Pediatric Psychology Internship - Rotations
The primary training activities are organized through three rotations:
- Child & Adolescent Mental Health
- Pediatric Neuropsychology
- Pediatric Psychology
In general, limited clinical experiences within the third rotation or with other services may be negotiated at the discretion of primary supervisors and the supervisors of the third rotation. Detailed descriptions of rotations are given to interns at the beginning of the rotations and may be reviewed at the time of interviews for the internship.
The National Matching Services computerized matching system matches interns with their choice of rotations through their choice of tracks (i.e. combinations of two rotations). Applicants rank each track (i.e., pairs of rotations) separately based on their relative interests. In other words, applicants may rank one, two, or three tracks (i.e., 3 actual rankings) in the list they submit to the NMS for the computer match. Most applicants ultimately rank the internship three times when submitting rank orders to the APPIC-NMS match in order of their preferences among the three tracks.
Final rotation assignments (i.e., the sequence of rotations) have generally been determined after the match, based on input from the faculty and interns. In rare circumstances it may be necessary to negotiate changes in rotations later in the year in response to unforeseen developments.
The Child & Adolescent Mental Health rotation is in the Division of Child & Adolescent Mental Health of the Department of Psychiatry and Behavioral Sciences. It provides rich opportunities for assessment and intervention with children, adolescents, and young adults experiencing a broad range of psychopathology. Psychological assessment is an integral part of this rotation. Interns gain experience in conducting psychiatric interviews as well as performing diagnostic, intellectual, neuropsychological, and personality evaluations. This rotation provides the greatest opportunities for psychotherapy within the Internship. Interns are assigned to outpatient clinical settings and maintain outpatient therapy caseloads throughout the rotation. Interns are supervised directly by psychology and psychiatry faculty and consult with additional faculty members and psychiatry fellows about psychopharmacological interventions.
In the outpatient clinics, interns provide diagnostic evaluations and formulate comprehensive treatment plans. As part of the assessment process, interns are expected to collaborate closely with schools and other agencies to ensure accurate interpretation of evaluations and to assist in implementing and assessing the outcome of intervention programs. Interns also participate in providing feedback to patients, families, and other professionals and complete comprehensive psychological reports.
The experiences in the outpatient clinics vary and include participation in the following specialty clinics:
- Child and Adolescent Anxiety Disorders Program with Gail Bernstein, M.D. and Sasha Zagoloff, Ph.D.
- Neuropsychology Clinic with Jeff Wozniak, Ph.D.
- Early Childhood Mental Health Program with Katie Lingras, Ph.D.
Interns are trained in several empirically-supported treatments including behavioral therapy, cognitive-behavioral therapy (CBT), parent management training, and dialectical behavior therapy (DBT). Therapies are offered for children, adolescents, and young adults with internalizing disorders such as depression, anxiety disorders, phobias and stress-related disorders. Interns will also be involved in providing DBT to adolescents and young adults. Therapy provided in the Child & Adolescent Mental Health Clinic includes outpatient individual, group and family therapy modalities.
Supervision from other supervisors may also be arranged. Supervised therapy experiences include:
- CBT for various conditions with Sasha Zagoloff, Ph.D (including Trauma-Focused CBT)
- CBT and parent management training with Katie Lingras, PhD. (including Trauma-Focused CBT and/or Child-Parent Psychotherapy informed treatment).
Interns are expected to complete an average of approximately 15-20 hours per week of direct clinical service delivery throughout the rotation (i.e., including assessment, therapy, and possibly consultation). Additional time is devoted to comprehensive supervision with multiple clinicians, a robust set of didactics, and medical documentation. Across the internship, approximately 50% of interns' clinical activity typically involves diagnostic interviewing and psychological assessment, and the other 50% involves therapeutic activities. Interns receive a minimum of three hours of individual supervision per week and participate in additional group supervision along with other interns, practicum students, psychiatric residents and fellows, and other staff and faculty. There may be opportunities for interns to participate in co-therapy with supervisors. Interns participate in Departmental and Division activities, including Anxiety Roundtable, Grand Rounds of the Department of Psychiatry and Behavioral Sciences, and other selected seminars and courses.
