INTERNSHIP SITES

 

Each of the internship sites has its own unique set of opportunities and responsibilities.  A description of each site follows.  It should be noted that an intern cannot possibly participate in all the options at each site.  However, the intern plays a fundamental role in formulating his or her training program, and should be highly independently motivated in order to delineate desired internship experiences.  A unique strength of the UCSD/VA Psychology Internship Program is its commitment to providing the intern with a well‑rounded clinical experience, while remaining flexible with regard to the intern's specific needs and interests. Because of the diversity of available experiences, there is no "typical" schedule for an intern.  However, an average week for an intern might include the following:

Hours per week                       Activity

11 to 16                       Clinical Responsibilities (Individual/Marital/

            Family/Group psychotherapy, Diagnostic intakes).

6 to 11                         Assessment (Test Administration, Interviewing,

            Scoring, Interpretation, Report Writing).

4 to 6                           Seminars (Psychology Series plus Site Specific).

5 to 7                           Administrative (Chart review, Treatment Plans,

            Team Meetings, Staff Meetings, Activity Reports).

4 to 6                           Supervision (Individual, Group).

0 to 8                           Research (Dissertation, Internship Project, etc.)

THE VA SAN DIEGO HEALTHCARE SYSTEM (VASDHS)

The VASDHS is a modern 350 bed general medical and surgical medical center situated adjacent to the University of California at San Diego and is closely affiliated with the UCSD School of Medicine.  The VASDHS is located 10 miles north of downtown San Diego and just one mile inland from the community of La Jolla on the Pacific Ocean.

The VASDHS has approved residency training programs including medicine, surgery, anesthesia, neurology, pathology, psychiatry, radiology, and audiology.  The medical staff is augmented by outstanding physicians, dentists, nurses, consultants, research investigators, and attendings in various specialties.  There are over 2,000 full‑and part‑time professional and administrative staff members.

The VASDHS Psychiatry Service has extensive inpatient and outpatient psychiatric facilities located in the medical center.  The entire second floor of the VA Medical Center is almost exclusively inhabited by the Psychiatry and Psychology Services.  There are 28 acute‑care psychiatry beds. In addition, there is a 30 bed Alcohol and Drug Treatment Program which features a comprehensive aftercare program for alcoholics and their families.  There is a Special Treatment and Evaluation Unit (STEP) for the study of affective disorders and primary care mental health patients and an outpatient mental health clinic located on the second floor, staffed by multi‑disciplinary treatment teams which provide over 22,000 outpatient visits per year.  Patient care activities in the outpatient programs include psychiatric admissions, crisis service, diagnosis specific medication clinics, and individual, marital, family, and group therapies. An active outpatient Gero‑Psychiatric Unit also exists at VASDHS.  Outpatient programs for Post Traumatic Stress Disorder and Dual Diagnosis were initiated in 1992.  There is a 20 bed Spinal Cord Injury Unit, offering inpatient and outpatient services.  Since 1994, selected interns have been assigned to serve the psychological assessment, treatment and consultation needs of two multidisciplinary teams in primary care, under the auspices of Medicine Service.

The Psychology Service at the VASDHS, while moderate in size, represents one of the most academically oriented staffs in the Department of Veterans Affairs hospital system.  Currently, fully accessible by the interns are 36 positions assigned to the Psychology Service.  These include 28 Ph.D. clinical psychologists, 3 psychology technicians, 3 vocational rehabilitation specialists, and 2 administrative support staff.  Many of the major sub-specialties of professional psychology are represented on the staff, including clinical psychology, neuropsychology, geropsychology, marital and family therapy, alcohol treatment, behavioral medicine, post-traumatic stress disorder, Assertive Community Treatment and related psychology research.  There are complete facilities at the VA for computer‑assisted psychological testing and videotaping of therapy sessions and all medical records charting is done electronically.  

Located approximately 12 miles from the hospital in Mission Valley, there are extensive medical facilities and mental health programs for outpatient care at the VA Outpatient Clinic, housed in a modern building which opened in November, 1998. Mental health programs located at the VA Outpatient Clinic include a Mental Health Clinic, the Family Mental Health Program, and the PTSD Clinical Team.  The VA Psychology Service also sponsors a Behavioral Medicine Program located in Mission Valley.

