management, Diabetes Education, or Cardiac/Pulmonary Rehabilitation, facilitating behavior change enhancement and stress management classes in these programs. Using Motivational Interviewing and ACT principles, the resident may collaborate with Pharmacy and Nursing to offer tobacco cessation services as well. Integrated care opportunities are also available with Oncology, Women’s Health and the Sleep Clinics. The resident may also conduct organ transplant and/or bariatric surgery mental health evaluations. Therefore, assessment and consultation skills, and both individual and group intervention modalities are available experiences. We aim to provide the resident with experience in working as part of medical teams in different parts of the hospital setting, consult with referring providers, and practice serving as a representative of the field of psychology in the broader healthcare setting.
Mental Health Clinic (MHC)
Training opportunities in the Mental Health Clinic include thorough and careful diagnostic assessment and psychotherapy training with a wide variety of outpatient clients. Residents may learn risk assessment and crisis intervention strategies, interviewing and assessment skills, and other screening techniques. Individual therapy cases and group therapy experiences (e.g., depression and anxiety) are available. The clinic offers opportunities to work closely with a variety of mental health professionals. Treatment approaches include empirically supported strategies, such as CBT, DBT, Motivational Interviewing, and Solution-Focused/Strategic Therapies. There are opportunities for residents to work with individuals from diverse backgrounds who present with a wide range of psychopathology. There is flexibility to accommodate individual resident interests in terms of caseload, development and implementation of treatment groups, and program assessment and evaluation activities.
Posttraumatic Stress Disorder Clinical Team (PCT)
The PCT functions as an outpatient specialty clinic within the medical center. This multi-disciplinary team provides comprehensive assessment, treatment, and research-based protocols to patients with PTSD. The resident may attend teaching rounds, perform assessments, and follow cases within this specialty clinic. Residents will have opportunities for training and practice in specialized PTSD evaluation and empirically supported treatments, including Prolonged Exposure and Cognitive Processing Therapy. In addition to weekly individual supervision, residents participate in weekly PCT staff meetings. This includes clinical case presentations, evaluation presentations, and didactic presentations on topics related to PTSD.
Psychosocial Rehabilitation & Recovery (PSR&R)
The Psychosocial Rehabilitation and Recovery (PSR&R) emphasis offers treatment opportunities across multiple specialty clinics (e.g., Psychosocial Rehabilitation & Recovery Center; Mental Health Intensive Case Management, Acute Inpatient Mental Health, Compensated Work Therapy, etc.) spanning the full continuum of care. The focus of PSR&R is weighted towards improving Veterans’ functioning, and role functioning. This means we work to help individuals develop and pursue their personal living, learning, and socialization goals in an effort to help them move forward in their mental health recovery. PSR&R offers multiple opportunities in initial and diagnostic assessments; recovery action planning; group-based EBPs (e.g., Cognitive Behavioral Social Skills Training, Illness Management & Recovery, Dual Diagnosis, , Cognitive Enhancement Therapy, Wellness Recovery Action Planning, etc.); individual therapy (e.g., CBT for Psychosis and Solution-Focused approaches); community-based work helping Veterans apply the skills they’ve learned or developed in groups; program development and evaluation; and working with peer-based services. Additional PSR&R opportunities are also available in the areas of home visits (MHICM), outreach, and working with community partners.
Substance Use Disorders Section (SUDC & SUD IOP)
The SUD experiences include opportunities for training in assessment and diagnosis, treatment planning, participating in multidisciplinary treatment, and training in empirically supported intervention approaches for individuals with substance use disorders with and without comorbidities. Psychological treatment approaches across levels of care include Cognitive Behavioral Therapy (CBT), Motivational Interviewing/Enhancement Therapy, Behavioral Couples Therapy, Harm Reduction, Mindfulness Based Relapse Prevention, and Contingency Management. The clinic provides core therapy groups using CBT, as well as a number of specialty interventions, (e.g., emotion regulation, IMR, behavioral pain management, insomnia treatment). There are opportunities for residents to work with individuals presenting with a wide range of psychopathology from diverse backgrounds in both inpatient and outpatient settings. There is also flexibility to accommodate individual resident interests in terms of caseload, development/implementation of treatment groups, program assessment/evaluation, and research activities.
Telemental Health Services
The VA is dedicated to improving access to care for Veterans using telehealth and telemedicine. Telemental health (TMH) is rapidly becoming the wave of the future, with ample opportunity for research and program development. Residents interested in telemental health services will have the opportunity to conduct evidence-based evaluations and interventions for a wide variety of mental health disorders using clinical video technology (CVT) to the community-based outpatient clinics (CBOCS), community partners, and to Veterans’ homes. Specific evidence-based modalities available include cognitive behavioral therapy (CBT) for depression and anxiety, CBT-Insomnia, CBT-Chronic Pain, Acceptance and Commitment Therapy (ACT), and Behavioral Couples Therapy (BCT). Common presenting concerns include depressive disorders, bipolar disorders, and anxiety disorders. However, the TMH team gets all types of referrals and will work with residents to assign cases that fit interests or learning needs. In supervision, special attention will be paid to development and maintenance of therapeutic rapport, as well as risk assessment and safety procedures using this modality. Residents will gain experience developing and navigating relationships with administrative and clinical staff at multiple locations. they will also attend weekly telemental health team meetings, which includes case consultation as well as administrative topics that are important in promoting and disseminating the telemental health service.
