Walter Reed National Military Medical Center Psychology Internship

Walter Reed National Military Medical Center (WRNMMC) is the "flagship" of military medicine. It is located in Bethesda, MD, just outside of Washington, DC. Nicknamed "The President’s Hospital," WRNMMC treats the President of the United States, members of the President's Cabinet, Congressmen, Senators, and service members from all branches of the armed forces.

Distinguished neighbors and valuable resources include the National Institutes of Health (NIH) and the National Library of Medicine.

WRNMMC offers over seventy-five accredited medical and dental residency and fellowship programs, including our psychology internship.

WRNMMC Doctoral Internship in Clinical Psychology

WRNMMC Internship Training Manual

Trainee Admissions, Support, and Outcome Data - Walter Reed

Our internship has been fully accredited by the American Psychological Association (APA) since 1964. It has been cited as a "model program" by the APA.

The internship has two broad goals:

• Provide the intern with experiences and competencies needed to function as a broadly trained clinical psychologist
• Equip the intern with program-specific military competencies needed to practice as a psychologist in the United States Navy

Major Rotations

Based on a generalist model, the internship exposes interns to a wide variety of patient populations and treatment modalities. Major rotations include:

Adult Outpatient Rotation:

The Outpatient Rotation enables interns to develop the skills necessary to provide appropriate care in both clinical and operational environments. The duties and responsibilities for interns on this rotation most closely approximate the duties and responsibilities that interns will have during their first post-internship assignments. These duties include conducting a variety of general mental health assessments, performing military-specific evaluations, and providing a broad range of therapeutic interventions. Interns will gain experience implementing evidence-based therapies for a variety of conditions. They will receive specialized training and supervision in the treatment of Posttraumatic Stress Disorder, and they will co-facilitate therapy groups. Interns will administer, score, and interpret psychological tests that help inform diagnostic evaluations, and they will integrate test data into diagnostic evaluation reports. Interns will also learn how to assess and manage risk for self-directed and other-directed aggression, and how and when to refer patients to more intensive or controlled treatment environments. In addition, interns will gain experience consulting with and advising military commanders about various mental health issues. Didactic experiences will include readings and discussions related to both military-specific issues and profession-wide competencies, with particular emphasis on the exploration of ethical issues and the development of military cultural competence. Interns will also become familiar with the logistics of administrative management in an outpatient behavioral health clinic.

Health Psychology Rotation:

The health psychology rotation is designed to help interns understand the psychological factors that can impact overall health. Interns will also become familiar with the pivotal role health psychologists play in improving the lives of patients treated in various medical settings. On this rotation, interns will learn how to evaluate and treat patients with a variety of medical issues using psychological techniques such as Cognitive Behavioral Therapy, Acceptance and Commitment Therapy (ACT), biofeedback, relaxation training, hypnosis, and the behavioral health consultation model. During this 12-week rotation, interns will work in Walter Reed’s Primary Care Clinic and Women’s Health Clinic, as well as the Pain Psychology and Endocrinology services, practicing a “collaborative population health” approach to behavioral health treatment. Interns will serve as consultants to healthcare providers who must rapidly evaluate patients' symptoms. Interns will address patients' needs related to both chronic medical conditions and behavioral health conditions. They will also strive to increase patients’ motivation for behavioral change, as well as provide brief, targeted interventions and dispositional recommendations. Problems addressed on this rotation will include headaches, pain, anxiety, insomnia, weight reduction, treatment adherence, and lifestyle management.

Inpatient Rotation:

During this rotation, interns will have the opportunity to work on Walter Reed’s Inpatient Psychiatry Service. They will become acquainted with the admission, diagnosis, acute stabilization, treatment, and disposition of patients with mental health disorders of such severity that they require hospitalization. Interns will serve as part of a multidisciplinary treatment team (comprised of staff psychiatrists and psychologists, psychiatric residents, nurses, social workers, and hospital corps staff) and they will be responsible for individual therapy, group therapy, and consultation.

Throughout this rotation, interns will also spend one day a week gaining an understanding of the basic elements of cognitive evaluation, and they will have the opportunity to evaluate inpatients and outpatients with a variety of neurological complaints. By the end of this rotation, interns will be able to accurately diagnose traumatic brain injuries, perform basic cognitive screening evaluations, decide when a referral to a neurologist or neuropsychologist is indicated, and understand how to critically read neuropsychological reports.

