Interns who are selected for the Adult Psychopathology Track will provide outpatient services as part of one of three primary rotations: Mood, Anxiety and Mindfulness, Early Psychosis Intervention Center (EPICENTER), and Suicide and Trauma Reduction Initiative (STRIVE). Interns will spend three days per week for a full year on their primary rotation and one day per week on a secondary rotation. We will contact interns prior to the start of internship regarding the secondary rotations that are available for the year and match interns with secondary rotations that align with their interests. The remaining day is reserved for didactics and optional elective experiences. Interns may receive up to one day per week of protected time to engage in research on their primary rotation. Information about potential research opportunities within each primary rotation will be shared with interns during orientation.
Each primary rotation on the adult psychopathology track is assigned its own number within the APPIC application system. Applicants may apply to multiple primary rotations on Adult Psychopathology Track as part of the APPIC application process.
The Adult Track intern’s typical schedule is as follows:
| Monday | Tuesday | Wednesday | Thursday | Friday |
|---|---|---|---|---|
| Primary clinical rotation | Secondary clinical rotation | Didactics and optional electives | Primary clinical rotation | Primary rotation (research and/ or clinical) |
Primary Rotations
Interns will complete a 12-month rotation at the Early Psychosis Intervention Center (EPICENTER) located within the Department of Psychiatry and Behavioral Health Outpatient Clinic. EPICENTER provides specialized clinical services to individuals with first-episode psychosis and individuals at clinical high risk for developing a psychotic disorder.
The internship is designed to provide trainees with opportunities to actively engage in the integration of clinical research and practice through a combination of clinical service, didactic training, and research activities. As integral members of our multidisciplinary team, interns will gain comprehensive training and experience in the delivery of interventions (e.g., CBT for psychosis, metacognitive remediation therapy, unified protocol, multifamily group psychoeduation, group social skills training) and assessments (e.g., SIPS, SANS/SAPS, PSP) to individuals with first-episode psychosis and individuals at clinical high risk for a psychotic disorder. Additional clinical training opportunities include inpatient experience, providing psychotherapy to individuals with longstanding psychotic disorders, administering comprehensive clinical assessments to individuals receiving care at EPICENTER, and assisting in the dissemination and delivery of EPICENTER services throughout Ohio.
Interns have a full day of protected, mentored research time throughout the entirety of the internship year, which can involve secondary analysis of existing/archival data or adding a component to an existing project. Current areas of active research include program development and evaluation, social and social cognitive outcomes, translational neuroscience, and suicide assessment and prevention using ambulatory assessment and are supported by grants from NIMH, SAMHSA, and the Ohio Department of Mental Health and Addiction Services.
In this full year rotation, interns will have the opportunity to provide comprehensive assessment and evidence-based treatments for individuals who are seeking outpatient psychological care for depression and anxiety. Interns will have clinical experiences across several areas of focus. Interns will complete comprehensive diagnostic assessments for patients with difficult to treat cases of depression within our multidisciplinary Depression Recovery Center (DRC). They will also participate in team meetings/case conferences in collaboration with DRC attending psychiatrists.
Interns will have a dedicated experience providing treatment for individuals with anxiety and obsessive-compulsive disorders, primarily via exposure-based individual and group-based interventions. Interns may have the opportunity to integrate innovative virtual reality technology as part of their work. Interns will provide individual and group-based interventions for acute depression and relapse prevention via cognitive-behavioral and mindfulness and acceptance-based approaches. While the majority of patients typically are interested in services for depression or anxiety disorders, the range of presenting problems can be quite broad. Because many of the outpatients that are seen in the Department of Psychiatry and Behavioral Health have more than one psychiatric condition and frequently present with physical health comorbidities complicating treatment, an emphasis on multidisciplinary collaboration and case formulation and adapting manualized treatment to the needs of the patient is also emphasized.
