Training Year 2011
1. Program Mission. The COPR is designed to prepare psychology residents to be competent providers of psychological services in support of individuals, families, and organizations within the U.S. Army. Training is based in a Practitioner-Scholar model and espouses the premise that specific training goals should be directly related to career outcomes. We prepare each resident for a career as an Army clinical and operational psychologist—essentially a dual career, that of military officer and professional psychologist. Training is guided by a competency model approach which focuses specifically on ensuring that the individual resident meets a minimum threshold expected of an independent practitioner of psychology across nine core and specialty-specific competency domains (described further below). Sound performances on prescribed benchmarks measuring these domains are expected to prepare the resident be able to successfully sit for the board certification in Clinical Psychology once eligible.
2. Program Goals. The 12‑month full‑time WAMC COPR is designed to train residents to become independent, competent, and responsible providers of psychological services. Training focuses primarily on adult mental health services and operational/occupational consultation and assessment services. The residents receive a breadth of experience to prepare them to function competently in a variety of clinical, military operational, and consultative settings, both within and outside of the military. Specific areas of evaluation across all training and supervision activities include the following identified core and foundational competencies:
a. Interpersonal interactions - As demonstrated through the resident’s ability to relate to colleagues, patients, clients, subordinates, and others in a sensitive, professionally effective and self-aware manner;
b. Individual and cultural diversity - As evidenced by the resident’s 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;
c. Ethical and legal foundations - 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;
d. Professional identification -As demonstrated through the resident’s 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;
e. Assessment - As demonstrated by the resident’s 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;
f. Intervention - As demonstrated by the resident’s ability to use proven modalities to effect change in individuals and/or military organizations after a thorough and informed assessment has occurred;
g. Consultation – As demonstrated by the resident’s ability to communicate professional or expert opinion 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;
h. Science base and application - As evidenced by the resident’s awareness of theory, research and practice concerning clinical and operational psychology and their ability to integrate and apply that knowledge in the selection of assessment tools and intervention techniques;
i. Supervision/teaching/management – As demonstrated by the resident’s ability to communicate their own knowledge in a instructive or didactic manner to junior officers or enlisted paraprofessionals in addition to their strengths in navigating the relationship complexities within the military training environment.
3. Program Design: The Residency Program consists of two broad, six-month training rotations – the Core Clinical and the Core Operational rotations. Although residents will be assigned to each rotation for a circumscribed 6 month period, the Core Operational rotation only comprises approximately 80% of the resident’s time during the six month period (4 out of 5 days) assigned. In other words, while on the Core Operational rotation, the assigned resident will also continue to be engaged in Core Clinical activities, allowing for peer overlap and supervision of ongoing, long-term psychotherapy cases. Transition between the two rotations is also provided through a structured one-week overlap in which residents facilitate orienting one another to their new rotation. Descriptions of the rotations and core program activities, as well as evaluation criteria, are provided to the residents during orientation and updated during the year as appropriate.
a. In general, the Core Clinical rotation provides ample opportunity for the residents to practice and obtain supervision in more “traditional” psychological assessment, intervention, and consultative skills. During the Core Clinical rotation, which occurs in a large medical center, opportunity for mini-rotations are available for those residents that have completed their EPPP and express an interest in a specialty-specific areas (such as Neuropsychology or Health Psychology). Supervision of a broad range of clinical and consultative psychological services in a multidisciplinary outpatient clinic occurs and other core clinical activities include didactics in psychological assessment, psychotherapy, health psychology applications, ethics and military-specific topics. The resident is assigned a primary supervisor who is responsible for supervision of all core activities and provides oversight of other adjunct supervisory activities.
b. In general, the Operational Psychology rotation will consist of training and experiences related to supporting a Special Operations Unit or organization such as a Special Forces, Civil Affairs, or Psychological Operations. These skills include selection and assessment, instruction, command consultation and leader development. During the operational psychology rotation primarily located on a separate compound (Camp Mackall), residents will participate in several mini-rotations in the area of Survival Evasion Resistance and Escape (SERE) Psychology, the Special Forces assessment and Selection (SFAS) program and provide psychological support to Leader Development programs and schools such as Special Forces Sniper School, Civil Affairs and Psychological Operations training exercises and Adaptive Thinking and Leadership programs. Supervision in these areas and other command consultation services (i.e., presenting cases to a selection board) occurs and the resident will participate in other clinical activities to include routine psychological evaluations, research with the (ARI) Army Research Institute and didactics in performance psychology. The resident is assigned a primary supervisor who is responsible for supervision of all core activities and provides oversight of other adjunct supervisory activities.
