Adult Psychology Track

Castle

Kathryn Castle , Ph.D.

Psychology Internship Training Director, Adult Track

Overview

The goal of the Adult Psychology Track is to provide a solid foundation of general clinical training for those interested in careers in patient care, teaching or research. Although we embrace the scientist-practitioner model in Psychology and the Department of Psychiatry, we view the internship year as a pivotal clinical year that is essential to the development of all professional psychologists, even those who will go on to be full-time researchers. Therefore, the majority of the interns' time is spent in clinical training activities, although we do provide elective opportunities for engaging in clinical research according to the interests and career goals of the intern.

Training

Adult Ambulatory Services

25 hours per week, year-long

During this aspect of the training experience, the intern engages in three primary activities.

Ongoing Assessment and Treatment of Adult Psychiatric Outpatients

Each intern follows a caseload of patients in our General Ambulatory Service (CMHC). Interns receive at least two hours per week of individual supervision from two different licensed psychology faculty members. Supervision focuses on the development of clinical interviewing skills, case conceptualization and diagnosis, treatment planning skills, and methods of individual psychotherapy. Interns learn to function as part of interdisciplinary teams and participate in a weekly treatment team meeting with General Ambulatory Service clinical staff and providers.

Group Psychotherapy Training

This training includes

  1. a didactic seminar on theory and practice,
  2. co-leadership of a therapy group, and
  3. group supervision of the interns’ group work.

The design of our group therapy training program is based on the guidelines set forth by the American Group Psychotherapy Association (AGPA) and offers the opportunity for increased depth and breadth of skills as a group clinician. Supervision takes place through live observation by a skilled group therapist/co-therapist and in biweekly group supervision of group therapy by a psychologist who is certified with the National Registry of Certified Group Psychotherapists.

Psychological Testing Service

This service deals with a wide variety of referral questions including issues of differential diagnosis, outpatient treatment planning, forensic matters, and learning disabilities. Interns perform 3-5 comprehensive assessments per year depending on their training goals and become familiar with a wide range of assessment instruments. Interns also perform psychological testing in the inpatient rotation at Rochester Psychiatric Center.

Rochester Psychiatric Center (RPC)

20 hours per week, 6 months:

Interns participate in one six-month rotation consisting of 20 hours per week in the Adult Services Unit (ASU) at Rochester Psychiatric Center, a 205-bed, state-of-the-art New York State psychiatric center.

The ASU is comprised of four 30-bed inpatient wards, serving treatment refractory patients.  Two interns are assigned during each six month period to one ASU ward. Interns may be assigned to an admissions ward, a forensic ward or an adult ward with extended stay patients.  This latter ward treats patients with severe mental illness who typically require extended lengths of stay, including patients retained under criminal procedure law (CPL).  The admission ward serves a variety of patients who have not been stabilized at community hospitals and need longer inpatient treatment.

The rotation focuses on both targeted assessment and individual and group treatment for treatment refractory patients. Interns will learn individual and group interventions appropriate for severely mentally ill patients, using rehabilitative skill modules, Dialectical Behavioral Therapy (DBT) interventions, and behavioral techniques.

Clinical or Research Elective Experiences

10 hours per week, 6 months

Interns select one successive six-month experience with program approval. The choices include the following:

  • Child and Adolescent Psychology (Jennifer West, Ph.D) – Designed to give the adult intern an opportunity to enhance his/her understanding of child and adolescent development, psychopathology, assessment and treatment.
  • Deaf Wellness Center (Robert Q Pollard, Ph.D., Amanda O’Hearn, Ph.D) – For trainees who are proficient in sign language, this elective offers supervised clinical practice in the assessment and treatment of deaf adults, and promotes trainees' abilities to provide independent psychological services in the high need area of mental health services for the deaf population.
  • Community Geropsychology (Deborah A., King, Ph.D.) – Provides the intern with an understanding of community-based collaborative care for late-life depression and other problems. The rotation aims to provide a general foundation of knowledge regarding late-life development and psychopathology, as well as an opportunity to participate in the design, conduct and/or evaluation of community-based care for older adults at risk for mental health problems.
  • Primary Care Psychology (Carol Podgorski, Ph.D.) – This rotation is based in the Behavioral Health Services of the University of Rochester Family Medicine Center, an ambulatory primary care medical clinic serving patients with a range of diagnoses and problems. Interns learn a model of systems-based consultation and collaboration in medical settings developed by the faculty of the Family Medicine Department and the Division of Family Programs in the Department of Psychiatry.
  • Behavioral Sleep Medicine (Sara Matteson-Rusby, Psy.D., C.BSM; Wilfred R. Pigeon, Ph.D., C.BSM) – Designed to educate the intern about behavioral assessment and therapy as it is provided in a behavioral sleep medicine clinic. This entails training and supervision in the assessment of sleep disorders, delivery of cognitive-behavioral therapy for insomnia and, if appropriate and available, behavioral management of other sleep disorders such as sleep apnea, circadian rhythm disorders, restless legs syndrome and period limb movement disorder. With permission from their primary supervisors, interns may also choose to receive training in delivering treatment for insomnia in the context of co-occurring disorders such as depression, PTSD and/or chronic pain. There is also the opportunity to engage in a sleep research project through the Sleep & Neurophysiology Research Lab.
  • Assessment and Treatment of Anxiety Disorders (Marc Swogger, Ph.D.) – Based in the Adult Ambulatory Psychiatry Clinic, this rotation provides the intern with training in the evidence-based assessment and treatment of anxiety disorders. The therapeutic approach is cognitive-behavioral, and incorporates techniques from "third wave" behavioral therapies in order to tailor treatment to patient needs.
  • Research Elective– At times interns have selected a research elective because they have specific interests and career goals that coincide with the established research program of a faculty member in the Medical Center. The plan must be approved by the Director of Training in order to help ensure the experience meets with the intern's overall career goals. Research opportunities may be available in areas including, but not limited to, interpersonal therapy for depressed women with trauma histories, addictions, late-life depression and suicide, mind-body approaches to medicine, community based approaches to addressing mental health disparities, and cognitive behavioral approaches to sleep disorders.

