Overview of Cognitive Behavior Therapy Tracks

The IOL internship program emphasizes the practical integration of psychological science and practice, and this approach is core to the Cognitive Behavior Therapy (CBT) internship track.  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 to support the development of core competencies as a health service psychologist, with a particular emphasis on CBT:

• 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 use evidence-based measurement 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 interns will spend at least 10 hours per week providing outpatient services at the Anxiety Disorders Center (ADC) for the duration of the 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 their 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 interns will also co-lead a 16-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).

Core Training Rotations

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

*NEW ROTATION* Equity-focused Recovery and Community Engagement 

This IOL rotation offers an equity-focused training experience across three areas: gender-affirming care through the Center for Gender Health, family engagement via the Family Resource Center, and psychosis intervention through the Schizophrenia Rehabilitation Program. Interns can choose one or combine experiences across these areas, with opportunities to practice patient-centered care that emphasizes empowerment and health equity. This rotation enhances skills in treatment planning, intervention (Aim #2), and cultural diversity (Aim #5).

Interns working with the Family Resource Center will also engage in community outreach, offering psychoeducation, family therapy, support groups, workshops to address mental health stigma, as well as workshops to community members on various diagnoses and evidenced-based treatments available. This engagement strengthens interns' consultation and interdisciplinary skills (Aims #7 and #8), and their understanding of diverse family systems and cultural backgrounds (Aim #5).

For those interested in research, the Center for Research on Racial Trauma and Community Healing offers opportunities to participate in cutting-edge research on the psychological effects of discrimination and trauma. Interns will engage in grant-writing, manuscript preparation, and research methodologies, developing scholarly inquiry and the application of evidence-based practice (Aim #4).

Throughout the rotation, supervision in psychodynamic and cognitive-behavioral approaches ensures that interns are well-prepared to integrate theory and practice, fostering reflective, competent professionals ready to enter the field.

(A) Anxiety Disorders Center

The CBT intern will spend the majority of their time at the Anxiety Disorders Center during one of their four-month rotations. The Anxiety Disorders Center is an outpatient clinic specializing in the cognitive-behavioral treatment (CBT) of anxiety 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 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 the adult CBT intern will be assigned predominantly to adult cases.

(B) Adult Inpatient Service

Each intern will be assigned to the general adult inpatient service that admits patients aged 18 and older for treatment of acute symptoms. 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. This training site will prepare interns to succeed within a managed care environment and strengthen their brief therapy skills. Each will serve as a representative of the Inpatient Psychology Consultation Service which provides consultation to requesting treatment teams across the four adult 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. 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, 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 one of our various Intensive Outpatient Programs. They include our DBT program, Professionals’ Program, Young Adult Services (YAS) General Mental Health Track Program, YAS Right Track/LGBTQ Specialty Program, the Psychosis Program (Schizophrenia Rehabilitation Program and the Potentials Clinic). 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 psychological support services to at least two ongoing patients, and 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.

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 incorporates any elective interests identified by the intern.

Electives offered will include:

• Young Adult Services
• Adolescent Inpatient Services
• Health Psychology
• Schizophrenia Rehabilitation Program
• Research (collaboration with faculty)

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:

1. Research
2. Ethical and Legal Standards
3. Individual & Cultural Diversity
4. Professional Values, Attitudes and Behaviors
5. Communication and Interpersonal Skills
6. Assessment
7. Intervention
8. Supervision
9. 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.

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

• Weekly Clinic Meeting at ADC
• Weekly Research Meeting at ADC
• Biweekly ADCer’s for Change (ADC’s department DEI initiative)

Our Commitment to Diversity, Equity, and Inclusion

The Anxiety Disorders Center (ADC), 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), bi-weekly meeting to promote equity, diversity and inclusion of ADC staff and trainees (ADCer’s for Change), 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.