Navy Clinical Psychology Internship Program Training Manual/Overview — Quality Assurance

by Walter Reed National Military Medical Center Department of Behavioral Health Consultation and Education

OVERVIEW

The Clinical Psychology Internship Program is sponsored by the Department of Behavioral Health Consultation and Education at the Walter Reed National Military Medical Center (WRNMMC), Bethesda, Maryland. It is fully accredited by the American Psychological Association (APA). The program is an intensive twelve-month period of clinical and didactic experiences designed to meet three broad aims: 1) To provide the trainee with experiences and skills needed to function competently as a broadly-trained clinical psychologist, 2) to equip the intern with additional knowledge and skills needed to practice competently within the Navy (e.g., unique military populations, personnel evaluation skills, etc.), and 3) To meet the overall requirements for continued accreditation as established by the APA in its Commission on Accreditation publications.

The internship is organized around a Practitioner-Scholar model. Day-to-day training emphasizes a sequential increase of knowledge and skill based on the current and evolving body of general knowledge and methods in the science and practice of psychology. Although active participation in research is not required as part of the internship, we expect interns to consistently refer to the psychology literature, and to be able to practically apply empircally supported interventions in their clinical work.

Before starting the internship, applicants who match with the internship are commissioned as Lieutenants in the United States Navy Medical Service Corps. During the internship (and subsequent service as active duty Navy psychologists), interns receive full pay and benefits as Navy officers. At the time of this writing, a new Navy Lieutenant assigned to Walter Reed National Military Medical Center receives an annual salary ranging from $80,604 to $83,004 (base pay + housing allowance for the Washington DC metro area). Annual pay raises occur as determined by the U.S. Congress and the military pay schedule.

The internship has been continuously accredited for over 50 years by the American Psychological Association’s Commission on Accreditation. The program is scheduled for its next site visit in 2018.

Questions related to the program’s accreditation status should be directed to the Commission on Accreditation:

Office of Program Consultation and Accreditation

American Psychological Association

750 First Street, N.E.

Washington, D.C., 20002-4242

(202) 336-5979 E-mail: apaaccred@apa.org Web: www.apa.org/ed/accreditation

APPIC Special Notice: This Internship Program has been a Member of the Association of Psychology Postdoctoral and Internship Centers (APPIC) since APPIC’s founding in 1990, and conducts intern selection in accordance with the policies and procedures of APPIC. This internship site agrees to abide by the APPIC Policy that no person at this training facility will solicit, accept, or use any ranking-related information from any intern applicant prior to Uniform Notification Day.

Navy Psychology Training and Practice:

Since few of our interns have had prior military experience, all attend the five week Officer Development School at Newport, Rhode Island prior to arrival at an internship site. This school includes didactic presentations on the history, traditions, and organization of the Navy. Instruction is designed to provide new officers with the knowledge and skills necessary for professional conduct in the United States Navy.

We have learned from former interns that graduates of Navy internships typically report to a professional assignment that demands a higher level of independent responsibility and professionalism than his/her peers in civilian practice. Our faculty has identified, and continues to develop, learning experiences aimed at imparting the skills necessary for effective professional performance at the next Navy assignment. These experiences are organized into a dynamic curriculum which embodies the principles set forth in the current Standards of Accreditation of the American Psychological Association.

There are a number of ways in which the general professional skills imparted through the internship can be operationally described. The Navy Clinical Psychology Internship Program at Walter Reed National Military Medical Center has adopted the profession-wide competencies outlined in APA’s Standards of Accreditation (2015) to include competencies related to: research; ethical and legal standards; individual and cultural diversity, professional values, attitudes, and behaviors; communication and interpersonal skills; assessment; intervention; supervision; and consultation.

The experiential clinical activities reflect the major areas in which military clinical psychologists may provide clinical services: Adult Outpatient Behavioral Health, Health Psychology (to include integrated behavioral health services in a primary care setting), Inpatient assessment and intervention, and Psycho-diagnostic Assessment. The profession-wide and program-specific competencies can be found in Appendix B.

