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Contents

Overview
Seattle Community
Program Description
Rotation Descriptions (to print)
Frequently Asked Questions
Application Instructions and Selection Process(to print button)
Training Faculty
2009-2010 Internship Cohort

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This website was last updated 10/02/09

Overview

Welcome to the website for the University of Washington Psychology Internship Program! This website is designed to provide prospective applicants and others with an introduction to our training program. Please explore the web site to learn about training opportunities and application requirements. For additional information please contact Joan Romano, Ph.D., Psychology Internship Training Director at psyintrn@u.washington.edu or Mary Horton, M.Ed., Program Coordinator at 206-543-7576 or hortom2@u.washington.edu.

The University of Washington Psychology Internship program was founded in 1961 with the goal of providing excellent clinical, didactic, and research training firmly rooted in the scientist-practitioner tradition. The program has been continuously accredited by the American Psychological Association (APA) since 1965, and has built a strong national reputation as a leading medical school-based internship, providing training in general adult psychology, general child psychology, and behavioral medicine/health psychology. Our faculty includes nationally recognized researchers and clinicians with a strong interest in teaching and clinical training. Our program is strongly committed to advancing diversity in the recruitment and training of psychology residents.

The University of Washington's predoctoral internship program is accredited by the American Psychological Association (APA). (The APA Office of Program Consultation and Accreditation can be reached at 750 First Street NE, Washington, D.C. 20002-4242 or by phone: 202-336-5979). Our internship program provides intensive training in psychology under the auspices of the University's School of Medicine. The program involves three medical centers (The University of Washington Medical Center, Harborview Medical Center, and Children's Hospital and Regional Medical Center) and their affiliated programs and clinics. Administrative oversight for the internship program is provided by the Department of Psychiatry and Behavioral Sciences.

The Internship program operates within a very active research context which offers an especially stimulating environment for psychology residents who are considering clinically relevant academic and/or research careers. The Internship program has a membership in the Academy of Psychological Clinical Science, which is associated with the American Psychological Society. The Academy of Psychological Clinical Science is a coalition of training programs that share a common goal of producing and applying scientific knowledge to the assessment, understanding, and amelioration of human problems. The University of Washington School of Medicine ranks first among all public universities in the amount of federal research funds received.

Our psychology resident selection process is weighted strongly toward applicants whose training, experience, and academic accomplishments indicate potential for both clinical and research excellence. For example, no applicants from professional school programs have been accepted to our program in the last decade. Successful applicants typically show evidence of scientific contribution, such as publications, presentations, and research activity. They also demonstrate evidence of a high degree of clinical competence and experience in assessment and therapy. We especially welcome applicants who have a combination of excellent clinical skills, strong research interests and potential, and well-developed interpersonal and communication skills that will allow them to flourish in a multidisciplinary environment. Our goal is to provide the highest quality training for residents in a supportive and stimulating academic medical center environment.

The University of Washington Psychology Internship utilizes a scientist-practitioner training model. It is a "generalist" program that permits additional emphasis in adult and child psychology and behavioral medicine. Training sites include medical and psychiatric inpatient and outpatient settings.

The internship program offers:

• Assessment: Training in the assessment of behavioral, cognitive, social, and psycho-physiological factors related to behavioral disorders, medical and neurological illness, and normal functioning.

• Intervention: Supervised experience with a wide variety of therapeutic interventions that may involve individuals, couples, families, or groups with an emphasis on empirically supported treatments.

• Consultation: Opportunities to develop the consultative and communication skills needed for doing professional work in interdisciplinary health care settings.

• Behavioral Medicine: Training opportunities in rehabilitation psychology, primary care, and consultation-liaison with medical-surgical inpatient and outpatient services.

• Research: Research activity is very strongly encouraged. Opportunities are provided to increase sophistication in the design and performance of clinical research, usually by collaborating on ongoing faculty projects. Independent projects can be pursued with faculty support.

• Grantsmanship: An interdisciplinary research training series of seminars providing didactic and experiential training in grant writing skills under the mentorship of faculty members.

• Education: A yearlong series of required didactic presentations and journal clubs. Special seminars and tutorials may be arranged. In addition, a spectrum of scheduled courses, colloquia, grand rounds, workshops, and conferences is available throughout the University.

• Diversity training: Diversity advancement is a strong priority for the program. Diversity issues are integrated into didactic, clinical and research training, and there is a committee devoted to advancing diversity issues within the internship. Many internship rotation sites provide opportunities to work with diverse populations, with many immigrant and minority groups represented. As a measure of this diversity of clientele the UW affiliated medical center interpreter services provides interpreters for over 80 languages.

