Anxiety and Mood Disorders
Health Psychology (VA)
Clinical Neuropsychology (UMC and VA)
Trauma Recovery Program (VA)
Psychophysiologic Disorders/Headache (UMC)
Addictive Disorders Treatment Program (VA)
Tobacco Cessation (VA)
Addiction Research and Treatment (UMC)
Cognitive Behavioral Treatment of Insomnia Clinic (UMC)
Community-based Dual Disorder Program (UMC)
( Dr. Coffey , primary supervisor; Dr. Schumacher )
The goal of this rotation is to learn how to treat mental illness that co-occurs with substance use disorders. The primary focus will be on evidence-based treatment of mood and anxiety disorders. This clinical experience takes place within the substance abuse treatment program of a local community mental health center (CMHC; 18 minute drive from UMMC campus), therefore, the resident will not only learn how to treat co-occurring disorders, but also how to participate in a multidisciplinary treatment team with fellow professionals who may have different treatment philosophies and values. Opportunities to train staff in cognitive behavioral treatment approaches and to provide general program consultation to the CMHC may also be available. Given that this CMHC is a major recruitment site for Drs. Coffey and Schumacher's NIH-funded grants, residents will also learn how to establish and maintain mutually beneficial relationships with community treatment providers. Given the importance that the National Institutes of Health have placed on testing psychological treatments in "real-world" settings, individuals interested in conducting research in community settings may benefit from experiences gained on this rotation.
Research opportunities include helping to write manuscripts from completed studies focusing on co-occurring conditions. These previous studies consist of laboratory-based and treatment studies of posttraumatic stress disorder and substance use disorders (three datasets from completed NIAAA- and NIDA-funded studies are available) and borderline personality disorder and substance use disorders (one dataset from a NIMH-funded study nearing completion).Other datasets may be available, including an assessment and referral intervention in a drug court setting and a large epidemiological study of the psychological impact of Hurricane Katrina on residents of southern Mississippi. Opportunities to collect original data within resident-led projects also may be available.
Clinical Neuropsychology(Dr. O'Jile and Dr. Bennett )
Two neuropsychology programs are offered. The comprehensive program involves a six-month full-time is designed for those residents who are interested in a career in neuropsychology and who are preparing to apply for post doctoral fellowships in clinical neuropsychology. This is modeled after the APA Division 40 guidelines for the training of clinical neuropsychologists.
Supervised experiences include conducting comprehensive neuropsychological evaluations with patients of all age groups. Referral questions in adults and children may include dementia, learning disabilities, traumatic brain injury, attention deficit/hyperactivity disorder, and a wide range of neurological and psychiatric disorders. The student will have the opportunity to participate with inpatient and outpatient multidisciplinary treatment teams. The second neuropsychology program is designed for residents who have an interest in gaining a greater appreciation of brain-behavior relations and experience in neuropsychology, but who are not interested in pursuing neuropsychology as a clinical specialty. This three or six-month experience will offer the resident the opportunity to conduct supervised neuropsychological evaluations, gain clinical experience with neurologically and medically compromised patients, and achieve a greater understanding of the neuroanatomical basis of behavior. At the UMC site, residents also participate in pre-surgical evaluations for morbidly obese patients who plan to undergo bariatric surgery, providing the opportunity for the resident to participate in a multi-disciplinary group. Residents in both programs are encouraged to become involved in ongoing neurocognitive research. Independent projects are encouraged, and there is a growing case series that residents can access for research purposes.
Addictive Disorders Treatment Program(Dr. Parker )
The ADTP at the VAMC provides training in broad spectrum behavioral treatment of psychoactive substance use disorders and their concomitant psychosocial problems. The ADTP provides screening and brief intervention services in VAMC primary care clinics, as well as detoxification and both residential and outpatient phase-one treatment programs. Case management services are available to ADTP patients and both individual and group continuing care services are provided to those in the maintenance phase of their recovery. The ADTP also offers a residential dual diagnosis treatment program for patients with both a psychoactive substance use disorder and another major psychiatric comorbidity. The ADTP provides consultation services to psychiatric and medical wards within the medical center and provides screening for pathological gambling. ADTP patients receive comprehensive assessment of biological, psychological and social domains.