Operational training trips enable the intern to experience professional activities, patient populations and service environments consistent with the work of a Navy psychologist. The trans-rotation experience offers longer-term practice of psychotherapy across the entire 12 months of training.

Following the internship, graduates are assigned to Navy medical centers or medium sized hospitals where they continue to practice under supervision until they attain licensure in one of the fifty states or the District of Columbia. Once licensed, they are able to be credentialed as a Licensed Independent Provider by the commanding officer of the medical facility to which he or she is assigned. All internship graduates are expected to achieve state licensure within 18 months of internship graduation. Ultimately, we encourage our graduates to earn Board Certification from the American Boards of Professional Psychology. To reward this process of professional development, the Navy pays all Board Examination fees, and pays an annual salary bonus to its Board Certified Psychologists.

PROGRAM DESCRIPTION
(GENERAL)

The internship at Walter Reed National Military Medical Center is comprised of an orientation period followed by two 16-week rotations (Adult Outpatient Behavioral Health and Psychodiagnostic Assessment), two 8-week rotations (Behavioral Health in Primary Care/Behavioral Sleep Medicine and Inpatient assessment and intervention), the overarching trans-rotation experience which is 12 months, operational training trips, and didactic presentations to include the Psychiatry Grand Rounds series and other military-specific didactic training.

Interns receive training from the Center for Deployment Psychology (CDP), associated with the Uniformed Services University of the Health Sciences in Bethesda, MD. CDP courses provide extensive training in aspects of the military deployment cycle, including situational and clinical factors impacting both deploying military members and their families. Additionally, CDP provides training in empirically supported treatment (either Prolonged Exposure or Cognitive Processing Therapy) for Post-Traumatic Stress Disorder, and Cognitive Behavioral Therapy for Insomnia.

Didactic training during the internship includes lectures, seminars, and Psychiatry Grand Rounds, sequenced in order to build on the training already received in graduate studies. Didactics include topics relevant to the general practice of clinical psychology (including professional ethics and cultural diversity), topics more specific to the practice of clinical psychology in the military, and ongoing education related to professional development as a Navy psychologist and naval officer. Training trips include, whenever possible, approximately one week providing psychological services aboard a major Navy combat vessel at sea, giving the interns a firsthand overview of life and clinical issues in the Navy Fleet. Additionally, interns will visit either Marine Corps Base Quantico, VA or Marine Corps Base Camp Lejeune, NC to observe training and health service delivery in a Marine Corps context.

Walter Reed National Military Medical Center, the largest tertiary care hospital in the Military Health System, offers a full range of administrative assistance opportunities. Interns have identified office space and are provided with laptop computers. The Medical Center’s medical library includes a range of journals, books, and electronic search capabilities related to the practice of psychology, as well as staff assistance with online literature searches.

PROGRAM DESCRIPTION
(SPECIFIC)

The program described below is planned for year 2016-17:

I. Orientation

The orientation period includes the first two weeks of the internship and covers such topics as departmental structure, standard operating procedures, a tour of the hospital, rotational competencies, preparing individual development plans, the importance of dissertation completion, seminar scheduling, office assignments, etc. As with every other newly reporting staff member, the intern will spend a full week during the first month attending hospital orientation and will attend training on the military electronic health record for clinical documentation.

II. Clinical Rotations

A. Adult Outpatient Rotation (16 Weeks): The Outpatient Rotation offers interns the opportunity to develop the necessary competencies that they will require to provide appropriate care in hospital and operational environments. These opportunities include experience with a variety of general mental health evaluations, military-specific evaluations, and experience in providing psychotherapy. Military evaluations include: Command Directed Mental Health Evaluations, Deployment Screenings, plus evaluations for: Drill Sergeant, Fitness for Duty, Sniper, Recruiter, Security, and Temporary Disability and Retirement. Additionally, the intern will co-facilitate a therapy group and participate in at least one couple's therapy case during the rotation. Interns will learn how to assess and manage risk for self-directed and other-directed aggression, as well as learn how and when to refer patients to more intensive or controlled treatment environments. Interns will gain experience communicating with military commands regarding Service member's performance and fitness for duty. Didactic experiences include reading and discussion related to military-specific issues as well as profession-wide competencies. The residents will also gain experience in managing their appointment template and in the logistics of administrative management in an outpatient clinic.

