TRAINING PROGRAM IN CLINICAL PSYCHOLOGY WITH AN EMPHASIS ON PEDIATRIC PSYCHOLOGY

    

Children’s Hospital of Michigan
APA- Accredited Predoctoral Internship Program,
 Match Number 136211

PROGRAM REQUIREMENTS

(Numbers below identify rotations described in Rotations Section) 

OPTIONAL ROTATIONS AND ELECTIVES

CLINICAL PSYCHOLOGY WITH AN EMPHASIS ON PEDIATRIC PSYCHOLOGY TRAINING PROGRAM.  Program Match Number: 136211

1. ROTATION REQUIREMENTS, GOALS, AND DESIRED  COMPETENCIES

The Clinical Psychology Internship with an emphasis on Pediatric Psychology consists of two six-month rotations: (1) Hospital Rotation, and (2) Outpatient Rotation.  There are four interns; two complete the Hospital Rotation first and two complete the Outpatient Rotation first.  Intern preferences are taken into account in determining the order of completion of the rotations.  Throughout the year, the interns also maintain 3-4 hours of therapy per week (4-6 cases to maintain 3-4 hours), complete one inpatient consultation per week, and attend the following didactic seminars: Neuropsychology, Pediatric Psychology, and Core Professional Issues Seminar.   The interns receive approximately two hours per week of individual supervision and three hours per week of group supervision (pediatric psychology, child therapy, and family therapy supervision seminars).  The track their supervision on written monitoring sheets reviewed by the Director of Training monthly. The intern can tailor the program to meet specific training goals, in addition to the general goals outlined below.  For example, a recent intern has a strong interest in developmental disabilities.  This intern was able to find several developmental disability treatment cases, conduct AD/HD and neuropsychological evaluations of developmentally disabled children, do inpatient consultations on developmentally disabled children, and see a great number of such children in the Myelomeningocele, Endocrinology, and Diabetes Clinics.   Two years ago another intern tailored her program to meet her desire to gain experience with oncology patients.  Three years ago, an intern wanted to tailor her Neuropsychology experience to take her strong interest in ADHD into account; she arranged to do executive functioning assessments of children suspected of having ADHD in place of certain aspects of the standard Neuropsychology rotation.

 

HOSPITAL ROTATION

Description:

The interns each attend three or four medical specialty clinics.   Two of the four interns are assigned to each of the following blocks of clinics: (1) asthma, myelomeningocele, HIV or (2) renal, diabetes, endocrinology, and sickle cell.   Children enrolled in these clinics are seen regularly by a multidisciplinary team of health care professionals, including physicians, nurses, psychologists, social workers, dietitians, physical and occupational therapists, and recreational therapists.  The exact composition of the team varies from clinic to clinic.    Interns are assigned to a clinic block based upon preference, background, and supervisor judgment.   The intern learns to provide ongoing evaluation, consultation, and interventions regarding the impact of the specific illnesses upon the child’s functioning in school, in the family, and with peers.  Medical compliance and adjustment to chronic illness are two of the most prevalent issues.  Training and supervision is “hands on” in the sense that the supervisor models conducting the interview with the child and family, then observes the intern conducting the interview, and gradually fades out his/her presence over the course of the rotation.  By the end of the rotation the intern is conducting the interview without the supervisor in the room.  In most clinics the intern and supervisor participate in team meetings reviewing the status of the patients seen in the clinic.  Interns then write brief reports of their patient contacts.

On the consultation liaison service, the intern responds to requests from hospital pediatricians to address the behavioral/ emotional problems of children admitted to Children’s Hospital for medical problems.   At first, the intern watches the supervisor conduct the consult.  Then, the intern conducts the consult while the supervisor observes and gives feedback.  By the middle of the year, the intern conducts the consult without the supervisor present and reviews the case with the supervisor afterwards.

Consultation requests include chronic illness adherence and adjustment issues, pain management, conversion and somatoform disorders, differential diagnosis of psychopathology, and family/ environmental concerns.  Many of these consults are for patients whom the interns have previously seen in the multidisciplinary clinics, allowing them the opportunity to learn about continuity of care from inpatient to outpatient settings.

