The Adult/Health Psychology Track emphasizes training in general clinical work with medical and psychiatric populations. The intern on this track will have the opportunity to develop competency in working with patients with and without primary psychopathology, who range in age from early adulthood to older adults, and who represent diverse social, economic, cultural, and ethnic backgrounds. Opportunities for psychological and neuropsychological assessment exist within this track. Although track faculty endorse a variety of theoretical orientations, cognitive-behavioral, acceptance-based, and interpersonal therapies, both brief and long-term, are emphasized.
The Adult/Health Psychology track has particular strengths in clinical service concerning therapy outcome, including the efficacy of pharmacological and cognitive-behavioral approaches to treating substance use disorders, depression, anxiety, and other disorders of emotional and behavioral dysregulation, including more severe mental illness. The program offers an opportunity to gain experience providing supportive and therapeutic interventions to individuals with medical concerns, through the Psychosocial Oncology, Consultation-Liaison, Transplant, Health Psychology, Weight Management, Surgical Treatment of Obesity, and Behavioral Sleep Medicine rotations. We also offer a Training and Administration rotation to introduce our interns to providing clinical supervision and developing an understanding of the administration involved in psychology training. The intern may also elect to do an outside rotation from one of the other tracks in order to obtain breadth in their training experience.
Adult psychology services are also provided to traditional psychiatric outpatients, and patients who require support and rehabilitation for neuropsychological and chronic psychiatric conditions. Services are provided to patients adjusting to acute medical crises as well as those managing chronic medical conditions. Many of these patients are referred by other members of the Department, in addition to University of Chicago faculty physicians outside the department, or are self-referred and specifically seeking treatment from a University of Chicago specialty clinic.
Interns will have the opportunity to develop their skills in the following clinical activities:
Consultation to medical inpatient services and outpatient clinics
Provision of CBT to patients with primary mood and behavioral disorders
Collaboration with health care providers and psychiatrists
Psychological and neuropsychological assessment of outpatients, and assessment of inpatient concerns in collaboration with the Medical Psychiatry team
Psychological treatment with chronically medically and psychiatrically ill patients
Psychological assessment and treatment of undergraduate and graduate students at the University of Chicago
Clinical work with minority and culturally diverse populations
The Adult/Health Psychology Track has a number of elective seminars, that are typically required given the particular rotation an intern may be undertaking, but that are open to all interns as well. These are often connected with a specialty rotation (e.g., the Consultation/Liaison Conference, Anxiety Team Meeting, Clinical Neuroscience Series).
Specific clinic rotations offered within the Adult Psychology Track are detailed below:
The Addictions Rotation will provide the intern with experience in chemical and behavioral addictions through assessment and therapy experiences in the newly formed Addiction, Compulsivity, and Impulsivity Disorders (ACID) research clinic, an interdisciplinary team led by Drs. Jon Grant and Andrea King. The intern will learn a variety of therapeutic approaches and semi-structured manuals using cognitive-behavioral, motivational enhancement and twelve-step techniques, as well as supportive counseling. There may also be an opportunity to assist the clinical psychologist in the ACID clinic who consults with the liver transplant program in assessment of substance use and other modifiable risk factors to determine appropriateness for surgery and post-transplant recovery. In the outpatient ACID clinic, patients present with alcohol or substance dependence disorders and/or behavioral addictions including pathological gambling disorder, sex, and stealing. The intern can customize his/her experience in terms of emphasis on diagnostic assessment, therapy, or clinical research depending on interest, background, and availability. Smoking cessation training via Courage to Quit® (www.lungchicago.org) may also be available. The intern will be supervised weekly and participate in team meetings on a regular basis. Didactics may include a one-day training session at the Respiratory Health Association of Metropolitan Chicago, directed readings and viewing of videotapes of the Motivational Interviewing and other clinical training series, and a review of culturally competent treatment approaches as the patient population is diverse. There are ample opportunities for research experiences, if desired, as part of the training rotation, or as a separate research rotation. This rotation is directed by Dr. Andrea King and also Dr. Jon Grant.
The Adult Anxiety Clinic Rotation provides outpatient individual and group assessment and psychotherapy for adults experiencing anxiety, obsessive-compulsive, and trauma/stressor and-related disorders. Presenting diagnoses in the clinic Panic Disorder, Agoraphobia, Generalized Anxiety Disorder, Social Anxiety Disorder,Specific Phobia, Obsessive-Compulsive Disorder, Hoarding Disorder, Body Dysmorphic Disorder, Disorders involving Body-Focused Repetitive Behaviors, Posttraumatic Stress Disorder, Acute Stress Disorder, and Adjustment Disorders. , Treatment is provided from a cognitive-behavioral perspective, using empirically supported approaches. However, patients may also learn skills taught as part of acceptance-based approaches, for example, dialectical behavior therapy (DBT) in a group format. The intern will conduct diagnostic evaluations, provide individual therapy, and co-facilitate one or more time-limited psychotherapy groups for different disorders. In addition, the intern will have the opportunity to gain experience in providing clinical supervision for advanced graduate students who are also training in the clinic. The intern on this rotation will receive one hour of individual supervision each week, and will carry a caseload of 3-4 individual patients. This rotation requires participation in a weekly multidisciplinary team meeting that addresses patient care as well as appropriate didactic training. Members of the team include Drs. Shona Vas, Emil Coccaro and Jon Grant, third year psychiatry residents, third year medical students, and psychology interns and externs. The rotation is directed by Dr. Shona Vas.
