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Bedford VA interprofessional Fellowship Program

The Bedford VA interprofessional Fellowship Program in Psychosocial Rehabilitation and Recovery Oriented Services is taking applications for the 2019-2020 Fellowship Year.  This interdisciplinary clinical training program offers masters level social work professionals, individualized, mentored, clinical and research training, combined with curriculum that emphasizes a comprehensive psychosocial rehabilitation approach to service delivery, education, and implementation of change in the mental health care setting.  

Attached is a copy of this year's overview for the which should give you more information about the requirements/responsibilities specific to the fellowship program we offer at the Bedford VA. Please keep in mind that there may be minor changes to the program from year to year (for example which programs you can choose from for your serious mental illness rotation and elective rotation; the trainings that are offered; etc.).

The fellowship position is full time 40 hours/week and fellows are entitled to enroll in healthcare benefits through the VA. The yearly stipend for post-masters social work fellows at the Bedford VA is $35,796 divided in bimonthly pay periods. Fellows accrue 4 hours of vacation leave and 4 hours of sick leave each pay period. Post-masters social work fellows are required to have obtained licensure prior to the start date in September 2019. A post-masters level license is acceptable, in MA this would be the LCSW but given we are a federal agency any post-MSW level licensure is acceptable. You would receive individual supervision by an LICSW in accordance with ASWB licensing standards.

Welcome to the

Edith Nourse Rogers Memorial Veterans Administration Hospital's
Interdisciplinary Psychosocial Rehabilitation Fellowship

2018-2019

Fellowship Goals: Below is a description of the Fellowship's overall goals, its target experiences and
the specific skills that Fellows will acquire during the training year.
Overall Goals: To provide training and clinical experiences for Fellows such that they become
grounded in the principles and values of psychosocial rehabilitation (PSR) and incorporate them into
their work with Veterans. In addition, Fellows will acquire knowledge of current PSR research and
practices in order to become a skilled PSR practitioner, and as such, be capable of promoting change in
the Bedford VA system (to act as "agents of change").
Target Experiences: There are four main components to the Fellowship
1. Serious Mental Illness Placement: You will work in one of our programs that serves Veterans
with a Serious Mental Illness (SMI). These include: 1) the Veterans Community Care Center
(VCCC)(a Psychosocial Rehabilitation & Recovery Center); 2) Community Residential Care
(CRC); 3) the Mental Health Intensive Case Management (MHICM) program (which uses an
ACT model); or 4) the long-term inpatient unit (6B/78GI). You must choose this placement by
September 28th 2018. Allow time to discuss your choice with your preceptor and possibly with

PSR staff. During orientation, you will visit each of the programs. In addition, feel free to go

back to programs you have visited with any questions you may have. Choosing early will allow

you to begin working in this placement while continuing orientation. Fellows can choose to work
together as a pair within a program. In some cases, preceptors may suggest this option
Supervisor: Dependent on program. (Estimated 10-15 hrs/week).
2. Elective Placement: Work in a mental health program, including those listed below, with
approval from one's preceptor and the PSR Fellowship Committee. Fellows' work in this
placement must be recovery-oriented and focused on Veterans with more significant mental
health disabilities. Possible programs include: Acute Inpatient Psychiatry Unit (78G); Behavioral
Addictions Clinic; Business Gym; Community Reintegration Team; Compensated Work
Therapy (CWT), including CWT/Supported Employment; the Critical Time Intervention (CTI)
program; Domiciliary; Peer Services; Healthcare for Homeless Veterans (HCHV); Veterans
Administration Supported Housing (VASH); Veterans Justice Outreach (VJO); Suicide
Prevention; The MIRECC/SOCRR; Early Engagement and Recovery (STEER); Vocational
Rehabilitation; and Transitional Residence (Crescent House). Megan MacKay has a full list of
the possibilities which will be reviewed with you during the Intro to the PSR Fellowship on
Thursday September 13th 2018. As an alternative, you can choose to work solely in your first
program placement (increasing the hours/week) and/or work with your preceptor to develop your
own initiative, programming, etc. that will serve as your Elective Placement. You must choose
this placement by October 12th 2018. Supervisor: Dependent on program. (Estimated 10-15 hrs/week).

3. Group Project: Program Development/Evaluation & Education Dissemination: Fellows will
work together throughout the course of the training year on a program development or program
evaluation project. Below are several suggested projects which you may choose from or you may
develop your own with approval from the PSR staff. The results will be presented either locally and/or nationally. A final, written report of the project, including lessons learned, will be submitted to the PSR Fellowship Committee. Past projects have included presentations at the Psychiatric Rehabilitation (PRA) annual conference, group presentation of survey results to Bedford VAMC program managers and staff of recovery-oriented programs, and presentations to individual programs' staff. You will have a chance to hear past Fellows talk about their projects.

