Mission

Develop psychologists to function as part of a fluid military medical environment across the clinical health psychology spectrum of prevention, intervention, rehabilitation, management, and administration. The education and training goal of our Postdoctoral Training Program in Clinical Health Psychology is consistent with our aims to prepare clinical psychologists for the advanced clinical health psychology practice competency level. Postdoctoral fellows in our program are provided with training in the recommended competencies as delineated by the Division 38 (Health Psychology; France et al., 2008), the American Academy of Clinical Health Psychology and the American Board of Professional Psychology.

Vision

Continuously contribute qualified behavioral health psychologists to the ever-changing landscape of military medicine and health care delivery.

Aims

1. Prepare postdoctoral fellows for clinical health psychology practice at an advanced level, with substantial understanding and skill pertinent to medical/legal issues, the practical resolution of ethical dilemmas, effective collaboration with other health professionals, issues of cultural and individual diversity relevant to psychology practice, and effective functioning in medical settings.
2. Develop advanced levels of specialty expertise in diagnosing and defining problems through clinical health psychological assessment and formulation, the planning and implementation of relevant psychological interventions, and consultation to health and other service providers (e.g., in hospitals, clinics, and social service agencies).
3. Develop depth of knowledge and research expertise in an area of clinical health psychology, develop the capabilities needed to initiate and carry out scholarly inquiry and independent, programmatic evaluation or research.
4. Develop advanced understanding of the scientific basis for clinical health psychology assessment and intervention and substantial experience in the meaningful integration of science and clinical practice.
5. Facilitate growth of professional identity, development of teaching or supervisory skills, and participation in professional activities.
6. Develop advanced understanding in management of personnel and administration of responsibilities required to effectively organize a functioning clinic.

Many didactic opportunities are available to Health Fellows throughout the training year. Fridays are reserved for required didactics and case conferences. Didactic topics include assessment, therapeutic intervention, ethics, cultural diversity, professional development, and research among others. There are also periodic faculty and Fellow case conferences. Fellows may attend workshops. In addition, there may be 1 to 2-day workshops offered on various topics throughout the year. These workshops are typically presented by notable clinicians in their respective fields of psychology.

The didactic curriculum for the Clinical Health Psychology (CHP) Fellowship requires fellows to spend up to 4 hours per week in self-study during the fellowship workweek. Many didactic opportunities are available to fellows throughout the training year. Training opportunities scheduled throughout the year include:

All-Fellows One-Hour Monthly Friday Journal Club

All fellows participate and each fellow is expected to present. The fellow will select an article in advance of the meeting, disseminate the article, and lead a discussion on the important aspects of the article. The fellow should include a measurable learning objective that is used as at least one discussion point during the presentation of the article. The journal club articles should reflect the following areas of psychology professional competencies:

• Ethics: Chapters or current articles on issues relating to the ethical practice of psychology. Fellows are encouraged to think critically about the ethical challenges discussed and reflect upon their own practices from an ethical standpoint. The goal is for the fellows to gain knowledge of ethical codes, standards and legal regulations, case law relevant to professional practice; ethical decision-making model; and how to apply the knowledge to the various roles as a professional psychologist.
• Cultural/diversity: Articles should cover a range of topics to include different ethnic and cultural groups, sexual orientation, disabilities, and military culture. The goal of the articles should be to help fellows increase self-awareness of their own attitudes, biases, assumptions, and knowledge about various dimensions of diversity; appropriate professional practice with persons from diverse groups; the consideration of individual and cultural differences in clinical work; and values consistent with such professional activities.
• Program Development and Evaluation: Fellows should choose articles that seek to understand health care and mental health care systems, including economic, legal, and socio-cultural aspects of health care delivery. Other areas include how systemic issues impact the delivery of services, especially those that involve other professionals and disciplines, knowledge about evaluations of clinical programs and development of innovative programs and patient care services.
• Supervision: Articles or book chapters that prepare fellows to provide supervision to practicum students, interns, and behavioral health technicians, such as readings that delineate ways that supervisors establish goals and objectives, assess the needs of the supervisees, facilitate growth within the supervisees, motivate supervisees, and work with difficult or defensive supervisees.

