The Adult Clinical Psychology Elective is designed to teach interns how to treat patients from an integrative perspective.

Cases are conceptualized from multiple theoretical perspectives in the service of identifying interpersonal vulnerabilities and personality factors that are enhancing and driving symptom presentation. This is particularly salient in this setting as patients are diagnostically complex and often have medical comorbidities. Conceptualizing patients in this way will directly inform the therapeutic stance/technique as well as the staging and delivery of interventions that best fit the needs of the patient. Interventions will derive from a variety of empirically supported treatment modalities. Interns will learn how to tailor these interventions flexibly based on each clinical encounter. The clinical rotations in this elective and broadly in this internship year support this tenet.

This elective in the Internship in Clinical Psychology is designed to train psychologists in the scientist-practitioner model. In this elective the scientist-practioner model is envisioned as the integration of the best available research knowledge and clinical expertise within the context of patient characteristics, culture and preference (APA, Presidential Task Force on Evidence-Based Practice, 2006).

Treatment

Interns choosing the adult elective provide individual psychotherapy to a wide range of diagnostically diverse patients in the outpatient clinic. On average, interns see approximately ten patients per week. Primarily patients are treated in two modalities: cognitive behavioral therapy and integrative psychotherapy. Additionally, interns participate on a dialectical behavioral therapy (DBT) team and co-lead two DBT groups with faculty. Specific didactic and supervisory experiences are provided for each treatment orientation.

Assessment & Evaluation

Interns receive broad based assessment training that includes  conducting traditional comprehensive outpatient evaluations. Outpatient assessments employ a multi-method data gathering approach to generate a comprehensive, coherent and integrated description of complex, confusing or treatment-resistant psychiatric conditions. Interns receive training in the use of a wide range of assessment instruments including: the Wechsler scales, self-report measures of psychopathology, performance-based measures of psychological functioning, tests of normal personality and standard neuropsychological instruments.

During the internship year, adult elective interns complete comprehensive outpatient assessments in the Psychological Evaluation and Research Laboratory (PEaRL).

During the internship year adult elective interns also complete two four month rotations in our Outpatient Treatment Evaluation Service (OTES) and Psychiatry Urgent Care Clinic (UCC). Adult elective interns will conduct evaluations to determine what type of psychotherapy would be most appropriate for individual patientsTriage evaluations during their OTES rotation. During their UCC rotation, they will conduct psychiatric/clinical evaluations (based on referral question) and carry at least one short-term therapy case focused on stabilization (up to 6 sessions).

Similar to the inpatient experience, we use a “tapering” training model to accommodate the range of backgrounds and familiarity working with acute psychopathology. This staging process is applied flexibly. All interns are required to see patients independently by the end of these 4-month rotations.

Research

Interns participating in the adult elective learn to integrate research literature into ongoing professional practice through discussion of readings, literature reviews, supervision and didactic training. Many adult elective staff members are actively engaged in assessment and psychotherapy research. In addition, the adult elective has a strong tradition of encouraging and supporting interns in presenting their research and training experiences at national conferences and publishing assessment or test-related journal articles.

Didactics

Two adult elective-specific seminars are required for the adult elective interns in addition to the internship core didactics:

  • PEaRL staff meeting: 1 hour weekly
  • Integrative Psychotherapy Seminar: 1 hour weekly
  • Psychological Assessment Seminar 1.5 hours weekly

Supervision

Interns receive substantial supervision for all their professional activities, including:

  • Individual psychotherapy:
    • 2 integrative supervisors (one hour each)
    • 1 CBT supervisor (one hour)
  • DBT groups
    • 1 DBT group supervisor (before and/or after group in real time)
  • Assessment Rotation
    • 1 assessment supervisor (conducts comprehensive evaluations together and also provides supervision outside of this to assist with scoring, interpretation, and report writing)
  • Inpatient Rotation
    • 1 inpatient supervisor (individual and group therapy occurs in real time and in person throughout weekly four hour shift)
  • Triage Services (4 month rotation)
    • Psychiatry Urgent Care Clinic (UCC): 1 supervisor (one hour)
    • Outpatient Treatment Evaluation Service (OTES): 1 supervisor (1 hour)

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