4. Program Faculty. The COPR faculty consists of military and civilian licensed clinical psychologists at Womack Army Medical Center and JFK Special Warfare Center and School, Ft. Bragg, N.C. These faculty members provide the majority of the training and supervision for the residents. Additional training, consultation and supervisory experiences are provided by adjunct faculty members, to include off-site licensed clinical psychologists, psychiatrists, neurologists, primary care physicians as appropriate for particular activities.
a. The Psychology Faculty Committee meets twice a month. The Committee provides guidance, planning, and ongoing evaluation of the Program and assists in formulating policy and designing the curriculum.
b. Membership of the Committee consists of the Program Director (Chairperson), the JFK SWCS Training Director, and all faculty members. Adjunct faculty and other individuals substantially involved in training residents may be invited to attend the meetings when appropriate. Resident representation/attendance is welcome at the initial portion of the first monthly training committee meeting.
c. The Program Director will be an ABPP board certified psychologist. Core and mini-rotation supervisors will be licensed clinical, health or neuropsychologists with a minimum of two years postdoctoral experience and a minimum of 1 year experience practicing in a military setting. Every effort will be made to assign the most senior military officers as core supervisors, particularly in the operational psychology rotation.
d. Minutes of the committee meetings are maintained in the Department of Behavioral Health, Psychology Service files.
5. Responsibilities.
a. Chief, Department of Behavioral Health:
(1) Overall responsibility for the quality and conduct of the Program.
(2) Obtain and allocate resources needed to accomplish the training mission.
b. Program Director:
(1) Directly responsible to the Chief, Department of Behavioral Health for all matters pertaining to the Program.
(2) Direct responsibility for the quality and conduct of the Program.
(3) Provide day‑to‑day administrative and procedural direction for the Program.
(4) In collaboration with the JFK SWCS Training Director and the Psychology Faculty Committee, devise the training curriculum that is sequential, graded in complexity, and consistent with the goals and objectives of the Program.
(5) Collaborate with the JFK SWCS Training Director to oversee recruitment and scheduling of speakers and consultants to provide the expertise needed to meet training goals.
(6) Coordinate with the JFK SWCS Training Director and program supervisors to ensure that residents are receiving appropriate clinical experiences and supervision.
(7) Coordinate with the directors of other departments, services, and outside agencies to provide training experiences for residents.
(8) Collaborate with the JFK SWCS Training Director to develop and publish the training schedule.
(9) Devise valid means and procedures for assessing resident’s progress and apprising them of their individual strengths and weaknesses.
(10) Maintain documentation of residents' academic preparation, clinical activities, evaluations, and other matters relevant to training.
(11) As requested, prepare correspondence to HRC, the Psychology Consultant to the Surgeon General, and other agencies and individuals seeking information about the Program or its graduates.
(12) Compose and publish a description of the program for use in recruiting and coordinate recruiting actions.
(13) Complete an annual self‑study in accordance with that expected by the American Psychological Association in order to obtain and eventually maintain accreditation. Ensure that accreditation requirements have been met.
(14) Prepare the training budget and monitor expenditures.
(15) Serve as Chairperson of the Psychology Faculty Committee. Maintain and coordinate the agenda and minutes of the Psychology Faculty Committee
(16) Serve as the faculty advisor to the residents.
c. Operational Psychology Training Director, JFK SWCS
(1) Oversee and impliment the day‑to‑day administrative and procedural direction for the Core Operational Psychology rotation.
(2) In collaboration with the Program Director and the Psychology Faculty Committee, devise the training curriculum that is sequential, graded in complexity, and consistent with the goals and objectives of the Program.
(3) In collaboration with the Program Director, oversee recruitment and scheduling of speakers and consultants to provide the expertise needed to meet training goals.
(4) Coordinate with the Program Director and JFK SWCS supervisors to ensure that residents are receiving appropriate clinical experiences and supervision.
(5) Collaborate with the Program Director to develop and publish the training schedule.
d. Individual Supervisors:
(1) Supervise training and clinical activities of the assigned resident and facilitate professional development as a military professional as well as a clinical psychologist.
(2) Recommend training goals and objectives for the core program.
(3) Recommend clinical experiences designed to meet established goals.