Application Requirements and Procedure

The internship program begins on July 1. By then, applicants must have completed at least three years of graduate study (a minimum of 1000 hours of practicum work should be accrued at the time of application). Applicants must be in good standing in an APA or CPA accredited, scientist-practitioner Ph.D. program in clinical, counseling, or "combined" psychology. Because our selection process is weighted toward applicants showing promise of future academic and/or clinical research careers, applicants from programs that are primarily geared toward training practitioners are less competitive. The program also prefers applicants who have completed comprehensive examinations and who have defended, or have made substantial progress on their dissertation by the time they begin internship. Because of this program's diversity and its geographic dispersion, it is best suited for individuals who are well organized, self-reliant, and adaptable. Completed applications must be received by November 1.

An interview is not a required part of the application process. However, All Tracks will offer appointments the afternoon of the Open House to give applicants the opportunity to meet with Faculty. (For details see Application Instructions).

Applicants under consideration who wish to familiarize themselves with our program are strongly encouraged to attend an Open House on January 5, 2010, where they can acquaint themselves with many of our training faculty, talk to current psychology residents, and visit training sites. Attendance at this Open House is not required for admission to the program. Initial applicant ratings will have been done prior to the Open House. We notify all applicants of their status by December 15th; only applicants still under consideration are invited to the Open House. Visits to our program may be arranged at times other than the Open House, but they yield less exposure to our faculty and facilities than at the Open House. Our selection process is driven primarily by the application materials. If you have specific questions about the training program, please e-mail the Training Director, Joan M. Romano Ph.D. psyintrn@u.washington.edu). Or e-mail the Faculty track coordinator any questions you have about the different tracks.

Adult Track: Debra Kaysen, Ph.D. dkaysen@u.washington.edu.

Behavioral Medicine/Neuropsychology Track: Dave Patterson, Ph.D. davepatt@u.washington.edu

Child Track: Rose Calderon, Ph.D. rose.calderon@seattlechildrens.org

You can also e-mail general questions to the Psychology Internship Program Coordinator, Mary Horton, M.Ed. at hortom2@u.washington.edu

Information of Interest to Minority Applicants

We strive to have classes that vary in terms of geography, age, socioeconomic background, gender, and race/ethnicity. The training faculty have diverse interests, personal, and professional backgrounds. The program facilitates supportive, collegial connections between psychology residents and faculty. In the larger University and School of Medicine community, there are a number of resources and events specifically for minority students. (See Office of Multicultural Affairs - School of Medicine) (See Diversity Advancement Committee)

Based on the 2000 census, about 73% of Seattle's population was White, followed by Asian/Pacific Islander-12%; African-American-5%; Native American-1%; Other-3%; about 6% endorsed being of Hispanic ethnicity. As noted in the rotation descriptions, some rotations specifically serve minority communities; others are representative of Seattle's ethnic diversity (e.g., most Harborview sites); and others are relatively less diverse (e.g., most fee-for-service sites, such as the Outpatient Psychiatry Clinic associated with University of Washington Medical Center). Seattle is a community known to be welcoming of other forms of diversity including a large and active gay, lesbian, bisexual, and transgendered community.

Internship training faculty would be pleased to speak with applicants further about any particular resources or aspects of the Seattle community that are of interest.

Information of Interest to Applicants with Disabilities

Applicants with disabilities are encouraged to apply to our program. In the past, we have accommodated psychology residents with a variety of physical disabilities, including disabilities requiring manual and motorized wheelchair accessibility. The Disabled Student Services Office coordinates special services made available to residents, including a variety of university services, equipment, and publications. Special services from the Department of Rehabilitation Medicine's Assistive Technology Resource also are available. The University of Washington Medical Center's Rehabilitation Medicine and Rehabilitation Psychology Divisions are internationally known, and collaborations between students and faculty members are regarded to be mutually beneficial. The internship program offers experience in working with patients who have a variety of physical disabilities.(Disability Services Office) (Access Guide)

Stipend and Benefits

The stipend for our psychology resident cohort is $24,000 plus non-retirement eligible benefits (includes medical, dental, and life insurance). Psychology residents receive eleven days of vacation, five days of professional leave, and accrue one day of sick leave per month. Because residents are here, for one year only, they are not eligible for leave under the Family Medical Leave Act. However, personal vacation can be taken for family medical emergencies. www.washington.edu/admin/hr/.

The University of Washington reaffirms its policy of equal opportunity regardless of race, color, creed, religion, national origin, sex, sexual orientation, age, marital status, disability, or status as a disabled veteran or Vietnam era veteran in accordance with University policy and applicable federal and state statutes and regulations. Further information regarding these policies and statutes may be obtained through the University of Washington Equal Opportunity Office website at: http://www.washington.edu/provost/ap/eoaa/

The University and the Health Sciences Center

The University of Washington was founded in 1861 on a 10-acre site in what is now downtown Seattle. In 1895, it was moved to its present 660 acres on the shores of Lake Washington. It now offers instruction in more than 200 academic disciplines. Approximately 35,000 students are enrolled. The School of Medicine of the University of Washington was established by the state legislature in 1945. The Medical School is centered in the Health Sciences complex on the University campus. Clinical teaching programs are conducted at the University of Washington Medical Center and in affiliated hospitals and clinical facilities throughout the city and the Pacific Northwest.