VASDHS ‑ Internship Opportunities

Inpatient training opportunities exist primarily in the Alcohol and Drug Treatment Program.  Otherwise, mainly outpatient rotations are available to the intern at the VASDHS.  The amount of time allocated to the separate rotations depends on the intern's needs and interests as well as the logistical constraints of the particular rotations and intern assignments.  Some rotations are too intense to allow for minor options.  However, for the intern who is interested in being involved with more than one rotation, arrangements occasionally can be made to incorporate these experiences into his or her program.  For example, at the VASDHS, an intern might spend 15 hours a week doing a major rotation, and 5 hours a week doing a minor rotation or 10 hours on one VA rotation and 10 on another all year. 

Inpatient Rotations

    1.  Psychiatry Service

On the Psychiatry Service at the VA Medical Center there are locked unit and open unit acute care beds.  Currently, there is no option for a major inpatient psychiatry rotation at the VA.  More intensive inpatient Psychiatry experience is available at UCSD Medical Center.  At the present time interested interns may select a minor rotation experience, e.g., 4‑6 hours per week.  Training experiences include testing, individual, and group intervention options.

    2.  Alcohol and Drug Treatment Program

The Alcohol and Drug Treatment Program (ADTP) offers a variety of programs and services for veterans, on an inpatient and outpatient basis, including group and individual therapy, educational lectures, a Couples Relationship Enhancement Workshop (CREW), and the Substance Abuse/Mental Illness (SAMI) dual-diagnosis program.  The 30-bed inpatient program is a 28-day intensive treatment providing educational and therapeutic activities for veterans.  The outpatient program offers educational and therapeutic services for individuals who can benefit from a less intensive yet equally structured treatment plan.  The SAMI program was established for individuals with substance dependence and one or more co-existing Axis I psychiatric disorders.  All ADTP programs include year-long aftercare, involvement of family and friends, and educational components.  The ADTP rotation provides the opportunity for an intern to gain experience appropriate to her/his level of training in the area of alcohol and drug treatment using cognitive-behavioral, interpersonal, and motivational enhancement approaches, as well as exposure to working within an interdisciplinary team setting.  The internship rotation involves participation in various components of the ADTP depending on the trainee's interests and program needs.  These opportunities include group therapy, long-term individual outpatient therapy, behavioral couples therapy, psychological assessment (e.g., diagnostic interviews, personality testing), involvement in SAMI program activities, educational lectures, and clinical research training.

Outpatient Rotations

    1.  Behavioral Medicine

The Behavioral Medicine rotation at the VASDHS trains interns to work as psychologists in medical settings.   We train interns to be consultants to medical providers and to conduct screening, assessment, brief intervention, and outcome evaluation with medical patients.  The major placements are in primary care, weight control, smoking cessation and spinal cord injury clinics.

The clinical training emphasizes the role of behavior in mental and physical health and behavioral and cognitive strategies to optimize patients' health status and quality of life.  Typical patient problems include chronic medical conditions (e.g., diabetes, hypertension, chronic pain, obesity), somatic symptoms (e.g., fatigue, pain), health threatening behaviors (e.g., smoking, physical inactivity, noncompliance) and mental health concerns (e.g., stress, depression).  Our interventions are matched to patient needs and may include brief contacts for psychoeducation, evaluation and triage, individual psychotherapy, and group interventions (e.g., weight management, pain control, reduction of stress and anxiety, sleep hygiene).  We have a tobacco use cessation program for patients with psychiatric comorbidity that includes cessation groups, educational lectures and consultation services.  We also perform assessments for patients about to undergo organ or bone marrow transplant, amputations, implantable pain procedures, and weight loss surgery.

    2.  The Neuropsychological Assessment Unit

The Psychological Assessment Service at the VASDHS is comprised of four Ph.D. clinical neuropsychologists, a neuropsychology postdoctoral fellow, and three psychometrists.  This rotation provides the intern with the opportunity to conduct neuropsychological evaluations on a wide range of patient populations, including neurological, rehabilitation, psychiatric, geriatric, and general medicine patients.  Opportunities for assessment and cognitive rehabilitation for veterans of Iraq or Afghanistan with mild to moderate traumatic brain injury are also available.  Interns are taught how to use the Boston process approach to interpret a wide range of assessment instruments (e.g., Boston Naming Test, Wechsler Memory Scale - III; California Verbal Learning Test - 2; Delis-Kaplan Executive Function System, etc.)  Interns will attend the Neuropsychological Assessment Seminar twice a week. There are many opportunities to integrate research projects with clinical services.

