Clinical Psychology Residency

The Psychology Department offers postdoctoral training in adult and child/adolescent clinical psychology.


Introduction and Context

The mission of Hartford Hospital and The Institute of Living (IOL), Hartford Hospital's Division of Psychiatry, is to promote, restore, and maintain the health of all people we serve. The Institute of Living, a teaching hospital founded in 1822, is one of the nation’s foremost psychiatric facilities. The Institute contains 125 inpatient beds, a school, adult and child outpatient clinics, partial hospital and intensive outpatient psychiatric and substance abuse treatment programs. Specialty programs in the Department of Psychology include the Center for Cognitive Behavior Therapy, Health Psychology, and Neuropsychology. We are a tertiary care hospital and many of the patients coming to the IOL have had several psychiatric hospitalizations with a large number of patients who have severe and persistent mental illness. The setting includes 35 acres of historic and finely landscaped grounds less than a mile from downtown Hartford, geographically located midway between New York and Boston.

In 1994 The Institute of Living, then functioning as a private psychiatric hospital, was consolidated with Hartford Hospital (a major teaching hospital and long-time neighbor) further enriching this training environment. In 2011 Hartford HealthCare became the parent corporate structure for Hartford Hospital. The IOL is part of the Behavioral Health Network, which includes the integration of seven hospitals with each other and other system resources, such as Neurology and Primary care settings.  The Department of Psychology is a section of the Department of Psychiatry. All psychologists are appointed to the Active medical staff and hold voting privileges within the Psychiatry Department. The Institute of Living retains its name and board and has been ranked over the past few years in US News and World Report as one of the top psychiatric services in the United States. The Psychology section has full financial support from the Department of Psychiatry and Hartford Hospital. Currently we employ >60  psychology staff and 18 interns/fellows at Hartford Hospital.

The first psychologists at The IOL were appointed in 1936 and we have had an APA-accredited Internship since 1957 (one of the oldest and longest accredited program for psychologists in the USA). The Postdoctoral Residency Program was accredited through APA in 2005 as a traditional psychology practice program. It is the mission of Psychology to hire and retain staff and trainees who will provide high quality treatment and assessment services to all patients as needed in the Hartford HealthCare System, and for the Director of Psychology and The Director of Training to be responsible for providing training in Clinical Psychology. All of the training programs are funded by Hartford Hospital. While there is no one academic umbrella for The IOL, many Psychologists hold one or more appointments at neighboring or distal Universities, including UCONN Health Center and UCONN, Yale University, the University of Hartford, and Wesleyan University. Some of the staff teach psychology courses at the undergraduate or graduate level throughout the Connecticut area. We also have a number of practicum students from doctoral programs throughout the New England area, as well as volunteers and summer externs.


Application Process

Applicants for the Neuropsychology fellowship have a deadline of January 1, and are required to participate in the APPCN match process. Applicants for the Anxiety and Related Disorders and CBT Therapy and Research Tracks should send application materials directly to Dr. Tolin, per instructions on the UPPD.

For all other programs, applications and supporting materials, transcripts, and letters of reference must be submitted by January 1 through APPA CAS. Our program will adhere to the APPIC guidelines and utilize APPIC's centralized postdoctoral application system (APPA CAS).

Interviews will be arranged by invitation after a review of all application materials is completed. Virtual interviews will be arranged between early January and mid-February. Inquiries regarding your application can be made by calling 860.545.7167.

Notification of acceptance will follow guidelines suggested by APPIC for this year's residency process.


Who Should Apply

Applications are accepted from doctoral psychologists from APA-accredited programs in Clinical or Counseling Psychology who have completed an APA-accredited internship. Residency applicants should have an interest and background in psychological evaluation and psychotherapy, and interest in advancing competencies in providing hospital-based services to patients experiencing both acute psychiatric difficulties and chronic mental health issues. Applicants need to have completed their doctoral degree or have a letter from their program attesting to the planned completion of degree requirements within the first month of the residency.


Training Program

The Psychology Department offers pre-doctoral (internship) training in adult and child/adolescent clinical psychology.  The internship has four tracks: (1) Adult Track; (2) Child/Adolescent Track; (3) Adult Cognitive Behavioral Therapy and (4) Child/Adolescent Cognitive Behavioral Therapy.

Post-doctoral fellows (residents) in Psychology are provided one year of training in a traditional psychology practice model with the goals of achieving advance practice methods in psychology that go beyond the entry level competence of interns.  Current areas of emphasis include:  (1) General Adult Psychology including placements in Adult Inpatient, Health Psychology, and Psychosis/Persistent Mental Illness; (2) Child and Adolescent Psychology, including placements in Child Inpatient, and The Grace Webb School.

The 2- year positions having a focus in Neuropsychology and Anxiety Disorders were separated from the traditional accredited program in 2015-2016, but continue to be integrated into the overall Residency program for a variety of learning, educational, and training experiences.

The Residency in Clinical Psychology

Prospective candidates for the one-year residency in Clinical Psychology can apply to be considered for one or more areas of emphasis.

As a tertiary hospital, The IOL specializes in the evaluation and treatment of acute and chronic medical, psychiatric and behavioral disorders, including acute exacerbations of chronic conditions. Stabilization of psychiatric crises using an integrated blend of brief psychotherapy, crisis stabilization, family consultation, psychopharmacology, case management, and contact with community resources has become the hospital's primary mission and those areas of practice are emphasized in the training of the residents in psychology. Special emphasis is given to suicide and violence assessment as part of each patient’s hospitalization. Residents are trained in the use of these tools as part of their inpatient and outpatient work.

