Psychology Internship Intervention and Prevention Rotations
Learn more about the training opportunities within the core rotation in prevention and intervention.
ABC: The Anxiety Behaviors Clinic at CHOP
The ABC provides training in the cognitive behavioral approaches to primary anxiety disorders and other disorders that commonly present with anxiety (i.e., selective eating). The CBT provided to patients is consistent with existing manuals and treatments supported by the scientific literature. Patients are seen in an outpatient context and range in age from 4 to 20 years. There is typically a strong focus on exposures in treatment sessions, as well as family involvement in treatment.
The training model consists of participation in supervisors’ ongoing cases, ongoing weekly supervision, and live observation by a supervisor. Participation in a CB group treatment may also be available.
- To understand the prevalence, variability of diagnostic presentation, and intricacies of primary anxiety disorders.
- To acquire skills in CBT conceptualization of anxiety disorders.
- To fluently and effectively administer these interventions to simple and complex cases, demonstrating flexibility within the treatment approach.
- To develop an understanding of the impact of these disorders on family functioning and how to include parents in treatment to improve effectiveness.
The Amplified Musculoskeletal Pain Syndrome Program (AMPS)
The AMPS Program consists of an interdisciplinary team including rheumatologists, a nurse practitioner, psychologists, physical therapists, occupational therapists, a music therapist, an art therapist, a school coordinator/social worker, and support staff. We treat children and adolescents with amplified pain through intensive physical, occupational and psychological/creative arts therapy to restore function without pain medications. This is a daily hospital-based program, Monday-Friday, 8 a.m. to 4 p.m. that takes 3-4 weeks on average.
Our mission is to provide a comprehensive holistic interdisciplinary team approach to the individualized treatment and care of children with Amplified Musculoskeletal Pain. We uphold this mission by empowering children and their families through instilling confidence and providing hope to restore overall healthy life function.
Interns participating in the AMPS Program will provide psychological services to patients including a minimum of two sessions per week, co-treatment with PT/OT and consultation with the interdisciplinary team to inform treatment planning. As available, interns will work in a group modality with patient and parents and participate in family meetings. Additionally, interns will have the opportunity to consult with outside mental health treatment providers, as appropriate.
- Increase understanding of amplified pain syndromes and their treatment.
- Develop psychotherapy skills as a member of an interdisciplinary team providing care to AMPS patients and their families.
- Develop skills working within an interdisciplinary treatment team, including providing feedback and consultation to the team.
The “BUFFET” Program
The BUFFET Program (Building Up Food Flexibility and Exposure Treatment Program) is a newly developed CBT treatment for food selectivity in school-age (8-12 years old), cognitively higher functioning children with ASD (Kuschner et al., 2017). The treatment is designed as a 14-session group-based, parent-assisted program that targets decreasing anxiety and increasing flexibility in order to help children expand diet variety.
BUFFET builds on aspects of evidence-based CBT treatments for children with ASD (Facing Your Fears, Unstuck and On Target) as well as commonly used exposure strategies used in feeding treatment programs. Groups include four to six children with ASD and their parent(s), with 90-minute sessions each week.
Behavioral Parent Training
The Behavioral Parent Training Rotation provides training in evidence-based approaches to addressing disruptive behavior across childhood, from preschool through early-adolescence. Behavioral parent training seeks to alter the coercive cycle of negative parenting practices and negative child behavior, which is a principal underlying factor in the development of disruptive behavior disorders.
This rotation will offer training in the components of individual behavioral parent training and group-based behavioral parent training. The needs, characteristics, strengths, and challenges of each family are recognized through all stages of care, including case conceptualization, session planning, implementation of treatment skills, and maintenance of treatment gains. Children seen through this program are experiencing familial, academic, and relational challenges. In addressing the child’s immediate home environment through positive parenting practices, the clinician facilitates a transition to a more reinforcing environment in which the child may experience greater success across daily experiences and interactions, contributing to a more adaptive pattern of behavior.
- To understand the impact of disruptive behavior disorders on individual, familial, and academic functioning.
- To develop expertise in clinical assessment and intervention with children presenting with disruptive behavior disorders
- To facilitate a developmentally-informed conceptualization of a child’s behavioral presentation.
- To implement a functional behavioral assessment and identify the role of antecedents and consequences in shaping behavior.
- To facilitate change in parenting practices through three modalities: psycho-education, role-play, and coaching.
- To gain experience in both individual and group implementation of behavioral parent training
Center for Management of ADHD - Group Treatment for Families
For families coping with ADHD, challenges related to treatment utilization and adherence arise for a variety of reasons, including family beliefs and stress, and limited provider availability. Group treatment formats are one method by which barriers might be reduced. Also, through group discussion and shared problem solving, parents and children derive support from others coping with ADHD, potentially increasing utilization and adherence.