B. Psycho-Diagnostic Assessment Rotation (16 Weeks): The Psycho- Diagnostic Assessment Service at WRNMMC receives testing referrals from the Inpatient Psychiatry Service, the Psychiatry Continuity Service, the Trauma Recovery Program, the Adult Behavioral Health Clinic at WRMMMC as well as from other Military Treatment Facilities within the National Capital Area. The training goals of this rotation include; familiarizing the Navy interns with the most frequently used psychological assessment measures in Navy and other military settings, developing an understanding of the administration and interpretation of these measures, as well as gaining experience working in a consultation role within a medical system. Interns attend weekly individual and group supervision, as well as a didactic seminar. Group supervision is also, along with the didactic seminar, an opportunity to review test construction, validity and reliability issues, as well as current literature on tests such as the MMPI-2, MMPI-2RF, the MCMI-III, and other commonly used measures. In addition, we do spend some time reviewing the new RPAS Rorschach system.

While on the Assessment Service, interns also participate in a brief rotation with the Psychiatric Consultation and Liaison Service where they assist in covering emergency room evaluations. Crisis management skills, along with risk assessment are the critical learning objectives of this experience. In addition, interns gain experience working on a multidisciplinary clinical team.

C. Health Psychology/Behavioral Sleep Medicine Rotation (8 Weeks): During this rotation interns work in the Primary Care clinic for eight weeks practicing a collaborative population health approach to behavioral health. Interns serve as consultants to primary care providers who rapidly evaluate patients' symptoms and functioning. Interns address patients' needs with regard to chronic health conditions and behavioral health conditions. They also increase motivation for behavioral change, provide brief, targeted interventions and dispositional recommendations. Problems addressed include headaches, pain, anxiety, insomnia, weight reduction, treatment adherence, and lifestyle management. Integrated throughout the 8 week rotation is an opportunity to learn about Behavioral Sleep Medicine (BSM). Interns will be trained in Cognitive Behavioral Therapy for Insomnia and other topics in BSM. Interns will have the opportunity to consult with providers in the Sleep Disorders Center on the treatment of patients.

D. Inpatient Rotation (8 Weeks): Interns will have the opportunity to spend one month each on the Inpatient Psychiatry Service and the Inpatient Neurobehavioral Service.

While rotating on the Inpatient Psychiatry Service, interns will become acquainted with the admission, diagnosis, acute stabilization, treatment and disposition of patients with mental health disorders of such severity as to require hospitalization. The intern is part of a multidisciplinary treatment team (comprised of staff psychiatrists and psychologists, psychiatric residents, nurses, social workers and hospital corps staff) and will be responsible for individual therapy, group therapy and consultation.

During the four weeks on the Inpatient Neurobehavioral Service, interns will have the opportunity to function within a unique multi-disciplinary setting (neuropsychiatry, psychiatry, psychology, neuropsychology, nursing, social work; physical, speech, occupation and recreational therapy) - providing consultation and individual and group therapy to inpatients with various neurobehavioral disturbances secondary to a brain injury. Interns will gain an understanding of the role of psychology in treating brain injury as well as how to understand and address the neuropsychiatric complications of brain injury.

Throughout the eight weeks, interns will spend one day a week focusing on gaining an understanding of basic elements in cognitive evaluation, having an opportunity to evaluate inpatients with a variety of neurological complaints. By the end of the rotation, interns will be able to accurately diagnose traumatic brain injuries, perform basic cognitive screening evaluations, decide when a referral to a neurologist or neuropsychologist is indicated, and understand how to critically read neuropsychological reports.

