Adult/Health Psychology Track

 Adult/Health Psychology Track

 We will recruit two interns for the Adult/Health Psychology Track which emphasizes training in general clinical work with medical and psychiatric populations. This track is an appropriate fit for interns who have interests in general and specific areas of emotional and behavioral dysregulation, interns who are aspiring health psychologists, and for interns who seek to integrate these areas by becoming familiar with the varied clinical presentations seen in a rich academic environment. Interns 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 evidence-based theoretical orientations, cognitive-behavioral and acceptance-based 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 cognitive-behavioral and pharmacological approaches to treating substance use disorders, depression, anxiety, trauma, obsessive-compulsive spectrum, and other disorders of emotional and behavioral dysregulation, including more severe mental illness. These rotations include the Adult Anxiety Clinic, the Additctive, Compulsivity and Impulsivity Disorders Clinic, Severe Mental Illness, and Obessive-Compulsive and Related Disorders Clinic. 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, Pain, Integrated Primary Care, Weight Management, Surgical Treatment of Obesity, Behavioral Sleep Medicine , and Reproductive Health rotations. We also offer a Training and Administration rotation to afford our interns more focused exposure to clinical supervision and to developing an understanding of the administration involved in psychology training. Interns 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, UCM providers outside the department, or are self-referred and specifically seeking treatment from a University of Chicago specialty clinic. Interns are embedded in the Adult section of the department and will interact with other providers with multiple contexts. Services offered by psychology interns include assessment, psychotherapy, consultation, and provider education. The Adult/Health Psychology Track has a number of elective seminars and treatment team activities that are typically required depending on the intern's particular rotation choices.

Specific clinic rotations offered within the Adult/Health 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, Andrea King, and Daniel Fridberg.  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. Daniel Fridberg with support from Drs. Andrea King and 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 include 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. Yasmin Asvat offers supervision specifically for psychotherapeutic services for oncology patients. 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 and individuals at genetic risk for cancer. The intern may also have the opportunity to work with patient caregivers, families and partners/spouses. Psychology services are available for cancer patients in the outpatient oncology clinics, utilizing a co-located care model. Cancer patients may also be seen during inpatient hospitalization. The intern will also provide consultation to oncology staff regarding issues important to the care of cancer patients. Interns have the option of selecting from two concentrations: 1) Sexual Health of cancer patients and survivors, supervised by Dr. Amy Siston or 2) Behavioral Symptom Management, supervised by Dr. Yasmin Asvat. While all interns will see a variety of cancer patients with diverse presenting problems, based on their concentration of choice, their case load will include at least 2-3 patients with either sexual health or behavioral symptom management needs. Supervision will take place weekly and the intern will participate in multidisciplinary supportive oncology team meeting weekly.  Monthly didactics are provided and include topics such as end of life issues, sexuality and relationships, and evidence-based interventions used in oncology (e.g., CBT, ACT, Meaning-centered psychotherapy).  Scheduling permitting, the intern also has the opportunity to attend weekly multidisciplinary tumor board meetings.

The Severe Mental Illness Rotation will provide training in the fundamentals of cognitive-behavioral therapy for adults with severe mood, anxiety, and psychotic disorders who require more intensive treatment than once weekly outpatient care. Interns may also elect to develop an Obsessive Compulsive and Related Disorders (OCRD) Rotation. In these rotations, interns 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 Transplant Psychology 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, nephrologists, gastroenterologists, nurses, social workers, psychologists, and psychiatrists) to develop knowledge and skills pertaining to the psychosocial assessment of candidates for kidney or 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. Transplant candidates at the University of Chicago are diverse in terms of race, sex, socioeconomic background, and sexual orientation. Candidates present with kidney or liver disease for which transplantation may be indicated, and vary considerably in terms of progression of their illness. Patients may experience a number of complications attributed to their illness 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 interviews 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. Andrea Busby.Interns in this rotation will have the opportunity to work in a multi-disciplinary (endocrinologist, psychologist, dietician, and nurses) clinic setting to develop knowledge and skills in delivering integrative psychological care in a medical setting.  The clinic is a satellite clinic of University of Chicago Medicine located in downtown Chicago at 150 E. Huron Street. The primary presenting problem for all patients will be obesity, although patients typically present with a number of other medical co-morbidities (e.g., diabetes, PCOS, thyroid disease, etc.) that may be of clinical relevance.  Interns will work collaboratively with Dr. Busby to provide psychological/lifestyle assessments and cognitive behavioral treatment for obesity and related conditions. Interns will first observe, then conduct semi-structured interviews to identify any behavioral or psychological concerns which might interfere with health behavior change. Individual and/or group-based cognitive-behavioral interventions are then provided as appropriate. Based on each patient’s needs, follow-up sessions are typically provided every 1-4 weeks, and need for treatment is re-assessed every 6 months. In addition to cognitive-behavioral treatment for obesity, cognitive behavioral treatment for binge eating disorder, depression, and anxiety is provided as appropriate; Motivational Interviewing and acceptance-based strategies are also used as needed. Interns are expected to provide the treatment team with verbal feedback and recommendations after each intake interview, as well as complete a psychological assessment report. The Chicago Weight rotation is offered as a full rotation (8-10 hours per week) only.

