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.

Training objectives

• 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. 

Training objectives

• 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.

ASD Intervention

Providing interventions to children and adolescents with ASD and common comorbid symptoms (e.g., anxiety, ADHD, depression, behavior problems, emotion dysregulation

Training Objectives

• Increase familiarity with evidence based practices for youth on the autism spectrum
• Promote competence in serving youth on the spectrum who present with comorbid behavioral health concerns
• Expand foundational cognitive and behavioral intervention skills to serve youth on the autism spectrum

Behavioral Parent Training

The Young Child Behavioral Parent Training Program provides training in evidence-based approaches to addressing disruptive behavior in early childhood, focusing on the preschool years. 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 with a particular focus on learning Parent-Child Interaction Therapy (PCIT) for young children who meet criteria for oppositional defiant disorder and conduct disorder. Other empirically based behavioral parent training approaches may also be utilized based on clinical presentation. 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.   

Training Objectives  

• 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 facilitate change in parenting practices through three modalities: psycho-education, role-play, and in-vivo coaching.  
• To gain experience and training in evidence-based behavioral parent training programs, with a specific emphasis on Parent-Child Interaction Therapy.

Intern Responsibilities 

• Carry representative caseload of patients; at least 50% of your total time will be face-to-face or team based clinical contact 
• Complete initial intake, progress notes, treatment plan, and discharge summary 
• Prepare for and participate in weekly supervision, consisting of live sessions and individual supervision 
• Complete training exercises to gain competency in coding of dyadic parent child interactions and coaching parents in positive parenting practices 

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.

Training objectives

• 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.

Training objectives

• 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.

Eating Disorder Assessment and Treatment Program

The EDATP provides training in family based approaches to the treatment of adolescents with eating disorders, The outpatient intervention used is Family-Based Treatment (FBT) and Acceptance-based Separated Family Treatment (ASFT). Both of these are manualized treatments with empirical support. Early stages of treatment focus on parental involvement in re-nourishment and weight restoration. Patients range in age from 12-18 and are seen on a weekly basis. The training model consists of observation of others’ on going cases, on-going weekly supervision, and live observation by a supervisor.

Training Objectives

• To understand the prevalence, variability of diagnostic presentation, medical complications, and intricacies eating disorders
• To develop expertise in clinical assessment with adolescents presenting with eating disorders
• To acquire skills in family-based approaches to treating eating disorders
• To gain an understanding of how acceptance-based behavioral therapy can be integrated in to family approaches for the treatment of eating disorders
• To effectively administer family-based interventions to simple and complex cases, demonstrating flexibility within the treatment approach.

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. 

Training objectives

• 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

Facing Your Fears – Group Intervention for Anxiety in ASD

This rotation offers the opportunity to co-facilitate the Facing Your Fears group -  a parent/child CBT approach targeting anxiety symptoms in autistic children ages 8 to 14 who have cognitive abilities in the average range. The intern will also have the opportunity to provide individual therapy to a caseload of 1-2 children and adolescents with ASD and common comorbid symptoms (e.g., ADHD, anxiety, depression, behavior challenges, emotion dysregulation) following the completion of group.

Training Objectives

• Flexibly implement a manualized, evidence-based CBT intervention for anxiety with autistic children and adolescents
• Develop more comprehensive understanding of/independence in determining targets for exposure and guiding children/families through practicing exposures in session and at home
• Increase confidence in management of behavior and group dynamics in the context of a group intervention

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.

Training objectives

• 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.

Headache Program

This is a 4-hour training rotation with a focus on intervention within The Pediatric Headache Program in the Division of Neurology. Interns will have the opportunity to conduct biopsychosocial assessments, coordinate with a multidisciplinary team, and provide cognitive behavioral therapy for patients with headache and migraine. Supervision will be live, with opportunities for the intern to become increasingly independent, consistent with a developmental approach. Interns who are interested in managing chronic pain or somatic symptoms in an outpatient setting may want to consider pairing this rotation with the consultation rotation in the Concussion Clinic. 

The Pediatric Headache Program is an outpatient multidisciplinary team specializing in providing comprehensive assessment, diagnosis and treatment for children with disabling and difficult-to-treat headaches who have not responded to standard treatment by their community neurologist.

Stress, anxiety, mood, and lifestyle can often contribute to and maintain chronic pain and pain related disability. The referral question for psychology typically involves assessing for psychological factors that may be contributing to headache pain. 

