Postdoctoral Residency – Napa/Solano

Intersecting Identities in Clinical Practice (DEI-Focused Group Supervision)
This bi-monthly group supervision provides postdoctoral residents with the opportunity to explore cultural factors and intersectional identity dynamics that arise in clinical work. Common topics that are the focus of discussion of clinical interactions, case presentations, and professional self-reflection include ethnic/racial identity, gender, sexual orientation, and other current sociocultural events. Cultural humility is encouraged and developed in this group supervision through active engagement in the discussions and presentations as opposed to merely learning facts or generalized cultural competence.

DEI Committee
Postdoctoral residents will also have the opportunity to participate in the DEI Committee. The committee consists of psychologists, LMFTs, LCSWs, psychiatrists, trainees, and support staff in the Napa/Solano Psychiatry Departments who are passionate about issues related to culture and diversity. The committee meets monthly to plan events and discussions for staff related to DEI, discuss trainings and speakers to bring to the department, and continue advancing employee understanding and engagement of issues related to DEI. Additionally, the committee discusses how to continue enhancing our Kaiser Permanente members care experience in our department, and ensure we create a welcoming and safe space for individuals and groups who have been historically marginalized. We invite interested residents to join the committee, where new ideas and perspectives are always welcome.

Regularly scheduled weekly didactic trainings, formerly held at the consortium level, are now organized and administered regionally in virtual format for all KP Northern California (KPNC) postdoctoral residents. Residents are required to attend this 2-hour weekly didactic, which focuses on developing competencies and expertise in clinical areas most relevant to their day-to-day work.

KPNC Mental Health Training Program also sponsors seminars for continuing professional development. These seminars are offered at select times during the year for all KPNC mental health trainees and KPNC Medical Center staff. Seminars are presented by local and national experts and cover a variety of cutting-edge topics in mental health treatment and research. Attendance at these region-wide seminars is required for all residents. Seminar dates and a list of speakers and topics can be found on the KPNC Mental Health Training Programs website. In addition, many of the presentations are recorded and available on the MHTP Continuing Education Seminar Library webpage.

Postdoctoral residents will attend:

• Weekly or bi-monthly department team meetings
• A bi-monthly meeting with the co-training directors focused on supporting residents as they adjust to Kaiser Permanente policy and workflows; topics include administrative issues and professional development as well as general support
• Training in supervision over the course of the training year alongside opportunities to provide 1:1 supervision support to psychology practicum externs

All postdoctoral residents are supervised by licensed psychologists and are assigned to a primary and secondary supervisor. These two clinical supervisors meet with their assigned resident one hour per week for individual face-to-face supervision, for a total of two hours of individual supervision per week. The primary and secondary supervisor in each training rotation is responsible for supervising the direct delivery of clinical services. The primary supervisor takes the lead role in developing the resident’s learning plan, monitoring their progress, and evaluating their training schedule. The primary supervisor is also responsible for supervising the resident’s clinical work and completing quarterly evaluations after gathering input from the other delegated supervisors and staff who have worked with the resident.

Residents are also provided with an hour of weekly clinical group supervision. This group supervision alternates between a Napa/Solano-based, DEI-focused supervision format described under the Equity, Inclusion, & Diversity section and an integrated North Bay Consortium supervision format, which features a mix of residents from all three consortium training sites. During the consortium group supervision, residents learn how to conceptualize treatment plans and frame interventions through broad cultural and contextual frameworks. In both group supervision formats, residents gain experience presenting clinical cases, as well as giving and receiving peer feedback. These feedback interactions help residents to develop both collegial and supervisory aspects of their professional identities as psychologists.

For residents training in the Psychiatry Department, a second hour of weekly group supervision is dedicated to psychological assessment and provides support for residents gaining proficiency conducting psychological evaluations. During assessment group supervision, residents have an opportunity to discuss several aspects of the assessment process, including how to interpret test results, formulate clinical impressions, and plan patient feedback. For residents training in the Trauma Surgery Center/Behavioral Medicine tracks, a second hour of weekly group supervision is dedicated to rounding with a board-certified psychiatrist and the Delirium Team.

