Overview of the Adult Internship Program

Three full-time positions are offered by the Clinical 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 wants 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 the general adult inpatient service that admits patients aged 18 and older for treatment of acute symptoms. This training site will prepare interns to succeed within a managed care environment and strengthen their brief therapy skills. Each will serve as primary therapist for up to two patients at a time and provide conjunctive family/marital therapy when indicated. Many of these patients will be referred for admission from one of our partial hospitalization and intensive outpatient programs. 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, many of whom have gone through unsuccessful outpatient and short-term inpatient treatments.

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 primary therapists and case managers, 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. Along with the unit psychologist and postdoctoral resident, the intern will also provide consultation to the treatment teams on the primary unit. A minimum of two hours of supervision per week will be provided to each intern. 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 Programs. Interns will choose between several of the PHP/IOP programs for this primary rotation. They include our Professionals’ Program, our Young Adult/LGBTQ program, our DBT program, and The Schizophrenia Rehabilitation Program. These are intensive outpatient programs for patients recently discharged from the inpatient service or referred from community providers who are in need of intensive services to prevent hospitalization and restore occupational/school and psychosocial functioning.

The intern will function as a staff treatment manager, providing case management services to at least two ongoing patients, and provide up to eight hours of group psychotherapy. 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 and a variety of cognitive behavioral methods. The goal of the rotation is to help interns gain experience in providing psycho-educational, insight-oriented, and skill-based approaches to group treatment 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 intern completes an intensive four-month testing rotation where they serve as the primary staff person responding to referrals for Psychological Testing, primarily from inpatient programs but also from our IOP and ambulatory 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. One to two hours of supervision per battery will be provided and the intern will be responsible for up to three assessments per week. Referrals will come from our centralized testing service that responds to diagnostic and risk assessment requests from all areas of the hospital.

Interns will be expected to develop competencies in the administration, 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 are a major focus of training. During this rotation interns will have the opportunity to pursue additional outpatient and group therapy training. Interests in neuropsychological testing can be pursued. Interns can expect to have completed approximately 25-40 assessments by the end of the training year.

Other Core Experiences

Individual Outpatient Psychotherapy

Interns will have the opportunity to provide psychotherapy to a variety of patient populations. 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 either the community or referred from our acute inpatient service. Training focusing on the use of psychodynamically and personality-informed models of treatment is available.

Hartford Hospital's Behavioral Health 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 manualized treatment protocols utilizing an exposure-based and response prevention model is emphasized.

Schizophrenia Rehabilitation Program and Potentials Clinic
These programs focus on the diagnosis, early intervention, and treatment of patients presenting with schizophrenia-spectrum disorders. The Schizophrenia Rehabilitation Program is a multidimensional treatment program for the more persistently ill patient that includes attentional retraining using computer technology, group therapy, motivational training, and individual psychotherapy. The Potentials Clinic provides early detection and intervention for young adult patients recently diagnosed, including individual, group, and family psychotherapies as well as pharmacotherapy.
Interns will be expected to carry at least two outpatients throughout their twelve months of internship.

Elective Rotations

In addition to the core rotations, interns 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 both psychodynamically-informed and CBT-based outpatient psychotherapy to patients presenting to the behavioral health service

Schizophrenia Rehabilitation Program: Providing individual psychotherapy or group psychotherapy to patients diagnosed with schizophrenia-spectrum disorders.

Anxiety Disorders Clinic: Providing group or individual outpatient psychotherapy using manualized treatment protocols.

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

Trainees attend a variety of seminars, offered by both the Psychology Department and the psychiatry residency training program. We anticipate the following seminars will be available this year:

  • Family and Group Therapy (Required)

  • Diagnosis and Assessment (Required)

  • Modern Readings in Personality and Psychotherapy (Required)

  • Weekly Grand Rounds (Required)

  • Psychosis Seminar

  • Focal Therapy and Case Conference Seminar (Required)

  • Diversity Seminar (Required)

  • Psychiatry Journal Club

In addition to the required seminars, all interns will attend the department's biweekly staff meeting where both administrative and educational issues are addressed. Besides involving the interns 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 intern will be expected to present to the faculty case material involving either a psychotherapy case or psychodiagnostic evaluation, research findings, or topic of their choice during the year