Subsequent treatment incorporates chemical dependence education, anger management/communication skills training, problem solving/relapse prevention, self-management training, individual therapy, and marital/family intervention. Exposure to Twelve-Step treatment modalities is also provided to facilitate the patient's utilization of local self-help resources during post-discharge recovery. Core rotation experiences include consultation, psychological assessment, leadership of both Cognitive-Behavioral skill-building groups and process-oriented groups, and individual treatment/case management for selected patients. In addition, residents frequently choose to see one or more patients during the aftercare phase, focusing treatment on comorbidities such as panic disorder or depression while monitoring recovery. Residents have often appreciated the opportunity to be involved in administrative and strategic planning aspects of ADTP; in fact all of ADTP's current treatment manuals and many recent program innovations owe their existence to the creative collaboration between residents and residency faculty.
Psychology, psychiatry, nursing, social work, occupational therapy, chaplaincy, and dietetic disciplines are represented in the ADTP's interdisciplinary treatment team. Psychology residents are fullfledged members of this team, being uniformly well-accepted and well-respected by other team members. ADTP offers an intellectually stimulating, busy, and humane training environment. There are many clinical research opportunities in ADTP utilizing a range of methodologies. Recent and current ADTP research projects focus on use of contingency management to increase continuing care participation, the effects of CBT for social anxiety on alcohol treatment outcome, and mental status and depressive symptom changes across the first few weeks of abstinence.
Specialty Rotation Experience in Substance Abuse and Trauma
Established in 2007 The Substance Use and Post Traumatic Stress Disorder Program (SUPT) provides assessment and treatment for veterans with co-occurring substance use and post traumatic stress disorders. Individual day hospital and group based interventions for veterans that have experienced combat or other traumas (e.g., Child abuse). Residents have the opportunity to learn empirically validated assessment and intervention techniques including prolonged exposure and 12-step facilitation. Opportunities for research and program development are available.
Trauma Recovery Program
(Dr. Lyons
)
The VA Trauma Recovery Program (TRP) is devoted to clinical intervention and education regarding post-traumatic stress disorder (PTSD) secondary to combat, sexual assault or other emotional trauma. TRP's clinical program incorporates a crisis care unit, a residential/day treatment unit, and a large outpatient clinic. Residents (co)lead exposure-based trauma-processing groups, life appraisal groups (dealing with issues such as shame, guilt, forgiveness, faith) and case management groups (focused on motivation enhancement and goal-setting). Residents participate in interdisciplinary team treatment planning and may take the lead in case management of one or more patients. Individual therapy cases may include initial treatment plan development, skills training and exposure therapy. Other clinical experiences (such as marital therapy or groups on other topics) can be negotiated, based on skills and interest.
Interdisciplinary research collaboration with other PTSD and family specialists in Biloxi, Houston, Little Rock, New Orleans, Shreveport and Oklahoma City is available through the regional MIRECC. Residents assist with ongoing local and multi-site research projects/grant-writing. Residents are encouraged to carve out an authorship-level portion of the literature review or analysis from such projects for presentation or publication. Resident-initiated projects consistent with the research and clinical missions of TRP and MIRECC are also welcome. Actometers, portable heartrate monitors, and videorecording equipment are available for research and clinical work. For those with a working knowledge of psychophysiological assessment, TRP also has Coulbourn lab equipment.
Students from local colleges and universities often seek clinical and research practica within the program. Residents often play a lead role in the training and supervision of these students. TRP's expertise in disaster response, trauma reactions, coping and caregiver burden results in frequent invitations to present on these topics. Residents often have the opportunity to serve as primary or co-presenter for such presentations to campus or community audiences.
Anxiety and Mood Disorders(Dr. Del Ben )
This UMMC rotation offers resident a wide variety of clinical experiences with patients at the Adult Outpatient Clinic (AOPC) located in the Jackson Medical Mall. The AOPC functions as UMMC's outpatient psychiatric clinic in Jackson and serves a largely urban population. Residents serve the as the primary therapist on selected cases primarily involving depressive, anxiety, personality, and adjustment disorders with an emphasis on the assessment and treatment of Posttraumatic Stress Disorder. Residents are expected to interact with other disciplines, to participate in interdisciplinary team treatment planning, and to become familiar with the resources available to the AOPC. Therapeutically, behavioral interventions are emphasized with a particular emphasis on empirically supported techniques and bio-behavioral aspects (including a working understanding of pharmacology to facilitate interdisciplinary treatment planning). Significant attention is paid to multidisciplinary treatment plans and the practical application of empirically supported techniques within a real-world clinic. Dr. Del Ben is also part of a multidisciplinary research team that includes a clinical immunologist, pediatric allergist, and geneticist studying the relation between acute and chronic stress and immunoregulatory responses; including, the long-term affect that stress can have on various medical diseases. Based on interest and skill level, specific clinical and research experiences can be negotiated within these ongoing clinical and research opportunities.
