Overview of Cognitive Behavior Therapy Tracks

The overarching aim of this track (as with the IOL internship as a whole) is the practical integration of psychological science and practice.  Within this general framework, the CBT track will emphasize the use of critical thinking skills, the application of basic and applied research to complex cases, and the thoughtful and systematic evaluation of clinical work using evidence-based practices. 

Two full-time positions will be offered by the Clinical Psychology Department; one focusing on Adult patients and one focusing on the treatment of children and adolescents. The training year is composed of three primary four-month rotations and several minor rotations. These two CBT tracks will include the following training experiences and objectives:

  •  To prepare psychologists who can consume new research findings and integrate them into practice. Using individual and group mentorship programs, interns will read, discuss, and evaluate practice-relevant research articles; develop treatment plans that consider the best available empirical evidence; and discuss the therapeutic, ethical, and legal aspects of evidence-based practice.

  • To prepare psychologists who can evaluate their own interventions using empirical methods. Interns will participate in research projects using evidence-based strategies of measurement and analysis in order to evaluate the efficacy of their treatments, to develop and refine programs, and to inform best practices for the institution.

  • To prepare psychologists who can produce new scientific findings that will contribute to the literature.  All interns will have the opportunity to participate in the broad range of basic and applied research conducted at the Institute of Living, including psychotherapy research, pharmacotherapy clinical trials, neuroimaging research, and more. 

The CBT track intern will spend at least 10 hours per week providing outpatient services at the Anxiety Disorders Center (ADC) for the entire internship year. This will allow them to treat patients over a longer period of time, become involved in longer-term projects at the ADC, and provide a "home base" that will include meeting with a primary internship preceptor. This will allow the CBT intern to strengthen his/her expertise in CBT while also having the opportunity to work collaboratively with mental health providers throughout the hospital from different disciplines and theoretical orientations. The CBT intern will also have the option of co-leading a16 week CBT class with Dr. David Tolin. This annual CBT class is offered to mental health providers within the IOL and Hartford Healthcare and is an opportunity for the CBT intern to contribute to the dissemination of CBT. Other speaking opportunities within the Hartford community are often available for the CBT intern.

While internship is meant to be primarily a year of clinical training, ample research opportunities are available at the ADC for interns who are interested in contributing to research. The ADC is an active research center with many active research studies at any given time, as well as archival data available for analyses. Intern opportunities for research include assisting with data collection of ongoing research projects, publishing and reviewing peer reviewed journal articles, and contributing to development of new research projects or program development. Interns with interest in research during the training year may be granted protected research time (up to 4 hours per week).

Our Commitment to Diversity, Equity, and Inclusion

The Anxiety Disorders Center (ADC), 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. This 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 Diversity Seminar for IOL psychology interns and postdoctoral fellows, bi-weekly meeting to promote equity, diversity and inclusion of ADC staff and trainees (ADCer’s for Change), and Let’s Talk (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.

Core Training Rotations

The Adult CBT track intern will complete 3 rotations, each lasting 4 months, including:

(A) Anxiety Disorders Center/Center for Cognitive Behavioral Therapy
The CBT intern will spend the majority of their time at the Anxiety Disorders Center/Center for Cognitive Behavioral Therapy during one of their 4 month rotations. The Anxiety Disorders Center/Center for CBT is an outpatient clinic specializing in the cognitive-behavioral treatment of anxiety, mood, and obsessive compulsive spectrum disorders. Interns will provide outpatient CBT to the clinic’s patients, including accelerated (daily) exposure therapy sessions to patients with moderate to severe anxiety disorders and OCD. Interns will also complete assessments of new patients utilizing structured diagnostic interviews and well-validated self-report measures. The ADC employs state of the art technology and assessment tools, including virtual reality technology, evidence based computerized assessment of treatment progress, which the interns will use in their patient care. In addition, interns will have the opportunity to contribute to research, gain experience in program development, and provide specialized consultation services to other departments of the Institute of Living. The ADC provides services across the lifespan, although each of the two CBT interns will be assigned predominantly to either adult or children/adolescent cases.

(B) Adult Inpatient Service
Each intern will be assigned to the general inpatient service. The Adult service 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 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 severely disturbed patients in need of hospitalization, many of whom have gone through unsuccessful outpatient and short-term inpatient treatments.

A broad spectrum of acute and high-functioning psychotic, personality-disordered, addicted, conduct-disordered, and affectively-disordered patients is represented. Interns gain experience not only as primary therapists and case managers, but also in functioning as psychologists in a multidisciplinary team while learning methods of milieu therapy. The intern will also be responsible for conducting a twice-weekly CBT group. Along with the unit psychologist and postdoctoral resident, the intern will also provide consultation to the other treatment teams. A minimum of two hours of supervision per week will be provided to each intern.

Competencies in rapid assessment of mental status, case formulation, diagnosis, and 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.

(C) Intensive Outpatient Programs
Each adult intern spends four months providing group psychotherapies and case management to adult patients admitted to the DBT Program and can seek elective experiences in one of several additional Partial Hospital Programs. They include our Professionals’ Program, our Young Adult/LGBTQ program and the Eating Disorders Track within the Adult Day 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.

The four-month rotation in the DBT program involves the provision of group therapy services to patients diagnosed with Borderline Personality Disorder receiving treatment in our DBT program. Interns will advance their skills with this population and co-lead groups along with the program’s clinical staff. The Intensive Outpatient DBT program is a three to four day per week program designed primarily for individuals in Stage One treatment. The program involves a minimum of three hours per day and focuses on safety, building connections in the community, and behavioral control.

The program encompasses a six week cycle that includes:

  • Skills training
  • Behavioral analysis
  • Behavioral rehearsal
  • Target-oriented case management
  • Telephone consultation
  • Medication management

Other Core Experiences

In addition, the CBT track intern may complete 3 electives, running concurrently with the Major Rotations, each lasting 4 months (although an elective could be extended to two periods by mutual agreement). The intern’s interests will be identified at the beginning of the training year so that a sequence of training can be established that takes into account any elective interests identified by the intern.

Electives offered will include:

  • Young Adult Services
  • Adolescent Inpatient Services
  • Neuropsychology
  • Health Psychology
  • Schizophrenia Rehabilitation Program
  • Anxiety Disorders Center/Center for Cognitive Behavioral Therapy
  • Research (collaboration with faculty)

Seminar Program

Trainees attend a variety of seminars, offered by both the Psychology Department and the psychiatry residency training program. Although the CBT track focuses on providing excellent CBT training, the seminars are led by psychologists across the Institute of Living, and provide the CBT intern an opportunity to hear and explore other perspectives, including psychodynamic and family systems approaches.

We anticipate that the following seminars will be available this year:

  • Weekly Clinic Meeting at ADC
  • Weekly Research Meeting at ADC
  • Monthly Continuing Education Seminar at ADC
  • Monthly Journal Club at ADC
  • Biweekly ADCer’s for Change (ADC’s department DEI initiative)
  • Diagnosis and Assessment (Required)
  • Modern Readings in Personality and Psychotherapy (Required)
  • Family and Group Therapies (Required)
  • Weekly Grand Rounds (Required)
  • Child Psychotherapy Seminar and Case Conference (Required for Child Track)
  • CT Children's Medical Center Grand Rounds
  • Psychosis Seminar
  • Focal Therapy and Case Conference (Required)
  • Diversity Seminar (Required)
  • Psychiatry Journal Club (monthly)