Reflecting Kaiser Permanente’s core commitment to mental health and wellness in our communities, each postdoctoral resident will spend at least 32 hours during their training year on a Community Partnership Project that focuses on improving mental health in the Napa-Solano community beyond our Kaiser Permanente patient members. Projects may include presentations on mental health topics or career mentoring in such settings as colleges/schools, faith-based organizations, and other local organizations dedicated to assisting those in need.

The goal of this project is to provide outreach to underserved populations to promote health and advancement. Anchors for the project include developing alliances with individuals and/or systems to improve the lives of those served; providing education and training based on the empirical literature; and presenting relevant outcomes data to partnership stakeholders. Residents will meet with the Community Partnership coordinator to assist with placement and the development of a project.

All postdoctoral residents training in the Psychiatry Department administer psychological assessments as part of their training. Initially, residents will be trained in and conduct specialty evaluations for autism spectrum disorder (ASD); as the training year progresses, residents will have opportunities for comprehensive psychodiagnostic evaluations as well. Residents have a dedicated group supervision for support, consultation, and training related to assessment.

All postdoctoral residents training in the Trauma Surgery Center/Behavioral Medicine tracks complete screenings and assessments with patients in the partnering departments of medicine where the embedded behavioral health services are delivered. Screenings and assessments are primarily focused on trauma, cognitive functioning, and mental status.

At the beginning of the training year, the training directors work with each postdoctoral resident to determine which research-based training activity they will engage in over the course of the training year. Residents may choose to collaborate on a program evaluation project with the MHTP Evaluation and Quality Improvement Lab (EQI Lab) or join the MHTP Journal Club.

• MHTP EQI Lab Program Evaluation: projects are guided by quality improvement goals that extend beyond local, site-specific programs. Projects may focus on outcomes of training program models, the impact of MHTP specialty training, the effectiveness of MHTP-sponsored treatment programs, or the incorporation of outcomes measures into clinic workflows. The EQI Lab holds weekly, 1-hour meetings throughout the training year to coordinate MHTP program evaluation projects and monitor progress. During these weekly lab meetings, residents receive consultation from MHTP clinical supervisors to ensure that their projects are relevant to current clinical work, integrated into clinical care, and appropriate for dissemination.
• MHTP Journal Club: research training consists of reviewing and critically evaluating research within a select subfield of psychology and developing a didactic tool for other clinicians to use to augment their clinical practice during the delivery of services within KP Mental Health. The primary expectation for each resident in the Journal Club is to prepare a cohesive presentation and actively participate in scholarly discussion during these presentations. The Journal Club holds monthly, 1-hour meetings.

12-month track (candidates who apply and are accepted into this track will complete their residency within this track for the duration of the training year)

The postdoctoral resident in this track will spend half of their clinical schedule specializing in Consultation/Liaison (CL) work in the Vacaville Medical Center’s Level II Trauma Surgery Center. Consultation/Liaison work in this track provides a unique and rich opportunity for the resident to be part of a tight-knit trauma surgery team in a role that prepares them to be an embedded psychologist. The role involves bedside consultation that includes assessment and screening of trauma and cognitive functioning as well as psychoeducation and brief interventions to assist with adjustment-related concerns. This role also involves morning rounding with the trauma surgery team to identify patients who might benefit from additional psychological services. In addition, the resident will join weekly rounding with the Delirium Team, which includes a board-certified psychiatrist.

During the other half of their clinical schedule, the resident will train with the Behavioral Medicine Services (BMS) Team in a role that prepares them to be an embedded psychologist in departments such as Primary Care/Family Medicine, Pain Medicine, and Women’s Health. In this role, residents will have the opportunity to diagnose, develop treatment plans, and deliver care to patients within the partnering departments of medicine. Depending on the department, the resident will treat conditions such as peripartum mood and anxiety disorders, loss, pelvic pain, infertility, and birth trauma or diabetes mellitus, chronic pain, headaches, insomnia, and irritable bowel syndrome, among others. Importantly, BMS providers are integral for treating adjustment disorders related to coping with medical diagnoses to improve whole-health patient outcomes. The BMS model allows for warm handoffs from physicians for patients who may be either ambivalent about treatment recommendations or likely to benefit from brief behavioral health interventions. As part of the BMS Team, the resident may serve as the liaison between patient and physician for monitoring response to medications or general treatment compliance with the goal of optimizing overall health. The resident is expected to attend all medical team huddles as well as weekly BMS staff and case consultation meetings.