    3.  Family Mental Health Program (FMHP)

The Family Mental Health Program specializes in providing conjoint therapy for relationship distress.  Referrals to the FMHP are received from throughout the VASD Healthcare System.  All types of cases are evaluated for treatment potential, including couples and families coping with major psychiatric disorders (e.g., major depression, substance abuse recovery, schizophrenia, dementia, personality disorders, phobias, etc.), interpersonal conflict (e.g., domestic violence, child abuse, step-parenting issues, marital dysfunction) and medical problems (e.g., cancer, cardiac disease, diabetes, HIV infection, etc.).  The program features an integrated cognitive-behavioral and family systems approach to assessment and treatment.  Interns function as co-therapists with other mental health providers or as independent therapists when appropriate to their level of training.  Patients and their families are seen both at the Medical Center and the VAOPC facilities.  Both major (10-15 hour) and minor (5 hour) year long rotations are available.

     4.  Cognitive and Behavioral Interventions Program

The Cognitive and Behavioral Interventions Program at the VASDHS trains psychologists and other mental health professionals in cognitive-behavioral treatments for mood and sleep disorders (with or without mood comorbidities). The focus is on developing skills in cognitive-behavioral interventions for a wide range of patients, and developing a strong theoretical understanding of this empirically based approach to treatment.  Interns are trained in a case formulation approach to cognitive-behavioral therapy, and in evaluating the effectiveness of clinical interventions.  Training opportunities include: a) the use of structured clinical interviews for assessing mental disorders; b) individual and group CBT for mood disorders; c) individual and group CBT interventions for insomnia; and d) individual and group imagery rehearsal therapy (IRT) interventions for nightmares. The sleep disorders patients provide interns with exposure to a range of populations, including mood, PTSD, anxiety, and pain patients.  Interns can also participate in a dialectical behavior therapy program for treating Borderline Personality Disorder. Supervision includes both group and individual supervision, review of videotape sessions, didactics, and co-therapy.  Interns are encouraged to develop both clinical and research interests related to this rotation (e.g., co-leading a group that is of particular interest to the intern, conducting outcome research).   Both10-hour and 20-hour year long rotations are available.

    5.  Schizophrenia Psychosocial Rehabilitation Program

The Schizophrenia Psychosocial Rehabilitation Program provides psychosocial treatment services to patients with schizophrenia and related psychotic disorders in inpatient and outpatient settings at the VASDHS. Group and individual psychotherapy is provided using psychoeducation, motivational interviewing, cognitive-behavioral therapy (CBT), cognitive rehabilitation, and social skills training interventions. Clinical trials of manualized psychotherapy interventions are conducted. Diagnostic evaluation and psychological and neuropsychological assessment are also available. Interns participate in all of these clinical and research activities in diverse patient settings.  Services may be provided in a variety of VASDHS settings, including inpatient psychiatry units, the Substance Abuse/Mental Illness Program serving outpatients with psychotic disorders and comorbid substance dependence (dual-diagnosis), Geropsychiatry serving older outpatients with schizophrenia, and the Cognitive Disorders Clinic serving outpatients with chronic schizophrenia and pharmacologic-treatment resistant psychotic symptoms. Interns will develop a strong theoretical understanding of empirically based individual and group psychosocial approaches to treating psychosis, with an emphasis on evaluating the efficacy of psychotherapy for psychosis.  Interns are encouraged to develop both clinical and research interests related to this rotation. 

   6.  Substance Abuse/Mental Illness (SAMI) Program

The SAMI Program is a dual-diagnosis specialty clinic within the Alcohol and Drug Treatment Program providing outpatient treatment to veterans with substance use disorder as well as independent major psychiatric disorders (including schizophrenia, bipolar disorder, depression, PTSD, and social phobia). Interns participate as integral members of a multidisciplinary treatment team providing cognitive behavioral, motivational enhancement, relapse prevention, behavioral, and psychoeducational group and individual psychotherapies. Training diagnostic and neuropsychological evaluation are also provided.  Major (20 hour) year-long rotations are available.

      7.  Anxiety Disorders Program

The Anxiety Disorders Clinic is a multidisciplinary specialty clinic that provides services for veterans with panic disorder with and without agoraphobia, social phobia, GAD, civilian PTSD, OCD, specific phobias, and adjustment disorders. Interns in this rotation assess patients using clinical interviews supplemented by standardized self-report measures. The clinic runs a general group for managing stress and anxiety as well as disorder specific groups. Individual cognitive behavioral therapy is used to supplement group treatment or as the primary intervention.

      8.  Home-Based Primary Care

The VA Home-Based Primary Care program provides comprehensive, interdisciplinary primary care services in the homes of older veterans with chronic and disabling disease. HBPC targets veterans in advanced stages of chronic disease, particularly those at high risk of recurrent hospitalization or nursing home placement. The HBPC team includes representatives from medicine, nursing, pharmacy, social work, and dietetics, as well as psychology.

