Supervisors: Anthony Mannarino, Ph.D. and Alvaro Q. Barriga, Ph.D.
The Center for Traumatic Stress for Children and Adolescents (CTSCA) is a specialty clinical-research program for children, adolescents, and their families who have experienced traumatic life events. Interns completing a major rotation through CTSCA will receive training in evaluating traumatized children and in two treatments that have been developed at the Center: Trauma-Focused Cognitive Behavioral Therapy and CBT for Children with Traumatic Grief.
Interns that choose a major rotation through CTSCA will be given the opportunity to provide therapy to patients between the ages of 3 and 18 who have experienced some type of trauma, including, but not limited to, sexual abuse, physical abuse, the traumatic and/or unexpected death of a loved one, natural disaster, and/or serious medical conditions. The intern will ideally carry a caseload of 8-9 clients and will receive one hour of scheduled supervision per week with additional supervision as needed. The CTSCA is extensively engaged in the scientific and empirical development and evaluation of culturally sensitive assessments and intervention with children who have experienced traumatic stress. Faculty provide modeling in the scientist-practitioner approach to clinical activity and interns are encouraged to participate in research, as appropriate based upon their level of experience and career interest.
Special Prerequisites: Prior to being allowed to complete a major CTSCA rotation, interested interns are required to have completed a graduate-level course in developmental psychopathology, complete a rotation specific interview with the training faculty and also the online, free TF-CBT training at www.musc.edu/tfcbt.
Supervisor: Nancy Kennedy, Psy.D.
As part of the adult rotation, interns obtain experience in the Adult Intensive Psychiatric Day Treatment Program where they will work with a comprehensive treatment team, including a licensed psychologist, attending psychiatrist, psychiatric residents, psychiatric nurses, and possible psychology graduate practicum students. This team works with acutely psychiatrically ill adults, often referred by providers to circumvent an inpatient admission. The program treats a variety of patients with different ethnic backgrounds and constituting diagnostic groups, most frequently affective, anxiety and personality disorders. The intern will gain experience in the conduct of comprehensive biopsychosocial evaluations and group psychotherapy in a culturally sensitive manner. In addition, interns will experience participation with a multi-disciplinary treatment team and gain an understanding of the interplay between intensive group psychotherapy and assertive medication management of the acutely ill psychiatric patient. As part of the developmental perspective on training, interns will participate in a three stage supervision plan, beginning with observation of the supervisor, co-leading with the supervisor and progression to the supervisor moving to observation of the intern with supervision feedback immediately following the group.
Adult Intensive Psychiatric Day Treatment Program Goals:
Supervisors: Hollie Dean-Hill, Psy.D., Michael D. Franzen, Ph.D., Matthew Page, Ph.D., Victoria-Maria Sekunda, Psy.D.
The 6-month major rotation in neuropsychology is for interns who are pursuing board-eligibility in clinical neuropsychology in order to meet APA Div. 40 Houston Guidelines. This track is for interns with extensive training in neuropsychology prior to internship. Interns who want some exposure to clinical neuropsychology in order to become more well-rounded practitioners are able to complete a year-long minor rotation in neuropsychology. This major rotation will prepare interns for competitive candidacy for neuropsychology post-doctoral fellowship programs. Interns on the advanced track will see a wider variety of clinical cases through both the medical inpatient consult and liaison (C&L) service at Allegheny General Hospital and through the outpatient Dept. of Psychiatry. Advanced neuropsychology trainees will also be expected to take a more in-depth role with the clinical interview process, test selection, test administration, and report writing consummate with their experience.
The initial stage of the rotation involves careful consideration of the intern’s prior coursework and practicum experiences with standardized assessment more broadly and neuropsychology specifically. Based on the intern’s prior experiences and his/her career objectives for what populations and practice setting he/she desires, an individualized training plan is developed in order to shape the rotation. At different points in training, interns are provided live observation during their training either by neuropsychology post-doctoral fellows and/or faculty members, depending on the supervisor. Interns receive extensive feedback on all aspects of the evaluation process toward preparing the intern for future independent practice.