Interns who choose the Child & Adolescent Mental Health rotation have the opportunity to see a broad range of patients in the outpatient clinic. This prepares them to work comfortably with the full continuum of severity of psychopathology and for a range of career paths including those in academic medical settings. Two of the faculty psychologists for this rotation were previously interns in the Division of Child & Adolescent Mental Health.
Italics designate the primary supervisor
The Pediatric Neuropsychology rotation is in the Division of Clinical Behavioral Neuroscience of the Department of Pediatrics. It provides a multidisciplinary diagnostic service for children with complex learning and behavioral challenges associated with neurological and neurodevelopmental disorders. Children are referred by health professionals at M Health Fairview Masonic Children's Hospital, clinics, and practitioners in the community. The Division of Clinical Behavioral Neuroscience serves the community, state, five-state area, and (for specific disease entities) the entire country and internationally. The clinical orientation of the staff is developmental. Patients range in age from early childhood to young adulthood, are across the gender and sexual spectrum, and come from diverse cultural, ethnic, linguistic, and socioeconomic backgrounds. The primary Pediatric Neuropsychology Clinic is housed in the outpatient clinic at the Masonic Institute for the Developing Brain. The approach to neuropsychology is to integrate knowledge from multiple sources (e.g., physicians, parents, schools, other involved agencies) to quantify functional deficits developmentally in association with knowledge gained from neurological examinations; diagnostic imaging; neurophysiological, genetic, and other laboratory studies; and medical and psychosocial history. The goal of this rotation is to provide training in pediatric neuropsychology which emphasizes the scientist-practitioner model and follows Houston Conference Guidelines. Although interns’ experience is primarily clinical, there are also academic aspects to this experience, including weekly didactic and related training events, opportunities to engage with research studies, and/or preparation for a postdoctoral fellowship in pediatric neuropsychology. It is strongly preferred, but not required, that interns who participate in this rotation will have undertaken basic coursework and/or practicum-level training in child or adult neuropsychological assessment prior to the internship.
Neuropsychological diagnostic services are provided for children with a wide range of neurological or medical conditions that can affect brain development, such as: epilepsy, traumatic brain injury, infectious diseases, various forms of cancer, neurotoxic conditions (e.g., lead poisoning), or congenital disorders (e.g., cerebral palsy, agenesis of the corpus callosum, hydrocephalus). We also see children with neurodevelopmental disorders (e.g., attention deficit hyperactivity disorder, autism spectrum disorder, developmental language impairment, learning disabilities, and intellectual disability, tic disorders). Notably, many of the supervisors on the Pediatric Neuropsychology rotation have special expertise in care for patients with rare genetic diseases that have neurodevelopmental or neurodegenerative sequelae. Psychiatric disorders such as depression, anxiety, and conduct disturbances (especially in children with comorbid medical conditions) and somatoform disorders are also commonly assessed. Diagnostic evaluations typically consist of a day-long (or occasionally a multi-day visit) to the Pediatric Neuropsychology Clinic where the interviews, testing, and feedback occur in the same day.
As part of the diagnostic process, interns organize and integrate information about patients and families including medical and neurological data, neuropsychological assessment data, educational information, interview observations, and other data and related history. The focus is on neurocognitive functioning as well as behavioral and emotional aspects of children’s functioning. Both environmental and biological factors are considered in evaluating children in the Pediatric Neuropsychology Clinic. Interns refine skills involving neuropsychological assessment and assessment of emotional and social development through interviews, objective measures, and behavior observations. Interns are supervised closely on every case. Interns receive direct case supervision to promote formulation of diagnostic impressions and treatment recommendations. Interns then participate in feedback meetings in which the results of assessments are communicated to parents. Interns prepare chart notes documenting patient visits, complete formal neuropsychological reports for patients’ medical records, participate in case management, and consult appropriately with physicians and other involved professionals.
Many patients with neurological and neurodevelopmental difficulties are monitored periodically by a pediatric neuropsychologist. This is especially true for patients who are required to take medications and for patients whose interventions require periodic reassessment. Because the M Health Fairview Masonic Children's Hospital is a tertiary care center, monitoring treatments of rare and complicated disorders (including transplants/gene therapies, epilepsy surgery, brain tumors, and experimental medications) is also conducted as part of both clinical and research protocols. Also, emphasis is placed on providing consultation regarding educational planning with educators adn schools.