Over the years, the STRIVE team has developed targeted treatments for suicide risk reduction as well as further refined and improved existing, evidence-based trauma disorder treatments. Interns in this rotation will be expected to learn our in house developed suicide prevention treatments, which include Crisis Response Planning (CRP) and Brief Cognitive Behavioral Therapy (BCBT), as well as existing VA/DoD recommended treatments for PTSD (e.g., Cognitive Processing Therapy, Prolonged Exposure). The intern will complete a yearlong rotation as an active member of The Suicide and Trauma Reduction Initiative (STRIVE) clinic. Initially established to help military personnel and veterans, STRIVE now provides treatment to all adults who are dealing with trauma and suicidal thoughts. STRIVE researchers and clinicians have pioneered methods to improve treatment outcomes for people with PTSD. Over 70% of people receiving treatment from STRIVE report significant reductions in symptoms and improvements in quality of life. STRIVE’s success, in part, comes from its view of PTSD as an injury rather than a chronic disorder.
In addition to their participation in the STRIVE clinic, the intern may have the opportunity to treat participants in ongoing clinical trials research. STRIVE currently has several ongoing clinical trials funded through the Department of Defense, National Institute of Mental Health, and various private corporations. As such, interns will work closely with project coordinators of the various studies to deliver evidence-based care with high fidelity. Interns will have opportunities to conduct eligibility screening and diagnostic assessment to determine the appropriateness of participation in the clinical trial. Interns in this rotation will gain firsthand experience in conducting applied clinical research within a highly active clinical research lab.
The program faculty emphasize a strong interest and background in the delivery of evidence-based care, applied clinical research, and prior experience working with veterans and/or active-duty service members.
Secondary Rotations
The ADHD Assessment and Diagnosis rotation provides interns the opportunity to enhance their assessment skills with a focus on ruling out/in ADHD as a possible cause for impairing symptoms/behaviors. Interns will get the opportunity to complete 2 to 4 psychological/psychoeducational assessments per month and provide patient feedback regarding treatment and academic/occupational accommodations (if applicable). Interns will also have the opportunity to provide umbrella supervision to psychiatry residents in monthly ADHD diagnosis meetings, where Dr. Barterian, an attending psychiatrist, and psychiatry residents review comprehensive data for each patient suspected of having ADHD in the psychiatry resident clinic. If interested, there is also the option to engaged in some limited CBT for ADHD treatment experience.
Sleep difficulties are pervasive across psychiatric and medical populations. The goal of this rotation is to provide training in assessment, conceptualization, and treatment of sleep disorders, primarily insomnia, but occasionally circadian disorders, nightmares, and other parasomnias (e.g., somnambulism). Additional opportunities may include provision of behavioral health support for CPAP-desensitization, hypnotic medication discontinuation, restless leg syndrome, and narcolepsy / hypersomnia.
Interns will have the opportunity to provide cognitive behavioral psychotherapy with individuals who have a primary anxiety disorder diagnosis [obsessive-compulsive disorder and related disorders (trichotillomania, excoriation disorder, hoarding disorder, etc.), social anxiety disorder, specific phobia disorder, generalized anxiety disorder, or panic disorder]. The rotation focuses on exposure-based treatments for anxiety disorders, including imaginal, in-vivo, interoceptive, and virtual-reality assisted exposures. Utilization of additional interventions, such as cognitive therapy, acceptance and commitment therapy, mindfulness, and third wave interventions, are encouraged when appropriate. The experience also incorporates guided readings and supervision on the theoretical background of the treatment.
This rotation aims to provide interns with opportunities to gain a deep understanding of the psychological, cognitive, and emotional aspects of aging. Trainees will gain experience in providing evidence-based interventions for clients referred to Geropsychology Service. Common referrals include the treatment of mental health concerns, such as depression, anxiety, adjustment to chronic illnesses, the stress of caregiving, and bereavement. The Pikes Peak Geropsychology Knowledge and Skill Assessment Tool will be utilized to evaluate progress in developing geropsychology competencies and to help define ongoing learning goals and training needs throughout the training cycle. Supervised experience for trainees will include direct clinical supervision, seminar attendance, interdisciplinary team participation, and relevant readings in clinical geropsychology. This training elective adheres to the guidelines outlined in the Competencies for Practice in Professional Geropsychology.