Additionally, fellows can attend trainings offered by the Department of Behavioral Health Distinguished Visitor Program or community training events.

Distinguished Visitor Workshops

Throughout the training year, workshops on various topics will be presented by notable individuals in the field of psychology. The Director Of Training may require fellows to attend select workshops, particularly those that are relevant to the practice of Clinical Health Psychology or to fill any identified gaps in the fellows’ training. Each visit by a visiting professor is a one or two-day experience and includes approximately 6 to 12 hours of seminar/workshop.

Case Presentations 

In addition to multiple opportunities to informally present and discuss clinical cases in supervision, each fellow will be responsible for formally presenting a clinical case at least twice during the fellowship year. Fellows will consult with their rotation supervisor to select appropriate patients. Presented cases are typically 60 minutes and should be challenging, complex, or demonstrate the development of the fellow’s clinical skills. Faculty in attendance will provide verbal feedback to the fellows in a collegiate manner and highlight areas of continued focus and/or mastery. Case presentations assist with the development of foundational and functional competencies of CHP.

Weekly Director of Training (DOT) Meetings

Fellows will meet with the DOT for one hour each week to discuss a variety of topics including: military service, Army health psychology, administrative issues, career mentorship, etc.

Weekly Didactics

Fellows participate in weekly professional psychology presentations/training focused on a variety of topics pertinent to the field of clinical health psychology (e.g., sleep disorders, pain management, specific psychological assessment instruments used in clinical health psychology, individual and cultural diversity issues, etc.). Fellows are required to present at least one didactic during the fellowship training. All participants (including fellows) will discuss the didactic schedule to aid program improvement efforts. Significant changes to the didactics schedule will be discussed with CHP faculty committee. Didactic experiences serve to develop the foundational and functional competencies.

Other Clinic Meetings

Fellows will attend all clinic meetings of the rotation that they are on when patient care allows. Safety meeting is an interdisciplinary staff meeting in which patients are staffed in a multidisciplinary setting and routine administrative issues are discussed. These meetings often offer an interdisciplinary didactic/training seminar. Safety meeting participation serves to develop the following profession-wide competencies: research, ethical and legal standards, individual and cultural diversity, communication and interpersonal skills, assessment, intervention, and consultation, and interprofessional/interdisciplinary skills. Participation in safety meetings is a requirement of the Department of Behavioral Health.

Behavioral Medicine Service

The Behavioral Medicine Rotation trains the fellow to be a well-rounded, clinical health psychologist, informed by relevant research using empirically validated intervention models. The rotation includes adult clinical activities with a diverse patient population of varying ages, duty status, and ethnic and cultural backgrounds. Rotation training experiences occur through the treatment and assessment of active-duty service members, dependents, and veterans. Fellows can conduct both individual and group treatment. The Behavioral Medicine rotation has an emphasis on assessment and intervention that includes experiential and didactic training experiences, in conjunction with doctoral level interns, practicum students and enlisted behavioral health technicians. The rotation utilizes a systems-oriented, biopsychosocial model to develop practice skills in prevention, assessment, and treatment of several medical disorders. Direct patient care activities include acquiring skills necessary to provide services to a wide range of medical patients. The rotation also allows for specific training in psychophysiological/biofeedback-assisted self-regulation techniques. Fellows receive comprehensive training in a range of specialty evaluations to include pre-surgical evaluations, among many others. The Behavioral Medicine rotation is intellectually challenging, and fellows can develop additional professional skills including supervision (of behavioral health technicians, interns and practicum students), consultation (multi-disciplinary and interdisciplinary teams), program development and research. Fellows will receive a minimum of one hour a week of individual supervision while on the rotation.