Further information about the University can be found at http://www.washington.edu

The Seattle Community

The Puget Sound region, which includes Seattle, is a region of impressive natural beauty with its snowcapped mountain ranges, lakes, rivers, and lush evergreen forests. Seattle and the surrounding areas enjoy a relatively mild climate throughout the year. Average high temperature through November and February is 47 degrees, with an average temperature of 72 degrees between the months of June through August. The average annual rainfall is 36 inches, which is lower than several cities across the U.S. (e.g., Washington DC, New York, Boston, Chicago). SPAN: Seattle Public Access Network The official website for the City of Seattle: Visitor, Citizen and Business information, Municipal Directory, other WA State links. Washington Trails Association Hiking guide, Signpost magazine, outdoors reports.

Natural recreational attractions vary widely, with an abundance of national, state, and city parks. The city of Seattle is the multicultural center of the Pacific Northwest, richly preserved in the architecture, art, and cuisine of the area. Seattle has many nationally recognized performing arts (ballet, opera, symphony, museums and theatre), and attractions (Space Needle, Pike Place Market, The Experience Music Project, Seattle Art Museum, Seattle Asian Art Museum) that contribute to its unique cultural identify. A range of professional (Mariners, Super Sonics, Seahawks, the Storm) and college (University of Washington Huskies) sporting events are active throughout the year. Seattle's educational facilities, both public and private, are excellent. In higher education, the metropolitan area supports six community colleges and five four-year colleges and universities.

For more information about the city of Seattle and the surrounding community, please refer to the following links:

www.seattleinsider.com/partners/seeseattle, www.seattlechamber.com,

http://www2.cityofseattle.net/GIS_Map/sub.asp?topic='Recreation'

http://www.ci.seattle.wa.us/html/VISITOR/festival.htm,

http://www.ci.seattle.wa.us/html/visitor/arts.htm

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Program Description

Orientation and Rotation Selection

Psychology residents are oriented to the training program during the first two days of the internship. Then, in consultation with the training track coordinators, residents indicate their preferred rotation sequences. Depending on the track, rotations can range in length from three to six months. When possible, residents are assigned to rotations so they have a planned, graduated experience across rotations. For example, a resident's first rotation may be in a more familiar setting; rotations in less familiar settings may occur later in the year.

Not all rotations will necessarily be offered every year. Psychology residents are assigned to those rotations that have space and funding available. Access to rotations that do not provide support is occasionally possible.

Organization of the Training Track System

The internship training program is a generalist program but offers three emphasis tracks:

1. General Adult Psychology
2. General Child Psychology
3. Behavioral Medicine/Neuropsychology

Rotations are primarily located at the University of Washington Medical Center (UWMC), Harborview Medical Center (HMC), and Seattle Children's Hospital (SCH).

Detailed descriptions of each rotation are included in the section below entitled Rotation Descriptions.

Outline of the Training Tracks:

1. General Adult Psychology. (APPIC/NMS program code = 161913)

Track Coordinator: Debra Kaysen, Ph.D. - dkaysen@u.washington.edu

A. University of Washington Medical Center

1. Inpatient Psychiatry
2. Outpatient Psychiatry Center

B. Harborview Medical Center

1. Consultation-Liaison Service

This track is designed to allow residents to experience broad-based psychological work with adults including assessment and intervention with medical and psychiatric patients on both an inpatient and outpatient basis. The three four-month long clinical rotations and sites are listed above.

2. General Child Psychology. (APPIC/NMS program code = 161912)

Track Coordinator: Rose Calderon, Ph.D. - rose.calderon@seattlechildrens.org

A. Seattle Children's Hospital (SCH)

1. Inpatient Psychiatry
2. Consultation/Liaison
3. Neuropsychological Consultation Service
4. Child and Adolescent Outpatient Psychiatry Program

The child track placements are at Seattle Children's Hospital (formerly Children's Hospital and Regional Medical Center). The overall goal of this track is to provide a resident with experiences of broad-based psychological work with children and families including assessment and intervention, short and longer term intervention, work with inpatients and outpatients, medical and psychiatric patients. Attention is paid to the integration of science and practice. Each resident will participate in the four core rotations; Inpatient Psychiatry (IPU), Consultation/Liaison (C/L), Neuropsychological Consultation Service (NP), and Child and Adolescent Outpatient Psychiatry.

