Overview of the Adult Internship Program
Three full-time Adult Intern positions are offered by the Psychology Department. The training year is composed of three primary four-month rotations. The primary training objective is to assist the intern in acquiring the necessary skill base to achieve a high level of competence in the evaluation, assessment, and treatment of acute psychiatric illness, including acute exacerbations of chronic mental illness. The Psychology Department believes that intensive training experience within an acute inpatient and intensive outpatient hospital service provides exposure to the broadest range of psychiatric disorders and aids in the development of confidence in the interns’ diagnostic and treatment skills.
An integrative treatment orientation that is directed by a deepening appreciation of early developmental and object-relational experiences will be provided. Interns will be expected to integrate the use of cognitive-behavioral interventions, skills training methodologies (e.g. Dialectical Behavior Therapy), and psychodynamically informed treatment planning. The training faculty seeks to assist the intern in deepening their ability to conceptualize on multiple levels and recognizing the interactions between intrapersonal, interpersonal, and systemic forces influencing the patients with whom they work. The adult track will prepare interns to function within a hospital setting and also to treat patients presenting with moderate to severe forms of psychopathology.
Core Training Rotations
Adult Inpatient Treatment
Each intern will be assigned to a rotation on the general adult inpatient service that admits patients aged 18 and older for treatment of acute symptoms. The unit is milieu-based and provides short-term therapies for patients with serious mental illness and are in an acute crisis in need of hospitalization. This training site will prepare interns to succeed within a managed care environment and strengthen their brief therapy skills. Each intern will serve as a representative of the Inpatient Psychology Consultation Service, which provides consultation to requesting treatment teams across the four adult units. The trainee will also run a combination of interpersonal process groups and skills-based groups across the four units.
The intern will interface with patients who present with the full spectrum of psychiatric disorders and are considered to be in an acute crisis. Interns gain experience not only as psychology consultants and group therapists, but also in functioning as psychologists in an interdisciplinary team while learning methods of milieu therapy. Each intern will gradually assume greater responsibility for conducting the unit's daily intensive psychotherapy group and other groups on multiple units. Other group therapy opportunities include CBT, DBT, substance use, and supportive group therapy approaches for patients with persistent mental illness.
Competencies in rapid assessment of mental status, case formulation, diagnosis, focal individual and group psychotherapy will be developed. In-depth exposure to psychopharmacological and other biological interventions (e.g., ECT) and close collaboration with psychiatrists, social workers, nurses, and physicians will prepare interns to assume careers in a hospital-based setting and settings servicing the broadest range of patient populations.
Intensive Outpatient Programs
Each adult intern spends four months providing group psychotherapies and case management to adult patients admitted to one of several Partial Hospital (PHP) or Intensive Outpatient Programs (IOP). Interns will choose between several of the PHP/IOP programs for this primary rotation. Options include our Professionals’ Program, Young Adult Services (YAS) General Mental Health Track Program, YAS Right Track/LGBTQ Specialty Program, DBT program, or the Psychosis Program (Schizophrenia Rehabilitation Program and the Potentials Clinic). Patients in the PHP/IOP programs are typically stepping down from the inpatient service or are stepping up from community providers to prevent hospitalization and restore occupational/school and psychosocial functioning.
The intern will function as a staff treatment manager, providing psychological support services to at least two ongoing patients, and provide about eight hours of group psychotherapy per week. Patients typically attend these programs for three or four days of programming that include traditional process group therapies and a variety of skill-based therapies, including Dialectical Behavior Therapy skills and cognitive behavioral therapy skills. The goal of the rotation is to help interns gain experience in providing psychoeducational, insight-oriented, and skill-based approaches in a group treatment format and to learn the principles of managing high acuity patients in a less restrictive treatment environment.
During this rotation, interns will have the opportunity to pursue elective interests, will continue to perform two to four psychological assessments per month, and will continue to carry a small caseload of outpatients.
Psychological Assessment Rotation
Training in comprehensive psychological testing occurs throughout the twelve months of the training year. However, each Adult intern also completes an intensive four-month testing rotation where they respond to referrals for psychological testing that we receive through our centralized testing service, primarily from inpatient programs but also from our ambulatory and outpatient programs.
This rotation will focus on the use of cognitive, intellectual, objective, projective, and personality-based measures. Advanced thematic and Rorschach interpretation and report writing skills will be emphasized. The intern will complete 20 psychological assessments over the 4-month rotation, with opportunity to complete more if interested. Close supervision is provided by psychologists with expertise in psychological and neuropsychological testing. During this rotation in particular, interns will have the opportunity to pursue elective experiences (e.g., group therapy, neuropsychological assessment).
The testing service plays a vital role in the mission of the IOL to identify risks for self-harm and interpersonal violence, as well as early indicators for psychosis and other forms of severe mental illness, and we expect interns to develop comfort and expertise in this consultant role. Interns will be expected to develop competencies in the administration, scoring, interpretation, and communication of test findings both verbally and in written form within a short time frame, and will gain valuable experience functioning as a consultant to the treatment team or referring clinician. Feedback skills, in particular, are a major focus of training.
Interns will be expected to develop competencies in the administration, interpretation, and communication of test findings both verbally and in written form and will gain valuable experience functioning as a consultant to the treatment team or referring clinician. Feedback skills are an imbedded aspect of this training.
Other Core Experiences
Individual Outpatient Psychotherapy
Interns will have the opportunity to provide psychotherapy to a variety of patient populations. Interns will be expected to carry at least two outpatients throughout their twelve months of internship. The available training sites include the following:
Adult Outpatient Clinic
Interns will have the opportunity to provide long-term psychotherapy to patients admitted to the clinic from the community or referred from our acute inpatient service. Training focused on the use of psychodynamically and personality-informed models of treatment is available.