The hospital has been successful in establishing an umbrella of care for its patients, integrating the use of inpatient, partial hospital, and intensive and less intensive outpatient services in response to a patient's changing treatment needs. We serve a multi-ethnic and multilingual community and services are available in many languages. One of the 5 pillars of Hartford HealthCare is Equity, and in our settings, cultural competency is emphasized in every supervisory and clinical contact.  We strive to recognize, reflect and respond to the ways that our staff’s and our patient’s gender, sexuality, ethnicity, religion, and social status affect the course and etiology of a patient’s illness.

The residency training program is structured such that the resident assumes primary clinical responsibilities within the hospital’s integrated healthcare delivery system. Indeed, residents assume responsibilities similar to those of a staff psychologist working within the same work site. However, the residents are closely supervised on their work with the mission of helping them to achieve independence in their clinical practice by the end of the training year.

To this end the weekly Early Career Seminar focuses of professional growth and development and attends to the need for residents to become supervisors. Residents are introduced to the methods of supervisory practice and are all involved in supervising either interns in Clinical Psychology or externs. There are also opportunities for peer supervision.

Our teaching faculty believes that the residents need to be responsive to the changing context of health delivery systems throughout the country, and are provided all the administrative tools in the Hospital, including detailed updates on administrative goals. Opportunities to gain expertise in administrative psychology/psychiatry are provided in individual supervision, and seminars, including the residency weekly seminar and elective attendance at the Department of Psychiatry’s leadership meetings.

Training Philosophy
The Institute of Living/Hartford Hospital (IOL) Postdoctoral Residency in Clinical Psychology adheres to a science-informed practice model of training. We view this model as being compatible with a diverse array of career paths, focusing on practice areas in psychology. Almost all of our graduates choose clinical areas of practice and research as their career choice, while many also teach or supervise. The unifying theme in this residency is the practical integration of scholarship and psychological science into practice. Toward this end, the residency emphasizes the use of critical thinking skills and the thoughtful and systematic evaluation of clinical work using a variety of best practices informed by current trends in the science of psychology as they evolve over time.

Orientation Period
During the first week of the residency each trainee meets with faculty members and various key administrative and clinical personnel in the healthcare system.

The purpose of these meetings is to meet with key personnel and to integrate into the flow of the department and the healthcare system.

Substance Use/Screening
The prevalence of drug use in today's society has received widespread recognition. In response to recent nationwide trends among both corporate businesses and hospital communities, the Institute has recognized the need to establish clear drug use policies for its employees. In light of this concern, the hospital has instituted a confidential drug testing procedure for all new employees. The hospital's Employee Assistance Program has requested that all departments notify prospective applicants of this procedure. Testing via urinalysis will occur prior to the residency start date with employment contingent upon the results.

Onboarding Benefits

Pre-Employment Screening
After matching/acceptance of an offer the applicant must complete the Hartford Hospital new employee application process prior to starting in September, which includes completing a written application, TB test, physical examination, and a drug screen.

Statement of Nondiscrimination
The Institute of Living/Hartford Hospital is an equal opportunity employer. We welcome applicants from various racial, ethnic, sexual orientation, religious, and cultural backgrounds as well as those with physical disabilities.

Training Format
Trainees will work 12 consecutive months, 40 hours a week, Monday through Friday. A total of 1960 hours will be spent in direct service, indirect service, didactic training, and supervision. Out of the 1,960 total hours, trainees are required to provide a minimum of 40% on direct service.

Stipends
Residency stipends are $42,500 (paid bi-weekly) and benefits include an employee-chosen health plan, 15 vacation days, five sick days, and 7 paid hospital holidays.

Benefits and Liability Insurance
Trainees will be offered paid (partially subsidized by the hospital) enrollment within the hospital’s health insurance and/or dental insurance programs and are covered by the organization’s liability insurance during their temporary twelve (12) months of employment (applicable Summary Plan Descriptions for further details regarding service, cost, and plan administration can be found on the Hartford Hospital Intranet and orientation packet). Since Trainees are employed by the hospital for their temporary twelve (12) months of employment, they are covered and must comply with all policies of the hospital, including but not limited to grievances, anti-harassment, and performance expectations. Trainees can access these policies during the hospital’s orientation process and in full through the Hartford Hospital website.

Paid Time-Off and Holiday Pay
Trainees receive three weeks of paid time off and five sick days as well as seven national holidays. Trainees request time off from their primary supervisor who approves, with final review by the Director of Training. Trainees are not permitted to take extended time off during the month of August.

Housing
Housing is provided by the trainee.

Accreditation Status

Psychology Training is accredited by the Commission on Accreditation of the American Psychological Association. We expect site visits in 2023 (internship) and 2022 (post-doc); visit status is in flux due to the COVID-19 pandemic. We remain accredited in good status as we wait for the next visits to be scheduled.