Behavioral Medicine Rotations Health Psychology
(Dr. Dubbert
)
Health Psychology rotation includes clinical, administrative, and research training. Direct clinical service experiences typically include psychological evaluations of patients with obesity or sexual dysfunction, and other assessment and interventions related to cardiovascular disease risk factors. Administrative experience offers opportunities to learn about leadership roles for professional psychologists, including identifying populations at risk and improving outcomes for health care programs. There are opportunities to be involved in interdisciplinary continuing education. Research opportunities include involvement in ongoing or newly initiated research on a variety of topics related to health promotion and cardiovascular disease and risk modification.
Psychophysiologic Disorders/Headache(Dr. Penzien )
There are four goals for residents completing this UMC rotation. First, residents will have an opportunity to broaden their understanding of psychological factors that affect physical conditions, psychophysiology, and stress-related disorders. Second, residents gain experience in the biobehavioral assessment and treatment of recurrent headache syndromes. Third, residents have ample opportunities to participate in behavioral medicine research, particularly research pertaining to headache assessment and intervention and headache-related comorbidities, although other areas may be addressed. A collaborative, team approach has been adopted, and residents are encouraged to assume principal responsibility for facets of the research. For example, a recent research projects have addressed the relationship of headache activity, reproductive hormones and menstrual distress, development of an Internet-based behavioral intervention for chronic headache, development of efficient psychopathology screening methods among headache patients, and facilitation of adherence to headache interventions.
Tobacco Cessation(Dr. Burke)
The Tobacco Cessation program is designed to provide residents with the opportunity to participate in a diverse array of clinical and research opportunities with patients that have current or historical difficulties with substance use (i.e., alcohol, drugs, and nicotine).
A primary focus of the rotation involves participating in the Tobacco Cessation Clinic. Residents learn to conduct group, individual, and telephone-based interventions using both cognitive-behavioral and motivational enhancement techniques. Consistent with current Surgeon General and Department of Defense clinical practice guidelines, interventions typically incorporate nicotine replacement or other pharmacotherapy, thus allowing residents to work collaboratively with pharmacologists, physicians, and other primary care providers. Services are typically provided on an outpatient basis but opportunities for telemedicine based interventions are both available and encouraged. Interested residents can also learn to provide tailored tobacco cessation interventions for veterans with co-morbid psychotic, anxiety, and/or substance use disorders. Additional clinical opportunities that are available based on resident interest and patient availability involve performing psychological evaluations for veterans being considered for interferon treatment and/or organ transplants.
Research activities: Residents who elect to participate in this rotation are encouraged to become involved in research activities. Current projects involve: weight management following tobacco cessation, HIV prevention, and examining short-term changes in mood and mental status as a function of substance use treatment. Interested residents are also encouraged to prepare professional presentations and manuscripts from ongoing projects.
Addiction Research and Treatment (ART) Laboratory(Dr. Coffey and Dr. Schumacher)
In the ART Laboratory, residents can gain exposure to treatment outcome research and basic experimental research with humans aimed at understanding underlying psychological mechanisms that may contribute to the development of, or maintenance of, addictive behaviors. Recent and ongoing topics have included the development of a Motivational Interviewing-based brief intervention for interpersonally violent alcohol dependent men, a laboratory-based study of impulsivity and emotion regulation in individuals with borderline personality disorder with and without a substance use problem, a laboratory-based study of impulsivity in crack cocaine dependent participants, and a psychophysiological study examining alcohol craving in participants with both posttraumatic stress disorder and alcohol dependence. Residents have the opportunity to participate in ongoing research projects or propose a study and collect data within the resources of the ART Lab. Beginning in 2005, Drs. Schumacher and Dr. Coffey have led an ongoing, year-long seminar on grant writing. The seminar reviews the major grant mechanisms and grant submission procedures available at the National Institutes of Health. If a Resident so chooses, grant writing mentorship will be available throughout the year with the goal of producing a draft of a fundable grant.
Cognitive Behavioral Treatment of Insomnia Clinic(Dr. Schumacher )
The goal of this rotation is to train residents in the cognitive behavioral treatment of insomnia and related disorders including assessment, diagnosis, treatment planning, treatment provision and follow-up, and to familiarize trainees with other pertinent aspects of sleep medicine (polysomnography, psychopharmacology) and to learn to work within a multidisciplinary treatment and research team. Residents have opportunities to develop and conduct original research projects on the etiology, sequelae, or treatment of insomnia within the CBT for Insomnia Clinic. Residents also have opportunities to propose archival projects utilizing data collected for clinical care. There will also periodically be opportunities to observe grant writing in the area of sleep research.