E. Trans-rotational Requirements: In addition to the basic requirements expected of the intern to meet the goals of the major rotations, the following trans-rotational objectives are required.

• Long-Term Individual Therapy Case: Each intern is expected to carry one long-term, psychodynamic outpatient case during the year (long-term means at least 9 months). The Training Director will coordinate the assignment of long-term cases and ensure weekly supervision is provided.

• Combat Trauma Cases: Each intern is expected to carry cases of patients suffering from Post-Traumatic Stress Disorder (PTSD). Whenever possible, a case will be treated to completion before the next is begun. Interns are given the opportunity to learn a variety of evidence-based therapies for PTSD with a principle focus on Prolonged Exposure and Cognitive Processing Therapy. All of the cases may be supervised by the same supervisor or different supervisors, depending on the model used and the expertise of the supervisor.

• Operational Psychology Seminar: This seminar is an informal facilitated discussion with senior Navy Psychologists from Department of the Navy communities (Marine Corps, Navy Air, Submarine, Surface, Navy Special Warfare). Interns receive information about the different assignments and duties Navy psychologists can perform outside of the traditional mental health setting. Topics address military-specific competencies to include discussions about military culture, military-specific psychological evaluations, and exposure to Navy and Marine Corps mental health policies and instructions.

III. Clinical Didactic Training Presentations:

A program of scheduled and sequenced seminars and other workshop presentations accompanies the intensive direct supervision on the clinical rotations. These didactic presentations are designed to expose the intern to contemporary information and training relevant to the practice of behavioral health, both as a clinical psychologist and as a Navy psychologist. The faculty, the presenter, and the level of interest of the attendees determine the particular format for a topic and the amount of time devoted to it. The presenters of these didactic programs frequently are distinguished colleagues from the Navy and civilian clinical/academic communities. Interns are also required to attend weekly Psychiatry Grand Rounds and periodic special training opportunities lasting a full day or longer.

IV. Operational Experiences:

A. The major operational experience is a deployment, lasting approximately one week, aboard a major Navy combat vessel during which the interns will experience shipboard living conditions and stresses, work in the ship’s Medical Department, interact with sailors, and learn about the industrial and psychological demands of working and living aboard a large ship. This deployment is typically aboard a US Navy aircraft carrier, under the guidance and supervision of the Navy Psychologist assigned to the carrier. In rare circumstances where the ship has no psychologist on board, a uniformed and experienced member of our Internship faculty will accompany interns to supervise their professional work and guide their experiential education.

B. When possible, a second operational experience is scheduled with the Second Marine Division or the Marine Special Operations Command, both at Camp Le Jeune, NC, and/or with Marine Security Group (MSG) at Marine Corps Base Quantico, VA. Particular emphasis is placed on gaining familiarity with the operational plans and stresses unique to the Marine Corps, and on developing skills for effective consultation with Marine Corps Commands.

V. Additional Intern Functions and Roles:

A. Class Adjutant: Each intern will function as the class adjutant on a rotating basis. As such, the intern serves as the senior member of the class and as a liaison for information between leadership, faculty, and intern. Specific responsibilities include the following:

• For the seminar series, the adjutant is responsible for attendance forms, lecture evaluation forms, continuing education forms for staff, and equipment needed by the presenter. The adjutant conveys weekly seminar information to interns at military, civilian, and Veterans Administration internships in the local area.

• Organize all paperwork and travel for operational activities for internship class.

• Maintain an email and phone list for Air Force, Army, civilian and Veterans Administration Interns.

B. Medical Service Corps: All Navy psychology interns are officers in the Navy Medical Service Corps (MSC), and are strongly encouraged to interact professionally and socially with other MSC officers assigned to the hospital. Such interaction is not only important to the smooth and effective performance of the psychologist's job when it extends beyond the mental health clinic, but also serves to increase the intern's appreciation for other nonphysician specialists in the Navy health care system, just as it increases others' awareness of the psychologist's role.

