Geriatric Mental Health Care and Research Track
Research training experiences in the Geriatric Mental Health Care and Research Track occur through the Houston VA Health Services Research and Development Center of Excellence (CoE). The CoE is one of 14 competitively awarded national centers of research excellence funded by the Health Services Research and Development Service of the Veterans Health Administration (VA). It was established in 1990 as a partnership between the Veterans Affairs Health Services Research & Development Service and Baylor College of Medicine (BCM). It is the largest center for health services research in the southwest and houses nearly 200 faculty, postdoctoral fellows, trainees and research staff.
Clinical training experiences for this track occur through: 1) the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC), 2) BCM geriatric and primary care clinics, and 3) a variety of community settings. The MEDVAMC is one of the largest facilities in the national Veterans Affairs Medical Center system, comprising 375 hospital beds, a 40-bed Spinal Cord Injury Center, and a 120-bed transitional care unit for long-term care. Veterans from around the country are referred to the MEDVAMC for specialized care, and the facility serves as the primary health care provider for more than 393,000 veterans in southeast Texas area.
Interns in this position receive training in geriatric mental health service delivery and research. At least 50 percent of the intern's time will be spent providing direct clinical service, primarily within the context of externally funded clinical research protocols addressing anxiety, depression, PTSD, co-occuring mental and physical health conditions, and dementia-related behavioral problems. Some opportunities may be available to obtain experience with supervising more junior trainees (e.g., practicum students, research assistants), and clinical activity outside of funded research may be available in some clinics. The remainder of the interns’ time will be spent in more focused clinical research activities, including study design, project oversight, data management, preparation of scientific manuscripts, and grant writing.
The year is divided into two six-month rotations. In each rotation, interns typically participate in two clinical research projects (26 hrs/week) and one elective clinical experience (6 hrs/week). Specific experiences and schedules are determined at the start of the internship and reviewed mid-year.
Ongoing Clinical Research Projects Within The Geriatric Mental Health Group
- Cognitive behavioral treatment for medically ill veterans in the primary care setting
- Psychoeducational intervention for improving mental health symptoms among obese Veterans
- Home-based psychoeducational intervention for addressing pain in persons with dementia
- Community-based care for the treatment of anxiety in largely underserved, minority communities; Integration of religion-spirituality into late-life anxiety treatment
- Treating anxiety and depression for rural Veterans in home-based primary care
Cognitive behavioral treatment for anxiety and depression in patients with Parkinson's Disease
Assessment and Consultation
Interns obtain experience in the use of various mental health screening measures and structured clinical interviews with geriatric patients. Caregivers are sometimes included in these assessments. Interns participate in clinical assessments and provide consultative feedback to physicians, social workers, and other referring providers for older adults in medical clinics, dementia clinics, and nursing homes.
Therapy experiences utilize an evidence-based approach, with an emphasis on cognitive behavioral interventions. Interns have the opportunity to provide treatment using structured treatment manuals, but flexibility in the use of these procedures to meet the needs of individual patients and their caregivers is emphasized. Within standardized treatment protocols, there is the opportunity to obtain experience with crisis management, collaborative care models, and integration of care with available social services. Additional experiences providing community-and home-based care are available.
Access to Diverse Populations
Interns have the opportunity to conduct assessments and treatment in a variety of settings including primary care clinics/behavioral medicine, Veterans' Affairs clinics, geriatric ambulatory care clinics, community service organizations, and patient residences. Interns work with older adults in both specialty and primary care clinics at the MEDVAMC, as well as a residential Community Living Center, with the potential to gain experience in populations with chronic medical illness (e.g. diabetes, cardiopulmonary disease, & obesity), neuropsychiatric disorders (e.g. Parkinson’s disease), significant cognitive impairment (e.g. executive dysfunction & dementia), and a range of mental health conditions (e.g. GAD, PTSD, MDD, & Dysthymia). Interns also have access to training experiences with individuals from a broad range of cultural and socio-economic backgrounds. In the MEDVAMC, approximately 75% of Veterans are men, approximately one-fourth of whom are African American. Most Veterans treated by interns are considered low-income. In contrast, training in BCM geriatric and primary care clinics consists of older adult patients who are mostly women and mostly Caucasian. Because these clinics are insurance-based, the majority of patients treated in these settings are from moderate income or higher. Community settings where interns work with older adults are largely low-income, underserved, and mostly minority. In these settings, interns also see a range of mental health conditions (e.g. GAD, PTSD, MDD, & Dysthymia), and participants included in ongoing clinical research from these settings are ages 55 and older.
Interns are expected to function within the scientist-practitioner model, utilizing evidence-based assessment and treatment procedures in the provision of clinical care as well as participating in more formal clinical research endeavors. Interns participate in weekly research meetings for projects in which they are involved and contribute to discussions about research design, implementation, and analysis. Interns assist in the preparation of scientific reports and are be expected to serve as lead author on at least one manuscript using data available from ongoing research programs. Opportunities for additional co-authorship roles and grant writing are also available. Participation in other ongoing publication efforts will be encouraged.
Supervision & Didactics
Melinda Stanley, Ph.D., is the faculty coordinator for this track.
Interdisciplinary supervision is provided by:
- Melinda Stanley, Ph.D., Coordinator (clinical psychology)
- Jessica Calleo, Ph.D. (clinical psychology)
- Jeffrey Cully, Ph.D. (clinical geropsychology)
- Gina Evans, Ph.D. (clinical health psychology)
- Mark Kunik, M.D. (geriatric psychiatry)
- Nancy Wilson, M.A., L.M.S.W. (geriatric social work)
Numerous didactic offerings are available, including a series of professional development seminars that focus on various aspects of academic career advancement, regular clinical research presentations from other investigators at the Center of Excellence and visiting professors, and research development seminars focused on topics related to health services research.
Elective Clinical Experiences
Elective clinical experiences may be chosen depending on availability and intern training needs and career goals. Experiences may include individual therapy or group therapy with older adults and/or family members.