The intern’s experience could include the following:

1)   Screening, assessment, intervention, and prevention-oriented services to veterans enrolled in the HBPC program.

2)   Work as part of interdisciplinary team that includes representatives from medicine, nursing, pharmacy, social work, and dietetics, as well as psychology.

3)   Neuropsychological assessment and dementia evaluations.

4)   Individual psychotherapy using CBT, life review, and Acceptance and Commitment Therapy (ACT).

5)   Couples and family therapy with patients and their caregivers.

    9.  OEF/OIF Program

The Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Program at the VASDHS trains psychologists and other mental health professionals in assessment and treatment of posttraumatic stress disorder (PTSD) and its comorbidities (substance use disorders, depression, other anxiety disorders, re-adjustment issues) in recently deployed veterans. The focus is on developing skills in empirically supported interventions for these disorders, and developing a strong theoretical understanding of empirically based approaches to treatment.  Training opportunities include: a) the use of structured clinical interviews for assessing PTSD and its comorbidities; b) individual and group cognitive processing therapy for PTSD; c) individual prolonged exposure therapy for PTSD; d) group Seeking Safety therapy for concurrent PTSD and substance use disorders; and e) interventions to reduce guilt related to combat experiences. The Program is part of a multi-disciplinary team represented by psychology, psychiatry, and social work. Staff interface with primary care, the polytrauma team, and other mental health providers to provide integrated care for the myriad of physical and mental health concerns of OEF/OIF veterans. The clinic continues to grow and evolve as we learn more about the needs and preferences of OEF/OIF veterans. Thus, the intern will have the opportunity to take part in program development and evaluation.  Supervision includes both group and individual supervision, review of videotape sessions, didactics, and co-therapy.  Interns can take part in consultation groups in prolonged exposure therapy, cognitive processing therapy, and seeking safety therapy.  Interns are encouraged to develop both clinical and research interests related to this rotation (e.g., co-leading a group that is of particular interest to the intern, conducting outcome research).  

    10.  Posttraumatic Stress Disorder Programs – Mission Valley

The Posttraumatic Stress Disorder (PTSD) Clinical Team (PCT) and the OIF/OEF PTSD Program at the VASDHS trains psychologists and other mental health professionals in cognitive-behavioral treatments for PTSD and related symptoms (e.g., nightmares, depression, anxiety, guilt, anger). The OIF/OEF PTSD Program serves veterans who have returned from the ongoing wars in Iraq and Afghanistan, and the PCT Program serves all other veterans (e.g., Vietnam War, Persian Gulf I/Desert Storm, Somalia, Korean War, World War II). In both programs, the focus is on developing empirically supported assessment and treatment skills for working with a veteran population, and developing a strong theoretical understanding of empirically based approaches. Interns will learn how to administer and interpret the major structured clinical interviews and self-reports for PTSD and associated features. They will also have opportunities to learn the state-of-the-art treatments for PTSD, including Prolonged Exposure Therapy, Cognitive-Processing Therapy, Seeking Safety, and Imagery Rehearsal Therapy. Supervision includes both group and individual supervision, review of videotape sessions, and didactics.  Interns are encouraged to develop both clinical and research interests related to this rotation (e.g., co-leading a group that is of particular interest to the intern, conducting outcome research). Year-long, 20 hours-per-week rotations are available.

11.  MST & WOMEN’S PTSD CLINIC

The intern working in the MST & Women’s PTSD clinic will screen, educate, assess and treat both male female patients with MST. The intern will also facilitate gender-specific services for female veterans with PTSD from any kind of trauma, and will work to further develop the MST screening process, provider and veteran education, treatment development and provision, and military outreach programs.  Direct clinical duties of the intern will include providing individual and group psychotherapy, psycho-education and assessment.  Training in assessing PTSD using standardized interviews (CAPS, SCID) and in providing empirically supported treatments for PTSD (Prolonged Exposure, Cognitive Processing Therapy, Seeking Safety) will be an important part of this rotation. The intern will have the opportunity to work in a multidisciplinary team where treatment planning is done in consultation with the Psychiatrist and Pharmacist as well as the licensed Clinical Psychologist in the program. Where appropriate the intern will be expected to maintain contact with the patient’s primary care or other providers for treatment coordination and consultation. Teaching and education opportunities include:  1) Conducting single session psycho-educational classes offered periodically for patients in the Firm Comprehensive Women’s Clinic focusing on “Common Responses to Trauma.”  2) Educating VASDHS providers about screening for MST and PTSD, mental health sequelae after trauma, the health correlates of trauma exposure, and the availability of the MST & Women’s PTSD Program for education, assessment, and intervention with patients.