The ADHD Center’s parent group treatment programs (Boot Camp and Family-School Success [FSS]) are intended to support diagnosis acceptance and treatment initiation/adherence. Additionally, the groups focus on developing and maintaining parent management skills and collaborative family-school relationships to support educational success. Group participants are parents of elementary aged children with ADHD. Also, in spite of the availability of effective parent training programs, many children with ADHD experience significant organizational skills impairments. In addition, as children get older, they need to become more independent in completing these tasks. The Middle School Organizational Skills Training (MOST) program is a skills-training group intervention targeting middle school students with organization, time management and planning deficits. This group also helps parents and teachers support students’ implementation and practice of skills to promote generalization.
- To understand the “active ingredients” involved in the CHOP ADHD Center’s group programs
- To acquire skills in case conceptualization and application of group family behavior therapy interventions for children with ADHD
- ADHD Boot Camp: To understand the process by which parents move from initial acceptance of the diagnosis to engagement in follow-up treatment, and to learn skills to help parents move through this process
- FSS: To acquire parent behavior management strategies and understand family-school and parent-child relationships and their effect on the success of children with ADHD
- MOST: To learn to implement an effective skills training intervention to treat organization, time management and planning deficits in middle school students with ADHD and address generalization challenges to implementation
Dialectical Behavior Therapy Multi-Family Skills Group
The Department of Child and Adolescent Psychiatry and Behavioral Sciences Outpatient Clinic provides training in delivering Dialectical Behavior Therapy for Adolescents (DBT-A) skills in a multi-family group format to address the needs of multi-problem teens presenting with depressive and other co-morbid disorders. The DBT-A Multi-Family Skills Group is a weekly out-patient group designed for high-school age adolescents and their parents. The group covers 5 skills modules: emotion regulation, interpersonal effectiveness, distress tolerance, walking the middle path, and core mindfulness. The training model involves the intern co-leading the group along with a supervising clinician and one other trainee (e.g. psychology extern or social work fellow). The intern also has the opportunity to participate in a twice monthly DBT-A consultation group.
- To acquire skills in the DBT-A conceptualization of depressive disorders and its comorbid symptom presentations.
- To effectively administer an empirically supported group intervention (DBT-A) to simple and complex cases, demonstrating flexibility within the treatment approach.
- To understand prevalence and risk factors for depressive disorders, its presentation in youth and the impact of these conditions on peer and school functioning.
- To assess and monitor suicide risk and implement safety planning for suicidal and self-injurious ideation and behaviors.
- To develop an understanding of the impact of depressive disorders on family functioning and how family interactions also impact the disorders and treatment.
- To demonstrate skills in clinical consultation about group families with individual treatment providers.
Diabetes Center for Children
This rotation is intended to provide the intern with training in motivational interviewing (MI) and cognitive behavioral therapy (CBT) while working with youth with Type 1 and Type 2 diabetes in the outpatient diabetes clinic.
Common reasons patients present for treatment are: difficulties with adherence to the medical regimen, problems coping with chronic illness, and parent-child discord surrounding disease management. The intern will gain supervised experience in outpatient consultation, assessment (clinical interview, medical chart review), and intervention. Specific intervention strategies include: use of MI strategies to promote adherence to the medical regimen, CBT to improve coping and functioning, and psychoeducation about the relationship between uncontrolled diabetes and mood and anxiety symptoms.
Interns will be expected to practice within a multidisciplinary care model, including endocrinologists, nurse practitioners, diabetes educators, dieticians, social workers, and a child life specialist. If schedules allow, the intern may gain exposure to inpatient consultation, assessment, and intervention with this population as well as the opportunity to participate in multidisciplinary rounds with colleagues in the Diabetes Center.
Family Stress and Illness Program (FSIP)
The Family Stress and Illness Program provides training in family systems intervention approaches to address the psychological needs of children and families experiencing acute or chronic illnesses, as well as more general child clinical concerns. The unique strengths of families are recognized through all aspects of care, in particular the essential impact families have on illness management and health outcomes. Priority is assigned to providing care for children and families who have recently experienced inpatient medical hospitalization and require ongoing psychological care to optimize healthy adjustments. Clinical presentations often focus on issues related to pain management, adherence, disease management, adjustment and coping, and trauma, with attention paid to the impact on family functioning and development. Many children seen through this program are experiencing somatic symptoms and related disorders (e.g., conversions, recurrent abdominal pain, irritable bowel syndrome, and other pain presentations). The training model utilizes a consulting team (psychology externs and interns), and includes live/in-the room as well as group and individual supervision.