Hospital Inpatient C&L: Depending on the specific supervisor and the intern’s individual training plan, interns are able to assist with conducting neuropsychological evaluations as part of a consult and liaison (C&L) service for medical inpatients in a level-1 trauma hospital. Approximately 60% of the patients present with traumatic brain injuries, while the remaining cases involve cerebrovascular accidents, hydrocephalus, seizure disorders, pre-/post-surgical evaluations, pre-/post-organ transplant evaluations, medical decision making capacity evaluations, and other acute medical events. These are brief (< 60”) bedside evaluations for acutely ill patients and trains interns in the rapid consult model within an interdisciplinary medical setting.
Outpatient Neuropsychology: All interns will assist with completing comprehensive outpatient neuropsychological evaluations who are referred to the department for a wide-variety of psychiatric and neurocognitive problems, including, but not limited to, traumatic brain injuries (TBIs), cerebrovascular accidents (CVAs), seizure disorders, genetic disorders, progressive neurocognitive disorders, and intellectual disabilities, pervasive developmental disabilities. Depending on the supervisor, interns may gain experience assessing individuals across the lifespan from approximately 6 years of age to 100+ years of age.
Tiered-Supervision: After the intern has demonstrated foundational knowledge and skill in neuropsychological assessment, each intern will provide tiered assessment supervision to graduate practicum students or interns completing the minor rotation in neuropsychology under the ultimate supervision of the intern’s faculty supervisor. This opportunity allows the advanced intern to begin developing and honing his/her own supervisory style in preparing for future independent practice. The intern’s supervision will include a discussion of different supervision theoretical models, the opportunity for role-playing, live observation of the tiered-supervision provided by the intern, and discussion regarding common ethical challenges that can occur in supervisory relationships.
Neuropsychology Rotation Goals:
Adult Outpatient Supervisors: Jordan Rood, Psy.D., Bruce Rohrs, Ph.D. Lori Siegel, Ph.D., Rebecca Weinberg, Psy.D, Richard Withers, Ph.D.
Child Outpatient Supervisors: Richard Withers, Ph.D., Alvaro Barriga, Ph.D.
As part of the training year, all interns will carry a caseload of at least 4-6 lifespan psychotherapy patients in the outpatient clinic. These cases are part of the intern’s year-long outpatient caseload requirement and serve to ensure the intern has sufficient exposure to a breadth of presenting problems and is able to develop at least basic-level competencies in providing therapy to children, adolescents, and adults.
Adult Outpatient Treatment Goals:
Child Outpatient Treatment Goals:
In the instances of off-campus rotations, AGH and the outside institution enter into a training agreement, and a psychologist supervisor must be identified at the outside institution and approved by the Director of the internship.
Consultation & Liaison (6 or 12 months)
The role of interns completing this minor rotation within the Neurology Clinic is to provide comprehensive psychological evaluations and treatment for patients presenting with headache and tic disorders. Treatment for patients presenting with headache consists of stress management, non-pharmacological interventions for pain and cognitive behavioral therapy. Common non-pharmacological interventions include relaxation training (e.g., diaphragmatic breathing, progressive muscle relaxation, guided imagery, autogenics), mindfulness training and biofeedback training. Cognitive behavioral therapy is also incorporated to address the impact that emotional distress and negative thinking may have on one’s headaches as well as to treat any comorbid anxiety or depression. For patients presenting with tics, interns will learn to provide Comprehensive Behavioral Intervention for Tics (CBIT). CBIT is a highly structured treatment that takes place over 8-12 sessions. It involves functional based assessment, awareness training, competing response training, relaxation training and strategies to maintain therapeutic gains. Dr. Scotti-Degnan is certified in CBIT from the Tourette Syndrome Association’s Behavioral Therapy Institute and will provide supervision for all rotating interns.
Children’s Hospital C&L Minor Rotation Goals:
Child Integrative Therapy (12 months)
Provides a more in-depth experience in child psychotherapy with a wider exposure to different psychopathology and treatment needs for children, adolescents and their parents. Developmentally informed case-conceptualization and integration of psychodynamic, cognitive-behavioral and child-centered treatment approaches will be encouraged. The minor will include training in evidence-based therapeutic uses of play and art with children and adolescents. Interns will teach behavior-management strategies to parents for challenging behaviors associated with impulse control, mood and anxiety disorders. Interns will also become familiar with more specialized treatment approaches, such as Parent-Child Interaction Therapy for younger children with behavioral disorders, behavioral treatments for anxiety disorders and OCD, and treatment approaches for Autistic Spectrum Disorders. Exposure to and training in these treatments will be provided as cases arise. Interns will also have opportunities to learn about children with severe medical difficulties through the Children’s Institute of Pittsburgh, and potentially to work with these children as cases arise.