If you are planning to present at a conference, it is important to be mindful of the due date for
proposals. The due date for selecting your group project is November 6th 2018.

Supervisors:

Patricia Sweeney, Psy.D. CPRP and Becky Dreifuss, LICSW. (Estimated 2-3 hrs/week).

4. Social Skills Group: You will begin meeting with Amy Wilson, Ph.D. for your initial training
and break-out sessions. The initial training dates will be October 4th and 5th 2018. You will then (co)-facilitate a social skills group for Veterans with SMI and have regular supervision to work to become a certified facilitator. Supervisor: Amy Wilson, PhD. (Estimated: 2 hrs/week) PSR Meetings: In addition to other psychology and social work meetings, there are several meetings specific to the Fellowship. These meetings are mandatory and take precedence over other potential conflicts so please consider this when you begin making your schedules with your placements. If you are unable to make a meeting then you must submit a written request via e-mail to the facilitators and include your preceptor on the e-mail.

➢ 1st, 3rd, and 5th (when applicable) Tuesday : 9-10/11am Seminar Series with PSR Faculty.
➢ 1st and 3rd Tuesdays of month: 11- 12pm Meet with Tricia Sweeney and Becky Dreifuss for
work on group project.
➢ 4th Tuesday of the month (Starting September 26th): 12-1pm: Meet with the PSR Fellowship

Committee as a group
National PSR Seminar Teleconference: Includes Fellows from all PSR Fellowship sites. It is important
that you leave this time open for the calls which will likely occur the 2nd Wednesday of the month 3:00 - 4:30pm. The first call is in October.

Background on PSR: There has been ongoing discussion about the definitions of Psychosocial (or
Psychiatric) Rehabilitation (PSR) and recovery. In the past, the term "Psychiatric Rehabilitation" was
associated with the medical model and "Psychosocial Rehabilitation" was seen as services separate from
mental health treatment. Currently, there is no significant difference between the two in the field; use of
one or the other has been an individual or organizational choice. In this Fellowship, we use the term
Psychosocial Rehabilitation rather than Psychiatric Rehabilitation.
The relationship between Psychosocial Rehabilitation (PSR) and recovery is commonly described this
way: PSR is the array of services and support offered to people in recovery from a serious mental illness
(SMI). Over time, the field has emphasized different terms. Currently, "recovery-oriented services" is
used interchangeably with "PSR." Below are some definitions/descriptions.
The President's New Freedom Commission on Mental Health (2003) begins its report (which can be
read at http://www.mentalhealthcommission.gov and which is widely quoted) this way:
"We envision a future when everyone with a mental illness will recover...a future when everyone
with a mental illness at any stage of life has access to effective treatment and supports essentials
for living, working, learning, and participating fully in the community."

Psychiatric Rehabilitation Association (PRA) (2007)

"Psychiatric rehabilitation promotes recovery, full community integration and improved quality of
life for persons who have been diagnosed with any mental health condition that seriously impairs
their ability to lead meaningful lives. Psychiatric rehabilitation services are collaborative, person
directed and individualized. These services are an essential element of the health care and human
services spectrum, and should be evidence-based. They focus on helping individuals develop
skills and access resources needed to increase their capacity to be successful and satisfied in the
living, working, learning, and social environments of their choice."
Substance Abuse and Mental Health Services Administration (SAMHSA) (2006)
"Mental health recovery is a journey of healing and transformation enabling a person with a mental
health problem to live a meaningful life in a community of his or her choice while striving to
achieve his or her full potential."
Mueser, et al, Psychiatric Services (2002) 53(10), p.1272
"Recovery occurs when people with mental illness discover, or rediscover, their strengths and
abilities for pursuing personal goals and develop a sense of identity that allows them to grow
beyond their mental illness."
PSR Goals, Values, & Principles: PSR is not based on a specific theory and is not a prescription for
specific practices; rather it is an approach to services based on "recovery-based" goals, principles, and
values. (Although, as you will learn, PSR evidence-based practices are being established and
emphasized.) At heart is the belief that people with SMI can and do recover. There have been a number
of descriptions of these which are quite similar in content.
Below are those closely adapted from Psychiatric Rehabilitation by Pratt, Gill, Barrett, & Roberts
(2007).
PSR Goals: There are 3 main PSR goals which serve to guide PSR services. PSR Services:
1. Strive to help people with a serious mental illness (SMI) achieve recovery
2. Are designed to help people with SMI achieve maximum community integration
3. Are designed to help people with SMI achieve the highest possible quality of life
PSR Values: Below are the main PSR values. They are attitudes that influence behavior and help
achieve PSR goals.
1. Self-determinism/Empowerment: Everyone has the right of self-determination, including
participation and choice in all areas that affect their lives.
2. Dignity & worth of every individual: PSR respects & preserves the dignity and worth of everyone
regardless of the degree of impairment, disability, or handicap.
3. Hope/ Recovery is possible: Everyone has the capacity to benefit from services, improve, & recover.
4. Cultural sensitivity & respect*: PSR is sensitive to & respectful of consumers' individual, cultural,
and ethnic differences.
*The Psychiatric Rehabilitation Association (PRA: http://www.uspra.org) has developed a list of
multicultural principles & guidelines.