Questions related to the program’s accredited status should be directed to the Commission on Accreditation:

American Psychological Association
Office of Program Consultation and Accreditation
750 1st Street, NE Washington, DC 20002-4242
Tel: 202.336.5979
Fax: 202.336.5978
Email: apaaccred@apa.org
Web: http://www.apa.org/ed/accreditation


Clinical Psychology Residency

PROGRAM TABLES

Download

Overview of the Residency

Areas of Emphasis

A prospective resident may apply to one or more areas of emphasis to be considered for the general training in advanced levels of competencies in psychology. Currently, there are 10 positions that are funded. An area of emphasis is defined as a placement setting in either child or adult psychology which serves as the primary site of training for the resident for the training year. The areas of emphasis are described below. Residents training in the specialty areas of Neuropsychology and the Anxiety Disorders Center have a two-year training structure and while they continue to be under the direction of the Director of Training and participate in the seminars with all residents, they are not currently part of the accredited Postdoctoral Training Program.

General Clinical Psychology Area of Emphasis - Child/Adolescent:

School-based Psychological Assessment and Psychotherapy
The department is led by senior Psychologists who adhere to a scholar-practitioner model that actively integrates contemporary psychodynamic and cognitive-behavioral models. The Grace Webb School is our on-site therapeutic school that provides elementary, middle, and high school programming. The Grace Webb School and the outpatient clinics serve the regional and local community, which is ethnically, racially, and socioeconomically diverse including both urban and suburban populations. The school, while providing academic programming to its students, also provides individual and group psychotherapies to the students. Grace Webb students are enrolled for the full academic year and as a result, the Residents have the opportunity to provide longer-term therapy.

The Resident will have the opportunity to provide individual, group, and family psychotherapies to the Grace Webb students and outpatients admitted into several of our clinics. They will also conduct cognitive and personality testing for children and adolescents. In the Grace Webb School the Resident will be expected to complete 3 comprehensive assessments each month. Testing referrals will include psychodiagnostic evaluations as well as triennial evaluations mandated by the school system. Residents will work closely with Psychiatrists, other Psychologists, teachers, and social workers within the service. There is also the possibility of the Resident becoming involved in elective training opportunities throughout the IOL's numerous clinics.

Child/Adolescent Inpatient
The Child/Adolescent Inpatient Fellow works closely alongside the Adult Inpatient Fellow and is integrated in the greater fellowship cohort through meetings and seminars. The training environment is highly focused on the professional development of each fellow as well as fostering the leadership skills required to succeed as an early career psychologist. 

Founded in 1822, The Institute of Living is the third oldest psychiatric hospital in the nation, and the first hospital of any kind in Connecticut. It lies in the center of Hartford CT, across the street from Hartford Hospital and Connecticut Children’s. The IOL has a rich history in treatment and research in psychiatry, and is one of the oldest training programs in the country.

Child/Adolescent Inpatient Training is science-informed, and will focus on the preparation for advanced practice competence in provision of brief inpatient treatment with children and adolescents presenting with a wide range of acute and severe psychopathology. The treatment model integrates empirically supported interventions, contemporary psychoanalytic object relations perspective and systems/family work. 

Residents will develop advanced skills and experience in rapid psychodiagnostic and risk assessment, psychodynamic case formulation, and integrating object relations assessment with DSM-V diagnosis. In addition, Residents will develop advanced competency in consultation, treatment planning, and case management (when appropriate). Interventions used/developed during training include focal individual psychotherapy, group therapy, psychopharmacology, family therapy, milieu therapy, and behavioral/cognitive-behavioral/DBT techniques. 

Residents will provide consultation through the Inpatient Psychology Consultation Service to the child and adolescent units throughout the duration of their training year. Depending on the consultation question and the clinical need, the resident will carry up to 3-5 consultations at a time. The consultation service acts as an adjunct and complement to the current treatment plan and can include the provision of individual psychotherapy, family therapy, specialized treatment interventions, individualized behavior plan and staff support plans, complex case conceptualizations, risk assessments, and treatment recommendations. Residents will work collaboratively with the multi-disciplinary treatment team to identify treatment needs and provide consultation. There is also the opportunity to provide consultation to the adult units when there is a need and interest. 

Residents will receive extensive training in group therapy; facilitating/co-facilitating around 8 groups per week across the child, pre-adolescent, and adolescent units. Training will focus on process-oriented and skills-based group psychotherapy with adolescents. Social-skills and psychodynamically-oriented group therapies are provided for child units. 

The amount of direct service will vary considerably based upon individual patient needs but on average, each patient will require a minimum of 30 minutes daily of direct contact individually and involve multiple family meetings (when doing a family therapy consultation) during the week. Additionally, an integral aspect of the Resident’s training is developing experience with and competence in milieu therapy; the Resident will support the Unit Psychologist in milieu management, crisis intervention, and staff education/training. There will be many opportunities to develop leadership skills through involvement in program development and implementation, unit-wide initiatives, and Trauma-Informed Care staff training.

General Clinical Psychology Area of Emphasis - Adult:

Adult Inpatient
The Adult Inpatient Fellow works closely alongside the Child and Adolescent Inpatient Fellow and is integrated in the greater fellowship cohort through meetings and seminars. The training environment is highly focused on the professional development of each fellow as well as fostering the leadership skills required to succeed as an early career psychologist. 

Founded in 1822, The Institute of Living is the third oldest psychiatric hospital in the nation, and the first hospital of any kind in Connecticut. It lies in the center of Hartford CT, across the street from Hartford Hospital and Connecticut Children’s. The IOL has a rich history in treatment and research in psychiatry, and is one of the oldest training programs in the country. The training program adheres to a science-informed model that actively integrates contemporary psychodynamic and cognitive-behavioral models. 