VI. Supervisors:

A. Most of the ongoing case supervision will be provided by designated privileged staff psychologists on the rotation to which the intern is assigned. Privileged psychiatrists serve as adjunct supervisors and provide additional supervision, particularly on the Psychiatric Consultation Liaison Service (PCLS) and Inpatient Rotations.

B. The intern may be assigned several staff members to supervise trans-rotational cases. Over the course of the year, the intern may receive supervision from several of the psychology faculty and some of the psychiatry staff. It is very important to note that in addition to scheduled supervision times, the faculty is available for and strongly encourages additional supervision and consultation as needed.

TRAINING AIMS

OVERALL TRAINING AIMS: As mentioned previously, the program’s training aims are to provide the trainee with experiences and skills needed to function competently as a broadly-trained clinical psychologist, and to equip the intern with additional knowledge and skills needed to practice competently within the Navy. We identify and evaluate a set of profession-wide and program-specific competencies to ensure we are meeting our broad training aims. By the end of the internship year, interns are expected to demonstrate competencies in the following clinical skills: individual and group psychotherapy (both brief and long term), psychological assessment by interview and by testing, emergent and urgent evaluation as a member of the Psychiatry Consult Liaison Service, interdisciplinary consultation with other healthcare providers, providing consultation to other healthcare providers, providing clinical consultation to active duty military commanders, basic cognitive assessment and referral, inpatient assessment and intervention, integrated behavioral healthcare in a primary care setting, and behavioral sleep evaluation and treatment. Additionally, when possible, interns will demonstrate basic competence in providing clinical supervision to other students, and a basic understanding of program evaluation. Competence in each of these areas at a level considered appropriate for initial licensure as a psychologist is the expected minimum standard of achievement. Interns will demonstrate that their work with each of these competencies is informed by the theoretical and research literature in psychology, is sensitive to multicultural factors impacting all aspects of clinical practice, and by the ethics of our profession.

Please see sample competency evaluation forms in Appendix B for an example of defined behavioral anchors for each competency.

GENERAL BEHAVIORAL CHARACTERISTICS EXPECTED OF INTERNS

• Willingness to learn
• Efficiency in work organization
• Assumption of responsibility
• Military bearing and appearance
• Creative problem-solving

EVALUATION

The evaluation process has two components: Measures of Intern Performance, and Evaluation of the Internship Program.

I. Intern Performance Evaluation

A. Weekly supervision. Throughout the internship year, the intern receives weekly scheduled and, when needed, unscheduled supervision. Each intern will receive at minimum four hours of scheduled supervision per week, at least two of which must be individual supervision. In addition to addressing clinical issues, case load, and professional growth, supervision is also a time for the primary supervisor to review intern progress toward program-specific and profession-wide competencies. At mid-rotation the intern and primary supervisor will have a formal session to review progress toward mastering clinical competencies and identify areas to be focused on during the second half of the rotation.

B. End of Rotation Competency Evaluation. The evaluation form (Appendix B) is submitted to the Program Director by the intern’s primary supervisor at the mid-point and end of each 16-week rotation (formal evaluations for 8-week rotations occur only at the end of the rotation, with informal evaluation provided at the mid-point). At the time of the evaluation, there is a meeting between the rotation supervisor and the intern to review performance, and to discuss areas to be focused on in upcoming rotations. The Program Director can attend this meeting if desired by the intern or supervisor, but this is not required. Mid-point and end of rotation competency evaluations are the primary means of determining "passing" of rotations and successful internship completion. Each competency is rated on a 5 point scale: “R”(Remedial Work Required), “E” (Entry Level), “I” (Intermediate Level), “P” (Proficient), and “A” (Advanced). In order to pass a rotation, an intern must achieve a rating of “I” or higher on all competencies. If an intern has any competency rated “R” (Remedial Work Required) or “E” (Entry Level) for an extended period of time, a remediation plan will be implemented to assist the intern in acquiring the identified competency. In some cases, this may involve repeating the rotation. All rotations must be passed to complete the internship. This could require extension of the internship past one year in order to achieve successful completion.