PSR Principles: There are 13 principles which reflect PSR values and, in turn, help achieve PSR goals.
1. Individualization of all services
2. Focus on consumers' involvement, preferences, and choices
3. Partnership between service provider and recipient
4. Community-based services which facilitate major social roles (worker, parent, etc.)
5. Strengths focus--building on strengths rather than focusing on perceived weaknesses or deficits
6. Situational assessments rather than overall assessments in order to match specific goals in the
consumers' environment of choice
7. Treatment/rehabilitation integration: a holistic approach
8. Ongoing, accessible, coordinated services
9. Vocational focus--work should be available to all who want it
10. Skills training to help consumers function in the environment of their choice (e.g., independent
housing)
11. Environmental modifications & supports necessary to function successfully in environment of their
choice (e.g., competitive employment)
12. Partnerships with the family
13. Outcome-oriented focus: determine how services meet consumers' needs
PSR Fellowship Staff:
Co-Chairs: There are 2 co-chairs who are responsible for facilitating meetings, participating on the
national directors conference call, and overseeing recruitment and other logistics. The current co-chairs
are Megan MacKay, LICSW, and Amy Wilson, Ph.D.
The PSR Fellowship Committee: Meets as a group monthly with Fellows (fourth Tuesday of the month
at 12:00 pm), and monthly without the Fellows. It is actively involved in working on program
development, orientation, training and evaluation issues. The Fellows' preceptors (the primary
supervisor who oversees the Fellowship experience) come from this group. Current members include:
Kevin Henze, Ph.D., CPRP; Patricia Sweeney, Psy.D., CPRP; Alice Van Ormer, Ph.D.; Amy Wilson,
Ph.D.; Amos Worth, LICSW; Rebecca Dreifuss, LICSW; Megan MacKay, LICSW; Jay Smith,
LICSW; Susie Morales, LICSW; Jay Gorman, PhD.; Brian Stevenson, Ph.D.
PSR Fellowship Staff: Can be involved in a variety of ways, with differing time demands. Staff can be a
Fellow's supervisor, present training seminar(s), assist with the Fellows' group project, serve as a
consultant in a specific area, etc. They are welcome to attend the monthly committee meetings.
Supervisors/Preceptors: Each Fellow will have a primary supervisor, a preceptor, who will oversee the
Fellow's overall experience with the fellowship. You will have additional supervisors depending upon
your program placements.

Licensure:
Different disciplines each have their own licensure requirements. For Psychology, these vary in different
states and have changed over time; specifics can be found on state licensure board web sites. For Social
Work, check with your LICSW supervisor to be sure you are meeting those requirements. It is critical
that you check the requirements out at the beginning of the Fellowship year to be certain that you will
meet them.

Final Words:
Local Recovery Coordinators at each of the VAs were asked for their top 3 "tips" or words of advice for
someone starting out in their job. Below are the top three which we believe are also useful for you:
1. Don't rush! Take time to become oriented to your job, get to know the culture and history of the facility, and the specific concerns, needs, and issues of staff and Veterans you will be working with.
2. Go in with an attitude of appreciation for the work people are already doing. Enlist those who are "early adopters and innovators" of recovery in your efforts.
3. Build relationships with people all across the facility. The more people you know, the easier it will be to get things done.

To apply for the fellowship please submit the following by 3/8/2019:

Resume and cover letter
Two references from direct supervisors/social work peers who have a clear understanding of your clinical skills and abilities

You can e-mail your application to Megan.MacKay@va.gov or mail it to the following address:

Megan MacKay, LICSW

ENRM VAMC

200 Springs Rd (122)

Bedford, MA 01730

Please reach out to the PSR Fellowship Social Work Co-Chair Megan MacKay with any questions at 781-687-3425.