The focus of the inpatient fellowship is on the delivery of brief, intensive treatment with patients admitted to our general adult inpatient psychiatric units in the role of Psychology Consultant. Within the inpatient hospital at IOL, there are 4 adult units and 3 child and adolescent units which are all serviced by the Inpatient Psychology Consultation Service. The Hartford area is richly diverse, allowing for advancement of cultural competence at the forefront of both patient and systemic interactions. Diversity and Equity are a focus within case formulation and treatment planning, while also being openly discussed in meetings and councils throughout the healthcare system. The consultation service acts as an adjunct and complement to the current treatment plan and can include the provision of individual psychotherapy, targeted interventions, individualized behavior plans, case conceptualizations, risk assessments, and treatment recommendations. The fellow acts as expert and consultant to the requesting treatment team. 

The fellow works across all adult and older adult units and becomes part of the requesting interprofessional team which includes, Psychiatry, Social Work, Nursing, Recreation Therapy, Recovery Support Specialists and Mental Health Technicians. The requests typically involve assistance with highly complex, high risk, or high needs patients. The fellow is a key member of this consultation service and will be expected to quickly assume an independent level of functioning; therefore, applicants with psychiatric inpatient experience are highly desired. Applicants should also be comfortable with psychodynamic theories and Cognitive Behavioral Therapy. Fellows will facilitate both process-oriented and skills-based groups across multiple adult inpatient units. At times, these groups will be run independently and intermittently co-facilitated with interns and practicum students. This will provide in-vivo supervisory experience for the Fellow in addition to 30 minutes per week of supervised supervision of the inpatient Intern. Fellows participate in supervised research (4 hours reserved/protected weekly) that has generally focused on clinical topics related to their fellowship. Fellows present their research at the Psychology Department’s Research Day during the summer. 

One of the many benefits of training within a larger hospital system includes availability of many elective experiences. The fellow will have the option to generate protected time for additional training interests, which may include: psychological and neuropsychological testing, working in the Psychiatric Emergency Department (Purple Pod) at Hartford Hospital, Consultation Liaison on the adult medical floors in Hartford Hospital, Family and Couples therapy both inpatient and outpatient, program development, and leadership.

Treatment of Psychotic and Persistent Mental Illness
The robust psychology training department at HH/IOL currently includes eight predoctoral interns, ten postdoctoral fellows, and numerous practicum students. The Psychosis/Persistent Mental Illness Resident is integrated in the greater fellowship cohort through meetings and seminars but focuses on psychosis across levels of acuity and throughout the lifespan. Founded in 1822, The Institute of Living is the third oldest psychiatric hospital in the nation, and the first hospital of any kind in Connecticut. It lies in the center of Hartford CT, across the street from Hartford Hospital and Connecticut Children’s. 

The IOL has a rich history in treatment and research in psychiatry, and is one of the oldest training programs in the country. The training program adheres to a science-informed model that actively integrates contemporary psychodynamic and cognitive-behavioral models. This area of emphasis prepares the trainee for advanced practice competence in the areas of treatment, evaluation and rehabilitation of adults with psychotic illness. 

The focus of this fellowship is to immerse the resident in work that focuses on treating individuals with psychosis across levels of acuity presenting with heterogeneity in symptom and at varying levels of onset (e.g., high-risk, first-episode, chronic).  As such, the resident's primary role will serve as a clinician in an intensive-outpatient setting for young adults experiencing first break symptoms. The resident will also have the option to carry an outpatient caseload of individuals suffering from psychotic illness across the lifespan.  Additionally, the resident will serve as a consultant to our inpatient service, providing expert knowledge on the therapeutic treatment and discharge planning for individuals with psychotic symptoms. 

While a primary rotation will be within the first-episode clinic, the resident will also rotate through other specialty clinics. Work at the Schizophrenia Rehabilitation Program (SRP) focuses on individual, group and family therapy, case management, cognitive remediation and psychoeducation for participants with chronic psychosis. The SRP also conducts and incorporates the latest research on the treatment and rehabilitation of schizophrenia to develop a best practice model for assessment and intervention. Research in the program includes vocational and cognitive interventions and outcomes, behavioral interventions and psychopharmacological interventions. There will also be opportunities to work with our adolescent psychosis program wherein the fellow will be exposed to those individuals presenting with at-risk or prodromal symptomology, or our Adult Day intensive outpatient program, where patients have a wider range of serious and persistent mental illness. Across settings, the fellow will facilitate both process-oriented and skills-based groups, be involved in individual and family treatment modalities, consult and work as part of various interdisciplinary teams, and be exposed to clinical research with these populations.

The Hartford area is richly diverse, allowing for advancement of cultural competence at the forefront of both patient and systemic interactions. Diversity and Equity are a focus within case formulation and treatment planning, and are openly discussed in meetings and councils throughout the healthcare system.  

Fellows participate in supervised research (4 hours reserved/protected weekly) that has generally focused on clinical topics related to their fellowship. Fellows present their research at the Psychology Department’s Research Day during the summer. One of the many benefits of training within a larger hospital system includes availability of many elective experiences. Some of these experiences may include: psychological and neuropsychological testing, working in the Psychiatric Emergency Department at Hartford Hospital, Consultation Liaison on the adult medical floors in Hartford Hospital, Family and Couples therapy both inpatient and outpatient, program development, and leadership.