Women Veterans’ Mental Health
This experience involves evidence-based care in the outpatient mental health clinics (MHC, SUDC, and PCT) and/or health clinics. The Women’s VAAAHS Resident may elect to focus in a single clinic or can collaborate with supervisors to incorporate clinical care opportunities from multiple clinics and sites. The focus on women’s mental or behavioral health training may involve participation in both individual and group therapy offerings specifically for women Veterans and training in common intersections between military culture, gender issues, and other aspects of diversity. Options include trauma-focused treatments for PTSD (CPT, PE), DBT, Interpersonal Violence, Wellness Group for Women, Military Sexual Trauma evaluation and interventions for women, and brief interventions within the Substance Use Disorders Clinics. Residents with interest in providing trauma-focused therapy with Women Veterans diagnosed with PTSD are required to attend the PE and CPT trainings at the beginning of the resident year. Residents may be integrated into the Women’s Health Clinic (4 hours per week) to provide consultation/liaison and/or brief interventions to women presenting for specialty medical assessments or care. There are several current research options available throughout the service. Residents are afforded many opportunities to be integrally involved in administrative activities (i.e., membership in the Women Veterans’ Mental Health Working Group, projects associated with mental health service aspects of the AAVHA Women Veterans’ Programming Committee).
Couples & Family Intervention
Residents may have the opportunity to see couples utilizing the Behavioral Couples Therapy Model (BCT), Behavioral Family Therapy for SMI, and the Integrative Behavioral Couples Therapy model (IBCT). Cases may be referred for numerous presenting problems (marital distress, substance use, SPMI, etc.). Residents may also provide evidence-based CBT for partner abuse. Opportunities for providing parenting skills training for Veterans and family education are also available. Opportunities for administrative activities are available as well through involvement in the family services work group.
Additional VAAAHS Clinical Opportunities
Compensation & Pension
Residents have the opportunity to interview, observe, and assess Veterans seeking financial compensation for a broad range of psychological disorders. The central responsibilities of the experience involve psychological and neuropsychological assessment of Veterans across the adult lifespan. These evaluations involve conducting and integrative review of the Veteran's Claims File (service medical records, etc.), computerized records, interview, and administration of psychometric measures. Residents are introduced to the idea of rendering a “medical opinion” in the context of a medico-legal evaluation.
Residents may practice and learn our battery of neuropsychological tests at the start of the year in addition to reviewing standard objective and personality test procedures. Psychological testing experience includes not only interpretation of tests, but also organization and integration of interview and historical data.
We believe that progress in understanding human behavior can come from testing hypotheses generated from clinical observations. Research involvement is a necessary component of the modern clinical psychologist and therefore is a significant emphasis of the Clinical Psychology Consortium training program. Residents typically select a research component to their training plan ranging from 10-40% of their training time at the VAAAHS. Here, residents are encouraged to work with a faculty member’s current research or produce a small original study that complements the interest of a faculty psychologist who could serve as a mentor for the project. MICHMED residents are matched with an academic/research mentor and spend roughly 40% of their time in research activities, with an emphasis on development and execution of original scientific work as well as manuscript/grant writing.
Consortium training faculty are involved in many kinds of clinical research efforts, including VAAAHS and NIH funded projects (often in conjunction with other University of Michigan faculty). These activities provide students with knowledge of psychology's interface with related health disciplines. Faculty is involved with projects in a variety of departments, such as Surgery, Psychiatry, Neurology, Internal Medicine, Neuroscience, the VAAAHS Serious Mental Illness Treatment Research and Evaluation Center (SMITREC), the University of Michigan Addiction Research Center (UMARC), and the Mental Health Research Institute. Residents also have access to the wealth of research-related resources at the University of Michigan, such as the Center for Statistical Research and Consultation (CSCAR) and Michigan Institute for Clinical and Health Research (MICHR). Training faculty is also involved as members of NIH or VAAAHS Research Committees and can introduce the resident to the elements of good peer research review. In a similar fashion, a number of faculty are active on editorial boards as editors, board members, or regular reviewers of research manuscripts and can mentor residents on how constructive peer reviews can improve the quality and utility of research.
- Lee Eshelman, Ph.D. (VAAAHS-Adult):Miami University; University of Wisconsin-Madison (Internship)
- Katherine Fedele, Ph.D. (VAAAHS-Adult): University of Akron; Clement J. Zablocki VA Medical Center (Internship)
- Tyler Grove, Ph.D. (MICHMED-Adult): University of Michigan; VA Ann Arbor (Internship)
- Greta Raglan, Ph.D. (MICHMED-Adult): American University; The Catholic University of America
The training program is accredited by the American Psychological Association. Questions about the accreditation and the accreditation process can be addressed to:
Office of Program Consultation and Accreditation
American Psychological Association
750 First Street N.E., Washington DC, 20002