Adult Psychology Track 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. Our training model supports practitioner-scholar careers. 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 that involve exposure to and experiences with a wide range of health and mental health problems as part of team-based, collaborative care. We also believe that psychologists are well suited to conduct empirical research and to translate the results of research into effective practice and programs in an array of settings and we provide a variety of opportunities for interns to meet with researchers in the Department and Medical Center community to discuss their interests and future career goals. The goals of the program are to enhance each intern's knowledge base and clinical skills in relation to psychopathology, assessment, treatment planning, and treatment implementation. These goals are consistent with the five overarching long-term goals for all interns across tracks. In the area of Professional Skills and Competencies, we aim to develop psychologists who have skills in: 1) diagnosis and assessment, and 2) treatment and consultation. In the area of Professional Standards and Behavior, we aim to develop psychologists who demonstrate: 3) ethical understanding and behavior, and 4) professional development and demeanor. In the area of Academic Competencies, we aim to develop psychologists who have skills in: 5) teaching, supervision and scholarship. We provide a number of elective opportunities for interns on the Adult Track including Primary Care, Behavioral Sleep Medicine, and Assessment and Treatment of Anxiety Disorders. Depending on their interest and resources, interns may also contribute to clinical research as part of their elective experience. Clinical Rotations Outpatient Rotation, 25 hrs/wk (12 months) Rotation Coordinator - Kathryn Castle, Ph.D. (Stephen Basler, Ph.D., Kathryn Castle, Ph.D., Dennis Foley, Psy.D., Stephanie Gamble, Ph.D., Sharon Gordon, Ph.D., Deborah King, Ph.D., Amanda O'Hearn, Ph.D., Marc Swogger, Ph.D.) 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 case load management, 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(s) with General Ambulatory Service clinical staff, providers, and other Departmental trainees. Group Psychotherapy Training Howard Markus, Ph.D., CGP, Sherrie Smith, LCSW-R, CGP; (3.5 hrs/wk) This training includes A didactic seminar on theory and practice, Co-leadership of a therapy group, and 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 Supervisor: Marc Swogger, Ph.D.; (2 hrs/mo) 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. Inpatient Rotation, 20 hrs/wk; (6 months) Rotation Coordinator - Christine Ransom, Ph.D. (Rochester Psychiatric Center) Supervisors: Dale Kulick, Ph.D., Jillian Bowden, Ph.D. 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 five 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 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. Core Didactics and Other Structured Training Experiences Interpersonal Psychotherapy (IPT; 1 hr/wk; 9 mos) 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. Screening, Brief Interventions, and Referral to Treatment (SBIRT); Stephanie Gamble, Ph.D. (1 hr/wk; 6 wks). This interdisciplinary seminar includes 6 hours of didactic lectures and experiential learning exercises designed to enhance participants' knowledge, confidence, and skills in the detection and treatment of co-occurring substance use and behavioral health disorders. This course teaches interns how to: Conduct screening for problematic alcohol and drug use Deliver Brief Interventions for problematic alcohol and drug use Employ a Motivational Approach based on patients' readiness to change Make referrals to specialized treatment when clinically indicated Dialectical Behavior Therapy (DBT; 1hr/wk; 10 mos) 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; 1hr/wk; 6 mos) - All interns will have a 6 month UCC experience. They will have group supervision of these cases for 30 minutes each week. The intern will also participate in a weekly UCC treatment team meeting along with psychiatry, psychology, and social work staff. Multicultural Case Conference Luncheon Series (1 hr/mo; 12 mos)– This monthly series provides an opportunity for trainees to present and discuss cultural formulations from their casework. Participants must present at least one formal cultural formulation from his/her casework during the course of the year. Department of Psychiatry Grand Rounds (3/mo; 12 mos) – This weekly forum brings together faculty, staff and trainees from multiple disciplines to learn together about new developments in education, clinical care, empirical research and other topics of interest. It serves as a way for interns to be exposed to information and people outside of their "silos" of expertise, setting, or daily focus. Presenters may be departmental faculty and trainees, national and international experts, and members of our local community. Grand Rounds also helps to build and promote shared understanding of the mission and values of the Department and the Medical Center. Interns may also choose to attend other Grand Rounds relevant to their training goals (i.e., Primary Care, and Public Health Sciences). Professional Development Seminar (2/mo; 12 mos) – Each month the Internship Training Director and Chief Fellow hosts a breakfast meeting attended by all interns that includes invited faculty speakers. The meetings are used to promote aspects of professional development such as increasing awareness of various roles that psychologists perform within academic medical centers and community settings and pathways to those roles, refining skills (i.e., job-search strategies, interviewing and negotiating) related to success in obtaining future professional positions, increasing knowledge of requirements for independent practice (licensure), and facilitating group cohesion among interns to promote collaboration/peer support and future networking. Several times a year, the interns join with the postdoctoral fellows for professional development topics appropriate for all. Leadership Projects (2.5 hrs/wk; 6-12 mos) - Each intern participates in a leadership project mentored by a faculty member. 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, etc. Interns 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). Wednesday Seminar Series (1 hr/wk; 12 mos.) - The overall goal of the Adult Internship Wednesday Seminar Series is to assist interns with acclimation to the training program and their primary training site, enhance clinical fund of knowledge, general therapy skills, and to build competency in the delivery of select empirically based treatment for adults. Topics that are covered include: a) the appropriate use of electronic medical record documentation in patient care; b) training in Problem Solving Therapy (PST); c) Aging (assessment, treatment, care giver issues); d) use of interpreters in mental health; e) exposure to Cognitive Processing Therapy (CPT); basics of adult psychopharmocological interventions; f) treatment with members of the LGBTQ community; g) the intersection of religion, spirituality and therapy; h) marital therapy. Clinical Elective Experiences, 10 hrs/wk; 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; Kathryn Castle, Ph.D.) – For trainees with prior experience working with children and adolescents, this elective is 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. Primary Care Psychology (Tziporah Rosenberg, 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 contribute to sleep research 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. 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. Elective Seminars and Other Training Conferences - Interns frequently take elective seminars with the Department or the larger University. These included: Interpersonal Violence Training, Commitment to Living Suicide Prevention Workshop and Standardized patient experience, and Eating Disorders Seminar. Group Meeting with the Director of Training - Interns meet quarterly with the Director of Training in Psychology to discuss training-related questions or concerns and their professional development and to provide feedback about the internship. Interns also have two-three individual meetings with the Training Director. Meetings with Track Director - Interns have bi-annual meetings with the Adult Internship Training Director where they can discuss questions or concerns related to their individualized training plan, the training program or their professional development, or provide feedback about the internship. During these meetings individual progress in the internship is provided, along with an exit interview a the end of the internship training year.