Health Psychology
The Department of Psychology at the Institute of Living/Hartford Hospital is pleased to accept applications for two (2) one-year postdoctoral residency positions in clinical psychology with an emphasis in health psychology, to begin in September of 2022. The residency follows the scientist-informed model of training and is an area of emphasis of the one-year APA-accredited postdoctoral residency program at the Institute of Living. The intent of the training program is to further the resident’s growth as a clinical psychologist and to develop advanced competency within the area of clinical health psychology. While the residency will emphasize evidence-based practices, the resident will receive training from various theoretical models, providing a unique perspective on the integration of mind and body problems.

The primary aim of the residency is to provide experiences in clinical assessment and intervention to adult patients experiencing a wide range of medical and psychological problems. The position is outpatient-based and includes consultation and diagnostic interviewing, pre-surgical psychological evaluations, short-term psychotherapy and behavioral interventions, and group therapy. The resident is provided ample didactic experiences and opportunities for teaching and supervision. There is also a requirement for a research project to be completed during the course of the year. Areas of clinical focus will be Digestive Health, Surgical and Medical Weight Loss, and Cardiology, but there is some flexibility in terms of additional areas of training, with possible opportunities in the following areas:

  • Pain management
  • Headache
  • Orthopedics/Sports Psychology
  • Epilepsy
  • Men’s Health
  • Women’s Health
  • Transplant 

Applicants must have completed all requirements for the doctoral degree, including the completion of an APA-accredited predoctoral internship in clinical psychology. Preference is given to candidates with prior training and experience in health psychology, but this is not a requirement.

Non-Accredited Specialty Tracks 

Clinical Neuropsychology Fellowship
We are pleased to offer a two-year full-time position for a postdoctoral fellow in Clinical Neuropsychology for the 2022-2024 cycle. Learn more.

Anxiety Disorders
The Anxiety Disorders Center/Center for Cognitive Behavioral Therapy (ADC/CCBT) at the Institute of Living/Hartford Hospital invites applications for two (2), one-year postdoctoral fellowships (with an option for a second year, to be determined mutually) beginning in Fall 2022. Learn more.

Seminar Programs

Residents attend a variety of seminars, offered by both Psychology and the Psychiatry Residency Training Program. The following seminars will be available this year and each resident will determine with his primary supervisor which seminars should be attended::

  • Early Career Seminar, weekly (Required)
  • Modern Readings in Personality and Psychotherapy
  • Weekly Grand Rounds (Required)
  • Department Meeting, monthly (Required)
  • Group and Family Therapy
  • Advanced Case Consultation (Required)
  • Pediatric Journal Club (required in that area of emphasis)
  • Neuropsychology Seminar (required in that area of emphasis)

Residents are required to attend the monthly psychology department staff meeting where both administrative and educational issues are addressed. Besides involving the residents in the full workings of the department and providing an inside view of the hospital-based practice of clinical psychology, a wide range of educational topics is discussed. In accordance with APA guidelines, each resident will be expected to present with findings from their research/program development/outcomes work during the year. Residents also present to individual members of the staff during Advanced Case Consultation.


Evaluation of Trainees and the Training Program

Training Requirements and Goals
The residency prepares the trainee to become skilled at utilizing new research and applied findings and integrating them into practice. Supervision and seminars will have the residents reading, discussing, and evaluating practice-relevant research and applied articles; developing treatment plans informed by best practices; and discussing the therapeutic, ethical, and legal aspects of current findings. All residents will be required to conduct a scholarly research project that involves program development or an evaluation of treatment efficacy. Residents will present their research projects during our annual “Psychology Day” at the end of the training year, during which the Department’s service contributions to the hospital’s core mission and training program are recognized at a hospital-wide celebration.

The overall education and training goal of the residency program is to train professional psychologists for primary practitioner roles in clinical services, particularly in the public sector, though some of the residents may choose to focus on teaching and research and more scholarly pursuits. This expected outcome flows from the primary goals of the program:

  1. The acquisition of advanced competencies in the foundational competencies of professional psychology in general and,
  2. To prepare residents for independent practice through the acquisition of best practice models of assessment and intervention that are pertinent to the areas of emphasis chosen by the resident and,
  3. To provide a supportive mentoring environment, and to foster further professional development and role consolidation necessary for autonomous functioning as licensed psychologists.

Advanced competencies are identified as involving the following core areas of competency in the Standards of Accreditation that have been identified by APA and include:

  1. Assessment, diagnosis and interventions;
  2. Consultation, program evaluation and supervision;
  3. Strategies of scholarly inquiry and the integration of science and practice;
  4. Professional conduct, ethics and law; and
  5. Issues of cultural and individual diversity

Initially, all residents are assessed for having met the core competencies appropriate to the internship level (entry-level of competence). Goals for the year are identified for each resident in terms of what they should expect to accomplish to achieve advanced levels of competencies over the training year.

Each of the areas of emphasis uses these competencies as the template for evaluating and assessing a resident’s growth and development over the year of residency training. All residents are exposed to supervisory experiences and receive individual and/or group supervision. Residents across all areas of emphasis meet together and with staff during several seminars and meetings (Psychology Department Meeting (monthly), Early Career Seminar (weekly), and  Advanced Case Consultation (weekly).