The goal of therapy for patients with chronic headache is functional restoration. Cognitive behavioral therapy is used to provide psychoeducation on the mind-body connection, help identify the connection between thoughts, feelings, behavior, and physiological response as well as to teach coping skills so that patients can regain functioning, and manage psychological factors that may be contributing to headache (i.e., anxiety). Components of ACT and DBT may also be integrated into therapy. Interdisciplinary communication between team members, parents, and school is an integral component of patient care for this clinic.

Training Objectives

• Identify at least 3 psychological factors that may contribute to headache.
• Develop competency in providing psychoeducation on CBT in the context of pediatric headache, the mind-body connection including the body's stress response system, and recommendations for functional restoration.
• Develop competency in providing CBT for patients with headache.
• Collaborate to develop school re-entry plans for patients with headache
• Collaborate with multidisciplinary Pediatric Headache team including Neurologists, nurse practitioners, and social work as well as other relevant providers (e.g., PT) to provide consistent care to patients.

Hematology (Comprehensive Sickle Cell Center & Bone Marrow Failure Program)

Provide assessment and intervention services (individual and family)  to patients with SCD/BMF, with the following being the most common referral reasons: pain management; adherence; coping with illness; school/peer-related issues and mood. Also provide consult and intervention services to SCD inpatients. Collaborate with a large multi-disciplinary team (both inpatient and outpatient)

Training Objectives

• Gain understanding of SCD/BMF from a medical perspective and being able to conceptualize patient cases integrating their medical and behavioral health needs
• Gain understanding of evidence-based treatments germane to SCD/BMF populations across inpatient and outpatient settings
• Participate in interdisciplinary collaboration (both inpatient and outpatient) in service of patient care

Pediatric Concussion Program

This rotation focuses on intervention within the Concussion Program and is ideal for interns interested in concussion/traumatic brain injury, chronic pain or somatic symptoms, outpatient pediatric psychology, and multidisciplinary care. Interns will have the opportunity to assess and support biopsychosocial factors impacting concussion recovery and to coordinate with a multidisciplinary team of medical and psychosocial providers. Patients are referred from medical providers in the Minds Matter Concussion Program due to emotional or behavioral changes following injury and/or concussion symptoms that have not resolved within expected time frames. Patients present with a variety of injury mechanisms including sport, assault, and motor vehicle collisions. Common presenting developmental and psychological co-morbidities including ADHD, anxiety, depression, and post-traumatic stress. 

Interns will provide health and behavior assessments and interventions. The goals of initial health and behavior assessments are to identify biopsychosocial factors impacting concussion recovery, deliver feedback about these factors to patients and their families, and provide treatment recommendations which may include health and behavior intervention with pediatric psychology, referral to concussion neuropsychology, and/or referral to community care for primary mental health treatment. Health and behavior intervention with pediatric psychology is designed to be short-term (i.e., <10 sessions), uses evidence-based strategies including CBT, ACT, and MI, and aims to directly support concussion recovery by increasing adherence to healthy lifestyle behaviors (e.g., improving sleep, gradually increasing daily activity), learning symptom management strategies (e.g., relaxation strategies, activity pacing, cognitive coping), and improving caregiver use of behavioral strategies to improve functioning

Training Objectives

• Identify common psychological and behavioral factors that impact concussion recovery
• Develop competency in explaining the biopsychosocial model within the context of concussion recovery
• Gain experience adapting evidence-based treatments (e.g., CBT, ACT, MI) targeting concussion symptoms
• Consult with multidisciplinary team members (e.g., physicians, nurse practitioners, social work, neuropsychology) to deliver coordinated care
• Coordinate with outside providers as needed (e.g., school teams, community therapists)

Pediatric Health and Behavior (PHAB) Program

The Pediatric Health and Behavior (PHAB) Program provides outpatient consultation and intervention to youth with a wide range of medical conditions (e.g., neuromuscular disorders, metabolic conditions, lupus, arthritis, stroke, asthma, etc.) who are experiencing emotional or behavioral difficulties secondary to their medical diagnosis or treatment. Typical referral concerns include: adjustment to new diagnosis or progression of symptoms; difficulties with self-management or adherence; medical trauma or anxiety related to medical setting; and behavioral concerns secondary to neurodevelopmental differences associated with medical diagnosis. Interns will have the opportunity to conduct intake appointments, create and implement treatment plans, and participate in multidisciplinary care by providing recommendations back to referring providers and care teams. Primary treatment modalities used in this clinic include CBT, TF-CBT, ACT, and Collaborative Problem Solving. This rotation offers the opportunity to develop breadth of experience with common pediatric medical conditions, and exposure to pediatric psychology intervention from intake through therapy termination. Supervision will be live, with opportunities for the intern to become increasingly independent, consistent with a developmental approach. Interns will be encouraged to identify special interests or gaps in prior training so their rotation caseload can be tailored to their individual training needs or goals. 