3. Behavioral Medicine/Neuropsychology. (APPIC/NMS program code =161914)

Track Coordinator: David Patterson, Ph.D. - davepatt@u.washington.edu

A. University of Washington Medical Center

1. Inpatient and Outpatient Spinal Cord Injury Rehabilitation
2. Inpatient and Outpatient Neurologically Impaired Rehabilitation
3. Outpatient Chronic Medical Conditions Rehabilitation
4. Neuropsychological Assessment and Consultation

B. Harborview Medical Center

1. Rehabilitation Psychology

a. Burn Unit and Rehabilitation Psychology Consultation Liaison
b. HMC Inpatient/Outpatient Rehabilitation Rotation

Psychology residents in this track receive training in rehabilitation psychology, neuropsychology and health psychology. The University of Washington Medical School is internationally known for its contributions in the area of rehabilitation medicine. Psychology residents trained in this rotation have been competitive for positions in applied behavioral medicine settings.

Program Evaluation and Supervision

At the beginning of each rotation, the psychology resident completes a self-assessment of his/her experience relative to the rotation learning objectives to focus the resident and the supervisor on the resident's needs. The self-assessment helps the supervisor try to tailor the resident’s experience on each rotation to be planned and graduated to fit the resident’s training needs. Progress will be monitored throughout the rotation. At the end of each rotation, the supervisor fills out an evaluation on the resident similar to the resident's self-assessment form. The psychology resident completes an evaluation of each supervisor and an evaluation of their experience at each rotation site. All evaluations are sent to the internship office. Copies of the resident evaluations are sent to the resident and their mentor. Copies of the resident evaluations of the supervisors are sent to the supervisor. Copies of the rotation evaluations are sent to the rotation coordinator and the track coordinator. All evaluations are reviewed by the director of the internship program before copies are sent out. The resident evaluations are summarized at the end of the year in a letter by the resident's mentor, to their graduate training program, to communicate our assessment of the resident’s progress during the year.

Each resident receives at least four hours of supervision each week, at least half of which is individual supervision. Many rotations also offer additional structured learning opportunities such as case conferences, interdisciplinary conferences, opportunities to observe faculty interviews or ongoing treatment with patients, and so forth.

Lectures and Seminars

Every psychology resident participates in a required weekly didactic lecture-seminar series. This series is comprised of modules such as professional and ethical issues, diversity issues, diagnosis and assessment, supervision, consultation-liaison, empirically supported therapies, and psychopharmacology. The content of didactics varies with the changing needs and interests of the residents and faculty. Subjects have included interviewing and diagnostic skills, community psychology, therapeutic methods, neuropsychology, treatment of populations with diverse cultural and personal values, and interprofessional relationships. In addition, journal clubs in each track meet once a month: general adult psychology, general child psychology, behavioral medicine/neuropsychology, as well as, the diversity journal club. Psychology residents are expected to attend ten journal clubs during the course of the year; they can of course attend as many as interest them. The journal clubs meet at various times, as arranged by the coordinator of each journal club.

Psychology residents may attend one or more elective seminars such as: Hypnosis and Psychotherapy, (Joseph Barber, Ph.D.)or Dialectical Behavior Therapy for Borderline Personality Disorder (Kate Comtois, Ph.D.) or residents may also join the psychiatry residents in seminars on Interpersonal Psychotherapy or Cognitive-Behavioral Therapy taught by various members of the regular and clinical faculty on a rotating basis. Residents are encouraged to attend lectures in the University of Washington community, including the Department of Psychiatry and Behavioral Sciences Grand Rounds (Department of Psychiatry and Behavioral Sciences).

Theoretical Orientation

Overall, the faculty psychologists use empirically supported assessment and treatment, with most frequently a cognitive-behavioral orientation. Most of our psychiatrists who provide adjunct supervision on many inpatient and C/L rotations have a more biological orientation. Interpersonal and psychodynamically oriented supervision also is available.

Additional Internship Opportunities

(1) Research

Psychology residents may apply to participate in a year long program and seminar on research skills and grantsmanship training. Participation in this activity includes the provision of 6 hours per week of release time from clinical rotations to participate in a seminar devoted to teaching skills needed for developing and writing grants, and to pursue development of a grant proposal or research project under the mentorship of an internship faculty member. Participation in the program is most appropriate for those residents who have either completed or are in the latter stages of their dissertation research, are interested in research areas that can be mentored by faculty members of the internship and are looking towards career choices in which grant writing skills will be needed. Residents are not required to participate in the seminar program.

Psychology residents not participating in the grantsmanship seminar program may apply for one half-day (4 hours) of release time, per week for research (including dissertation research) with an internship training faculty supervisor.

(2) Committee Membership

Several committees are actively involved in the planning and organization of the internship training program. Psychology residents typically volunteer for these committees, or are elected by their fellow residents at the beginning of the year. Listed below are current committees available for resident participation.

(a) Didactic Planning Committee (Co-Chair Jeanne Hoffman, Ph.D. and Kelly Schloredt, Ph.D.)
Functions: To review, revise, organize and plan didactic modules for the following internship class.
Resident Participation: Two to four residents serve on the committee which meets in the Spring. Residents work with various faculty members and obtain feedback from fellow residents in the planning and scheduling of prospective didactic modules with specific didactic presentations.

