Psychology Service is a part of the Mental Health and Behavioral Sciences Service at the Miami VA Healthcare System along with Psychiatry Service. Psychologists provide appropriate treatment for all eligible Veterans who require and can benefit from clinical psychological services. Psychology offers services in psychological assessment, neuropsychological assessment and rehabilitation, vocational assessment and rehabilitation, individual and group psychotherapy, consultation, and psychoeducation. Psychological assessment includes vocational, psychodiagnostic, and neuropsychological testing, as well as, structured interviews to determine present and potential functioning. Psychological treatment includes the application of psychological principles and techniques to alleviate emotional, vocational and behavioral problems. Psychological services are provided to the Veteran, the Veteran's family, and other persons significant to the Veteran.
Patient care needs are assessed both individually by psychologists as well as collaboratively as part of a multidisciplinary treatment team. Patient care needs a re-assessed by clinical interview, standardized psychological testing, direct observation, and information obtained from the patient's family and significant others.
All patients must be referred for psychological services by their treating physician, nurse or psychiatrist. Referrals should be made by an electronic consult to Psychology. Psychology Service and the Chief of Psychology can be contacted at (305)-575-3215.
- Vocational Rehabilitation
Services are provided to both inpatients and outpatients by referral from a physician or Primary Care provider. Services provided include vocational assessment, referrals for education and training, and referrals for job placement. Veterans with long histories of unemployment, substance dependence, mental illness, and/or homelessness who may not be appropriate for other vocational rehabilitation service are often considered for Compensated Work Therapy (CWT). CWT participants are assigned to transitional employment positions in and around the medical center supervised by VA employees. Veterans in the CWT program attend weekly group meetings and at least monthly individual sessions to learn and improve skills to obtain and maintain employment in the community-the primary goal of CWT.
- Psychological Assessment
Psychodiagnostic assessment provides structured tests and interviews to provide diagnostic, personality and functional information about the patient being evaluated. Neuropsychological assessment provides the diagnostic assessment of patients with known or suspected brain dysfunction with an emphasis on the relationship between brain functions and behaviors.
Patients are provided with brief, short term individual psychotherapy which is goal focused. Therapy usually lasts six to eight sessions. Therapy can be provided in a variety of orientations, but is usually cognitive-behavioral. Family and couples counseling is also available when relevant to the Veteran's presenting problems. All patients must be referred to Psychology by their psychiatrist or primary provider.
- Spinal Cord Injury Program
The Spinal Cord Injury Program provides comprehensive assessment, therapeutic and rehabilitative services to Veterans and their families with spinal cord injuries, both as inpatients as well as outpatients. Psychologists provide a wide range of psychological services including individual and group psychotherapy, family and couples counseling, psychological assessments and evaluations, intake screenings, consultations with treatment team, treatment team rounds and treatment planning, psychoeducation, program management, research proposals, and supervision of psychology trainees. Habit Management provides outpatient classes in various locations on managing unwanted addictions or habits such as smoking and maladaptive eating. All classes combine cognitive-behavioral interventions, education and social support. Patients receive services through psychoeducational and cognitive-behavioral approaches to smoking cessation and weight management. Patients are treated in groups, although the psychologist may provide individual time-limited smoking cessation or weight management therapy to particular patients in need. A dietitian co-leads the weight management group.
- Physical Medicine and Rehabilitation
Psychologists provide mental status examinations, dementia evaluations, supportive psychotherapy and brief neuropsychological screenings. They also provide therapy to family members, education and support to staff, and provide psychoeducation and cognitive retraining to head injured patients and those suffering cognitive impairment. Outpatient support groups for patients with head injuries and strokes are available. Psychologists provide individual psychotherapy to some patients and their families after their discharge. They also educate patients about the rehabilitative process and program and works with patients whom the staff identify as potentially or historically non-compliant.
- Behavioral Medicine
Behavioral Medicine is the application of psychological theory to interventions with medical patients. Staff of the Psychology Service of the Miami VA currently function as consultants, members of interdisciplinary treatment teams, and managers of psychological service programs in various medical sections of the hospital. Psychological evaluation (particularly deficits in cognitive functioning and personality variables which lead to treatment difficulties), individual psychotherapy and counseling, family counseling and interventions, and staff consultation/education are provided to patients. Assessment and case conceptualization are comprehensive and consistent with traditional psychodiagnostics and a biopsychosocial theoretical base. The psychologist provides brief, problem/solution focused interventions. Stress management, proactive emotionally adaptive psychoeducation, and treatment compliance interventions are provided. The psychologist will, in addition to individual counseling and interdisciplinary consultation, conduct groups that focus on psycho-education/prevention, habit management and replacement, pain management, general stress management, and psychosocial support/process.
Psychologists also participate on the Pain Management team. Initial interviews/evaluations are conducted with one of the team's anesthesiologists and treatment plans are developed. Pain patients are then followed by Psychology in weekly groups. Psychologists may also conduct individual therapy or family interventions for patients in the intensive program.
- Special Immunology Program
Psychologists attend weekly inpatient (acute) treatment planning meetings and medical rounds, and provide services to HIV positive Veterans at all phases of treatment. Psychological services to HIV infected and affected Veterans include initial screenings, and assessment of cognitive dysfunction secondary to HIV infection, short-term individual psychotherapy, couples and family therapy, educational and support groups for staff, and community educational programs.
- Extended Care
Psychologists in Extended Care Service (which includes the Intermediate Care Unit, Hospice, the Geriatric Evaluation and Management Unit, Acute Medicine, Oncology, and Renal Service) provide a full range of psychological services to medically fragile and primarily geriatric patients and their families. These services include assessment with specialized training in bedside clinical interviewing of chronically and catastrophically ill patients who represent a wide variety of medical diagnoses such as cancer, end-stage renal disease, chronic obstructive pulmonary disease, cardiovascular problems, and dementia. Interventions with aging and terminally ill patients use treatment approaches emphasizing supportive, palliative care in assisting patients to cope with grief, depression, anxiety, and other psychological issues attendant to grave medical illnesses. Strategies for pain management and adjustment to treatment regimens may be employed where appropriate. In addition, psychologists may provide crisis interventions as well as pre and post? bereavement therapy to patients' families.
- Computer Education
Psychology Service provides a variety of computer administered psychotherapeutic services to inpatients and outpatients. The Miami VAMC was the first VA in the country to provide computer therapy services to Veterans, and has remained a leader in this field. Psychoeducational lessons in Self Awareness, Communications, Problem Solving, Stress Management, Relaxation Training, Habit Management, Medication Management, Anger Management, Post Traumatic Stress Disorder with built-in multiple choice quizzes on each lesson are available to patients on the residential rehabilitation treatment programs.
The Miami VAMC Psychology Service Training Program is accredited by the American Psychological Association and the Association of Psychology Post-Doctoral and Internship Centers. The program trains eight predoctoral psychology interns from all over the country and around a dozen psychology graduate practicum students from local doctoral programs. The program is funded for four general interns, two PRIME interns and two GRECC interns. Interns and practicum students train under the direct supervision of the Psychology doctoral staff in all areas of the medical center. The program consists of a combination of didactic lessons and supervised clinical experiences.
For further information, please contact Psychology Service at (305) 575-3215.
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