Candidates with education and previous experience training in hospital consultation & liaison services, the emergency department, outpatient medical clinics, and Women’s Health are preferred.

12-month track (candidates who apply and are accepted into this track will complete their residency within this track for the duration of the training year)

The postdoctoral resident in this track will spend their whole clinical schedule training with the Behavioral Medicine Services (BMS) Team in a role that prepares them to be an embedded psychologist in departments such as Primary Care/Family Medicine or Women’s Health. In this track, the resident will receive training in primary care psychology while working within a close-knit BMS Team; they will have the opportunity to diagnose, develop treatment plans, and deliver care to patients within the partnering departments of medicine. BMS providers co-treat chronic conditions such as diabetes mellitus, chronic pain, headaches, insomnia, irritable bowel syndrome and adjustment disorders related to coping with medical diagnoses. This role broadens and deepens the resident’s brief assessment and intervention skills across many diagnoses and with a diverse group of patients.

The BMS model allows for warm handoffs from physicians for patients who may be either ambivalent about treatment recommendations or likely to benefit from brief behavioral health interventions. The resident will have opportunities to collaborate with physicians on the evaluation of psychotropic medications within their scope of practice and may serve as a liaison between patient and physician in monitoring medication compliance and response. The position also involves conducting brief cognitive screenings as requested by the primary care physician; opportunities to conduct Bariatric surgery evaluations are available via MHTP specialty training and requires additional application and approval from the training team. As part of the BMS Team, the resident is expected to attend weekly BMS staff and case consultation meetings. While the resident in this track will be training primarily in a BMS embedded department identified above, they will also have an opportunity to work and train in other areas of the medical center such as the Emergency Department in a Consultation/Liaison capacity, Pain Medicine, Parkinson’s Disease support group, Oncology, Concussion/Sports Medicine Clinic, and diabetic education.

This position requires autonomy and flexibility in fast-paced medical settings. Candidates with education and previous experience working in behavioral medicine or health psychology settings are strongly preferred.

12-month track (candidates who apply and are accepted into this track will complete their residency within this track for the duration of the training year)

The postdoctoral resident in this track will spend half their clinical schedule specializing in mental health services and programming for more acute and chronically ill patients. As part of the Intensive Outpatient Program (IOP) Team, residents may encounter patients who have been recently discharged from higher levels of care, such as inpatient hospitalization or crisis residential placements, or be at risk for psychiatric hospitalization. In this role, the resident will gain experience co-facilitating psychoeducational and process-oriented groups, conducting IOP intake assessments, and developing treatment plans geared toward stabilization of acute psychiatric crises. The role also involves twice daily meetings and consultation among a small tight-knit, interdisciplinary treatment team. The position will broaden and deepen the resident’s clinical skills across all diagnoses and with a diverse group of patients, all while working closely with a supportive group of colleagues.

During the other half of their clinical schedule, the resident in this track will join the Psychiatry Department’s Adult Services Team in a generalist role. In this role, the resident will conduct individual intake assessments, provide individual psychotherapy, and co-facilitate psychoeducation, skills, and treatment groups. Adult Psychiatry hosts over 40 groups across the Napa/Solano service area each week for a variety of populations and presenting problems, including depression management, Trauma Recovery, Bipolar Support, Mindful Mood, and many more!

12-month track (candidates who apply and are accepted into this track will complete their residency within this track for the duration of the training year)

The postdoctoral resident in this track will spend half of their clinical schedule specializing in trauma-focused treatment. In this role, the resident will conduct individual intake assessments and provide individual and group treatment of trauma-related disorders. The resident will gain experience and expertise in utilizing evidence-based trauma treatment with a diverse patient population who come from communities experiencing a high trauma burden. The resident will also have access to case consultation with trauma specialists during the Trauma Team’s weekly meeting. In addition to receiving training and treatment with individual and group cognitive processing therapy (CPT), the resident will also receive individual supervision provided by CPT certified psychologist. There may also be opportunities for the resident to learn prolonged exposure therapy (PE) and EMDR; however, these specialized training opportunities require additional application and approval from the training team.