During this rotation, the intern will accomplish the following goals and objectives and develop the following competencies:

Goal 1: Develop intermediate skills in understanding issues related to the treatment and prevention of illness in children and adolescents.

Objective A: Develop familiarity with models of coping with chronic illness and differentiate normal coping with chronic illness from psychopathology.

Objective B: Demonstrate a basic understanding of specific illnesses and their treatment regimens, including relevant cognitive and emotional issues.

Objective C: Identify the psychological factors associated with the prevention, treatment, or management of physical health behaviors.

Objective D: Demonstrate intermediate skills in interviewing children and families in medical specialty clinics, conceptualizing their problems, and giving them feedback and intervention suggestions.

Goal 2: Develop intermediate to advanced skills in working with multidisciplinary teams in a family-centered care model.

Objective A: Demonstrate respect for opinions and information provided by other disciplines, such as medicine, nursing, dietary, and social work.

Objective B: Demonstrate the ability to seek out information from family and team members and integrate it into assessment and treatment plans and reports.

Objective C: Demonstrate the ability to provide feedback to family and team members in  a constructive manner.

Objective D: Demonstrate primary and secondary prevention skills to promote health and reduce risk in a multidisciplinary clinic.

Goal 3: Develop intermediate to advanced consultation- liaison skills.

Objective A: Demonstrate intermediate to advanced skills in investigating a consultation request, obtaining information from medical charts and medical/ nursing staff, and deciding how to proceed to complete the consultation.

Objective B: Demonstrate intermediate to advanced skills interviewing children and families and formulating a working diagnosis and treatment plan.

Objective C: Demonstrate intermediate to advanced skills in verbal and written communication of the diagnostic and treatment plans to parents, physicians, nurses, and other allied health professionals working with the children.

 

OUTPATIENT ROTATION

Description:

The interns participate in five activities: (1) pediatric neuropsychology (6 months), (2) ADHD Clinic (3 months), (3) Rehabilitation Services (3 months), (4) autism clinic (6 months), and (5) inpatient consultation liaison (6 months).

 The interns spend 20 hours per week in pediatric neuropsychology.  They learn to select and administer neuropsychological test batteries to children and adolescents with various neurologic disorders.  They have the opportunity to observe intracarotid amobarbital procedures, language and motor mapping, and participate in multidisciplinary team evaluations of children undergoing epilepsy surgery.  They learn to write comprehensive neuropsychological test reports and conduct inpatient neuropsychological consultations.

 The interns spend five hours per week in ADHD Clinic.  They participate in evaluations of children and adolescents suspected of having ADHD, learning, and behavior problems.  They administer and score a variety of tests and rating scales, and conduct differential diagnostic interviews with parents and children.  The supervisor is always in the room with the intern during the differential diagnostic interviews, and feedback is given on the spot.  The interns also learn to write comprehensive evaluation reports, with a particular emphasis on helping families advocate for school-based services.  Interns who wish to learn how to conduct adult ADHD evaluations can exercise this option for several of their cases.

 During the Rehabilitation Rotation, the intern conducts consultation, follow-up, brief therapy, and assessment of children hospitalized for traumatic brain injury, orthopedic problems, spinal cord injuries, spina bifida, and other rehabilitation issues.  The intern participates in the daily activities of the multidisciplinary teams on the inpatient Rehabilitation unit.

 In autism clinic, interns participate in comprehensive assessments of children suspected of having autism and/or developmental disabilities.  They have the opportunity to become acquainted with common measures used to assess pervasive developmental disorders and developmental disabilities.  They participate in formulating and recommending educational and behavioral interventions for the children whom they have evaluated.

 Interns will have the opportunity to attend school conferences and IEP Meetings to advocate for their patients during this rotation.  Supervision will be provided to prepare for school meetings.

 The intern continues to conduct one inpatient pediatric consultation per week during the Outpatient Rotation.