One day a week on the inpatient rotation interns will be assigned to an inter-disciplinary team on the Psychiatric Consultation and Liaison Service, where they will assist in covering emergency room evaluations. Crisis management skills, risk assessment, medical consultation, and functioning as a member of an inter-disciplinary medical team are the primary objectives during this training experience.

Trans-rotational Clinical Experiences:

In addition to the four major rotations, interns have several year-long training experiences. These include:

Long-term Psychodynamic Psychotherapy:

Interns are assigned psychotherapy cases to be seen across the various rotations. These cases typically employ a psychodynamic model, and weekly supervision is provided.

Trauma Therapy:

Interns will have opportunities to employ empirically supported therapies to treat patients with Post-Traumatic Stress Disorder. Weekly supervision is provided for these cases as well.

Navy Leadership Seminar:

This seminar is a bi-weekly, informal, facilitated discussion with a senior Navy Psychologist. These meetings will include discussions about military culture, ethical issues within military psychology, military-specific psychological evaluations, career development and management, and exposure to Navy and Marine Corps mental health policies and instructions. Interns will also receive information about the different assignments and duties that Navy psychologists can perform outside of the traditional mental health setting.

Didactics:

Didactic training is offered in the form of half-day seminars and one or two-day workshops throughout the internship year. These didactic activities are also attended by interns from nearby programs, and by graduate students and faculty members from universities and professional schools throughout the National Capital Area. These events provide rich opportunities to interact with psychologists at various levels of professional development. Interns also attend and participate as presenters in our weekly, hour-long Grand Rounds sessions, which address a wide range of clinical and research-related topics.

Operational Experiences:

The major operational experience of the internship is a deployment, lasting approximately one week, aboard a Navy Aircraft Carrier. Through this training, interns experience shipboard living conditions and stresses, work in the ship’s Medical Department, interact with Sailors, and learn about the industrial and psychological demands of working and living aboard a large Navy ship. This training experience is supervised by the Navy Psychologist assigned to the carrier. A second operational experience is held at the Marine Security Group (MSG) in Quantico, Virginia. During this training, emphasis is placed on gaining familiarity with the organizational structure of the Marine Corps, understanding the unique stressors Marines face, and developing skills for effective assessment and consultation with Marine Corps leaders. When possible, interns also spend a day visiting the Navy Bureau of Medicine and Surgery (BUMED), and a day at the United States Naval Academy (USNA). These visits provide exposure to the unique command and training environments in the National Capital Area.

Supervision:

Most of the ongoing case supervision will be provided by designated privileged staff psychologists on the rotation to which the intern is assigned. Privileged psychiatrists will also serve as adjunct supervisors and will provide additional supervision, particularly on the Psychiatric Consultation Liaison Service (PCLS) and the inpatient rotations. Interns may also be assigned to different staff members for supervision during trans-rotational cases. Over the course of the year, interns receive supervision from several of the psychology faculty and some of the psychiatry staff. It is important to note that in addition to scheduled supervision times (at least four hours per week), the faculty is available for and strongly encourages additional supervision and consultation as needed.

Class Adjutant:

Each intern serves as class adjutant for a designated period during the internship year. The adjutant role in the Navy is traditionally an administrative role, working with senior department leaders to ensure adequate communication within their department or division. In our internship program, the adjutant serves as an assistant to the Program Director, ensuring effective communication between the faculty, the intern cohort, the rotation directors, and the Service and Department Chiefs. Additional duties include organizing and coordinating with guest lecturers for didactic presentations, working with administrative personnel to assist with work or social functions, and completing other duties as assigned. This role is considered a program specific (military) competency.

For more information on our internship, please see our Training Manual
Important dates:

• Deadline for submitting APPIs: 13 November 2023
• Deadline for completing Navy commissioning application: 15 December 2023
• Application interviews will be conducted from 5 to 7 December 2023. These interviews will be virtual, but opportunities for in-person visits will also be available.

Contact:
Richard D. Bergthold, PsyD
Director, Navy Clinical Psychology Internship Program
Walter Reed National Military Medical Center
Bethesda, MD
Phone: 301-319-2997
Email: richard.d.bergthold.civ@health.mil