Updated July 11, 2024
valuable and professional members of the treatment team with opportunities to participate in administrative meetings and gain experience managing clinical crises as appropriate.
Note: Most responsibilities require the trainee to be on campus for in-person clinical services, although some remote work may be arranged.
Community Living Center (CLC)/Acute Rehabilitation Unit (ARU) Supervisors: Phuong Chau, Ph.D., ABPP-CN, Morgan Macaluso, Ph.D.
The Community Living Center (CLC) is an 85-bed subacute inpatient facility that serves Veterans in need of a) slower-paced physical rehabilitation, b) skilled nursing care (e.g., IV antibiotics, wound care), c) respite care, d) a bridge to longer term placement, or e) end-of- life hospice care. The patient population is diverse, with most common medical issues to include deconditioning from prolonged illness, recovery following intensive surgery, cancer, stroke, dementia, limb loss or other orthopedic injury, and terminal illness. Veterans residing in the CLC are typically older adults with multiple medical problems. There are also frequent co-morbid cognitive, psychiatric, substance abuse, and psychosocial difficulties. CLC psychologists serve as primary mental health consultants to a large interdisciplinary team and work in close collaboration with allied health disciplines from Geriatric Medicine, Nursing, Rehabilitation Therapy, Pharmacy, Dietary Services, Recreation Therapy, Social Work, and Psychiatry. Fellows are able to participate in a wide range of clinical work to include providing mental health assessments, individual psychotherapy, family education/support, neuropsychological assessments with the emphasis on using test results to inform interventions and care planning, medical decisional capacity evaluations, and assisting teams with challenging patient behaviors. There is also opportunity for Fellows to gain experience working with the hospice team on end-of-life care issues. The Acute Rehabilitation Unit (ARU) is a small (<10-beds) inpatient physical medicine and rehabilitation (PM&R) unit that provides intensive rehabilitation services to those recovering from surgery, stroke, brain injury, or other medical debility. ARU stays tend to be more brief, ranging from a few days to weeks. Rehabilitation goals can include physical strengthening, adjustment to prosthetics, household or community mobility, or other personalized goals. Fellows will have the opportunity to work closely with team members from Physiatry, Physical Therapy, Kinesiotherapy, Occupational Therapy, Speech Pathology, Nursing, and Social Work to help promote rehabilitation success. Reasons for psychology referrals in ARU overlap with those above in CLC. Overall, there tends to be more of a focus on assisting with mood/anxiety/cognitive issues that are actively interfering with or have the potential to disrupt rehabilitation progress and helping to identify and plan for post-discharge mental health care needs. Note that Fellows on this rotation will be working primarily with Dr. Chau in the CLC and ARU. There may also be opportunities to work with Dr. Macaluso in CLC hospice if that training experience is desired. Fellows interested in obtaining additional neuropsychology experience may be able to see occasional outpatient neuropsychological assessment cases with Dr. Chau through referrals from the outpatient geriatric evaluation/management (GEM) clinic. We will strive to tailor the clinical experiences on this rotation to best meet the Fellow’s unique training goals, to the extent possible.
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