 During the fourth to sixth months of this rotation, the intern may elect to do either a 20 hour per week rotation or a 10 hour per week elective.  The available rotations and electives are listed earlier in this website.  The Research Elective is a new addition to the internship; this involves establishing a collaborative research relationship with a faculty member and either working in the faculty members’ ongoing research or developing a small research project in a similar area of research.  For example, one intern arranged to work both with Dr. Ellis analyzing a portion of the data from her treatment trial of Multisystemic Family Therapy for diabetic youth and with Dr. Robin validating a measure of family interaction with youth who have Spina Bifida.  A 20 hour rotation will replace Neuropsychology for these three months, while a 10-hour elective will reduce Neuropsychology time.  The intern will attend autism, rehabilitation, and ADHD Clinics as outlined above.

 During this rotation, the intern will accomplish the following goals and objectives and develop the following competencies:

Goal 1: Develop competency in assessment.

Objective A: Demonstrate intermediate to advanced skills in selecting, administering, and interpreting the following types of psychological measures:

1. Tests of intelligence and measures of child development

2. Tests of academic achievement

3. Empirical measures of child behavior problems

4. Tests of visual-motor skills

5. Measures of attention

6. Measures of adaptive behavior

7. Rating scales

8. Measures of health behavior

Objective B: Demonstrate beginning to intermediate skills in selecting, administering, scoring, and interpreting tests of neuropsychological abilities, including:

1. Verbal and visual memory

2. Receptive language tests

3. Expressive language tests

4. Problem solving tests

5. Processing efficiency measures

6. Manual motor tests

Objective C: Demonstrate intermediate to advanced interviewing skills for the purposes of:

1. Gathering a psychosocial history.

2. Conducting a differential diagnostic interview.

3. Formulating a case based upon interview data.

4. Making an appropriate diagnosis using DSM-IV and/or DSM-PC.

Goal 2: Identify appropriate assessment methods and techniques for diverse populations and different types of psychopathology, incorporating cultural and individual diversity in this process.

THERAPY ACTIVITIES

The intern conducts therapy for 3-4 hours per week, which usually necessitates carrying 4-6  therapy cases at any one time throughout the internship.  These must include at least one child therapy, one family therapy, and one pediatric psychology case.   The supervisors will provide a pool of cases.  Interns can select therapy cases that are consistent with their interests.   It should be noted that members of the faculty are currently participating as therapists and/or investigators in research on the effectiveness and efficacy of the following therapies: cognitive behavior therapy for OCD in children, cognitive behavior therapy for adolescent depression, multisystemic family therapy for diabetic adolescents with noncompliance problems, motivational interviewing and related techniques for noncompliant asthmatic patients, and behavioral family systems therapy for adolescents with AD/HD.  It is also common for members of the faculty to serve as co-therapists with interns for the more difficult cases, such as eating disorder cases.  Interns with interests in these areas will have the opportunity to learn how to conduct these therapies.  In addition, there is the opportunity for interns to participate in HIV therapy and support groups and a summer camp program for HIV children.

Below are the goals and objectives for the therapy activities:

Goal 1:  Develop intermediate to advance competency in psychotherapy.

Objective A: Display intermediate to advanced skills in individual psychotherapy, including evidence-based child, adolescent, and pediatric psychology individual therapies.

Objective B: Demonstrate intermediate to advanced skills in family therapy, including parent training, behavioral family systems interventions, and strategic/ structural family therapy.

Goal 2:  Identify appropriate treatment methods and techniques for diverse populations and different types of psychopathology, incorporating cultural and individual diversity in this process.

TRAINING FACULTY

Below is a list of the core Training Faculty and their areas of supervision.  More information about each Faculty Member can be found by clicking on Training Faculty.

1. Arthur L. Robin, Ph.D.  Director of Training.  ADHD Clinic, family therapy supervision, Endocrinology Clinic, Diabetes Clinic, Myelomeningocele Clinic, inpatient consultation liaison.