Case conferences are held weekly for one hour and allow the resident to present clinical and scholarly material to their peers and to Consulting Psychology and Psychiatry staff. Early-mid career psychology staff co-lead the weekly Early Career Seminar to mentor and guide the residents as they acquire the skills and material necessary to meet an advanced level of competency in primary areas of clinical work.

All of the teaching and clinical staff attend Psychology Department meeting monthly.

Reading lists and educational materials specific to each area of emphasis provide additional scholarly introductions to the application of general skills in that area. Consultation skills are learned through working with interdisciplinary staff, presenting clinical and scholarly material at case conferences, and attending seminars and professional education seminars. The residents are looked upon by other staff as educators and they have the opportunity to supervise and consult to non-psychology staff. Residents are expected to present scholarly material as part of their case conferences, citing relevant scholarly and research issues related to empirically informed and guided treatment, best practice models, and up-to-date information on practice standards.

The Director of Psychology runs a monthly Department meeting with all staff and trainees.  Herein is shared information about the department (report outs from each clinical area), the larger system (financial status, current initiatives) as well as discussion of larger issues in the field. In this context, staff will discuss and help distill the impact that hospital and non-hospital systems have on trainee professional development and care of patients. All residents are expected to demonstrate significant growth in their professional development and maturity as well as advanced knowledge of ethical, legal, diversity and cultural issues present throughout their work as psychologists.

We stress a model of lifelong learning and the formation of peer support groups for post-residency learning and support the residents’ acquisition of new models of learning based on best practice models, empirically informed treatment models, and the development of research protocols for studying one’s methods and practices when necessary.

As a group of psychologists, we meet at the beginning of each training year to discuss with the training faculty the objectives and goals for training for all the residents in psychology. In order to ensure consistent education across areas of emphasis we use a single tool to measure adherence to the training and we get feedback every six months from residents and staff regarding the achievement of the core objectives and goals in each of the training areas of emphasis. All residents are evaluated at the end of the year on the same set of core competencies regardless of their chosen area of emphasis. Supervisory staff meet together on a monthly basis to provide feedback about training goals and objectives for each resident, to provide feedback about whether the individual is appropriately achieving their goals for their residency, and to determine whether or not a resident is satisfying the criteria for graduating and sitting for licensure as an independent practitioner.  Growth edges are discussed with interventions planned collaboratively in a supportive manner.

In order to graduate, all residents regardless of area of emphasis are required to demonstrate Core Competency in the following areas, as described below:

Core Competency 1: Assessment, Diagnosis and Interventions
Residents will become proficient in providing consultation to members of their treatment teams, other allied health providers requesting psychological services, and to peers, consulting with other professionals regarding the utility and necessity for psychological assessment, and in determining the tools and methods appropriate to that task. Residents will demonstrate advanced proficiency in the use of relevant assessment tools so as to diagnose, identify patient strengths, and to assist in carrying out appropriate interventions for their patients in diagnosis, assessment and any relevant interventions related to treatment and discharge planning.

Core Competency 2: Consultation, Program Evaluation and Supervision
Residents will become proficient in consultations within areas of emphasis. They will become competent in evaluating their programs, learning about how to utilize patient satisfaction measures and how to evaluate their interventions. This may involve learning how to evaluate specific tools to measure patient outcome and the administration, scoring, interpretation, and reporting of the results of patient feedback onto treatment objectives. This may also relate to learning appropriate assessment and consultation methods to achieve treatment goals and/or tools that assist in diagnosis, identification of patient strengths, and in treatment planning. This includes the provision of feedback to patients and to treatment team members. Residents will supervise interns or externs and learn and acquire supervisory training and skills at an advanced level of competency, beyond that learned during internship training.

Core Competency 3: Learn Strategies of Scholarly Inquiry and the Integration of Science and Practice
Residents will utilize the scholarly literature to inform their interventions with patients. Residents and supervisors will be required to bring to the supervisory experience relevant scholarly literature related to specific assessment, treatment, and therapy goals and how they may influence treatment and planning decisions. Residents will learn how to read relevant scientific literature on empirically supported treatment, empirically informed methods of treatment, and outcome treatment studies that inform us as to the best practice models.

Core Competency 4: Professional Conduct, Ethics and Legal Issues
All treatment is affected by the professional role of the psychologist with the patient and by relevant ethical and legal issues that guide professional practice. Every clinical supervisory encounter involves issues of boundaries, boundary maintenance, inevitable boundary crossings, and the avoidance of boundary violations. These issues are presented to the entire staff at the beginning of each year in the context of professional presentations at Psychology Rounds and the Early Career Seminar.

Issues of liability, risk, ethical, and legal problems are presented to the residents throughout their training year – primarily through supervision and systems discussions. By the end of the training year the resident will be expected to raise these issues and to know how to resolve professional and ethical dilemmas, how to seek out professional consultation, and how to engage the patient in the process of discussing these issues as they arise in the evaluation, consultation and treatment of patients. Residents are expected to demonstrate an increased sophistication in their management of professional relationships and to respond to increasingly complex clinical and professional situations with greater autonomy and confidence. Openness to supervisory feedback to commitment to self-reflection and lifelong learning are key elements.

Core Competency 5: Issues of Cultural and Individual Diversity
All direct care involves integrating the unique perspective of the patient and the intersubjective process of the therapeutic dyad into the treatment plan. This style of inquiry involves the recognition of the important of issues of how culture and diversity affect patient symptoms and treatment. It is expected that every clinical encounter, including supervision, must make reference to how the unique issues of gender, culture, spirituality, and ethnicity affect the treatment process. We emphasize to Residents how a patient’s metaphors of their illness interact with our metaphors of illness, and how those metaphors need to be incorporated into the treatment plan.