Interdisciplinary Pain Management Center

The Interdisciplinary Pain Management Center rotation trains the fellow to evaluate and treat chronic pain conditions within an integrated multidisciplinary team. The fellow is trained in a comprehensive biopsychosocial model to implement evidence-based treatments for chronic pain management in the group and individual treatments. The pain rotation builds upon psychophysiological/biofeedback-assisted self-regulation training for musculoskeletal pain conditions and performance training. Fellows are trained to consult within the interdisciplinary team to include Pain Physicians, Clinical Pharmacists, Chiropractors, Acupuncturists, Medical Massage Therapists, and Physical Therapy. Fellows are trained in functional pain assessments to assess patient and program outcomes, inform treatment planning, and presurgical evaluations to provide consultation with patient selection. The fellows participate in regional consultation and training through ECHO to include the delivery of Pain Psychology didactics. The pain rotation may also include supervisory, administrative, and program development opportunities based upon the fellow’s individual training goals and developmental needs.

Cardiology

Cardiac psychology is a specialization of health psychology that focuses on the primary and secondary prevention of heart disease by incorporating strategies to address the emotional and behavioral barriers to lifestyle changes (e.g. smoking cessation), and that seeks to enhance recovery in cardiac patients by means of providing patients tools (e.g. stress management and psychotherapy) to cope with life and physical changes associated with their disease. Cardiac psychologists can help cardiac patients across the lifespan: prevention, pre-surgery, post-surgery, and rehabilitation of cardiac disease with a particular emphasis on achieving optimal quality of life outcomes. Common cardiovascular diseases encountered on this rotation include coronary heart failure, palpitations, atrial fibrillation, and sinus tachycardia. Fellows learn a variety of interventions to assist with treating these disorders to include biofeedback, capnography, physical activity, cognitive behavioral therapy, mindfulness, and self-relaxation techniques. Fellows are also encouraged to become involve with program development activities for this population.

Pulmonary

Clinical health psychologists are in a unique position to understand the relationship between breathing disorders and psychological distress, outside of the common belief that most breathing issues are a direct result of underlying anxiety and mental health. Common pulmonary disorders encountered on this rotation include dyspnea, vocal cord dysfunction, chronic hyperventilation syndrome, asthma, and chronic obstructive pulmonary disorder. Fellows learn a variety of interventions to assist with treating these disorders to include biofeedback, diaphragmatic breathing techniques, smoking cessation, motivational interviewing, and self-relaxation techniques. Fellows will also collaborate with other specialty clinics in treating these patients to include Speech Therapy and Ear, Nose, and Throat (ENT).

Endocrinology

The study of endocrinology, the branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones, is critical to the overall understanding of disease states and pathophysiology. This understanding is crucial to shaping one’s identity as a health psychologist. Common endocrine disorders encountered on this rotation include diabetes, infertility, low testosterone, osteoporosis, polycystic ovary syndrome and thyroid disorder. Fellows learn a variety of interventions to assist with treating these disorders to include providing targeted psychoeducation, mindfulness, cognitive behavioral therapy, goal setting, motivational interviewing, and self-relaxation techniques.

The first year of fellowship is largely prescriptive with an opportunity to seek a military unique curriculum (MUC) experience week. The second-year practice and project topics are largely elective in nature while maintaining a balance of both throughout the year. Fellows are given the opportunity to select a practice area and specialty clinic to prioritize for specialization for the duration of their second year.

Previous fellows have elected to specialize with integration in pain at the Center for the Intrepid, sleep medicine, women’s health, cardiology, pulmonology, disease management and nutrition, and primary care settings. Regarding projects, fellows can elect to prioritize work with a variety of units/topic areas and develop a plan for their elective project/research emphasis rotation during their first year to optimize efforts in second year. Previous fellows have focused on clinical research with sleep medicine, weight management, chronic pain, women’s health, and others. Line-related research has been conducted in collaboration with 2nd Air Force, 37th Training Wing (Basic Military Training), other specific training technical school (Maintenance, Explosive Ordinance Disposal, Air Traffic Control), Air Force Medical Readiness Agency, and with the office of the Air Force Vice Chief of Staff. Topics of research have largely been related to health behaviors such as sleep, alcohol, tobacco, weight management, motivational interviewing for behavior change, and other broad behavioral science design programming.