2. Kara Brooklier, Ph.D.  Autism training.

3. Michael Butkus, Ph.D. Inpatient consultation liaison, child therapy supervision.

4. Deborah Ellis, Ph.D.  pediatric psychology therapy supervision, mentor.

5. Jill Meade, Ph.D.  HIV Clinic and HIV group work.

6. Jocelyn McCrae, Ph.D.  Sickle Cell Clinic

7. Georgia Michalopoulou, Ph.D. Chief of Staff. Administrative meetings, mentor.

8. Sylvie Naar King, Ph.D. Motivational Interviewing training and supervision.

9. Robert Rothermel, Ph.D.  Neuropyschology.

10. Preeya Taormina, Ph.D. Asthma/Allergy Clinic, Renal Clinic.

The interns also participate in seminars and lectures with our two child psychiatry faculty members and several other psychology faculty members:

1. David Rosenberg, M.D.  Chairman of Child Psychiatry and Psychology.  Directs Child Psychiatry Grand Rounds and Child Psychiatry and Psycology Case Conference

2. Jimmie Leleszi, M.D.  Lectures to interns on end-of-life issues, inpatient consultation liaison.

SEMINAR/CASE CONFERENCE  ACTIVITIES

In addition to the Core Seminar, which all of the Wayne State University Psychology Interns participate in, interns in the Clinical Psychology Program with an Emphasis on Pediatric Psychology will participate in the following seminars and case conferences:

1. Pediatric Psychology Didactic Seminar- this weekly seminar involves presentations by faculty members and outside speakers on a variety of topics related to chronic illness, pediatric psychology, and psychopharmacology.  A physician from Children’s Hospital typically makes a presentation on a particular chronic illness one week; a psychologist then makes a presentation on the psychosocial aspects of the same chronic illness the next week.  All of the chronic illnesses included in the clinics which the interns attend are covered in this manner, along with many other topics such as evidence-based interventions for pediatric psychology problems.  Drs. Rosenberg and Leleszi provide psychopharmacology lectures. 
   

2. Pediatric Psychology Supervision Seminar- this seminar is a group supervision and case discussion of the interns’ pediatric psychology therapy cases.  Conducted by Dr. Deborah Ellis, this seminar also includes didactic information on evidence-based interventions.
   

3. Pediatric Neuropsychology Seminar and Case Conference- this weekly seminar focuses on developing skills in the interpretation of cognitive deficiency patterns from test data (including the WISC-IV and neuropsychological tests).  The format is to practice blind interpretation of data derived from a library of cases collected by the supervisor.   Dr. Robert Rothermel leads this seminar.  Each intern is expected to direct one seminar meeting with a presentation of didactic material related to a topic in pediatric neuropsychology.
   

4. Child Therapy Supervision Seminar- this seminar is a group supervision and case discussion of the interns’ child therapy cases.  Dr. Mike Butkus conducts this seminar.
   

5. Family Therapy Supervision Seminar- this seminar is a group supervision and discussion of the interns’ family therapy cases.  It also includes a small amount of didactic presentation.  Dr. Robin leads this seminar.
   

6. Child Psychiatry and Psychology Case Conference- once a month, on Wednesday from 11:30 AM to 12:30 PM, all of the psychology and psychiatry trainees and faculty at Children’s Hospital of Michigan participate in a case conference led by Dr. David Rosenberg.  Difficult child and adolescent cases are presented and discussed.  Lunch is provided for this case conference.  Each intern will present one case in the conference.
   

7. Child Psychiatry Grand Rounds- once a month, on Tuesday from 12:30 PM to 1:30 PM, nationally known researchers and clinicians in the field of Child Psychiatry and Psychology present a Grand Rounds on their research and clinical practice.   Lunch is provided for this case conference.  Previous speakers have included Dr. William Pelham, Dr. Barbara Geller, Dr. Christopher Kratochvil, Dr. Catherine Lord, Dr. Joseph Biederman, and many others.
   

8. Psychiatry and Behavioral Neurosciences Grand Rounds- weekly, from September to June, on Wednesdays, 1 PM to 2:30 PM.

An addition, the interns participate in several regional conferences such as The Michael Golds Memorial ADHD Conference and conferences sponsored by The Michigan Psychological Association.  The interns also receive training in Motivational Interviewing through a full-day seminar.

MENTORING SYSTEM

By the end of the first month of the internship, the Director of Training asks each intern to select a faculty member as a mentor.  The intern and mentor meet regularly throughout the year to help guide the intern on making decisions regarding Post-Doctoral Fellowships, jobs, career issues, and any personal issues which arise.