Interpersonal and Social Rhythm Therapy (IPSRT) is an evidence-based therapy for bipolar disorder that emphasizes techniques to manage stressful life events and reduce disruptions in their social rhythms or daily routines. It is designed to help people with bipolar disorder improve their symptoms by understanding and working with their biological and social rhythms, as well as improving interpersonal functioning. IPSRT also teaches patients skills that help them protect against the development of future episodes. Interns on this rotation will be trained to deliver IPSRT to individuals with bipolar disorder in an outpatient setting.
The Nisonger Center transition clinic is part of the LEND program and University Center of Excellence in Developmental Disabilities. This clinic takes place on Tuesdays; team meetings and assessments are from 9am to 12:30pm with the afternoon typically used for assessment scoring, report writing and feedback sessions. This is an interdisciplinary team of psychology and social work providers and trainees. This clinic typically conducts assessments with adolescents and young adults ages 14 to 22 evaluating autism, and through that process we may assess for co-occurring or differential diagnoses such as depression, anxiety, trauma-related disorders, ADHD, and Intellectual Disability, among others. Interns will have the opportunity to conduct thorough chart reviews, partake in interdisciplinary interviews, and conduct a range of assessments often including cognitive, adaptive, and mental health assessments. Interns will observe and have the opportunity to become reliable in administering the ADOS-2 autism assessment. Interns will write psychological reports and assist in conducting feedback sessions. There may be additional opportunities for interns to take on their own additional assessment cases with adequate experience.
PAT is a recently developed, empirically-supported behavioral activation approach for patients primarily suffering from anhedonia and low positive affect, typically delivered throughout the course of 12-15 sessions. PAT aims to upregulate positive affect by implementing a structured behavioral activation protocol at the beginning stages of treatment, diverging from traditional cognitive-behavioral approaches by teaching patients skills that allow them to attend to positivity more often (e.g., "finding the silver linings" and savoring recent positive experiences). PAT also implements skills that teach patients to cultivate positivity in the latter stages of treatment to continue orienting them to positivity-based behaviors (e.g., practicing loving-kindness and generosity). Interns will thus have an opportunity to incorporate positivity-based interventions within a core cognitive-behavioral framework in this rotation.
Interns will receive training in evidence-based treatments for substance use disorders, with an emphasis on Mindfulness-Based Relapse Prevention (MBRP) and Motivational Interviewing (MI). Interns will co-lead 2 MBRP groups and develop skills leading mindfulness inquiry. Interns will learn the fundamentals of MI and apply skills in individual therapy sessions (seeing 3-4 patients per week), alongside CBT-based approaches. Interns will also complete diagnostic assessments, with an emphasis on differential diagnosis in the context of substance use. Additionally, interns will receive general training about substance use disorders and consult with psychiatry providers.
The intern will complete a yearlong rotation as an active member of The Suicide and Trauma Reduction Initiative (STRIVE) clinic. STRIVE exists to advance research and provision of clinical treatment in the areas of suicide and trauma prevention and intervention for military personnel, veterans, first responders and civilians. Over the years, the STRIVE team has developed targeted treatments for suicide risk reduction as well as further refined and improved existing, evidence-based trauma disorder treatments. Interns in this rotation will be expected to learn our in house developed suicide prevention treatments, which include Crisis Response Planning (CRP) and Brief Cognitive Behavioral Therapy (BCBT), as well as existing VA/DoD recommended treatments for PTSD (e.g., Cognitive Processing Therapy and Prolonged Exposure). Interns on the secondary rotation will spend one full day seeing patients in the ambulatory clinic using the treatments specified above. Supervision experiences will include individual and group, with review of recorded session material during supervision.
Women’s Behavioral Health (WBH) is an interprofessional Academic Center of Excellence providing innovative behavioral health care for women, woman-identifying patients and their families during life events that are unique to women. WBH helps with mental and behavioral health across the life span, whether it is during family planning, the perinatal period, sexual health, gynecological and breast cancer treatment, during menstrual cycles or menopause. Interns will be provided individual and group supervision, which includes trainees across psychiatry and psychology. Interns will spend one full day seeing patients in the ambulatory clinic using Cognitive Behavioral Therapies with opportunities to lead therapy and education groups.