The Adult Psychiatry Consultation-Liaison Service Rotation provides consultation and acute management services to University of Chicago Medicine inpatients across the varied medical, surgical, and obstetrical care services. Delirium, depression, adaptation to illness, and co-occurring psychiatric disorders are the most common reasons for referral. The intern on this rotation can participate in biopsychosocial evaluations of referred patients and have the opportunity to offer psychotherapeutic services at the bedside with acutely ill patients. The intern will typically see a broad array of cases from general medical or surgical services, but can focus on particular areas of interest, such as burns, organ transplants, cancer, neurological conditions, or cardiac disease. The Director of the Adult C-L Service is Dr. Marie Tobin, and Dr. Amy Siston provides additional clinical supervision as necessary. Dr. Michael Marcangelo provides clinical supervision for care of patients who are seen through the Transplant Service.
The intern electing to complete the Psychosocial Oncology Rotation will provide assessment, consultation, and treatment for individuals with newly diagnosed cancer, individuals in active treatment, cancer survivors, individuals at genetic risk for cancer, and family members when appropriate. Psychology services are available for cancer patients in the outpatient oncology clinics, as well as for those individuals with acute problems who are hospitalized. The intern will also provide consultation to oncology staff regarding issues important to the care of cancer patients. Supervision by Dr. Amy Siston will take place weekly and the intern will participate in multidisciplinary team meeting three times a month. Monthly didactics are provided and include topics such as end of life issues, sexuality and relationships, and cognitive-behavioral methods used in oncology. The intern is also expected to attend weekly cancer tumor board meetings for cancers of the breast and head and neck.
The Severe Mental Illness Rotation will provide training in the fundamentals of cognitive-behavioral therapy for adults with severe mood, anxiety, and psychotic disorders. The intern will gain experience in: intensive treatment for adults with Obsessive-compulsive Disorder, including exposure and response prevention (ERP); group cognitive-behavioral therapy for adults with depressive and anxiety disorders; and individual therapy for adults with bipolar and psychotic disorders. The intern will receive one hour of weekly individual supervision from Dr. Lindsay Brauer, and carry up to 2 cases outside of intensive and group sessions.
The Liver Transplant Clinic will be offered as a mini-rotation (approximately 4-5 hours/week) directed by Dr. Daniel Fridberg. Interns on this rotation will have the opportunity to work with a multidisciplinary team (surgeons, hepatologists, gastroenterologists, nurses, social workers, psychologists, and psychiatrists) to develop knowledge and skills pertaining to the psychosocial assessment of candidates for liver transplantation. Interns will receive referrals to see transplant candidates for psychological evaluations and will assist the team in assessing candidates’ psychiatric history and appropriateness for transplant. Liver transplant candidates at the University of Chicago are diverse in terms of race, sex, socioeconomic background, and sexual orientation. Patients may experience a number of complications attributed to advanced liver which may warrant hospitalization and contribute to the medical complexity of this population. In addition, confusion or altered mental status due to hepatic encephalopathy, depression, anxiety, and substance abuse concerns are common in these patients. Interns will learn to conduct semi-structured psychological screenings to identify psychosocial barriers to transplantation which would benefit from further assessment or intervention. Opportunities to provide time-limited brief interventions (e.g., motivational enhancement, CBT) to address these issues may exist depending on candidate need and eligibility. Interns will provide feedback on the assessment to transplant candidates and will facilitate referrals to other providers as needed. Interns will be expected to provide the treatment team with verbal feedback and recommendations after evaluating a transplant candidate, as well as complete a written evaluation which will be entered into the candidate¹s medical record.