Hartford HealthCare is devoted to fostering awareness of issues related to diversity, equity, inclusion and belonging.  As noted above, Equity is one of the hospital system’s 5 core values. The larger hospital (Hartford Hospital) and the Institute of Living both have active DEI groups – trainees are encouraged to join.  At the Institute of Living, virtual “Let’s Talk” events occur at least twice monthly, which provides an open forum for conversation about DEI issues and how they affect personal and professional lives.

Evaluation of Trainees and the Training Program
The tool for measuring a resident’s achievement of the core competencies is assessed by satisfactory scores achieved on the Core Competency Scales used by supervisors in assessing their residents. All of the residents’ supervisors fill out the evaluation form every six months. Training in utilizing that instrument is provided on a yearly basis so that uniformity in a resident’s ratings are consistently done across areas of emphasis and are a valid indicator of a person’s achievement of those goals. Moreover, these issues are discussed on a monthly basis in the supervisory meetings set up by the Director of Training.

The Core Competencies are assessed by the Core Competency Scale that utilizes the following:

Outcomes:

  • The resident must receive supervisory ratings of 4 (High Intermediate) on a 5-point scale (entry level) at mid-year, and a minimum rating of 4 at year’s end (functions mostly independently/meets advanced proficiency level) in order to graduate. At midpoint any resident whose level of achievement of the Core Competencies are deficient (less than 85% of the competencies rated as “4”, High Intermediate”) will be given a warning and a remediation program to follow in order to satisfy graduation requirements. At year’s end, residents are required to have 85% of their ratings be a “5” (Advanced).
  • The resident must receive satisfactory hospital QA reports indicating that they have met all of the hospital requirements for competency in care and meeting all of their clinical responsibilities over the year, meeting Hartford Hospital H3W goals of ICES (an acronym for achieving the goals of Integrity, Caring, Excellence, and Safety in their patient care). As part of their responsibilities residents must demonstrate timeliness of process notes, charting in the medical record, and follow-through on any responsibilities that are part of their areas of emphasis.

Evaluation Measures

  1. Evaluations completed by Residents
    Residents are asked to evaluate their supervisors twice per year using the Evaluation of Supervision Form. Finally, residents are asked to complete a written evaluation of the residency program using the Program Evaluation Form and, after the training year, are asked about their post-residency employment on the Post-Residency Information Form.
  2. Evaluations of the Residents
    Residents will be evaluated on an ongoing basis throughout the residency year. An initial informal review of the residents’ strengths and weaknesses occurs after the first two months of the training year. Formal written evaluations will take place every six months. In order for residents to maintain good standing in the program, they must meet the minimum thresholds for achievement identified for each review on the Resident Evaluation Form. However, there will also be many informal opportunities for feedback as well. These include weekly individual supervision meetings, team staffing meetings, and group resident supervision meetings with the Director of Training. In addition, staff members and supervisors make themselves available to meet with residents outside of scheduled times if issues arise.

Requirements for Completion of Residency

Successful completion includes:

  • Completion of all paperwork, including reports, consultations, and progress notes.
  • Completion of research project as established with primary supervisor.
  • Presentation of case conceptualization during psychology rounds.
  • Attendance at weekly didactic opportunities.
  • Completion of 1960 hours; 40% of time in direct services.
  • Satisfactory completion of program training objectives in each of the six core competency areas as indicated by supervisory ratings of at least “4” on all rated areas by year’s end, reflecting the resident is capable of practicing independently.
  • Meet criteria of evaluations/minimum thresholds for achievement; 85% of all competency ratings must be a rating of “5” (Advanced Competency).
  • Minimum Thresholds for Achievement.

Remedial Instructions
In the rare situation when it is recognized that a trainee needs remedial work, a competency assessment form should be filled out immediately, prior to any deadline date for evaluation, and shared with the trainee and the director of training. In order to allow the trainee to gain competency and meet passing criteria for the rotation, these areas must be addressed proactively and a remedial plan needs to be devised and implemented promptly.

Goal for post-doctoral evaluations done prior to 12 months
All competency areas will be rated at a level of competence of High Intermediate (4) indicating Occasional Supervision Needed or Advanced (5) indicating autonomous practice with consultation. Only areas where the post-doc has no prior experience will be rated I. No competency areas will be rated as Remedial or E (New Skill).

Goal for post-doctoral evaluations done at 12 months
At least 85% of competency areas will be rated at level of competence of Advanced (5). No competency areas will be rated as I, R or E. Note: exceptions would be elective rotations that would take a more intensive course of study to achieve this level of competency and the major supervisor, training director, and trainee agree that a level of HI is appropriate for that particular rotation (e.g., Supervisory Skills).

Remediation and Termination
The program’s minimal levels of achievement are linked to the evaluations that directly correspond to the program’s goals and objectives. Residents, supervisors, and the Training Director can easily track progress through the year and identify areas where a resident might be in jeopardy of not meeting the program’s minimal levels of achievement. Should a resident not achieve minimum thresholds for achievement at any six-month evaluation, a developmental or remediation plan will be collaboratively developed by the resident’s supervisor(s) and the Director of Training. This plan will be presented to the resident and the resident will be given the opportunity to present feedback and suggestions. The resulting remedial plan will serve as a training contract between the resident and the program staff, and adherence to this plan will be closely monitored on a weekly basis. The resident will be required to sign the training plan. Due Process Guidelines will also likely be implemented.