(b)Diversity Advancement Committee (Chair: Steven Vannoy, Ph.D., MPH)
Functions: To provide training of residents and faculty on issues of individual and cultural diversity as these relate to theories and methods of assessment, diagnosis, and effective intervention; consultation, supervision, and evaluation, and research methods/design. (This diversity training includes: ethnic minorities, gender/sexual orientation, physical disabilities, SES,age, and others). To serve as a resource "hub" of information (clinical and social service resources, research, lectures, and expertise at the University of Washington and surrounding community) on diversity issues for everyone involved in the internship. To recruit and retain diverse residents, fellows, faculty, and speakers as well as those interested in diversity issues.
Resident Participation: All interested residents are encouraged to participate on the committee which remains active throughout the internship year. Residents work with regular and allied faculty members, as well as representatives from the local community.

(c) Professional Development Committee (Chair: Dawn Ehde, Ph.D.)
Functions: To provide guidance, information, and support to the residents during the internship year. Example activities that this committee sponsors include a Career Fair, Post-Doctoral Fellowship Fair, Mentoring, and opportunities to practice job talks.
Resident Participation: At least two residents serve on the committee each year who provide a crucial link to the resident class. The resident representatives play an active role in shaping the focus of the committee’s work in that particular year.

(d) Steering Committee(Chair: Joan Romano, Ph.D.)
Functions: To assist in the administration, planning, organizing, and functioning of the overall internship training program.
Resident Participation: Each of three residents serves on the committee for four months. The committee meets once every two months. Residents work with other residents, track coordinators, various faculty members, and psychologists in the local community in overseeing the administrative functioning of the internship training program.


(3) Post-Internship Opportunities

A number of post-doctoral positions at the University of Washington are available every year. Psychology residents who become productively involved with research and who exhibit superior clinical performance may compete successfully for these positions. UW-affiliated post-doctoral fellowships in psychology are typically available through the Departments of Psychiatry and Behavioral Sciences, Rehabilitation Medicine, Anesthesiology, Psychology, School of Nursing, School of Social Work, and School of Dentistry. The Psychology Internship DOES NOT administer these post-doctoral fellowships. Prospective psychology residents who would like to discuss post-doctoral training possibilities should contact Joan Romano, Ph.D. (psyintrn@u.washington.edu). Alternatively, some residents opt to pursue postdoctoral positions at other Universities, entry-level faculty positions, or other positions, such as Research Scientists. Listed in the following Table is a summary of positions held by recent graduates of the internship training program.

Rotation Descriptions

This section provides a more detailed description of the training emphasis tracks, and available rotations by institution. Not all rotations will necessarily be offered every year. These descriptions are organized according to the three emphasis tracks in the internship training program. For additional information about a particular rotation, please contact the person whose last name appears in parentheses.

I. GENERAL ADULT PSYCHOLOGY TRACK)(APPIC/NMS program code = 161913)

Current General Adult Track Psychology Residents

A. University of Washington Medical Center

1. Inpatient Psychiatry (Steven Vannoy , PhD, MPH)

2. Outpatient Psychiatry Center (Debra Kaysen, PhD)

Rotation Description & Patient Demographics
The University of Washington Psychiatry Outpatient Center (UPOC) is an outpatient psychiatry clinic staffed by faculty and residents in psychology and psychiatry. It serves a predominantly middle and lower middle class population. Patients come from diverse ethnic and cultural backgrounds and sexual orientations. Patients present with a broad range of clinical problems, including mood, anxiety, adjustment and personality disorders.

The UPOC is located approximately five blocks west of the main campus of the University of Washington and approximately 10 blocks from the main School of Medicine complex. The clinic has a large waiting room, faculty offices, several examination and blood draw rooms, and therapy rooms assigned to psychology residents. Three rooms are equipped with videotape capability; portable audiotape equipment, and mobile VCRs/monitors are available for faculty and resident use. Computers are available in each clinic room, providing access to the scheduling and computerized medical chart systems, e-mail and the Internet.

Training Experiences & Treatment Modalities
The educational model of the UPOC emphasizes an empirically supported scientist-practitioner approach to psychological assessment and treatment. The psychology faculty have specialized training in evidence based cognitive-behavioral therapy, interpersonal therapy for depression, and dialectical behavior therapy for borderline personality disorder.

