Predoctoral Psychology Internship

The Fargo VA Health Care System offers a Pre-Doctoral Psychology Internship Program for students pursuing a doctoral degree in clinical or counseling psychology.  Within the internship, a Health Psychology/Mental Health Primary Care rotation is offered that emphasizes development of skills needed to integrate psychological services within interdisciplinary treatment teams in medical settings.

The Fargo VA is a general medical and surgery facility serving a Veteran population of more than 89,000 from North Dakota, northwestern Minnesota, and northeastern South Dakota. The center provides primary and secondary medical, surgical, psychiatric inpatient care, primary and specialized outpatient care, and rehabilitative care. Tertiary care is referred to the Minneapolis VA Health Care System. The center operates nine community-based outpatient clinics (CBOC) primarily in highly rural locations. The Fargo VA Health Care System maintains an active research program and it supports residents in internal medicine, surgery, and psychiatry.

Psychology has greatly expanded tele-medicine services, including group therapies.  In 2011 around 70% of telemedicine appointments at the Fargo VA were provided by the Mental Health Service Line, with over 2,500 mental health telemedicine visits.  Assessment, therapy, and consultation services are also available to those in rural communities via home-based primary care up to a distance of 50 miles from Fargo.  Additionally, most CBOC sites have a mental health staff member on site.  Psychology service is integrated within the Mental Health Service Line, which also consists of psychiatry, pharmacy, and social work.

The pre-doctoral psychology internship program adheres to a scholar-practitioner approach to training that focuses on the consideration of research to guide clinical practice.  Emphasis is placed on utilization of empirically supported treatments, both brief and long-term.  There is also a strong emphasis on assessment and consultation.  All interns participate in a year-long assessment clinic that offers instructions in both personality and cognitive assessment.  They also choose to complete three major rotations, one of which provides in-depth training in health psychology and mental health primary care.   Interns meet for weekly didactic seminars, where a variety of topics related to program competencies are reviewed (i.e. personality and cognitive assessment, various professional development issues). Psychology staff, as well as other disciplines, present on such topics and some training may span weeks in duration.  Case presentations and psychiatry grand rounds (which involves presentations to physicians, psychologists, residents, and other medical staff on specific psychiatric related issues) offer additional avenues for didactic training. Each intern may also be expected to present a topic of expertise at grand rounds or a local university during their training. 

The Health Psychology/Mental Health Primary Care rotation emphasizes development of skills needed to integrate psychological services within interdisciplinary treatment teams in medical settings. Major components of the rotation include brief evaluation and treatment of clinical and health psychology problems; triage decision-making to prioritize service delivery; consultation and collaboration with primary care providers for psychological and medical management; psychological assessment, individual and group psychotherapy, referral to specialty mental health programs; and coordination of care with the on-site psychiatrists and social workers.

Interns have the opportunity to take part in leading empirically based treatment groups on topics such as sleep, pain, and weight management.  In addition, interns develop skills in promoting healthy behaviors (i.e. physical activity) and help patients resolve other medically-related problems (i.e. pain management, treatment adherence, coping with illness, and disease management).  Specialty training is provided in motivational interviewing and problem solving therapy. Interns also have the opportunity to work as a mental health liaison to a multidisciplinary Patient Aligned Care Team (PACT) within primary care.  The intern attends weekly team meetings that focus on administrative and clinical issues.