C. Navy Fitness Report. All Navy officers receive annual Fitness Reports, an evaluation of their performance both in their areas of specialization and, more generally, regarding their leadership abilities, team work, etc. These reports are prepared by the Program Director and forwarded to Senior Navy leadership for review and signature.

II. Internship Program Evaluation

At the mid-point and end of the internship year, each intern will submit a written evaluation of the training program to the Program Director. This report discusses both specific aspects of each rotation, as well as an overall assessment of the training program’s success in preparing the intern for future work in psychology. Additionally, at the end of each rotation, interns are required to submit an evaluation highlighting strengths of the rotation and supervision, along with suggestions for improving the rotation.

FACULTY SUPERVISION OF INTERNS

Rotation Supervision:

During the Psychology Internship each intern rotates through the aforementioned clinical rotations. While assigned to a rotation, the intern’s clinical work is supervised by a licensed independent provider. All documentation written by an intern is reviewed and signed by the responsible supervisor. High-risk patients (those with significant suicidal or homicidal ideation/plans/threats, or unable to adequately care for themselves) are to be discussed with supervisors and documented PRIOR TO departure of the patient from the clinic or service.

Trans-rotational Supervision:

Each intern is assigned multiple cases to be seen across rotations. Interns will be assigned a faculty supervisor who is responsible for supervising the evaluation, treatment, and documentation for trans-rotational cases. Supervision for trans-rotational cases will be scheduled, although unscheduled supervision for urgent or emergent issues is always available. As stated above, high-risk patients are to be discussed with supervisors and documented PRIOR TO departure of the patient from the clinic or service.

IN-PROGRAM REMEDIATION OF PSYCHOLOGY INTERN PERFORMANCE:
A PROCEDURAL OUTLINE FOR DUE PROCESS MANAGEMENT

Introduction: It is the goal of the Navy Clinical Psychology Internship Program to educate and graduate interns. The faculty recognizes its duty to provide special assistance to interns who are having difficulty learning. When an intern is determined to be making insufficient progress, faculty supervisors and the intern involved will cooperatively attempt to find the reasons for the difficulties in order to develop a thoughtful and comprehensive plan for remediation.

Additionally, it is the intent of this policy to separate failure to learn from disciplinary matters. The latter is handled through the WRNMMC chain of command, the Director, WRNMMC, and the Commanding Officer, Navy Element, WRNMMC and may result in formal counseling statements, letters of reprimand, or even non-judicial punishment under the Uniform Code of Military Justice. On the other hand, it is recognized that not all transgressions or ethical violations should be viewed simply as disciplinary matters. Some may be due to ignorance or misunderstanding and therefore legitimately require concurrent remedial training under this training manual, consistent with policy directives from the WRNMMC Professional Education Training Committee (PETC).

1. Acceptable levels of performance on each rotation are established. (See Competency Evaluation forms in Appendix B)

2. Performance criteria will be provided to each intern at the beginning of the internship year via a copy of this Training Manual.

3. The rotation's supervising psychologist will meet with the intern individually for at least two hours weekly. The supervisor will provide verbal feedback outlining the performance against the criteria.

4. Mid-rotation and end-of-rotation evaluations are forwarded by the rotation supervisor to the Program Director and are discussed with the intern.

5. In order to meet internship requirements, all rotations must be satisfactorily completed. Failure to meet criteria satisfactorily for one rotation does not necessarily exclude the intern from the next rotation, but may delay the scheduled graduation from the internship.

6. If unsatisfactory progress is determined by the Program Director, the intern will be placed on a written in-program remediation plan which the intern will be able to review and sign. (Remediation plan for one rotation may continue while the intern is on another rotation.) The Program Director will outline in writing the deficiencies and suggest methods and objectives to regain satisfactory status. A Review will be held 30 days, and then 60 days (if necessary) following the original notification of Remediation Plan (or more frequently if deemed appropriate). Once standards are met, remediation status will be removed, and the intern will be in good standing within the internship.

