Postdoctoral Residency – San Francisco

We are committed to nurturing and integrating diversity training into all aspects of our postdoctoral residency program and strive to do so by:

1. Providing residents with opportunities to work with diverse patients who represent various aspects of diversity, including age, religion, gender, socioeconomic status, ethnicity, values and lifestyle
2. Placing a high value on residents’ willingness to engage in self-reflection and learning and supporting the exploration of attitudes, beliefs and therapeutic postures that could have a negative impact on clinical interactions
3. Maintaining a consistent focus in clinical supervision on expanding residents’ multicultural awareness and competence in the provision of psychotherapeutic services and by providing guidance, suggestions, and resources on topics related to diversity
4. Providing formal in-person or online training on diversity topics such as discovering and mitigating unconscious bias, respecting every voice, and cultivating a sense of inclusion and belonging in the workplace

Residents are encouraged to participate in the Regional Mental Health Training Program EID Committee’s advanced trainings on topics related to cultural sensitivity and competence alongside a forum to reflect on and discuss their varied experiences in a safe environment.

The Pain Medicine Department offers the following didactic curriculum forums which include:

Local Seminars

Monthly didactic seminars on relevant pain management topics are offered. Topic examples include but are not limited to Understanding Chronic Pain, Racial, Ethnic, and Sociodemographic Disparities in Pain Assessment, Acceptance and Psychological Flexibility in Pain Coping, Therapeutic SCS Assessment, and Best Practices in Opioid Management.

Regional Seminars

Our Regional Mental Health Training Program also sponsors seminars for continuing professional development that extend beyond the central training foci at our local site. The seminars are offered at select times during the year for all KP mental health trainees and staff at Kaiser Northern California Medical Centers. Local and national experts present on a variety of cutting-edge topics in mental health treatment and research. Regional seminar dates and a list of speakers and topics can be found on the Regional Mental Health Training Programs website. In addition, many of the presentations are recorded and available under the continuing education lecture library webpage.

Biofeedback Seminar
A one hour weekly, didactic training in biofeedback is offered and is a pillar of the postdoctoral residency program. Residents are trained in peripheral biofeedback modalities including heart rate variability, capnometry, electromyograph, and temperature training. In addition to receiving weekly didactics on clinical psychophysiology, residents co-facilitate biofeedback groups, and treat individual patients using biofeedback training.

Journal Club Meetings
The journal club provides residents with opportunities to keep up-to-date with the current pain medicine literature. Articles are chosen for review and residents lead discussions on their relevance and applicability to patient care.

Department Staff Meetings
Residents attend monthly department staff meetings oriented to updating staff on medical center initiatives, providing a communal space for staff to collaborate on departmental goals, and engaging staff in team-building activities for the purposes maintaining a positive department culture.

Patient Rounds/Team Meetings
Residents attend varied patient rounds/team meetings and discuss patient status and progress in treatment. Multidisciplinary providers collaborate, share clinical impressions and decide upon modifications to patient care plans.

Grand Rounds
Residents attend monthly Grand Rounds on pain medicine-related topics. Additionally, residents present their own research project at Grand Rounds toward the close of the training year.

Postdoctoral residents receive regularly scheduled, individual supervision for two hours per week split between two training supervisors, a primary supervisor and a delegated (secondary) supervisor. Residents receive a third hour of individual supervision that is specifically focused on biofeedback training. A fourth hour of group supervision is facilitated by the training director. Group supervision topics include professional development, interdisciplinary communication and systems issues, program evaluation and multicultural competence and diversity awareness. Additional individual supervision is provided for psychological testing cases.

Reflecting Kaiser Permanente’s core commitment to mental health and wellness in our communities, each resident is required to complete a 32-hour Community Partnership Project that supports forging meaningful partnerships with a community organization and/or institution to expand pain management education and training for the staff and patients and/or members that they serve.

Resident Community Partnership Projects have included the development and delivery of in-service presentations on relevant pain management topics to local homeless shelters, senior centers, medical burn units, addiction medicine clinics, and educational institutions. Residents have also engaged in outreach to community doctoral programs to educate graduate students about specialty education and training in Pain Medicine.

Assessments completed by postdoctoral residents in the Pain Medicine Department are specific to the setting. Residents complete 4-6 psychological screening assessments for patients under consideration for a spinal cord stimulator trial. Each resident is assigned a testing supervisor who is responsible for training them in testing procedures and helping them to determine the appropriate measures to be used in each case. Residents conduct a thorough chart review and clinical interview, administer, score and interpret measures, and write up integrative testing reports incorporating relevant treatment recommendations. There is a focus on therapeutic assessment emphasizing the value of testing feedback sessions.

Each resident is required to undertake a program evaluation project during their training year. The project is selected based upon the resident’s interests and skill set and should fall within the regular scope of departmental services.

It may involve collecting and analyzing data to improve administrative operations, or a quality improvement project aimed at improving or assessing a treatment program or process. Examples include developing and evaluating a treatment group, intake procedure or other new programming; evaluating factors associated with treatment outcomes; or a needs assessment of a service that may be enriched by psychological consultation. Residents meet with the program evaluation supervisor as a group regularly over the course of the training year to review progress on their projects.

Pain Medicine Track
The Pain Medicine Department offers residents opportunities to develop, refine, and expand their assessment and treatment expertise working with adult patients who experience chronic, benign pain and often, psychological comorbidities, who have exhausted standard medical treatment options. Residents are trained in delivering Cognitive Behavior Therapy (CBT), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), Positive Psychology, Mindfulness and Biofeedback treatment within individual and group-based treatment settings.

Interdisciplinary Team
Chronic pain is a difficult and complex problem for which no one discipline has an adequate answer. Residents work as part of an Interdisciplinary care team, combining the unique contributions of health psychology, medicine, pharmacology, physical therapy, and acupuncture which has proven to be an effective treatment approach for most people. The department’s overarching goals in treating patients are adequate pain control, improved physical function and pain-related coping, reduced affective distress, and enhanced social support.

Available Training Rotations:

• Intensive Chronic Pain Management Program
• Intermediate Chronic Pain Management Program
• Headache Management Program
• Medication Management Program
• Biofeedback Service
• Alumni Program
• Specialty Programs (available to seniors, young adults, and patients with opioid overuse).