RESEARCH TRAINING

Because the demanding internship curriculum is a full-time endeavor, there are no requirements for interns to conduct scientific research.  However, as noted above, a new Research Elective is now available during the outpatient rotation. We have the following goal in the scholarly area:

Goal: Understand strategies of scholarly inquiry and the relationship between science and practice.

Interns will have opportunities to achieve this goal through attendance at Child Psychiatry Grand Rounds, discussion of the relationship between science and clinical practice during seminars, preparation of presentations for Pediatric Psychology Didactic and Neuropsychology Seminars, and their utilization of various databases and libraries in the Detroit Medical Center and Wayne State University School of Medicine.  If an intern wants to participate in faculty research, there are ample opportunities to do so through the Research Elective.  Major clinical research is underway in our Department on the following topics: effectiveness of CBT and medication for treating OCD in children, effectiveness of CBT and medication for treating depression in adolescents, the neurobiology of OCD, adolescent depression, and AD/HD, the genetics of AD/HD, the effectiveness of Multisystemic Family Therapy for treating noncompliant adolescents with diabetes and adolescents with HIV, the use of motivational interviewing with asthma patients, validation of measures of parent-adolescent conflict and interactions, and a variety of neuropsychological topics.

SUPERVISION TRAINING  

WHAT TYPE OF INTERN ARE WE LOOKING FOR?

 Often, applicants ask us what type of intern are we looking for?   First, we are looking for interns who have learned the basic assessment and therapy skills.  We look seriously at the number of administrations of basic IQ and achievement test, the number of child and adolescent therapy cases, and the number of integrative reports on your application.  Applicants with fewer than 10 WISC-IV, fewer than 10 achievement test administrations, and fewer than 10 integrative reports are unlikely to receive interviews because we do not want to be teaching basic testing skills during an internship; we are looking for achievement tests such as the WIAT II or the Woodcock Johnson.  Applicants with fewer than 10 child and/or adolescent therapy cases are unlikely to receive interviews because we don’t want to be teaching basic therapy skills.  We consider your work experience as well as your practicum experience in determining whether you have sufficient testing and therapy experience to succeed in our internship.  Second, we are looking for interns who have a demonstrated interest in pediatric psychology, beyond an interest in child and adolescent psychology.  The candidates whom we interview have done a practicum or research in a pediatric health care setting, have Master’s Theses or Dissertations on child health-related topics, and/or have volunteered in hospitals or clinics.   Applicants without such experiences usually do not receive interviews in our setting.  Simply writing about your interest in pediatric psychology in your application essays is insufficient; you must have proven your interest by the work you have already done in order to receive an interview at Children’s Hospital of Michigan .

EVALUATION PROCEDURES

At the end of the third, sixth, ninth and twelfth months of the internship, each supervisor completes a written evaluation of each intern.  These evaluations specifically assess the extent to which the intern has met all of the goals and objectives of the training program as outlined on this website.  The three and nine month evaluations are primarily qualitative progress reports; the six and twelve-month evaluations are both quantitative and qualitative.  All evaluation are reviewed by the supervisors with the interns, signed by both the interns and supervisors, and forwarded to the Director of Training.  The Director of Training sends feedback letters to the interns’ graduate programs at the end of six and twelve months.  Each intern anonymously evaluates each supervisor at the same time intervals, and also evaluates the program at the six and twelve month intervals.  All of the evaluations are reviewed by the Director of Training and the Training Committee, who recommend annual changes in the program based upon this feedback.

ADDITIONAL QUESTIONS

If you have additional questions about the program after reading this description, feel free to E mail or call Dr. Robin using the contact information given below.    You may also want to explore the following related websites:

Children’s Hospital of Michigan:   http://www.chmkids.org/chm

The Detroit Medical Center    http://www.dmc.org/

The City of Detroit   http://www.ci.detroit.mi.us/

MAIL APPLICATION MATERIALS TO:

Arthur L. Robin, Ph.D.
Director of Psychology Training
Department of Child Psychiatry and Psychology
Children’s Hospital of Michigan
3901 Beaubien Blvd.
Detroit, MI 48201

Phone: 313-966-0602
Fax: 313-993-0282
E mail: arobin@med.wayne.edu
Program Match Number: 136211