During the other half of their clinical schedule, the resident in this track will join the Psychiatry Department’s Adult Services Team in a generalist role. In this role, the resident will conduct individual intake assessments, provide individual psychotherapy, and co-facilitate psychoeducation, skills, and treatment groups. Adult Psychiatry hosts over 40 groups across the Napa/Solano service area each week for a variety of populations and presenting problems, including depression management, Trauma Recovery, Bipolar Support, Mindful Mood, and many more!

12-month track (candidates who apply and are accepted into this track will complete their residency within this track for the duration of the training year)

The postdoctoral resident in this track will spend half of their clinical schedule developing expertise in dialectical behavior therapy (DBT) by co-facilitating a number of DBT skills groups across our service area. In this role, the resident will provide individual and group psychotherapy for patients participating in our DBT Intensive Program, which offers weekly individual and group treatment to individuals diagnosed with borderline personality disorder. The resident in this track will also meet weekly with the DBT team for ongoing case consultation.

During the other half of their clinical schedule, the resident in this track will join the Psychiatry Department’s Adult Services Team in a generalist role. In this role, the resident will conduct individual intake assessments, provide individual psychotherapy, and co-facilitate psychoeducation, skills, and treatment groups. Adult Psychiatry hosts over 40 groups across the Napa/Solano service area each week for a variety of populations and presenting problems, including depression management, Trauma Recovery, Bipolar Support, Mindful Mood, and many more!

12-month track (candidates who apply and are accepted into this track will complete their residency within this track for the duration of the training year)

The postdoctoral resident in this track will work with general psychiatry patients providing short-term individual therapeutic intervention for a variety of clinical concerns. A specialty training emphasis is offered for this position depending on the resident’s clinical experience and clinical interest; most specialty emphases will span the duration of the training year. The resident may choose one of the specialty training options below if they have the prior training and/or experience necessary to participate in the specialty.

Eating Disorder Emphasis (EDO Team): In this year-long training specialty, the postdoctoral resident will gain experience working with a variety of eating disorder presentations through our outpatient clinics. The EDO Team serves patients struggling with anorexia, bulimia nervosa, and binge eating disorders as well as ARFID and unspecified eating disorders. In this specialty, the resident will manage an individual caseload of patients struggling with disordered eating behavior and body image concerns. The resident will actively participate in a weekly multidisciplinary case consultation to round on cases and consult with our incredible medical team and top-notch medical nutrition therapists. The resident will also have access to specialized regional trainings specific to the treatment of eating disorders in an outpatient setting. There are also opportunities to co-facilitate clinic groups focused on the treatment of disordered eating behavior and body image concerns, including our Adult DBT Focused Treatment Group for Eating Disorders. For those interested in learning more about working with eating disorders in the younger season of life, there are opportunities to co-facilitate the Teen Eating Disorders group. Some eating disorder training and treatment experience is preferred but not required.

Maternal Mental Health Emphasis: The postdoctoral resident training in this specialty will gain experience working with peri-/post-partum mood and anxiety concerns as well as collaborate regularly with our multidisciplinary team. Our Maternal Mental Health treatment pathway focuses on utilizing brief interpersonal therapy (IPT) interventions to help birthing parents navigate the challenges of postpartum depression and anxiety. In addition to the work with the medical clinic teams (OBGYN, psychiatrists, and lactation consultants), the resident will also have the opportunity to co-facilitate the outpatient Postpartum Support group, which is held weekly. Some experience with peri-/post-partum care preferred but not required.

Unified Protocol Emphasis (Uplift Program): The postdoctoral resident training in this emphasis will gain experience providing an emotion-focused, transdiagnostic treatment called the Unified Protocol (UP) for treating a variety of mood and anxiety disorders. Patients referred to the Uplift program typically present with moderate to severe symptom severity, and episodes of care span anywhere from 8-16 bi-monthly individual therapy sessions. The resident training with the Uplift Team will also have access to regular trainings and consultation meetings with licensed staff who are also using the UP. Basic understanding of cognitive and behavioral interventions recommended but not required.