The Chicago Weight Clinic Rotation is supervised by Dr. Shona Vas. Interns will have the opportunity to work in a multi-disciplinary (endocrinologists, diabetes educators, dieticians, exercise physiologists, and nurses) clinic setting to develop knowledge and skills in delivering integrative psychological care to patients presenting to an endocrinology clinic focused on weight management. Primary medical complaints include obesity and diabetes management issues, though patients typically present with a number of other medical co-morbidities (e.g., PCOS, thyroid disease, etc.) that may be of clinical relevance as well. Interns conduct a semi-structured psychological screening to identify any mental health concerns which might interfere with health promoting behaviors and would benefit from further psychological assessment or intervention. Focused and time-limited cognitive-behavioral interventions (no more than 5 sessions) are provided if appropriate. Should longer-term psychological care be indicated, interns provide feedback to the patient and facilitate referrals as needed. Interns are expected to provide the treatment team with verbal feedback and recommendations after screening a patient, as well as complete a brief written report. Interns may also have the opportunity to develop and implement approved empirical research in collaboration with other health professionals to investigate questions related to obesity, diabetes, and/or weight management as they relate to various psychological outcomes.
The Center for the Surgical Treatment of Obesity (CTSO) provides psychological services to adults seeking bariatric surgery at the University of Chicago Medical Center (http://www.uchospitals.edu/specialties/minisurgery/bariatric). The intern will receive training in conducting brief psychological evaluations of potential surgery candidates and in the follow-up of patients who undergo bariatric surgery. The intern will work closely with a multidisciplinary team of surgeons, dieticians, nurses, and clinical psychologists. Training includes didactics, training in assessment procedures for reliability, and supervision of clinical work. A monthly support group for patients is also co-led by the intern. Additional group programs, including a stress management group and the PREP (preoperative readiness) group are also commonly led by the intern, and available as opportunities for training. This rotation is directed by Dr. Andrea Goldschmidt and is supported by Kristen Anderson, LCSW.
The Health Psychology Rotation is directed by Dr. Nancy Beckman and provides at least one hour of weekly individual supervision. Interns will also assigned readings to enhance their understanding of psychological issues common to specific medical conditions, as well as ethical, diversity, and other issues encountered in health psychology settings. During this rotation, interns provide outpatient assessment and therapy to patients with comorbid medical and mental health conditions. Therapy is focused on helping patients make positive health behavior changes and navigate changing identity and relationship issues for improved symptom management and quality of life. This rotation will emphasize the application of cognitive behavioral therapy, as well as motivational enhancement, mindfulness, biofeedback-assisted relaxation training, and will require consultation with other members of the patient’s medical team. Interns will also have the opportunity to help design and implement group therapy for patients with chronic illness. Opportunities for research in collaboration with other health professionals, brief screening, and brief therapy within the outpatient medical clinics may also be available.
The Training and Administration Rotation is designed to help interns develop foundational skills in the provision of supervision, medical student education, and activities relevant to clinical psychology training in an academic medical center. Interns will provide weekly supervision to a psychology extern and will review audiotapes of therapy sessions. Interns will then receive supervision of their supervision experiences, provided by Dr. Shona Vas who will review audiotaped supervision and provide feedback and instruction to promote supervision competencies. Supervision training in this rotation is largely influenced by a developmental model of supervision, and interns will become proficient in identifying levels of development of a supervisee and adapting supervisory behaviors as appropriate to each level of development. Interns will be introduced to the responsibilities and roles maintained by the Director of Clinical Training and will develop an understanding of relevant regulatory requirements of a psychology training program. Interns will learn about policies and procedures related to intern recruitment and selection, trainee and supervisor evaluation, budgeting, and program coordination in an academic medical center setting. The intern may also be involved in the development and implementation of at least one quality improvement project to gain skills in needs assessment, operationalization, relevant data collection/analysis, and final implementation. Finally, interns may have the opportunity to provide lectures/seminars to medical students, residents, and other medical professionals, allowing them to develop skills in communication across medical disciplines.
The Adult Behavioral Sleep Medicine Rotation directed by Dr. Lisa Medalie includes assessment and treatment of patients with Insomnia and other behaviorally related sleep disorders such as Nightmare Disorder, Circadian Rhythm Disorder, Inadequate Sleep Hygiene, and Night Eating Syndrome. .Interns will become familiar with interpretation of sleep lots and actigraphy. They will become proficient at providing Cognitive-Behavioral Therapy for Insomnia (CBT-I), consulting to medical professionals whose patients have sleep disorders, participating in multidisciplinary clinics and providing referrals as necessary.
At the end of the internship year, interns in the Adult Psychology Track will have mastered the following specific competencies:
Assessment and intervention skills suitable for improving the functioning of psychiatric and medical patients, both via individual and group intervention formats.
Use of cognitive-behavioral and interpersonal approaches to the evaluation and treatment of major mood and anxiety disorders, personality disorders, chronic mental illness, neuropsychological disorders, disorders of emotional and behavioral dysregulation, and psychological aspects of medical conditions.
Knowledge and competence in the use of empirically supported treatments for major Axis I and Axis II disorders.
Cultural competence in working with an ethnically and socially diverse urban population.
Capacity for consultation to other health professionals including physicians and social workers using a multi-disciplinary approach.
Exposure to and familiarity with all aspects of clinical research including development, implementation, analysis and dissemination of results.