Interns will be expected to develop facility in working with educators and others involved with children, and helping families to access community resources relevant to treatment needs. They will become familiar with child psychopharmacology practices and gain experience in coordinating treatment with psychiatrists and other physicians.
Child Integrative Therapy Minor Rotation Goals:
In addition to general child outpatient therapy goals, interns would be expected to:
Women’s Behavioral Health Program (6 or 12 months)
The Women’s Behavioral Health program at AHN’s West Penn Hospital is an integrative behavioral health clinic for women presenting with mood and anxiety disorders in pregnancy or the postpartum period as well as women struggling with distress related to infertility, pregnancy loss and other reproductive problems. Interns that choose a minor rotation at Women’s Behavioral Health will be given the opportunity to evaluate and provide therapy to patients between the ages of 16 and 45 who present with depressive, anxiety and /or bipolar disorders who are currently pregnant, postpartum, engaged in fertility treatment or who have experienced pregnancy loss. The intern will learn about providing behavioral health services in a medical setting and will ideally carry a caseload of approximately 4-6 clients and will receive on hour of scheduled supervision per week and additional supervision as needed. This minor is under the direction of Rebecca Weinberg, Psy.D.
Women’s Behavioral Health Minor Rotation Goals:
This rotation is primarily located at West Penn Hospital (WPH) within the AHN Psychiatric and Behavioral Health Institute, although there may be an infrequent need to travel to off-site locations for some clinical experiences (e.g., heart transplant evaluations at AGH). The primary goal of the rotation is to provide clinical health psychology training within an academic medical setting. Clinical Health Psychology is a specialty that is dedicated to the development of knowledge regarding the interface between behavior and health, and to the delivery of high quality services based on that knowledge to individuals, families, and health care systems. Interns choosing this minor rotation will have flexibility to choose among the listed training opportunities to find a combination that provides the best fit with their training experiences and career goals.
Kimberly Fleming, PhD
Neuropsychological Assessment in either Dept. of Psychiatry or Neurology (12 months)
The internship offers a minor rotation in neuropsychology through either the Dept. of Psychiatry or through the Dept. of Neurology for interns seeking a career in neuropsychology (which also requires the intern to complete a major rotation in Neuropsychology): The training through the Department of Psychiatry is well-suited for interns who want to become well-rounded general clinical psychologists. In this setting, interns will be exposed to a wide-variety of presenting problems that frequently involve both neurological and psychiatric conditions. At the completion of the training year, interns will have greater skills in completing an initial diagnostic interview, administering objective, standardized assessments, and will gain an appreciation for the cultural and ethical considerations involved in general cognitive assessment
Interns who are planning a career in Neuropsychology are encouraged to consider completing a minor rotation with Dr. Carol Schramke through the Dept. of Neurology. In that capacity, interns will gain significant exposure to providing evaluations for patients presenting with complex epilepsy, psychogenic non-epileptic seizures, motor disorders (e.g., Parkinson’s disease), Multiple Sclerosis, and will also participate in pre- post-surgical evaluations.
Neuropsychology Minor Rotation Goals:
The example training programs below are provided for illustrative purposes only and represent just a few of the major and minor rotation combinations available to give the prospective applicant a sense of the wide variety of unique training programs the intern is able to craft.
This is a sample training program for an intern interested in gaining a full range of child, adolescent and adult therapy experiences.
This is a sample training program for an intern who is interested in providing evidenced-based treatment within a medical system, emphasizing providing therapy within an intensive outpatient program designed for perinatal women experiencing psychiatry difficulties.
This sample training program would be ideal for the intern who wants in-depth training in child neuropsychological assessment to meet Div. 40 Houston Guidelines, while obtaining additional competencies in CBT therapy children and adolescents and gaining exposure to pediatric consultations within a children’s hospital.
This sample training plan is designed for the intern who wants advanced training in adult neuropsychological assessment across multiple settings in addition to developing competencies for providing adult psychotherapy within acutely ill psychiatric patients.
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