(4) Attend Psychology Faculty Committee meetings.
(5) Be available to any resident for “curbside” consultation as needed.
(6) Provide focused training or remediation in a particular area of expertise should the need arise.
e. Mini-rotation Supervisors:
(1) Supervise rotation‑specific activities of residents assigned.
(2) Recommend training goals and objectives for the mini-rotation.
(3) Recommend clinical experiences designed to meet established goals.
(4) Attend Psychology Faculty Committee meetings.
(5) Be available to any resident for “curbside” consultation as needed.
f. Psychology Residents
(1) Consistently display conduct expected of an U.S. Army Officer. This means adhering to the seven Army Values (Loyalty, Duty, Respect, Selfless Service, Honor, Personal Courage, and Integrity) at all times on and off duty.
(2) To participate fully in the educational and scholarly activities of the program; this includes, but is not limited to, reading assigned articles in advance of didactics, preparing adequately for presentations assigned, and completing assignments prescribed during the course of supervision.
(3) Complete all requirements for WAMC Clinical and Operational Psychology Residency Program.
(4)Communicate with the Program Director in good faith regarding training needs and difficulties.
(5)Actively provide feedback for improving training goals and activities for the core program.
(6)Perform all military duties required of officers in Medical Service Corps.
6. Supervision. Residents are exposed to a variety of supervisory experiences throughout the year. It is expected that each resident receives a minimum of 4 hours of supervision or formal didactic training (at least 2 individual supervisory hours) per week. In practice it is likely that the actual supervision time will be considerably more at any given time, depending on the rotation and specific activities. The individual supervision will generally consist of regularly scheduled supervision hours with a consistent assigned supervisor. It is expected that supervisors will spend additional time in such supervisory activities as observation of interventions, review of chart notes and assessment reports when indicated.
a. Flexibility in supervision is encouraged such that other faculty members will participate when expertise or other factors become relevant. However, responsibility for supervision continues to rest with the primary and mini-rotation‑specific supervisors.
b. Supervision is documented by the supervisor's electronic signature on each case note. A supervisor's signature signifies review of foregoing notes and treatment plans. The resident is responsible for ensuring that the supervisor reviews and signs all notes after each patient contact. All psychological reports, letters, and responses to consultation requests must be countersigned by a supervisor.
c. Other supervisory experiences include, but are not limited to, case conferences, supervision of group treatments, treatment team planning meetings, intake and disposition conferences, and so on.
d. The Program Director serves as the faculty advisor for all residents. As such, the Program Director assists the residents in their adjustment to the residency and the military in order to optimize the training experience. In addition, the Program Director monitors the progress of each resident within the Program.
7. Evaluation of Resident Performance. Evaluation of resident performance is a continuous ongoing process which is designed to be formative in nature, helping residents to recognize their strengths and identify areas for improvement. Ongoing, informal (verbal) evaluations of each resident are conducted by the primary supervisors, the mini-rotation supervisors and the PD throughout the training year. Formal written evaluations are maintained by the PD in the resident's training file and will be discussed with the resident as noted in the following sections.
a. Monthly evaluations of resident’s progress are made on the first faculty meeting of each month, after any attending residents are excused. Evaluation will be written; the format is flexible and to be determined by the PD. It should contain statements related to the residents’ progress with specific notations regarding any areas needing improvement. Indications of insufficient progress will be supported by bullet statements regarding the nature of the problems/issues, and plans to rectify or remediate. Each resident will have an opportunity to discuss the evaluation with the PD, the SWCS Training Director, the evaluating supervisor and/or mini-rotation supervisor. The evaluation will be signed by the resident, the PD and/or SWCS Training Director, and may be signed by the supervisor. Progress in problem areas will be discussed in subsequent faculty meetings.
b. A formal evaluation of each resident is conducted by the entire faculty at the mid-year and end-year time-points (rotation transition points). This evaluation, the Supervisory Review and Resident Skills Inventory, is comprehensive and provided to each resident in written format. Final copies of the faculty's written summaries are signed by the primary supervisor, the resident, and the Program Director and/or SWCS Training Director, and are maintained in the resident's training file.
c. Residents will also be evaluated via oral presentations to a panel of faculty members at the beginning and end of the training year. For theses Oral Comprehensive Evaluations (OCEs) the resident will be assessed on his/her ability to conceptualize and articulate a case formulation based on various data including history and test instruments. Generally, this oral examination is designed to prepare the resident for future examination committees as it simulates the oral examination required to obtain board certification in Clinical Psychology.