Much of the fellows’ curriculum focuses on helping fellows apply advanced foundational skills and concepts within a military-specific healthcare environment. These topics may include obesity and physical fitness standards related to the military.

There are several required trainings throughout the year and those may vary from year to year. These courses are shown on the didactic schedule and are typically biofeedback and hypnosis.

Much of the curriculum is delivered by the fellowship faculty members as it pertains to leadership training. New opportunities exist to gain experience in executive medicine and leadership throughout the fellowship.

Fellows will participate in a scholarly activity which may culminate in a conference presentation or a peer-reviewed article.

There are several professional development activities throughout the year. Some of the opportunities are program directed in the form of didactics, others are collaborative in nature and are initiated by quarterly developmental counseling, and still others like the fellows seeking out professional development opportunities on their own are program-supported/encouraged. Fellows are expected to consult with senior medical officers and unit commanders in areas related to the patient’s progress and building unit support. Fellows can develop health-related, organization-wide interventions to treat such diseases as obesity.

• Tripler Army Medical Center

The fellowship opportunity is advertised by the Army Medical Department as well as the Chief Psychologist of the Army. Potential Fellows will apply via this application process outlined in the Army Long Term Health Education Military Personnel Message released yearly. Once the application has been received and vetted, the applicant will be interviewed by the fellowship selection committee at Tripler Army Medical Center.

Application Deadline

The application deadline is approximately one year before the start of the Fellowship.

Diversity

Our faculty and the Army values cultural and individual diversity and strongly encourage qualified candidates from all backgrounds to apply. In keeping with our commitment to diversity, we seek a fellowship class representing a wide range of backgrounds, interests, talents, and life experiences. It is the policy of our program and the Army to provide equal opportunity in employment for all qualified applicants. Discrimination based on race, color, religion, gender, gender identity, national origin, age, disability, sexual orientation, or status as a parent, is prohibited. In accordance with United States law, applicants must be United States citizens and meet age, security background, and medical qualification requirements for an Army officer commission before being placed on the internship’s APPIC Match ranking list.

There are no civilian positions available. All Fellows must be commissioned as active duty Army officers.

All interviews are 50-minute virtual interviews. Each candidate will have one individual interview with a three-member committee that consists of three fellowship-trained health psychologists. The chair of the committee is the Fellowship Director.

At the end of the first year of the fellowship, Fellows are encouraged to consider submitting an application for the American Board of Professional Psychology.

Fellows are encouraged to and supported in imparting knowledge both formally and informally in various contexts. Fellows are required to deliver one formal didactic to the behavioral health technicians, and interns and one brief during Grand Rounds. Fellows will have the opportunity to present at The Hawaii Psychological Association and/or the American Psychological Association Convention.

Faculty members are board certified by the American Board of Professional Psychology in Clinical Health Psychology or are pursuing board certification in either Clinical Health Psychology. Additional board certification in Behavioral Sleep Medicine and Biofeedback also exists among program faculty.

Each incoming fellow will be assigned a mentor/sponsor from the outgoing class to provide them with guidance and support as they transition during the training year. Fellows are also encouraged to seek mentorship both within and outside the program to grow their unique interests and foster a continued understanding of life and opportunities within the military. Fellows have the option of requesting a preceptor to mentor/guide them in challenging areas that may arise during their training journey.

We aim to foster a space in which the TEAM and its individuals are valued. Collaboration, support, and friendly competition are emphasized as tools to be successful in the Fellowship and beyond. The importance of self-care and well-being are not only highlighted during didactics, but time is given during the training year to practice. There are several points throughout the year where we pause from the typical day-to-day activities and go out into the community on this beautiful island to do a unique activity that enhances well-being and team building.