Lesbian, Gay, Bisexual, Transgender, Queer And Questioning (LGBTQ) Inter-professional Fellowship

Lesbian, Gay, Bisexual, Transgender, Queer And Questioning (LGBTQ) Inter-professional Fellowship
Dr. Stephen Gresham | stephen.gresham2@va.gov

This residency position in the LGBTQ Inter-professional Care track is a unique opportunity within VHA to work primarily with lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) Veterans. The postdoctoral fellow will engage in direct clinical care (individual, couples, group), program development, supervision, outreach/training, and research/program evaluation.

This work will take place in the Mental Health Clinic Recovery Service (specialty mental health), the Behavioral Addictions program, and the Domiciliary. Through education, outreach, and advocacy, the fellow will further the larger goal of improving the culture of the VA to include and affirm LGBTQ+ identities. Through direct provision of clinical services and supervision of a practicum student, the fellow will further the goal of providing competent and LGBTQ-affirming mental health services to our Veterans. Trainings tailored to those goals will be provided to the fellow throughout the training year, to cultivate a clinical specialization in providing care to LGBTQ communities and in working in inter-professional settings. Previous experience with LGBTQ communities is preferred.

The LGBTQ Inter-professional fellowship seeks to provide the fellow with the opportunity to provide individual and group direct service provision to LGBTQ Veterans in multiple inter-professional contexts, including specialty mental health, behavioral addictions, and the Domiciliary. The fellow provides outreach to LGBTQ Veteran communities, conducts program development focused on improving the healthcare experience of LGBTQ Veterans, and develops and presents trainings to increase the knowledge, skill, and awareness of other providers in the VA Bedford Healthcare system.

The LGBTQ Inter-professional fellowship will be led by Dr. Stephen Gresham, PhD, (Director of DEI Programs, Co Associate Director of Training for Psychology, LGBT Special Emphasis Program Manager, and VISN 1 LGBTQ+ Veteran Care Coordinator ). Supervisors include Dr. Dipali Patel, Ph.D. (Domiciliary Staff Psychologist), Dr. Garret Sacco, Ph.D. (Behavioral Addictions Clinic), and Dr. Lisa Richards (Mental Health Clinic Staff Psychologist.

The LGBT fellowship includes the following components:
Specialty Mental Health
The fellow will be a member of an inter-professional mental health team in the outpatient clinic. The fellow will have opportunities for collaboration and consultation with members of their team and will build skills in inter professional work. The fellow will receive LGBTQ-focused referrals and clinical opportunities for individual and group therapy. Additionally, referrals will also be received from members of their mental health clinic team. During the training year, the fellow will facilitate 1 group for the LGBTQ Veteran community (LGBTQ+ Well-Being Group) and will have the opportunity to start other groups of interest. Fellows will learn about Hormone Readiness Evaluations and, depending on the availability, will have the opportunity to conduct a gender affirming surgery readiness evaluation.

Behavioral Addictions Clinic
Through this clinic, the fellow will have the opportunity to provide individual therapy with clients struggling with behavioral addictions (e.g., gambling, compulsive sexual behaviors, binge eating disorder, etc.). Additionally, the fellow will facilitate group psychotherapy using Mindfulness-Based Relapse Prevention and psychoeducation/motivational interviewing approaches. Varied opportunities (e.g., research, program development, clinic administration) are available which the fellow may access to further training and professional goals.

The Domiciliary
Through this clinic, the fellow will have the opportunity to provide individual therapy with clients struggling with substance use disorders. Additionally, the fellow will facilitate group psychotherapy on varied topics (e.g., healthy relationships, shame resilience, etc.). Varied program development opportunities are available which the fellow may access to further training and professional goals.

Outreach
The fellow will have the opportunity to participate in varied hospital committees that will enable the fellow to be aware of the various outreach activities, disseminate information regarding LGBTQ services, address consultation needs across the hospital, and to target activities throughout the year to LGBTQ Veterans.

Program Development
The fellow will work to actively promote education and competence through program development. These include: Safe Zone, Transgender Day of Remembrance, National Coming Out Day, LGBT Health Awareness Week, and Boston PRIDE for example. Additional program development opportunities may be available depending upon the interest and abilities of the postdoctoral fellow.

Learning Objectives

1. Knowledge of mental healthcare needs of Veterans.

2. Knowledge of mental healthcare needs of sexual minorities and transgender Veterans.

3. Proficiency in performing gender dysphoria assessments and evaluations of readiness for cross-sex hormone treatment.

4. Knowledge of empirically-based treatment approaches for recovery from PTSD.

5. Ability to coordinate mental health treatment within an inter-professional team.

6. Skill in providing education and process-approach group therapy to LGBTQ Veterans.

7. Skill in providing education to other providers about working with LGBTQ Veterans.

8. Skill in delivering outreach to LGBTQ communities within our catchment area.

9. Proficiency in delivering mental health treatments to Veterans with comorbid mental health and substance use disorders as well as chronic health conditions.

10. Proficiency in carrying out research and program development focused on the provision of care to LGBTQ Veterans.

11. Build awareness of their own countertransference when working with LGBTQ Veterans.

12. Develop skills on the assessment and treatment of addictive behaviors and other-occurring issues with LBGTQ Veterans.

13. Build skill at advocating for LGBTQ Veterans within their various systems.

14. Ability to use VA resources (particularly SharePoint sites and CPRS consult system) to meet the needs of Veterans.

15. Develop familiarity with the local and national VA policies related to LGBTQ Veterans. Target Professional

Experiences
1. Conduct gender dysphoria diagnostic assessment.

2. Conduct assessment for readiness of cross-sex hormone interviews.

3. Facilitate therapy groups for LGBTQ Veterans.

4. Provide short or longer-term identity affirming therapy for LGBTQ Veterans through outpatient mental health.

5. Provide outreach to LGBTQ Veteran communities.

6. Provide education via one or more presentations to mental health staff.

7. Participate on inter-professional teams.

8. Assume select administrative duties for the LGBT Services consult system.

9. Program development and/or research activities focused on LGBTQ Veteran health.

10. Assist in planning and coordinating events for National Coming Out Day, Transgender Day of Remembrance, and LGBTQ Pride, either on-campus or with Veterans in the community.