12.   Traumatic Brain Injury Cognitive Rehabilitation Program

The rotation within the Traumatic Brain Injury Cognitive Rehabilitation Program at the VASDHS provides the intern with the opportunity not only to conduct neuropsychological assessments but also provide cognitive rehabilitation to veterans of Iraq or Afghanistan with mild to moderate traumatic brain injuries.  Opportunities are available for cognitive rehabilitation focused on compensatory strategies, family education, and other interventions.  Supervision is provided in both group and individual contexts.  Given the high rate of comorbid mental health, orthopedic, and other health concerns within this veteran group, this rotation provides interns with numerous opportunities for interdisciplinary interactions.  Additionally, there are many possibilities to integrate research projects with clinical services.

VAMC Seminars

One required Internship Seminar Series is designed specifically for the interns (see Appendix C ‑ Internship Seminar Series).  In addition to the required internship seminar, other seminars are required as part of particular rotations, and interns are invited to attend Grand Rounds and Professors Rounds, which are sponsored by the Department of Psychiatry, UCSD Medical School and occur on a weekly basis at the VAMC. Interns are also eligible to attend most of the seminars offered throughout internship facilities to psychiatric residents, psychiatric nurses, and psychiatric social workers.  Visiting lecturers' presentations, from various disciplines, are also available to the interns. 

UCSD OUTPATIENT PSYCHIATRIC SERVICES

The UCSD Outpatient Psychiatric Service is one of the primary outpatient psychotherapy and psychosocial rehabilitation training sites in the Department of Psychiatry for psychiatric residents, psychology students and interns, social work and marriage and family therapy interns and medical students.  It consists of three interlocking clinical programs: Gifford Clinic, a public mental health service; the Co-Occurring Disorders Integrated Treatment and Recovery Program, and Psychiatric Associates, a private practice model mental health service. Over 2,000 patients from diverse socioeconomic, cultural and ethnic backgrounds are served annually. 

UCSD Outpatient Psychiatric Services ‑ Internship Opportunities

Interns selected for this service are provided a rich variety of clinical learning opportunities with supervision from a multidisciplinary group of experienced faculty and staff whose primary mission is clinical training.  Interns work 20 hours within the Gifford Clinic, a publicly funded outpatient mental health service. They evaluate one new patient a week and provide approximately 10 clinical hours weekly. Services include brief-focused and ongoing psychotherapy to individuals, couples and families, crisis intervention and care coordination. Each intern co-leads at least one psychotherapy group using evidence based group interventions such as Dialectical Behavior Therapy (DBT) and Seeking-Safety. Interns work closely with psychiatric faculty and residents regarding psychopharmacologic treatment of their patients.

As part of the overall internship assessment requirement, interns conduct up to 5 assessments over the year. They have the opportunity to combine neuropsychological with personality assessment measures in the evaluation of patients with challenging diagnostic issues.  They also collaborate with psychiatric residents in an integrated case presentation for Departmental Professor’s Rounds.

Learning opportunities include weekly individual supervision using videotapes and audiotapes, a weekly multidisciplinary evaluation team meeting, weekly group supervision on assessment, a weekly clinical seminar focused on issues in psychotherapy and treatment of personality disorders and a weekly DBT consultation group for those involved in that program. All interns are encouraged to attend the Department of Psychiatry weekly Grand Rounds and other lectures and workshops sponsored by the Department.

UCSD CHILD PSYCHIATRY DEPARTMENT AT RADY CHILDREN'S HOSPITAL

Rady Children's Hospital and Health Center is the major comprehensive pediatric health care facility for San Diego County.  Rady Children's Hospital has had a long standing relationship as a teaching facility for the Child Psychiatry division of UCSD Department of Psychiatry.  It is located about six miles southeast of the UCSD Medical School and VA Medical Center in La Jolla. It is also equidistant between the downtown UCSD Medical Center and the UCSD Child and Adolescent Psychiatry Service (CAPS). 

There are 200 beds at Rady Children's Hospital for acutely ill inpatients as well as extensive outpatient services in more than 37 specialized clinics.  As part of the affiliated divisions of Rady Children's Hospital and Health Center, the Children's Outpatient Psychiatry Clinic serves diverse needs of children and their families from San Diego and Imperial Counties as well as from the hospital.  The clinic is the largest provider of county funded outpatient services for youth and also serves as a teaching facility for clinical psychology training, general psychiatry residents, fellows in Child Psychiatry, and graduate students in social work and counseling.