Resident Expectations & Supervision
The UWPOC rotation will be conducted on a full time basis for a period of four months. The training objectives of the UPOC are designed to foster the acquisition of a broad generalist experience from among the following activities:

a. Treatment: Individual psychotherapy comprises the majority of the clinical caseload, although periodically, couple and group therapy experiences are available. In coordination with the UPOC Triage Team, attempts are made to match residents' preferences for particular training experiences. For example, residents may elect to have the majority of their caseload devoted to anxiety related disorders. Considerations of differential diagnosis, case conceptualization, and treatment planning continuously evolve over the course of care. UPOC supervisors are generally, but not exclusively, cognitive-behaviorally oriented. Training books, manuals, video and audio tapes, and validated measures of therapist adherence and competence in specific treatments may be used to facilitate feedback and learning by the psychology resident. A typical caseload for each day will involve approximately four to five hours of direct clinical contact.

b. Assessment: Psychology residents can administer a range of self-report indices in the outpatient clinic or refer/consult with the UWMC for more comprehensive assessment batteries (e.g., neuro-psychological assessment). The decision to obtain testing and, if so, which tests, is made in consultation with the supervisor on a case-by-case basis. In this way, residents learn the indications for testing and the clinical utility of testing results in treatment planning. Psychology residents with specific assessment or treatment interests can obtain specialized supervision by qualified members of our clinical faculty.

c. Research: Participation in specialty clinical treatment and research programs involving anxiety and mood disorders, behavioral medicine, couples therapy, substance abuse, and sexual dysfunction are available. Psychology residents are encouraged to consult with their supervisors regarding ways to facilitate research interests during their internship year.

d. Supervision: Psychology residents will receive individual supervision with one of the attending psychologists. They will also participate in a 1 hour per week combined psychology and psychiatry resident clinical case conference, moderated by the UPOC training faculty. The case conference is a combination of didactic presentations, readings and faculty/peer consultations.

B. Harborview Medical Center

1. Consultation-Liaison (C/L) Service (Barbara McCann, PhD)

Training Experiences & Treatment Modalities
This service is a very active service with many new consults per day. Individuals on the team will have the opportunity to assess and develop brief treatment plans for patients who are medically ill, need suicide assessment, are delirious or need evaluation for decisional capacity. Treatment plans are often also directed, toward how the service requesting the consultation may be better able to manage the patient. Unique cases are often seen, including varying types of somatization disorders (e.g.,factitious disorder). In addition, there is a high rate of traumatic injury and substance abuse seen in patients at HMC and residents receive training in brief, motivational interventions. Psychology residents will also have the opportunity to see approximately 3 to 4 outpatients per week through the Behavioral Medicine Clinic. The Behavioral Medicine Clinic receives referrals from the various primary and specialty care services affiliated with the hospital.

Resident Expectations & Supervision
The team on this rotation includes psychiatry and psychology faculty, two or three psychiatry residents, one psychology resident, and often medical students. The HMC C/L faculty specialize in areas ranging from PTSD and HIV to Borderline Personality Disorder. Residents receive two hours per week of individual supervision on the C/L service, and an additional 1 hour per week of individual supervision for their Behavioral Medicine Clinic patients. Residents also receive on-going group supervision with the C/L team.

II. GENERAL CHILD PSYCHOLOGY TRACK (APPIC/NMS program code = 161912)

Current General Child Track Psychology Residents

A. Seattle Children's Hospital (Formerly Children's Hospital and Regional Medical Center (CHRMC))
Department of Psychiatry and Behavioral Sciences-Division of Child and Adolescent Psychiatry

1. Inpatient Psychiatry (Rose Calderon, PhD)

2. Neuropsychological Consultation Service (David Breiger, PhD)

Rotation Description & Patient Demographics
The Neuropsychological Consultation Service provides evaluations to most clinics in the hospital, including Psychiatry, Neuro-oncology, Neurodevelopmental, and Neurology. Neurodevelopmental disorders frequently seen include autism, ADHD, learning disabilities, and mental retardation. In addition, children are seen before neurosurgical intervention and during treatment and follow-up of brain tumors.

Training Experiences & Treatment Modalities
Psychology residents are primarily affiliated with the Neuropsychological Consultation Service. In addition, residents participate in the Learning Disorders Clinic which provides an interdisciplinary evaluation of children and adolescents with learning problems. The resident is involved in the neuropsychological assessment of a wide age range of children, and becomes familiar with a number of commonly used neuropsychological assessment instruments. The psychology resident will become competent in using a structured interview to gather developmental and diagnostic information from parents. The resident is involved in consultation with schools and in reporting results to parents, referral sources, and treatment teams.

Resident Expectations & Supervision
Interdisciplinary consultation, information gathering from a variety of sources, and integration of psychosocial, medical, neuropsychological data requires that the psychology resident be well-organized and adaptable. Through supervision and directed readings, the resident is exposed to different theoretical approaches to pediatric neuropsychology.

Evaluation of Psychology Residents
Psychology residents participate in standard evaluation practices that are part of the overall internship which includes self-evaluation, evaluations by their supervisors, resident evaluation of their supervisors and resident evaluation of the rotation site.