7. If the intern fails to meet the criteria necessary for removal from the remediation plan, the Program Director shall place the intern on probationary status and inform the appropriate Department Chief and the WRNMMC Professional Education Training Committee (PETC) of the intern’s probationary status. The Program Director shall advise the intern in writing of this decision, detailing those areas of deficiency which could lead to termination of training, and establish a "cautionary period" of time (not more than 60 days, or the original ending date of the internship, whichever comes first) within which time the deficiencies must be brought up to acceptable levels.

A. The intern has the right to address the Program Director concerning his/her probationary status and performance.

8. After the designated cautionary period of probation has been completed:

A. IF PROGRESS IS SATISFACTORY, the intern’s good standing is restored by a letter from the Program Director

B. IF INTERN PERFORMANCE DOES NOT IMPROVE TO A SATISFACTORY LEVEL, a request will be made to the WRNMMC PETC for action. It should be recognized that the Medical Center Director, upon the recommendation of the PETC, has the ultimate authority by regulation to make decisions regarding dismissal from the Training Program.

PROCEDURE FOR INTERN GRIEVANCES

If an intern finds him/herself with a grievance toward the training program, Program Director, or a faculty member, the grievance procedures are as follows:

1. In accordance with conflict resolution research, the APA ethical code, and general principles of human resource management, the intern should first attempt to communicate the grievance as clearly and specifically as possible to the party perceived as the source of the problem, either verbally or in writing.

2. In the event that an intern has a grievance with a faculty member or another supervisor, the intern should initially attempt to resolve the issue with the faculty member or supervisor concerned. If the intern cannot resolve the grievance with the individual involved, the matter is brought to the attention of the Program Director. The Program Director reviews the matter with the intern in order to clarify the issues. The Program Director attempts to resolve the grievance informally by discussing the issue with the faculty member or supervisor involved. If the grievance cannot be resolved informally, the Program Director reviews the matter with the Chief, Behavioral Health Consultation and Education (or the Professional Education Training Committee (PETC) if the issue is with the department chain of command), and subsequently makes appropriate recommendations for resolving the issue. If grievances continue, and are found to be legitimate, the matter will continue to be addressed by the Program Director and Chief, Behavioral Health Consultation and Education, in consultation with the PETC, until resolution is achieved. If the grievance is with the Program Director, the intern should initially attempt to resolve the issue with the Program Director. If the intern cannot resolve the issue informally with the Program Director, the issue will be brought to the attention of the Chief, Behavioral Health Consultation and Education, who makes appropriate recommendations for resolving the issue.

3. If these informal channels fail to bring a resolution that is satisfactory to the intern, the next step in the process would be for the intern to make a formal complaint to the PETC. This body will review the complaint and the documentation of attempts to deal with the problem on the local level. The PETC will make a formal determination and inform all parties of the results and recommendations.

4. Information for equal opportunity complaints (SECNAV INSTRUCTION 5354.2), Navy Equal Opportunity policy (OPNAV INSTRUCTION 5354.1F) or sexual harassment complaints (SECNAV INSTRUCTION 5300.26D) are available online at the Navy Bureau of Personnel website (http://www.public.navy.mil/bupers-npc). A hard copy can also be obtained from the Officer in Charge, Navy Element, WRNMMC. Interns electing to make a formal complaint of sexual harassment or assault may contact the chain of command, or the DoD Sexual Assault Support Hotline at 877-995-5247 or safehelpline.org.

POLICY ON INTERN MILITARY LEAVE (VACATION)

I. The following guidelines have been developed to help faculty evaluate requests by psychology interns for time away from the internship. Interns are required to plan their absences, if any, well in advance and to submit their requests in a manner that will allow adequate review by the Rotation Director and the Program Director.