Training Objectives

• Develop an understanding of the impact of chronic illness and medical traumatic stress on development and family functioning
• Cultivate interdisciplinary and consultation skills by communicating regularly with medical and social work colleagues
• Build comfort applying CBT, TF-CBT, and ACT skills in the context of chronic illness
• Practice integrating conversations about family culture and identity within health and behavior assessments and interventions; Create and implement treatment plans that appropriately target behavioral health symptoms within the context of developmental level, medical diagnosis, and family culture

Pediatric Regional Epilepsy Program and Tic Disorders

The training goal of this rotation is to provide the intern with opportunities in administering psychological services as a member of the interdisciplinary Pediatric Regional Epilepsy Program (PREP). Additionally, interns can choose to also have experience delivering Comprehensive Behavioral Intervention for Tics for patients with tic disorders. Psychological services provided include

1. assessment of patient and families coping with epilepsy and/or tics and co-morbid behavioral health diagnoses
2. individual and/or family CBT based therapy for children within a broad age range (ages 3 to 19)
3. comprehensive behavioral intervention for tics (CBIT) for children ages 6 and up and
4. 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.   

Training Objectives 

• To develop an understanding of epilepsy and tic disorders as well as the common psychiatric and educational issues children and families face when seizures and/or tics 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 and/or tics. 
• To develop skills in administering CBIT treatment for tics.
• To develop skills in consultation with medical, nursing, social work, and school staff to support patient and family coping with complex medical issues.   

Primary Care (for IBH and Pediatric Psychology Track Interns)

The Primary Care rotation fulfills partial requirements in the core areas of intervention and consultation and includes individual and family therapy, parent training in behavior management, clinical assessment, and consultation with families, primary care pediatricians, school personnel, child psychiatry fellows and pediatric residents.

This rotation is based at the South Philadelphia, Karabots, Norristown, or Cobbs Creek Primary Care locations.

In conjunction with their psychologist supervisor, psychology interns participate in a brief initial clinical consultation, which focuses on the presenting concern and need for follow-up behavioral health concerns. Clinical consultation results are shared with the referring pediatrician, as well as parent(s). Based on the level of the concerns, short-term, evidenced-based treatment plans are developed. The child and parent(s) are seen for follow-up mental health intervention by the psychology intern at the primary care office location. If necessary, children and families are referred for longer-term community-based care. For these cases, psychology interns work in conjunction with the practice-based social workers to encourage engagement in longer-term care.

Training Objectives

• To learn about strategies for providing integrated mental health services in pediatric primary care.
• To learn strategies for conducting brief consultations to develop evidence-informed treatment plans.
• To provide individual and family EBPs to children and families in a primary care setting.
• To learn effective techniques for interviewing parents and children.
• To learn how to conduct behavioral consultation with other primary care providers.
• To become an effective consultant on empirically supported interventions to primary care providers.
• To collaborate with trainees from other disciplines in a primary care setting.

School Based Mental Health Program

The intern will shadow the supervising psychologists in their daily responsibilities as mental health clinicians embedded within the school setting. The intern's time will be split between Anderson Elementary School (K-8th grade) and Mastery Hardy Williams Elementary Charter School (K-6th grade). Both schools are located in southwest Philadelphia and serve a predominantly African-American student population. The intern will provide comprehensive, evidence-based mental health services to students within the school setting including individual/group therapy to student clients, consultation to teachers and school staff, and providing Tier 1 services (e.g., professional development for teachers, social-emotional learning lessons in classrooms). Common referral concerns include trauma, behavioral difficulty at school/home, anxiety, depression, and adjustment problems. The intern will work as part of an interdisciplinary team that includes psychologists, psychiatrists, social workers, teachers and school administrators, school counselors, and the school nurse.

Training Objectives

• Enhance skills and competence in evidence-based, comprehensive school mental health services including assessment and treatment of school-aged children.
• Function as a member of an inter-disciplinary team within school-based settings.
• Develop professional skills as a psychologist through supervision, mentoring, and training.