Psychology Internship Electives

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.

Interns are strongly encouraged to participate in research activities. Clinical psychology interns may choose to independently investigate a research question under faculty supervision. This can involve secondary analysis of existing/archival data or, with their supervisor’s consent, adding a component to an existing project. Interns are also able to work as part of a faculty member’s research team.

Areas of faculty research include the following:

• Behavioral Cardiology – Cheryl Carmin, PhD, Todd Barrett, MD
• Clinical Neuroscience Research Lab – Stephanie Gorka, PhD
• Emotion Dysregulation/Mindfulness – Sophie Lazarus, PhD
• Depression – Jay Fournier
• Psychosis – Nick Breitborde, PhD, Aubrey Moe, PhD, Heather Wastler, PhD, Jessica Turner, PhD, Isy Tso, PhD
• Trauma and suicide – Justin Baker, PhD, Rosie Bauder, PhD
• Neuropsychology – Laura Boxley, PhD, Chris Nguyen, PhD
• Phan Lab – K. Luan Phan, MD
• Women’s Behavioral Health – Kristen Carpenter, PhD

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.

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.

The intern will complete a one year 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 is an interprofessional Academic Center of Excellence providing care to women experiencing stress or stress-related illness during life events that are unique to women. We provide state-of-the-art care for mood and anxiety disorders, sexual health and stress, with a special emphasis on pregnancy, the postpartum period, gynecologic and breast cancers, menopause and the menstrual cycle. During this rotation, interns are integral members of a treatment team that includes psychologists and psychiatrists. Emphasis is on enhancing skills in sexual health interventions, psychotherapy to cancer patients and psychotherapeutic interventions for mood and anxiety disorders in the peri-partum. Clinical experiences are primarily outpatient, with some possibility of consultation-liaison work in Labor and Delivery.

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.

The consultation-liaison psychiatry service is a inter-professional team staffed by faculty psychiatrists, psychiatry residents, a social worker, and medical students. Interns will have the opportunity to provide consultations to hospitalized individuals who have been referred to the Department of Psychiatry and Behavioral Health based on the referring physician’s assessment that there is a need for a mental health intervention. Interns will learn to differentiate between delirium and other cognitive deficits that may be causing treatment interfering behaviors. They will play a major role in assessing if there is a need for pharmacological and/or psychological intervention and learn to prioritize those treatments that are available during a patient’s hospital stay.
 
Depending upon logistics, interns may have the opportunity to follow patients who were seen during their hospitalization as outpatients. Each patient who is seen on the service is staffed the same day by the team, providing the opportunity for inter-professional group supervision. Interns will also receive individual supervision from a faculty psychologist for those patients for whom they are the assigned mental health professional. This experience can be structured for up to six months or for a shorter period of time.

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 participate in MBCT groups as part of an elective experience. MBCT is an empirically supported intervention developed by Zindel Segal, Mark Williams, and John Teasdale, based on Jon Kabat-Zinn’s Mindfulness-Based Stress Reduction program. It was developed to facilitate recovery from depression and prevent future relapse, and is based on cognitive-behavioral principles and practices and eastern mindfulness practices.  Interns must commit to at least two 8-week group cycles in order to participate. The experience consists of guided readings and supervision on the theoretical background of the treatment, one round of group participation as a “participant-observer,” followed by the opportunity to co-lead the group.

The purpose of this elective is to educate interns regarding the utility of outpatient neuropsychological assessment in an academic medical center. Interns will spend time observing and participating in diagnostic interviews and writing reports with the attending neuropsychologist. The patient population consists of adult individuals seen through our general outpatient service, who are typically psychologically/medically complex. Common referrals include the assessment of cognitive concerns secondary to neurodegenerative diseases, major medical illnesses, developmental disorders, and psychiatric disorders. Interns on the elective rotation participate in Wednesday morning neuropsychology didactics, including group supervision and neuropsychology seminar.

This elective will be most useful for future psychologists looking to increase their exposure to clinical neuropsychological assessment, common presenting conditions, and case conceptualization. Participating in the elective rotation does not allow sufficient time or exposure to constitute specialty training in neuropsychology as outlined in Houston Conference Guidelines. Rather, primary goals of the experience are to develop increased awareness of the role neuropsychology plays in patient care, understand when and why patients might be referred for evaluation, and learn how neuropsychological assessment results can be used to guide treatment decisions.

The Nisonger Center provides diagnostic and evaluation services for individuals with suspected developmental disabilities (including autism) aged 12 months through 22 years of age. Interns will have the opportunity to participate in an interdisciplinary diagnostic interview and observe standardized assessments and feedback sessions. The nature of the observation can be flexible based on the interest and experience of the intern. In this elective, interns will have the opportunity to observe interdisciplinary evaluations in one of three clinics. The Interdisciplinary Diagnostic Clinic, which evaluates children 12months through 5 years of age meets in Wednesday mornings (2nd. 3rd, 4th Wed) and afternoons (1st Wed). The School Age Autism and Developmental Clinic, which provides interdisciplinary evaluations for individuals 5 up to 12 years of age meets on Thursday afternoons. The Transition-Age Clinic, serves individuals aged 13-22 years of age meets on Tuesday mornings.

This elective will provide interns with an opportunity to increase knowledge and skills related to the epidemiology, assessment, diagnosis, conceptualization and treatment of chronic pain and related psychiatric and substance use comorbidities. Interns will work to integrate brief psychotherapy, relaxation and behavior modification into patients’ pain management. The assessment and treatment goals aim to restore function in physical and social areas. Additionally, if desired, interns would have opportunity to conduct pre-surgical psychosocial evaluations prior to implantable therapy procedures. Depending upon logistics of this opportunity, interns will be involved in the initial intake and treatment planning, and possibly providing treatment through individual psychotherapy.

Interns will have the opportunity to assess, diagnose, conceptualize and treat tobacco use disorders and any related psychiatric conditions. Interns will learn to adapt interventions based on related physical health comorbidities and will increase knowledge of the latest tobacco products as well as nicotine replacement therapies. Treatment modalities are based in CBT and MI principles and may include coaching patients’ use of web and mobile-based interventions. 

The intern interested in this elective will have the opportunity to co-lead an evening group therapy for adults with executive function deficits with the primary diagnosis of ADHD. The group runs for 12 sessions, typically on Wednesdays from 6:00pm until 7:30pm usually in the spring. The group follows the evidence-based CBT program developed by Mary Solanto, Ph.D. Interns will become proficient at coaching effective time management and organizational skills which are essential for those individuals diagnosed with ADHD and are applicable beyond the ADHD diagnosis.