d. Each resident is also rated annually with an Officer Efficiency Report (OER) (DA Form 67‑9) as required by Army regulations. Residents are briefed on the OER and OER Support Form (DA Form 67‑9‑ 1) within 30 days of their assignment. The rater for all residents is the Program Director, the intermediate Rater is the JFK SWCS Training Director, and the senior rater is the Chief, Department of Behavioral Health.
e. Graduation from the Program requires satisfactory completion of all training requirements of both Core Rotations. These specific requirements can be found in the document titled “Supervisory Review and Resident Skills Inventory.” It lists in detail the skills, behaviors and competencies that each resident should have developed throughout the course of the year. Training requirements are based on the foundational competencies described in the Program Goals section above. Each of these competencies has a detailed list of benchmarks that make up a global category and determines satisfactory completion of this requirement. Documentation of successful completion of the Residency Program is provided to each resident in the form of a graduation certificate.
8. Insufficient Progress and Probation.
Refer to Departmental SOP on Insufficient Progress of Residents and Trainees.
9. Resident Evaluation of Program.
a. Continuous input from the residents regarding the quality of the Program is strongly encouraged. This feedback is provided informally via discussions with the Program Director and the SWCS Training Director, at Psychology Faculty Committee meetings, and in meetings with supervisors.
b. Residents provide formal written evaluations at the end of each rotation. They also complete a comprehensive written evaluation of the program at the end‑year point. The residents' evaluations focus on the extent to which the Residency Program is meeting their needs and expectations, as well as recommendations for changes in the Program.
c. The residents' written evaluations of the Residency Program are kept in a secure file for future reference.
10. Grievance Procedures.
a. In the event that a resident has a grievance with a faculty member or supervisor, the resident should initially attempt to resolve the issue with the faculty member or supervisor concerned.
b. If the resident 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 resident 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, Department of Behavioral Health and/or Psychology Faculty Committee, 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 Chief, Department of Psychology and the Program Director, in consultation with the Psychology Faculty Committee, until resolution is achieved.
c. In the event that the grievance is with the Program Director, the resident should attempt to resolve the issue with the Program Director. If this attempt is not successful, the resident sends a memorandum through the Program Director to the Chief, Department of Behavioral Health who assists in resolving the issue.
11. Attendance and Absences.
a. Residents must meet the requirement of one calendar year of training. Personal leave may be granted when, in the judgment of the PD, such absences do not interfere with a resident's progress in the Program. Ten duty days off may be granted during the training year (residents still accrue paid leave at the rate of 2.5 days per month, the rest of which may be taken after completion of the residency). Duty days are days in which the clinic is officially open. These ten days normally are taken in the form of personal leave. Leave generally is not granted during the first 6 weeks or last 6 weeks of the residency. Time off during the winter "holiday schedule" is counted against these 10 days.
b. Residents may be granted up to five working days of Permissive Temporary Duty (pTDY) for the purpose of attending professional workshops, meetings, or presentations. These pTDYs will be at no expense to the government. Permissive TDY approval is granted by the Program Director if it is deemed to contribute to the training goals of the Program. Days off for pTDY may be counted against the ten days allotted off during the residency year. Training required of residents as part of the Program (such as attendance at local conferences or seminars or sitting for the EPPP) is not considered part of this 5‑day pTDY allowance nor of the ten days off during the residency year. However, preparatory courses for the EPPP will be counted against this pTDY allowance.
c. All requests for leave, pTDY, TDY, or any other activities that take place away from the hospital must be reviewed by the Program Director.
12. Duty Hours.
a. Duty hours for residents are 0700 hours to 1700 hours.
b. Residents may not "call in sick". To be excused from duty a resident must see a physician during military sick call. The physician then decides whether the illness warrants being placed on quarters. In the event of extended illness, extension of the residency training period might be required and decisions are made under appropriate guidelines by the PD.
13. Withdrawal or termination from the program.
a. Residents are advised that military professional education and training programs are governed by Army regulations as well as by department SOPs. Procedures for withdrawal (including voluntary withdrawal), probation and termination from a program by an officer in training are covered within Army Regulation (AR) 351-3, Professional Education and Training Programs of the Army Medical Department.
b. When officers voluntarily withdraw or are terminated from the training program, their status and assignment as an Army officer will then be determined by the Medical Command.