The Eating Disorders Program Rotation, directed by Dr. Jennifer Wildes, provides evidence-based assessment and treatment services to patients with anorexia nervosa, bulimia nervosa, binge eating disorder, and other feeding and eating problems (e.g., avoidant restrictive food intake disorder, purging disorder). Interns are embedded in an interdisciplinary treatment team that includes psychologists, psychiatrists, social workers, and medical staff with expertise in the outpatient management of feeding and eating disorders. Responsibilities include conducting initial intake assessments and providing psychotherapy utilizing cognitive behavioral (individual and group), dialectical behavioral, and family based treatment modalities. Interns also are expected to attend weekly rounds and didactics meetings and have the option of attending a weekly eating disorders research meeting. A separate eating disorders research rotation is available, if desired. For interns in the Adult/Health Psychology track, the caseload will consist primarily of college students and adults with eating disorders.

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. Jennifer Wildes and is supported by staff social worker, Christine Daemicke.

The Health Psychology Rotation is directed by Dr. Nancy Beckman and can be either a half or full rotation.  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, acceptance and commitment therapy, and mindfulness. It will require consultation and communication 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.  The Health Psychology rotation is designed to provide broad exposure to various presentations of comorbid medical and mental health conditions, though it can be shaped, depending on an intern’s interest and patient availability, toward a particular patient population (e.g., GI disorders or chronic pain). In contrast to brief treatments often provided in health psychology settings, this rotation is designed to provide depth as interns expand their knowledge and ability to apply evidence-based treatments for mood, anxiety, and other disorders to include medically-oriented concerns. Dr. Beckman provides at least one hour of weekly supervision for interns in this rotation. Opportunities for research in collaboration with other health professionals, brief screening, and brief therapy within other outpatient medical clinics may also be available. 

The Integrated Primary Care Rotation is directed by Dr. Nancy Beckman. This can be either a half or full rotation.  Interns who choose the primary care clinic rotation will gain experience working in the fast-paced, multidisciplinary, primary care setting.  Interns will see scheduled patients for assessment and brief intervention and receive warm hand-offs for same day consultations.  Through this experience, interns will learn to conduct a rapid, focused assessment to identify relevant behavioral health concerns and clarify the presenting problem.  Interns will learn to collaboratively identify short-term behavioral goals to target prioritized problem areas and deliver evidence-based treatment, up to 5 sessions.  Treatments are mainly drawn from cognitive behavioral therapy, acceptance and commitment therapy, and motivational interviewing.  Interventions may include psychoeducation, motivational enhancement, problem-solving, behavioral activation, cognitive restructuring, exposures, relaxation training, assertive communication, etc.  Should longer-term psychological care be necessary, interns provide feedback to the patient and primary care physician and facilitate referrals as needed. Interns are expected to provide the treatment team with verbal feedback and recommendations after screening same day patients, as well as complete written reports.  Interns will also learn about administrative, physician education, and other implementation issues related to behavioral health integration.  In collaboration with other health professionals, interns may also have the opportunity to be involved in research related to behavioral health integration. Interns on this rotation receive live supervision during clinic and one hour of scheduled, weekly supervision. They also attend one weekly primary care didactic and team meeting.

The Pain Clinic rotation is directed by Dr. Nancy Beckman and can be either a half or full rotation. Interns on this rotation gain experience working with patients with varied chronic pain presentations in a multidisciplinary setting. Interns will learn more about chronic pain, its impact, and treatment, as well as goals of improving functional outcomes and ways to assist patients and physicians in efforts to reduce medication use.  Interns will see patients for evaluations and deliver evidence-based, time-limited treatment using cognitive behavioral therapy, motivational enhancement, acceptance and commitment therapy, and mindfulness techniques.  In addition to individual therapy, interns will also help develop and lead a 6-8 week pain management group.  Evaluations can involve presurgical psychological assessments for spinal cord stimulators, occipital nerve stimulators, and intrathecal pumps, as well as comprehensive psychological pain evaluations.  Interns will work closely with pain clinic staff and maintain clear communication around patient care.  Interns will participate in interdisciplinary pain management meetings and will receive live supervision in clinic, as well as one hour of weekly scheduled supervision. In collaboration with other health professionals, interns may also have the opportunity to conduct a research related to pain management.

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 recorded supervision sessions 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. The primary emphasis of this experience is learning to assess and treat insomnia with a secondary emphasis on other behavioral sleep issues (e.g., circadian rhythm disorders, insufficient sleep syndrome, poor CPAP adherence). Interns become proficient in the provision of CBT for insomnia (CBT-I). Options to add training in sleep medicine and learn about sleep apnea and CPAP compliance are also available. Some exposure to other behaviorally-based sleep disorders such as nightmares, nocturnal panic, and night eating syndrome might be available.

The Reproductive Health Psychology Rotation emphasizes training in assessment, diagnosis, and treatment of mood and behavior disorders, and psychosocial contributors to reproductive health risks and disorders in adolescent girls and women. The intern electing to complete the Reproductive Health rotation will provide assessment, consultation, and brief treatment for girls and women presenting for a variety of issues related to reproductive health. Psychology services are available for girls and women in outpatient and gynecology (OBG) clinics, as well as for those individuals with acute problems are hospitalized. The intern will also carry a small caseload of anxiety, trauma, and fertility issues. The intern provides ongoing consultation to obstetrics and gynecology providers about shared patients and the psychosocial contributors to their reproductive health and wellness. Supervision by Candice Norcott 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 trauma-informed care, gender-responsive services, psychosocial aspects of abortion, abortion ethics, end of life issues, sexuality and relationships, and cognitive-behavioral methods used in oncology. The intern is also expected to attend weekly MacLean Center's Ethics Series.