UCSD Child Psychiatry Department at Rady Children's Hospital - Internship

Opportunities

In the Children's Outpatient Psychiatry Clinic placement, interns gain experience in diagnostic evaluation, psychological testing, individual, group, and family psychotherapy, parent education and training, and psychiatric consultation/liaison services.  Interns will gain experience with a diverse patient population, ranging in age from toddlers through adolescents and presenting with a variety of diagnoses, including disruptive, mood, anxiety, substance abuse, and developmental disorders.  The patient population is also diverse in terms of socio-economic status, race/ethnicity, and family composition. Interns will collaborate with an interdisciplinary "Treatment Team" coordinating the care of all families receiving services.  Interns also provide psychiatric consultation/liaison services for medical patients at Rady Children's Hospital, including crisis intervention, pain evaluation and management, parental education and training regarding needs of chronically ill children, and evaluation of suicide risk. The theoretical orientations of the faculty and staff in the clinic are eclectic.  Exposure to, and supervision in, cognitive behavioral and behavioral interventions including parent training, family systems, humanistic, and psychodynamic approaches, is provided in the context of an understanding of developmental psychopathology.  Depending on the patient characteristics and funding mechanisms, some patients and families receive intensive short term treatment, whereas others may remain in treatment for more than one year.   Work with the families often includes case management and community liaison activities, including interaction with child protective services, family or juvenile courts, other health care providers, and the school systems. 

In addition to individual and group clinical supervision, interns participate in a variety of didactic and professional development activities within the Division of Child and Adolescent Psychiatry at UCSD.  These include Grand Rounds presentations, Consultation/Liaison seminar, forensic seminar, case conferences, journal club meetings, and staff in-service training sessions.  On alternate years a neuropsychiatry seminar is also available.

UCSD CHILD AND ADOLESCENT PSYCHIATRIC SERVICES - (CAPS)

UCSD CAPS is a licensed, inpatient service for children and adolescents and is a part of the UCSD Medical Center.  The facility is part of a broad health care network and is an integral part of the Division of Child and Adolescent Psychiatry at UCSD and the Department of Psychiatry at Children's Hospital and Health Center.  It is located approximately 15 minutes from the UCSD Medical center and about 20 minutes from the main campus and the VA Hospital.

CAPS is an outstanding academic and clinical center of excellence in patient care, scholarship and teaching.  The facility provides comprehensive services to severely emotionally disturbed children and adolescents between the ages of 2 and 18 years.  As its goal, CAPS offers the “absolute quintessence” of inpatient psychiatric treatment which includes biological and psychological interventions.  All intervention strategies reflect empirically based humane, responsible and progressive techniques.  Aside from patient care activities, CAPS is also a teaching venue for doctoral interns in clinical psychology as well as social work and marriage and family therapy interns and for fellows in child psychiatry and residents in adult psychiatry.

UCSD CAPS - Internship Opportunities

The psychology internship at UCSD CAPS is designed to provide interns with hospital-based experience in the comprehensive assessment and treatment of children, adolescents and their families.  Children/adolescents admitted to CAPS typically have histories of emotional disturbance complicated by a variety of psychosocial stressors, such as physical/sexual abuse, abandonment, in utero exposure to drugs and alcohol, family histories of substance abuse and psychiatric disorders and legal problems.    Nearly all youngsters admitted to the facility have one or more major psychiatric disorders.  Length of stay is variable but often averages 1 week.  A multidisciplinary treatment team meets weekly to develop a comprehensive treatment plan that includes individual, family and group therapy as well as pharmacological intervention, nursing care, and occupational and recreational therapy.  Active involvement of the family is strongly encouraged and extensive contact with community and social service agencies augment the internship training experience.  In addition, psychology interns provide assessment services including intellectual, achievement, neuropsychological and personality evaluations.  All interns will train under the guidance of a licensed psychologist but will participate as active members of a multidisciplinary treatment team.  Each intern will have experience working with both children and adolescents.

UCSD MEDICAL CENTER, HILLCREST

UCSD Medical Center, Hillcrest, is a modern 440-bed full-service teaching and research facility. The Medical Center is located near the Downtown area of San Diego, about 20 minutes by car from the main UCSD campus in La Jolla.  The UCSD Medical Center is a rich environment which offers exposure to state-of-the art treatment and research opportunities and participation in educational opportunities in the area of psychology/psychiatry and other related specialties. The Department of Psychiatry oversees a thriving Consultation/Liaison service, where psychology interns may participate in the evaluation and treatment of patients with concomitant medical illness.  Psychology interns also staff clinics in the UCSD Center for Pain and Palliative Medicine (Pain Clinic) and participate in multidisciplinary Pain Management treatment team rounds; conduct organ transplant evaluations, and help staff at an adult attention-deficit hyperactivity disorder evaluation clinic.  Interns also staff the Burn Service where they play an integral part in the multidisciplinary treatment, and more recently have become involved in providing individual and group psychotherapy to patients of the Moores UCSD Cancer Center.