A resident failing to comply with the remedial plan due to lack of motivation or gross deficits in skills will be scheduled for a performance review. The resident will be notified of the impending review and concerns to be addressed. This performance review may be requested by the Director of Training, medical director, current rotation supervisors, or the resident. The resident will have the opportunity to respond to concerns.

A written report of the performance review will be presented to the Training Committee, who will determine the need for further action, such as continued monitoring, revision of the remediation plan, and/or probation. The resident will be notified in writing of the Training Committee’s decision and will be required to review and sign the new training plan. Residents wishing to appeal any aspects of this remediation plan will submit a written request to the Director of Training within 14 days of being presented with the new plan.

The resident failing to comply with the remediation plan, failing to improve while on probation, violating ethical and professional codes, or transgressing official policies, may be recommended for termination from the residency after a meeting of the Training Committee. In such a case, the Director of Training will provide the resident with written notice of the Training Committee’s decision to recommend to the hospital that the resident be terminated from employment. The resident will have the opportunity to appeal the decision through the hospital’s Human Resources Department and request consultation with APPIC and/or APA.


Requirements for Completion of Residency

Successful completion includes:

  • Completion of all paperwork, including reports, consultations, and progress notes.
  • Completion of research project as established with primary supervisor.
  • Presentation of case conceptualization during psychology rounds.
  • Attendance at weekly didactic opportunities.
  • Completion of 1960 hours; 40% of time in direct services.
  • Satisfactory completion of program training objectives in each of the six core competency areas as indicated by supervisory ratings of at least “4” on all rated areas by year’s end, reflecting the resident is capable of practicing independently.
  • Meet criteria of evaluations/minimum thresholds for achievement; 85% of all competency ratings must be a rating of “5” (Advanced Competency).
  • Minimum Thresholds for Achievement.

Remedial Instructions
In the rare situation when it is recognized that a trainee needs remedial work, a competency assessment form should be filled out immediately, prior to any deadline date for evaluation, and shared with the trainee and the director of training. In order to allow the trainee to gain competency and meet passing criteria for the rotation, these areas must be addressed proactively and a remedial plan needs to be devised and implemented promptly.

The goal for post-doctoral evaluations done prior to 12 months
All competency areas will be rated at a level of competence of High Intermediate (4) indicating Occasional Supervision Needed or Advanced (5) indicating autonomous practice with consultation. Only areas where the post-doc has no prior experience will be rated I. No competency areas will be rated as Remedial or E (New Skill).

The goal for post-doctoral evaluations done at 12 months
At least 85% of competency areas will be rated at level of competence of Advanced (5). No competency areas will be rated as I, R or E. Note: exceptions would be elective rotations that would take a more intensive course of study to achieve this level of competency and the major supervisor, training director, and trainee agree that a level of HI is appropriate for that particular rotation (e.g., Supervisory Skills).

Remediation and Termination
The program’s minimal levels of achievement are linked to the evaluations that directly correspond to the program’s goals and objectives. Residents, supervisors, and the Training Director can easily track progress through the year and identify areas where a resident might be in jeopardy of not meeting the program’s minimal levels of achievement. Should a resident not achieve minimum thresholds for achievement at any six-month evaluation, a developmental or remediation plan will be collaboratively developed by the resident’s supervisor(s) and the Director of Training. This plan will be presented to the resident and the resident will be given the opportunity to present feedback and suggestions. The resulting remedial plan will serve as a training contract between the resident and the program staff, and adherence to this plan will be closely monitored on a weekly basis. The resident will be required to sign the training plan. Due Process Guidelines will also likely be implemented.

A resident failing to comply with the remedial plan due to lack of motivation or gross deficits in skills will be scheduled for a performance review. The resident will be notified of the impending review and concerns to be addressed. This performance review may be requested by the Director of Training, medical director, current rotation supervisors, or the resident. The resident will have the opportunity to respond to concerns.

A written report of the performance review will be presented to the Training Committee, who will determine the need for further action, such as continued monitoring, revision of the remediation plan, and/or probation. The resident will be notified in writing of the Training Committee’s decision and will be required to review and sign the new training plan. Residents wishing to appeal any aspects of this remediation plan will submit a written request to the Director of Training within 14 days of being presented with the new plan.

The resident failing to comply with the remediation plan, failing to improve while on probation, violating ethical and professional codes, or transgressing official policies, may be recommended for termination from the residency after a meeting of the Training Committee. In such a case, the Director of Training will provide the resident with written notice of the Training Committee’s decision to recommend to the hospital that the resident be terminated from employment. The resident will have the opportunity to appeal the decision through the hospital’s Human Resources Department and request consultation with APPIC and/or APA.

Housing
Housing is provided by the Resident.

Accreditation Status
The Psychology Residency is accredited by the Commission on Accreditation of the American Psychological Association.

For information pertaining to APA accreditation, please contact:
American Psychological Association
Office of Program Consultation and Accreditation
750 First Street, NE
Washington, DC 20002-4242
Tel: 202.336.5979
Fax: 202.336.5978
Email: apaaccred@apa.org
Web: http://www.apa.org/ed/accreditation