News Date: Monday, December 5, 2022 - 10:00
The Addiction Treatment Service at the Palo Alto VA is thrilled to announce a postdoctoral opportunity with the APA-accredited Clinical Postdoctoral Fellowship Program at the VA Palo Alto Health Care System (VAPAHCS) specializing in the treatment of addictive behaviors, trauma, and co-occurring disorders. Please see below for the full announcement and additional information:
The Continuum of Care for Addictive Behaviors, Trauma, and Co-occurring Disorders (CCATC) fellowship includes training opportunities across many settings and levels of care. One of the goals of the fellowship is to create the opportunity for fellows to provide evidenced based treatments across the broad spectrum of VA intervention from the most intensive (e.g., ICU admission for medically supervised withdrawal) to the community level (e.g., Veteran’s Justice Outreach, HUD-VASH, Compensated Work Therapy) and all the steps along the way (e.g., residential, intensive outpatient, outpatient etc.). During the fellowship year, the expected competencies to be acquired will closely follow the VA/DoD Clinical Practice Guidelines for Substance Abuse Treatment (developed with the Substance Abuse and Mental Health Services Administration and the Center for Substance Abuse Treatment) and VA/DoD Clinical Practice Guidelines for co-occurring disorders and PTSD including concurrent and phase based approaches for dual diagnoses and trauma focused treatments (e.g. DBT/PE, DBT-PTSD, DBT for SUDs, PE, CPT, WET, etc.). These competencies form the basis of the fellowship program focus area aims and competencies.
This fellowship involves training in the following areas:
• Research, including understanding the research literature in the area of substance use, trauma and co-occurring illnesses and conducting a research project in this area
• Biological aspects of substance use and substance-related illnesses
• Comprehensive biopsychosocial assessments, referral to appropriate treatment, and assessment of therapeutic and programmatic efficacy
• The role of multiple identities in formation of worldview, therapeutic alliance, and choice of appropriate intervention for Veterans (i.e., multicultural competence)
• Supervision of trainees
• Interface and collaboration with other disciplines through participation on interdisciplinary teams, consultation in a variety of venues, and making appropriate referrals
• Didactic training in addiction and co-occurring issues and appropriate treatment interventions
• Evidence-based treatments for specialty populations (e.g. motivational enhancement, PE, CPT, CBT for relapse prevention, DBT-SUDS, DBT-PTSD, ACT, community reinforcement approach, housing first, critical time interventions, etc.)
• Pharmacotherapies for addiction treatment, including methadone, suboxone, naltrexone, acamprosate, disulfiram
• Unique concerns of special populations (e.g. OIF/OEF, women, serious mental illness, dual diagnosis, etc.)
• Program management/leadership
• Resources and services available for disenfranchised Veterans
• Special ethical and legal issues working with homeless and SUD populations
VAPAHCS is a teaching hospital and is affiliated with the Stanford University School of Medicine and associated training programs. The CCATC Fellow will spend roughly 70% time in clinical service, 10% time in program development/research, and 20% time attending didactics and providing teaching and supervision contingent on the specific fellows training plan/goals. The individualized training plan for the CCTAC Fellow will be developed with the assistance of their Primary Preceptor who will collaborate with the fellow to plan the fellow's over-all program, ensure sufficient depth and breadth of experience, and which of the faculty will serve as supervisors during the fellowship year. The Training plan will specify in which of the many possible training venues the Fellow will have comprehensive rotations with options of mini-rotations (e.g., DBT, ACT, CPT, Motivational Enhancement Training, etc). The aim is to ensure attainment of general clinical competencies as well as to provide experience in each of the focus area-specific competencies.
Outpatient training will occur in the Addiction Consultation & Treatment (ACT) team, which provides group, individual and community reinforcement evidenced based psychotherapy as part of our Intensive Outpatient Program (IOP). ACT IOP serves Veterans from a harm reduction standpoint, as an outpatient, step-down and step-up service with our residential treatment programs. Psychologists provide telehealth and in person services, including groups, individual sessions integrating motivational and behavioral treatments within a trauma informed lens. Psychologists lead ATS case conferences discussing complicated cases and enhancing team collaboration to facilitate case conceptualization and derive individualized treatment plans for Veterans. Fellows having the unique opportunity to participate as an integrated member of a comprehensive DBT/EBT informed team providing trauma informed and motivationally based interventions. In addition, psychologists collaborate in various multicultural dialogue spaces, including monthly Multicultural Consultation, veteran facilitated IOP community diversity committee, and staff Multicultural Mornings. Psychologists are involved in consult triage for the hospital fielding and responding to all requests for addiction treatment throughout the entire VAPAHCS VISN. Psychologists also assess for and implement emergent and planned hospitalization to provide ambulatory, medicine and psychiatric medically supervised withdrawal. ACT is an ideal rotation for professional development through liaison, management of systems related issues, consultation with professionals from various backgrounds, administration and leadership and cultivation of opportunities to provide evidence-based training and perspectives.
Residential treatment training can occur in one of three residential rehabilitation programs: Foundation of Recovery Program (flexible length of stay, Addiction Treatment Program with 19 beds), First Step Program (90-day Addiction Treatment Program with 30 beds), and the Homeless Veterans Rehabilitation Program (180-day National Center of Excellence in the treatment of homelessness with 70 beds, described in more detail below). The residential programs all provide 1) CBT-based milieu treatment including community meetings; 2) Small group therapy; 3) Case management; 4) Psychoeducational skills-building classes (e.g., relapse prevention, 12-Step Facilitation, communication, Skills Training in Affective and Interpersonal Relationships [STAIR]); 5) Recreational and leisure activities; and 6) Weekly aftercare outpatient groups. There are also opportunities to be a member of the providers who offer services within the trauma specific treatment track providing Cognitive Processing Therapy, WET and Prolonged Exposure and participating in trauma specific consultation. Other training opportunities are offered through the Veterans Justice Outreach Program, the outpatient PTSD Clinical team and the residential Trauma Recovery Program. Finally, the Fellow will also have the opportunity to work with researchers in the HSR&D Center for Innovation to Implementation on new or ongoing research relevant to the focus area and the fellow’s clinical and research interests.
We are deeply committed to training and cultivating the professional development of postdoctoral fellows, many of whom following graduation have become members of our treatment team. The fellowship includes myriad opportunities to supervise within and across disciplines and to receive supervision specific consultation and guidance. There are also a wealth of opportunities to engage in administrative processes, program development and hospital leadership. Our staff is passionate about access to care, evidence-based treatment for addiction and trauma-related disorders, systems and community-focused interventions, complex trauma and traumatic stress in the context of oppressions, and dismantling stigma and shame that perpetuate marginalization.
For more information, please do not hesitate to contact: firstname.lastname@example.org
In order to apply to our fellowship track, please submit all required applications elements via the APPA CAS system (APPIC Member Number 9032) on or before December 27, 2022.