UCSD MEDICAL CENTER, HILLCREST – Behavioral Medicine Opportunities

UCSD Organ Transplant Rotation.  As an intern you will become proficient in outpatient pre-transplant evaluations for the Organ Transplant Service.  The most common organ transplantation procedures at UCSD involve a kidney or liver, with lung transplants occurring less frequently.  You will spend approximately 6-12 hours per week dedicated to this rotation, which includes evaluations (2-6 hours), supervision with Dr. Marc Norman (1 hour), and report writing time (3-5 hours).  Evaluations consist of a focused interview, short neuropsychological battery (PPVT, RBANS, Grooved Pegboard, Trail Making, Fluency), and scales of emotional (BDI) and health (SF-36) functioning.

You will integrate various aspects of end-stage liver, kidney, or lung disease, including precipitating biochemical events, risk factors, physical symptoms, and neurocognitive sequelae with functional implications and treatment considerations.  Results of the evaluations are discussed with the transplant team to increase outcome success.

UCSD Burn Center Rotation.   The UCSD Burn Center is located at the UCSD Medical Center in Hillcrest on the 5^th floor.  As an intern at the UCSD Burn Center, you will work primarily with adult and child inpatients and their families in the 8-bed Intensive Care Unit or the 10-bed Special Care Unit (step down from ICU).  You will spend approximately 10 hours at this site weekly.

Roles consist of (1) psychological assessment to assess for psychiatric disorders and past or current substance abuse problems, (2) use of various interventions and provision of support for patient and families in coping with physical injuries and treatment (including behavioral interventions to assist patient with acute pain, emotional/cognitive/behavioral responses to traumatic experience, discussion of body image concerns, brief motivational interviewing for substance use-related injuries), and (3) providing recommendations to multidisciplinary staff to enhance outcomes of working with the patient and his/her family.  You will also participate in weekly Friday morning rounds. 

You will learn extensively about burn care and the physical and psychological effects of burn injury.  Interactions with patients can be as brief as a one-time meeting or twice weekly follow-up with the patient and his/her family lasting up to a few months depending on the extent of the injury.  In addition, you will learn how to work closely with other medical disciplines, combine assessment and brief intervention in the span of a few sessions, and tailor your recommendations to fit with the fast-paced trauma care environment. 

UCSD Center for Pain and Palliative Medicine.  As an intern in the UCSD Center for Pain and Palliative Medicine (at the UCSD Thornton Hospital in La Jolla) you will play a central role in a truly multidisciplinary treatment team. The clinic is under the auspices of the Department of Anesthesiology and the patient population carries a fairly wide range of chronic pain diagnoses.

The bulk of your time (probably 80-90%) in the clinic will be devoted to initial assessment and consultation on patients. This will include:

1)    Pre-procedure psychological evaluations of patients being considered for invasive surgical techniques (including intrathecal pump and neurostimulator implant procedures); 

2)    Chronic opiate psychological evaluations intended to provide input to the attending physicians who are making recommendations to primary care providers for long-term management of chronic pain conditions;

3)    General psychological evaluations of patients with co-morbid psychiatric issues, substance abuse problems (both prescription and illicit), and other behavioral and coping-related issues.

All evaluations include a short battery of self-report questionnaires with which the intern will become familiar through the year, and interns are encouraged to supplement these measures with more extensive personality or neuropsychological tests when the case warrants it.

Interns will also have the opportunity to participate as co-facilitator (with Dr. Hickman) of an ongoing Pain Management psychotherapy group, and to periodically work on a short-term basis with patients in individual psychotherapy.

The multidisciplinary treatment team meets one times per month for one hour to review the cases of patients seen by our service, and interns are expected to present their cases to the team and facilitate discussion of relevant issues.

All supervision of interns in the pain clinic is done by Dr. Steven Hickman and each intern participates in one hour of individual supervision with Dr. Hickman per week.