Opportunities to learn about brain-behavior relationships from a developmental standpoint are abundant in informal and formal contexts on the Pediatric Neuropsychology rotation. Interns attend a didactic seminar in neuropsychology and present cases at the Pediatric Neuropsychology group staffings. The neuropsychology seminar includes didactic presentations by the neuropsychology staff or invited guest lecturers, as well as test conferences, Masonic Institute for the Developing Brain colloquia, and interdisciplinary meetings with Developmental Behavioral Pediatrics residents/fellows. Attendance at Grand Rounds for the Department is optional.
Research opportunities are varied in the Pediatric Neuropsychology rotation. Ongoing studies address childhood inherited metabolic diseases, effects of bone marrow transplants, social-emotional development in various populations, and a variety of other topics. A sizable minority of interns participate in a research project or a case study during the year, either independently or as part of a larger ongoing project led by one of their supervisors. Research participation is not a requirement for interns as many are focused on completing their dissertations.
Interns are expected to complete approximately three neuropsychological evaluations per week while on the Pediatric Neuropsychology rotation. Days not in clinic allow interns time to attend training activities, devote attention to clinical management issues, and participate in other professional activities, such as psychotherapy or research. On the Pediatric Neuropsychology rotation, interns have the opportunity to work with all (or nearly all) of the participating supervisors on the rotation.
Postdoctoral fellowships in Pediatric Neuropsychology are sometimes available through the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN) Resident Matching Program following the internship year. Several interns have remained within the Pediatric Neuropsychology Division as postdoctoral fellows after completing the internship.
Italics designate the primary supervisor for each rotation.
Italics designate the rotation training director
The Pediatric Psychology rotation is in the Division of Clinical Behavioral Neuroscience of the Department of Pediatrics. Through consultation, therapy, and neuropsychological assessment, we focus on developmental and psychosocial aspects of pediatric patients. Because a variety of social, educational, psychological, and medical factors contribute to children’s total well-being, interns on the Pediatric Psychology rotation participate and work cooperatively with many subspecialty services within the Department of Pediatrics. The interdisciplinary approach is utilized because the behavioral, psychological, psychosocial, and medical problems are affected by children’s stages of development and often are too complex to be resolved by any single professional or discipline.
Interns on the Pediatric Psychology rotation provide consultation, therapy, and neuropsychological evaluations. Various educational and didactic opportunities are offered at the rotation, internship, and departmental levels. In addition to interns, the Pediatric Psychology rotation also provides training for practicum students and post-doctoral fellows. Collaborative research projects with Pediatric Psychology faculty members are available but not required.
Services Provided: Interns on the Pediatric Psychology rotation can expect that clinical work will be split between providing intervention (~4-6 hours per week) and neuropsychological evaluations (~2 per week).
- Outpatient therapy related to chronic disease management
- Consultation (primarily on outpatient basis with medical teams)
- Parent training and family management of chronic disease
- Adolescent Bariatric and Metabolic Surgery preparation program
- Neuropsychological Evaluations
Patient Populations: Patients are referred to the Pediatric Psychology program from the MHealth Fairview system, as well as from the community for a broad range of psychological concerns. We often serve patients who are managing acute and chronic diseases. Interns will work with patients who range in age from preschool to young adulthood, as we often support the transition from pediatric to adult care.
Patients are commonly referred for consultation or ongoing therapy from the following groups:
- Pediatric Pain and Palliative Care
- Pediatric Weight Management Clinic
- Endocrinology (e.g., Type 1 and Type 2 Diabetes)
- Pre- and post-transplant
- Various other subspecialties treating chronic diseases (e.g., pulmonology, gastroenterology, rheumatology, neurology)
Patients commonly referred for neuropsychological evaluations have the following:
- Fetal Alcohol Spectrum Disorders and other prenatal substance exposure
- Metabolic and Genetic Disorders (e.g., PKU, galactosemia)
- Pre- and post-solid organ transplant (kidney, liver, heart)
- Long-term follow-up of former NICU patients
- International or domestic adoption
Didactics and Supervision: Interns participate in at least 2 hours of scheduled individual supervision each week, as well as rotation-specific group supervision for assessment and therapy each week. We also have one rotation-specific didactic presentation each week covering a variety of topics related to pediatric psychology and pediatric neuropsychology.