3. Consultation/Liaison (C/L) (Elizabeth McCauley, PhD)

4. Child and Adolescent Outpatient Psychiatry Program (Matthew Speltz, PhD)

III. BEHAVIORAL MEDICINE/NEUROPSYCHOLOGY TRACK

(APPIC/NMS program code = 161914)

Current Behavioral Medicine/Neuropsychology Residents

A. University of Washington Medical Center Department of Rehabilitation Medicine
(Kristy Brewer Sherman, PhD, Jeanne Hoffman, PhD, Mary Pepping, PhD, ABPP-CN and Myron (Moe) Goldberg, PhD, ABPP-CN)

B. Harborview Medical Center Department of Rehabilitation Medicine (David Patterson, PhD)

General Rotation Description & Patient Demographics
Behavioral Medicine/Neuropsychology rotations provide training in medical psychology and are comprised of three areas: Inpatient Rehabilitation (Bombardier), Outpatient Rehabilitation (Ehde), and Rehabilitation Consultation and Burn Unit (Patterson and Wiechman-Askay). These rotations are described in greater detail below, after the rotations have been described more generally. An important aspect of these rotations is understanding the role of clinical psychologists within an interdisciplinary team framework and within a health care delivery system. Psychology residents work with multidisciplinary teams that include physicians, nurses, speech pathologists, physical therapists, occupational therapists, social workers, and vocational counselors. This rotation provides abundant opportunities to apply psychological principles in a medical setting with patients experiencing a variety of medical conditions.

Patients are commonly admitted to HMC due to trauma or acute illness. Psychology residents typically work with patients who have sustained traumatic brain injury, cerebral vascular accidents, spinal cord injuries, severe burn injuries, and multiple traumas. Patients come from diverse backgrounds in terms of ethnicity, socioeconomic status, and geographical location. The Burn Unit provides residents with extensive experience in pediatric consultation and liaison. Psychology residents have access to IBM computers for report-writing, and dictation experience is offered. A shared, on-site office space is provided.

Training Experiences & Treatment Modalities
The mission of the psychologists at the Harborview Medical Center (HMC) rotation is to provide primary psychological care for inpatients on the Rehabilitation Medicine and Burn Units as well as patients followed by the Outpatient Rehabilitation Medicine Service. Also, consultations are provided for inpatients on Neurosurgery, Orthopedic Surgery, Neurology, General Medicine, Intensive Care Units, and occasionally on the Psychiatric units. Psychology residents on the HMC rehabilitation psychology rotation therefore are exposed to a wide variety of consultation and liaison experiences and learn to work on interdisciplinary medical teams in both inpatient and outpatient settings. Harborview Medical Center is a Regional Level I Trauma Center serving five states with a highly diverse patient mix. Psychologists play a prominent role in the care of these patients. This rotation provides a unique opportunity to work with a multiethnic patient population and to obtain training from psychologists who regularly integrate clinical and research activities. It also gives the experience of providing psychological services in a fast-paced, intense, but extremely collegial environment.

Psychology residents work closely with a variety of medical and adjunctive medical disciplines such as physical therapy, occupational therapy, speech pathology, nursing, social work, rehabilitation counseling, and therapeutic recreation. Surgery and rehabilitation medicine physicians are our two most prominent medical colleagues. HMC rehabilitation psychologists must rely on treatment modalities that fit well into the trauma setting. As such, there is a heavy emphasis on consultation/liaison, brief psychotherapy, and focused assessment. Behavioral and cognitive-behavioral frameworks are used frequently. More traditional psychotherapy is practiced through the outpatient rehabilitation and burn clinics as well. Training in hypnosis for pain control and motivational enhancement therapy for substance abuse is available. The psychologists often rely on a systems approach in which the patient is evaluated and treated within the context of the interdisciplinary health care team and family. Assessing and treating team behaviors is often essential to assisting the patient.

Psychology residents at HMC rehabilitation first undergo a group orientation session with tours of the facility. Residents then accompany and observe an attending psychologist doing clinical work. Based on the residents' level of comfort they are then provided with the opportunity to see patients under visual supervision. As the comfort level of residents' further progresses, supervision increasingly takes the form of CO-treatment or face-to-face review of cases. Group supervision meetings are held on a weekly basis as well as individual sessions with each of the psychologist supervisors. Generally there is a minimum of two hours of individual supervision a week, although psychology residents are encouraged to page the supervisors with day-to-day questions about the patients. A psychology resident handbook is provided that contains extensive reading materials pertaining to the patient populations served and resident clinical responsibilities. Model reports, structured evaluation formats and practical clinical care guidelines are also included. Psychology residents typically attend multidisciplinary Rehabilitation and Burn Unit rounds, thereby becoming familiar with the work of other professionals. They continue to attend the regular internship didactics through this rotation as well as specialized seminars for rehabilitation.