UCSD Moores Cancer Center  - The intern will play a central role in the fast-growing psychosocial program of this NCI-designated Comprehensive Cancer Center.  Working as part of the team under the supervision of Steven Hickman, Psy.D. and with a team consisting of social workers, psychiatrists, psychology post-doctoral fellows and practicum students, the intern will primarily focus upon providing brief assessment, individual psychotherapeutic intervention and therapy/support group facilitation.  This rotation will be one day per week and will

periodically also include attendance at multidisciplinary psychosocial rounds with the treatment team.  In the course of the year, the intern will also have the opportunity to take on some supervisory duties in working with practicum-level students also providing services in the Cancer Center.

UCSD MEDICAL CENTER, HILLCREST - Senior Behavioral Health (SBH). 

SBH is a voluntary, inpatient, geriatric psychiatry unit located at the UCSD Medical Center in Hillcrest on the 7^th floor.  As an intern at SBH, you will work with elderly adults suffering from a variety of neurologic illnesses (e.g., dementia, stroke) and psychiatric conditions (e.g., depression, psychosis, bipolar disorder). You will spend approximately 24 hours at this site weekly.

Roles consist of (1) conducting inpatient neuropsychological assessment to identify cognitive decline and assist in the diagnosis of dementia or other neurologic conditions; (2) providing recommendations to multidisciplinary staff to maximize  treatment  outcomes  and  develop  effective  staff  interventions; (3)

leading a weekly Connections Group geared toward helping patients manage diverse issues such as disease-related stress, age related losses, or other psychosocial stressors.  You will also participate in treatment team rounds on Monday, Wednesday, and Friday mornings.  In addition to working with inpatients, you will also conduct one weekly outpatient neuropsychological assessment, and have the opportunity to provide direct feedback to patients and families.

On this rotation, you will learn extensively about psychiatric and neuropsychological issues in the geriatric population, and be exposed to a myriad of medical and social issues important in the care of geriatric patients.   In addition, you will learn how to work closely with other disciplines (psychiatry, social work, internal medicine, nursing, occupational therapy) in creating a comprehensive plan for each patient’s care after discharge. 

UCSD MEDICAL CENTER, HILLCREST - Neuropsychological Assessment Program.  Interns are involved in neuropsychological evaluations for patients with dementia, stroke, closed head injuries, and suspected neuropsychological dysfunction secondary to general medical and psychiatric conditions. The Boston process approach is used to quantify overall performance as well as investigate the mechanism by which performance is disrupted in those with neuropsychological dysfunction. Responsibilities include administration of neuropsychological tests, interpretation and case conceptualization and feedback to the patient and/or family. Supervision is conducted by Drs. Perry and Norman, along with Post-Doctoral Fellows in the department.

UCSD EATING DISORDERS (ED) PROGRAMS

Intensive Outpatient Program for Eating Disorders.  The Eating Disorders (ED) Program at UCSD is a newly developing program and the selected interns will have an opportunity to both participate in treatment of patients as well as assist in developing new treatment strategies. Our objective is to foster interns who approach their clinical work with an inquisitive, investigative and empathic attitude and are competent to function exceptionally as clinicians.

The program is based on the scientist-practitioner model. Interns selected for this service will work with a team of multidisciplinary professional staff.  This group will incorporate results from empirical science into the treatment approach for eating disorders. 

Interns will have the opportunity to receive specialized training in the assessment and treatment of anorexia and bulimia nervosa, as well as more general concerns with weight and/or physical appearance. Interns will have the opportunity to work with teens as well as adults. Treatment is multidimensional and may involve combinations of individual, group, family, and couples psychotherapy.  The intern will carry a caseload of approximately 5 individual eating disorder clients and co-lead treatment groups throughout the training year. Interns will train under a licensed psychologist but will also collaborate with a multidisciplinary treatment team. This will include work with psychiatrists and thus the coordination of appropriate care for each patient.    Interns    will   learn about    the    interface    of psychotherapy and psychopharmacology and their integration in individualized treatment. Interns will evaluate the efficacy of their work with clients on an ongoing basis with their supervisors and will review the current literature for guidance about which treatment strategies are best suited to particular problems.  Our objective is to train interns to integrate empirically driven interventions with an empathic approach to treatment. 

Interns will participate in comprehensive assessments including specialized eating disorder questionnaires, neuropsychological testing, as well as individual and group therapy and advanced methods for symptom recovery of eating disorder patients.  Interns will collaborate with a multidisciplinary treatment team, consult with medical staff, and participate in patient rounds. Regular team meetings will provide the opportunity to present cases, bring up issues for supervision and foster team cohesion.  Interns will also be able to further develop their skills in report-writing. Furthermore, interested interns will have the opportunity to participate in ongoing research opportunities, including genetic and brain imaging studies.