- To understand the impact of acute and chronic illness on child, family, and caregiver functioning
- To develop expertise in clinical assessment and intervention with children presenting with a wide variety of behavioral health concerns
- To acquire skills in family systems conceptualization of cases
- To develop collaborative relationships with healthcare providers through conjoint conceptualization and management of cases
- To acquire an understanding of medical conditions as they impact upon child and family development
Gastroenterology and Nutrition
This rotation offers an opportunity to be part of an outpatient interdisciplinary team comprised of medicine, nursing, nutrition, social work and psychology. Our patient population includes children and adolescents with a range of presenting gastrointestinal conditions that include Inflammatory Bowel Disease, Functional Gastrointestinal Disorders, Eosinophilic Esophagitis, Celiac Disease, as well as Defecation Disorders.
This rotation is generally completed as a four-hour rotation. However, other arrangements may be made to accommodate needs of a particular intern’s training interests/schedule.
- Develop skills in assessment and outpatient psychological interventions for children and adolescents with gastrointestinal conditions and their families. Common treatment goals include improving adjustment to new chronic illness diagnosis, developing cognitive and behavioral skills for coping with pain and other GI symptoms, improving adherence to medical treatment, promoting improved daily functioning, and implementing behavioral treatment for encopresis and rumination.
- Develop skills in multidisciplinary consultation and collaboration with colleagues in medicine, nursing, social work, nutrition and Child Life.
Medical Behavioral Unit
The Medical Behavioral Unit (MBU) provides evaluation and intervention for acute inpatients ages 3 to 18 with a primary medical issues and behavioral needs that are affecting medical treatment in addition to medically cleared patients awaiting mental health facility placement. The MBU is a 10-bed unit with an interdisciplinary team of medical and behavioral supports.
- Complete diagnostic interview of child and parents.
- Assess immediate needs of the child and recommend evidence-based interventions.
- Implement evidence-based treatment for a variety of behavioral health issues such as anxiety, depression, self-harm, suicidality, feeding difficulties, psychosis, bipolar and other mood disorders, substance use, developmental and intellectual disabilities.
- Completion of safety plans.
- Provide crisis management interventions as necessary.
- Documentation of all assessments and interventions in the medical record, co-signed by supervisor.
Pediatric Epilepsy Program
The Pediatric Epilepsy Program rotation provides the intern with opportunities in administering psychological services as a member of the interdisciplinary Pediatric Epilepsy Program. Psychological services provided include:
- Assessment of patient and families coping with epilepsy and co-morbid behavioral health diagnoses
- Individual and/or family CBT based therapy for children within a broad age range
- Consultation with medical team around patient/family coping with anti-epileptic drug side effects, epilepsy surgery, ketogenic diet, and any additional medical treatments.
Common referral issues include adjustment to illness, treatment adherence, managing medication side effects, child/parent coping with anxiety directly related to seizures, and assessment/treatment for co-morbid psychiatric issues such as anxiety, depression, ADHD, and behavioral issues.
- To develop an understanding of epilepsy and the common psychiatric and educational issues children and families face when seizures are present.
- To develop skills in completing an initial outpatient evaluation and providing family with appropriate clinical recommendations.
- To develop skills in administering CBT based treatment targeting anxiety, depression, and issues related to coping with seizures (e.g. medication adherence).
- To develop skills in consultation with medical, nursing, social work, and school staff to support patient and family coping with complex medical issues.
Sleep Well! Sleep Intervention in Urban Primary Care
The goal of this 4-hour rotation is to provide interns with clinical experience in implementing Sleep Well!, a brief, manualized intervention for early childhood sleep problems that is tailored for use in an urban primary care setting. Interns provide direct intervention to caregivers and their young children (ages 1.5 to 5 years) with behavioral sleep problems (pediatric insomnia [difficulty falling/staying asleep]; insufficient sleep) in the context of a research study funded by the National Institutes of Health (NIH). The Sleep Well! program consists of two 60-minute, in-person sessions and 2-3 follow-up telephone calls in between sessions, with additional sessions provided on a case-by-case basis. The goal of the research study is to assess patient/family acceptability and to identify optimal program duration (number of in-person sessions and telephone calls) and patient resources (handouts; web links; text message reminders).
- Learn about strategies for providing behavioral sleep treatment in urban pediatric primary care and in the context of a funded research study.
- Provide brief, manualized treatment for early childhood insomnia and insufficient sleep.
- Learn effective techniques to support family engagement in care and empowerment in treatment.
- Develop consultative working relationships with primary care colleagues (referring providers, including HMHK providers, primary care providers, and primary care social workers).
- Develop skills in working with urban underserved communities facing multiple psychosocial stressors.