A. With rare exceptions under special circumstances, no more than five working days personal leave will be permitted during the internship year.

1. In addition to the above (and per MILPERSMAN 1320-210), no more than five consecutive days of no-cost temporary additional duty (TAD) for the purpose of obtaining housing at a new station will be allowed.

B. Two leave periods should not normally be requested during the same rotation. This implies that if a request for house hunting is going to be made during the last rotation, other requests should be planned in earlier training periods, if possible.

C. All requests for absences are contingent upon the projected requirements of the intern's training assignments and upon the intern's progress in the internship. Above all, patient care responsibilities are primary.

D. Consideration of additional time away, such as time for meeting with dissertation committees or defending dissertations will be on a case-by-case basis.

PSYCHOLOGY INTERNSHIP DIDACTIC PRESENTATION SERIES

I. The purpose of the series is to provide the psychology interns with didactic training in areas relevant to the practice of clinical psychology generally, and Navy psychology specifically. Didactic training includes a Psychiatry Grand Rounds series, scheduled on Wednesdays from 1600-1700. Additional didactic trainings will be scheduled on Friday afternoons from 1300-1530. Friday afternoon didactics occur once or twice a month. Navy Psychology interns meet weekly with the Training Director, during which administrative issues are covered, journal articles are discussed (focusing on Leadership, Ethics and Multicultural Competence), and prepared case presentations made and discussed.

The following principles have been established for the various didactic training series:

A. Each presentation is practice oriented.

B. The interns will be exempted from scheduled clinical responsibilities during the planned didactic seminars. Any exception must be cleared with the Rotation Director and Program Director.

C. For interns, attendance is mandatory, unless time away has been approved by the Program Director in advance. Clinical responsibilities should be scheduled so as not to be a reason for absence.

Following each presentation, those attending will complete an evaluation form.

Examples of Recent Seminars, Grand Rounds, and Extended Training Topics

Cognitive Processing Therapy (two day course)

Prolonged Exposure Therapy (two day course)

Case Formulation and Presentation Program Evaluation Military Specific Psychological Evaluations

Cognitive Behavioral Therapy for Insomnia

Ethics and Professional Practice in Psychology

Ethics and Professional Practice in a Deployed Setting

Licensure, Board Certification, and Other Credentials in Psychology

Traumatic Brain Injury

Psychological Practice with Lesbian, Gay, and Bisexual Clients

Diversity: Experiencing “Otherness”

Military Sexual Trauma

Military Transgender Issues and Policy

Navy Psychology Practice on Aircraft Carriers

Ethical and Effective Practice of Supervision

Supervision Training: Defining and Assessing Competencies

Special Operations in Navy Psychology

Psychopharmacology

Substance Use Disorder Assessment

Collaborative Assessment and Management of Suicidality

MMPI2-RF

Personality Assessment Inventory

Rorschach Performance Assessment System

ADJUNCT FACULTY

Adjunct training faculty members are considered critical in the delivery of the internship program as presently outlined.

Adjunct Psychology Faculty: Licensed psychologists not part of the Core Faculty but readily available to interns for adjunctive supervision and consultation.

Psychiatry Staff: Attending Psychiatrists on Inpatient Service, Attending Psychiatrists on Psychiatric Consultation Liaison Service, Attending Psychiatrists on Adult Outpatient Service

Outside Consultants: Provide didactic material in areas supplementing Navy CPIP faculty expertise.

QUALITY ASSURANCE

In order to assure the maintenance of the standards of quality patient care, the following steps will be taken by the faculty. The Program Director is responsible for assuring that each step is accomplished.

I. Supervisors will submit written rotation competency evaluations to the intern and the Program Director indicating that the evaluation of the intern has taken place as scheduled (mid-point and end of rotation).

II. At the mid-point and end of the internship year, each intern will submit to the Program Director a formal evaluation of the training received.

III. At the end of each 8 week or 16 week rotation, each intern will submit to the Program Director a formal evaluation of the rotation-specific training, and of the supervision received.