Core Didactics and Other Training Experiences

  • Interpersonal Psychotherapy (IPT) Seminar and Supervision – IPT is an evidence-based treatment that helps to reduce psychological symptoms by intervening in relationship difficulties. This interdisciplinary seminar includes eight hours of didactic lectures followed by weekly group supervision that allows trainees to discuss cases from an IPT framework. The text for the seminar is made available for all participating trainees: Stuart, S. & Robertson, M. (2003) Interpersonal Psychotherapy: A Clinicians Guide. London: Arnold.
  • Dialectical Behavior Therapy (DBT) Seminar and Supervision – DBT is a cognitive-behavioral treatment for individuals with emotional dysregulation and other difficulties commonly associated with borderline personality disorder. This interdisciplinary seminar includes eight hours of didactic lectures followed by weekly group supervision that allows trainees to discuss cases from a DBT framework. The text and training manual for the seminar are made available for all participating trainees: Linehan, M.M. (1993) Cognitive Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press (Text); Linehan, M.M. (1993). Skills Training Manual for Treating Borderline Personality Disorder. New York: Guilford Press.
  • Urgent Care Clinic (UCC) - All interns will have a 6 month UCC expereince. They will have group supervision of these cases for 1 hour each week. The intern will also participate in a weekly UCC treatment team meeting along with and MD and social work staff.
  • Group Therapy Seminar – A twelve-week seminar on the theory and practice of group therapy.
  • Multicultural Case Conference Luncheon Series – This monthly series provides an opportunity for faculty and trainees to present and discuss cultural formulations from their casework. Each intern must present at least one formal cultural formulation from his/her casework during the course of the year.
  • Department of Psychiatry Grand Rounds – This weekly forum provides an opportunity to hear nationally or internationally prominent speakers present in an area of their expertise and on current topics in psychiatry.
  • Monthly Professional Development Luncheons – Each month one of the Track Training Directors and the Chief Postdoctoral Fellow hosts a luncheon that includes invited faculty speakers. The meetings are used to promote aspects of professional development such as finding a fellowship or job after internship.
  • Weekly Group Supervision – The interns have a weekly meeting with the Training Director to share feedback or concerns about the program and to discuss clinical cases.
  • Leadership Projects -

    Each intern participates in a leadership project mentored by a faculty memeber. The leadership project is designed to:

    • enhance the intern’s understanding of complex issues facing the Service or Department
    • give interns exposure to the scope and depth of the functioning of psychologists within a Service or Department and increase their ideas regarding the “value added” of psychologists.
    • provide current Service and Department leaders with new perspectives and ideas for addressing long-range issues.

    The project can be an evaluation of a program; building of a web-based resource bank; patient satisfaction

    The interns will have 2 hrs., set aside, each week to work on the project and 30 to 60 min. to meet with the project mentor (total of 2.5 to 3 hrs. per week).

  • Comprehensive Psychiatric Emergency Program (CPEP) - The New York State designed CPEP is comprised of a traditional walk-in emergency service, a Mobile Crisis Team and observational beds for boarding without hospitalization, and emergency housing units. This optional experience is 4 hours per week, for one month. The intern will offer evaluation, triage, and crisis intervention to individuals and family, fully participating on the multidisciplinary team.
  • Seminars and Other Training Conferences – Interns frequently take elective seminars with the Department or the larger University.