The rotations at Harborview are as follows:

1. Burn Unit and Rehabilitation Psychology
Consultation Liaison Residents on this service are actively involved in a thriving psychology consultation service that provides treatment for the majority of the services in a regional, level 1 trauma center. The main focus of this rotation is the Burn Unit, which is world famous and provides interdisciplinary care on an inpatient and outpatient basis. Frequent clinical issues include facilitating adjustment to burn injuries, managing acute pain, assessing for reactions to trauma, and behavioral management. One third of the patient population on the Burn Unit is pediatric and residents are given the opportunity to work with children. Training with hypnosis is available and often emphasized on this service.

Residents on this rotation spend roughly half their time on the Burn Unit and the other half doing consultation on most units of the hospital. Patients are commonly seen on the Neurosurgery, Neurology, Orthopedics, Medicine, and Surgery units. Clinical work with such patients often involves assessment and treatment after multiple traumas. This service differs from Psychiatry Consultation/Liaison in that the emphasis is on adjustment to physical trauma and brief psychotherapy as opposed to Psychiatry's emphasis on suicide assessment, treatment of psychosis, and pharmacologic treatments. The services differ enough so that residents can rotate through both and receive different types of training.

2. HMC Inpatient Rehabilitation
For the inpatient rehabilitation aspect of the rotation (Dr. Bombardier) residents are the first line consultants to the medical, nursing and therapy team members regarding the assessment and treatment of psychiatric disorders, substance abuse disorders, adherence to treatment issues, and overall adjustment to injury or disease. Residents learn about common cognitive, behavioral, and psychological conditions associated with traumatic injuries such as brain injury and spinal cord injury as well as neurological conditions such as stroke and aneurysms. They learn how to help patients, their loved ones, and rehabilitation team members cope more effectively with the rehabilitation process. The rotation emphasizes brief assessment and treatment skills, behavior management, motivational interviewing, basic psychopharmacology, and consultation skills. Interested residents may also learn to interpret and report on results from a brief cognitive assessment battery

3. HMC Comprehensive Outpatient Rehabilitation Program (CORP)
On the outpatient side of the rotation, residents will similarly function as an integral member of an interdisciplinary outpatient rehabilitation medical team that serves outpatients with neurological conditions (brain injury, stroke, spinal cord injury), chronic pain, and other medical/surgical conditions such as amputations. Residents provide a range of psychological services including psychological assessment, consultation, and psychotherapy. Psychotherapy is typically short-term (4-12 sessions) and problem-focused. Residents work with the family as well as the patient, consult to team members and community agencies, and utilize neuropsych test results in treatment planning. Residents will also have the opportunity to observe and Co-lead group interventions (stress management, pain management).

General Resident Expectations & Supervision
HMC rehabilitation psychologists seek to train residents in a scientist/practitioner model. In addition, psychology residents learn to provide assessments and treatment within a primarily medical context. Thus our objective is that residents completing this rotation are comfortable in medical settings in general, as well as rehabilitation and burn unit placements specifically. General skills that are taught during this rotation include clinical assessment of people with disabilities, DSM IV diagnosis, behavioral management, hypnosis for pain control, brief interventions for psychological distress related to medical conditions/grief, brief interventions for substance abuse problems, working with adult and pediatric patients with burns, and working with families of people who have had trauma or disability.

What follows are some general expectations. The activities described below are dependent on what HMC Rehabilitation rotation the resident chooses. Psychology residents are generally expected to be responsible for eight inpatient beds on the rehabilitation medicine unit. Residents provide an initial comprehensive psychological evaluation on each of their rehabilitation patients. Clinical responsibilities with such patients include seeing the patients once a week and combining their input with those of a multidisciplinary team during weekly rounds. Psychology residents are also expected to attend the burn unit psychosocial rounds each Monday morning and to respond to whatever consults are generated during those rounds. After evaluating patients with burns, residents then report to the general medical team rounds held once or twice weekly on the burn unit. Psychology residents also provide consults on several different floors throughout the hospital. Residents generally follow two to three outpatient therapy cases throughout the rotation. Outpatient residents are expected to carry a caseload of 8-12 patients, attend outpatient team rounds, collaborate with multidisciplinary team and participate in groups. Psychology residents participate in standard evaluation practices that are part of the overall internship which includes self-evaluation, evaluations by their supervisors, resident evaluation of their supervisors and resident evaluation of the rotation site. Residents and supervisors exchange verbal feedback at the mid-rotation point. Written and verbal feedback is exchanged at the end of the rotation. In addition, residents are provided with feedback throughout the rotation based on observations of treatment, as well as participation in multidisciplinary team rounds. Training is provided by four attending psychologists (faculty within the Department of Rehabilitation Medicine) and, frequently, one or two postdoctoral fellows. At least two hours of individual supervision per week is provided by psychology faculty, with additional supervision offered on an as-needed basis. One hour per week of group supervision is provided.