Health Psychology Service
Integrated within the Health Psychology Division of the Psychology Department, this service provides both short and long-term treatment of patients presenting with co-morbid medical and psychological problems. Interns also can acquire skills in the evaluation of patients presenting to the Pain, Bariatric, Transplant, and Epilepsy services.
Anxiety Disorders Center
Interns can elect to carry individual and/or group psychotherapy patients presenting with a variety of anxiety disorders. Training in the use of cognitive behavioral treatment utilizing an exposure-based and response prevention model is emphasized.
Psychosis Programs: Schizophrenia Rehabilitation Program and Potentials Clinic
Interns can choose to work in the Psychosis Programs as a primary IOP rotation (see above) or can participate in an elective capacity. Elective opportunities include co-leading groups or individual therapy. The Psychosis Programs focus on diagnosis, early intervention, and treatment of adults with psychotic disorders. The Schizophrenia Rehabilitation Program is a person-centered recovery model program for adults with schizophrenia or schizoaffective disorder who are working on functional goals for the community such as work, school, social relationships and independent living. Interventions include cognitive therapy such as computer-based attention and memory training, compensatory skills training, social cognitive therapies, dialectical behavioral therapy or cognitive behavioral therapy skills for psychosis. Process psychotherapy groups, individual therapy, medication management, family support, and case management services are embedded in the Psychosis Programs. Further, vocational and educational support resources are offered from Easter Seals and Viability. The Potentials Clinic provides early detection and intervention for young adults recently diagnosed with a psychotic disorder. Interventions include individual, group, and family psychotherapy as well as pharmacotherapy. Both programs include Recovery Support Specialists on the treatment team who provide support through the perspective of lived-experience.
Center for Gender Health
The Center for Gender Health (CGH) is conveniently located in Hartford, near Hartford Hospital and The Institute of Living, part of the Hartford HealthCare Behavioral Health Network. Because each person’s experience is unique, we bring together experts in endocrinology, gynecology, plastic surgery, primary care and behavioral health to tailor care to each individual’s needs in a supportive, private environment. Within the behavioral health component, interns can elect to carry individual psychotherapy patients presenting to the CGH to help with gender dysphoria, identity concerns, depression, anxiety, and social insecurity.
Neuropsychological Assessment
Depending on prior level of preparation, involvement with the Clinical Neuropsychology Service providing neuropsychological assessment.
Elective Rotations
In addition to the core rotations, interns may participate in elective training experiences during the year, with the majority of time occurring during the four-month psychological assessment rotation. However, elective training experiences can be pursued at any time during the training year. Opportunities include:
Health Psychology: Providing assessment and short-term treatment to patients with comorbid medical and behavioral health issues.
Schizophrenia Rehabilitation Program: Providing individual psychotherapy or group psychotherapy to patients diagnosed with schizophrenia-spectrum disorders.
Anxiety Disorders Center: Providing group or individual outpatient psychotherapy using cognitive behavioral therapy with an emphasis on exposure and response prevention.
Neuropsychological Assessment: Depending on prior level of preparation, involvement with the Clinical Neuropsychology Service providing neuropsychological assessment.
Young Adult Program: Including the Right Track, our LGBTQ specialty track within the Young Adult Program.
Seminar Program
The Core Seminar Series is an important aspect of the intern training experience. This is a protected three-hour time block where interns come together and engage in didactic learning which is led by some of the departments most valued content experts. The primary focus of the core seminars is centered in the development of advanced knowledge in the core competencies for Health Service Psychologists. Intervention-related seminars are heavily focus on modern reading in personality and psychodynamic psychotherapy as well as cognitive behavioral therapy, family therapy, group therapy, DBT, and other empirically supported approaches to treatment. While the Core Seminar Series is the primary didactic modality for the program, additional seminars that support the development of core competencies specifically relevant to CBT are also included for CBT interns.
Core Competencies Addressed in Intern Seminars:
- Research
- Ethical and Legal Standards
- Individual & Cultural Diversity
- Professional Values, Attitudes and Behaviors
- Communication and Interpersonal Skills
- Assessment
- Intervention
- Supervision
- Consultation and Interprofessional/Interdisciplinary Skills
In addition to the required seminars, all interns will attend the department's monthly staff meeting where both administrative and educational issues are addressed. In accordance with APA guidelines, each intern will be expected to present case material, involving either a psychotherapy case or psychodiagnostic evaluation, to the faculty at least once during the training year.
Our Commitment to Diversity, Equity, and Inclusion
The Psychology Training Program, Institute of Living (IOL), and Hartford Healthcare (HHC) are committed to promoting diversity, equity, and inclusion among our staff, trainees and the people we serve. Equity is one of our five core values as a system.
We are committed to the fair treatment, access, opportunity and advancement for all. We value the uniqueness of each person and embrace diverse backgrounds, opinions and experiences. We foster intellectual, racial, social and cultural diversity and treat everyone with dignity and respect.
This commitment is reflected on all levels of our healthcare system and trainees have many avenues to pursue continued growth in their own cultural competence in addition to incorporation of diversity and cultural aspects within clinical supervision. Some examples include the core diversity-related seminars for IOL psychology interns and postdoctoral fellows, our IOL Diversity and Equity Committee (open to all trainees), and the IOL “Let’s Talk” forums (the Behavioral Health Network’s monthly open forum to discuss aspects of diversity, equity, and inclusion).
We welcome applications from trainees from diverse backgrounds. We encourage you to inform us of any relevant life experiences in your cover letter or essays.