The Adult 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, behavioral, cognitive-behavioral, and interpersonal therapies, both brief and long-term, are emphasized.
The Adult 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. The program offers an opportunity to gain experience providing supportive and therapeutic interventions to individuals with medical concerns, through the Psychosocial Oncology and Consultation-Liaison rotations. The intern may also select 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
Clinical work with minority and culturally diverse populations
The Adult 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.
Adult Anxiety Clinic ROtation
The Adult Anxiety Clinic Rotation provides outpatient individual and group assessment and psychotherapy for adults experiencing anxiety-related disorders including Generalized Anxiety Disorder, Social Phobia, Specific Phobia, Obsessive Compulsive Disorder, and Post Traumatic Stress Disorder. 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. The rotation is directed by Dr. Shona Vas.
Adult Psychiatry Consultation-Liaison Service Rotation
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.
Psychosocial Oncology Rotation
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.
Third Wave Behavior Therapies Rotation
The 3rd Wave Behavior Therapies Rotation is directed by Dr. Julia Wernke who provides an hour of weekly individual supervision. During this rotation, interns provide outpatient assessment and therapy using mindfulness and acceptance-based therapies. Interns will also become familiar with other “third-wave” behavior therapies including Dialectical Behavior Therapy (DBT). Additionally, interns will engage in guided reading assignments accompanied by some experiential exercises. This experience may only be offered as a “mini” rotation.
Sleep Disorders Rotation
We hope to be able to offer a Sleep Disorders Rotation facilitated by Dr. Lisa Medalie, a newly hired clinical psychologist in the Department of Medicine. This rotation is in the process of being developed. We expect that activities will include the assessment and treatment of patients with sleep disorders, specifically, insomnia. Trainees will become proficient at providing CBT for insomnia (CBT-I) and improving patients’ CPAP compliance, 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.