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. 

Three full-time positions will be offered by the Clinical Psychology Department; two 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 options for elective rotations. The adult and child 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 8 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 an 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 analysis. Intern opportunities for research include assisting with data collection of ongoing research projects, publishing and reviewing peer-reviewed journal articles, and contributing to the development of new research projects or program development. Interns with an interest in research during the training year may be granted protected research time (up to 4 hours per week).

Core Training Rotations

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

(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 (ADC) 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. Child CBT interns will gain specific experience treating anxiety and mood disorders in our school refusal accelerated treatment program. Treatment combines traditional CBT for childhood anxiety and related disorders with parent management therapy to reduce excessive parental accommodation. There are many opportunities for parent-focused treatment of childhood anxiety within and outside of the accelerated program. Interns will also co-facilitate an adolescent transdiagnostic group (depending on group availability). 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 CBT consultation services to other departments of the Institute of Living. The ADC provides services across the lifespan, although the child CBT intern will be assigned predominantly to children/adolescent cases.

(B) Equity-Focused Recovery and Community Engagement

Each intern will spend four months engaging in a clinical-community engagement hybrid rotation that integrates Hartford HealthCare's Radical Recovery mission across multiple specialized areas. Interns will select from diverse clinical experiences including gender-affirming care through the Center for Gender Health, family systems work through the Family Resource Center, psychosis intervention through the Schizophrenia Rehabilitation and Young Adult Potential Programs, child and adolescent services through Grace Webb Therapeutic School and the Child and Adolescent Outpatient Program, autism specialty care through the Autism Clinic, and perinatal mental health through the Perinatal Intensive Outpatient Program. The community engagement component centers on the Family Resource Center, where interns provide family therapy, psychoeducation, consultation, support groups, and community workshops that reduce stigma and help families access resources. Interns may also participate in the Patient and Family Advocacy Council (PFAC), working alongside individuals with lived experience. Additionally, interns can engage in research activities through the Center for Research on Racial Trauma and Community Healing. This rotation provides opportunities to develop skills in evidence-based interventions, consultation, interdisciplinary collaboration, and culturally responsive care with underserved populations. Supervision will be provided for all clinical activities along with guidance surrounding the development of a recovery-focused, equity-centered approach to care.

(C) Child and Adolescent Inpatient

The Child and Adolescent Inpatient Service consists of a 15-bed adolescent unit and a 17-bed child unit, and is staffed by psychiatrists, psychologists, social workers, nurses, recreational therapists, and psychiatric technicians. The units provide a range of services, including short-term managed care treatment approaches to longer-term services for patients with severe and persistent mental illness in need of hospitalization, many of whom have gone through unsuccessful outpatient and short-term inpatient treatments. The patient population is comprised of a broad spectrum of acute and chronic conditions, including but not limited to psychosis, developmental disabilities, personality disorders, substance use disorders, eating disorders, conduct disorders and problematic behaviors, and affective disorders.

Each intern will complete a four-month rotation on this service and will be split across the adolescent and child units for the duration of their time. This rotation provides an immersion into the role of an inpatient psychologist. Interns gain experience not only in inpatient treatment and case management, but also in functioning as a psychologist in a multidisciplinary team. During their rotation, Interns will function within a consultative role for two patients at a time, providing targeted treatment to identified patients through the Inpatient Psychology Consultation Service. Consultations may include individualized behavior planning, brief CBT/DBT therapy, assessment for diagnostic clarification of anxiety-related disorders, and other brief treatment interventions. Additionally, the Intern will facilitate two inpatient group therapies throughout the duration of the internship year, and will increase to four weekly groups when on the Inpatient rotation. Interns will receive specific training in process-oriented group psychotherapy with adolescents, and social-skills group therapy with children. 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.  Interns will receive two hours weekly of individual supervision.

Training objectives include a thorough learning of DSM-5 diagnoses and Interns will develop competency in a repertoire of interventions, including development of CBT/DBT intervention skills and other integrated approaches to treatment in a brief, acute care setting, group therapy, family therapy (when appropriate), and milieu therapy. Interns will collaborate as part of an interdisciplinary team and will receive exposure to psychopharmacological and case management care decisions.

Year Long Training Experiences

Consultation service
The Child CBT intern will consult with providers in the therapeutic day school, credit recovery, inpatient and PHP/IOP programs across all three rotations. The consultative role includes collaboration with providers on behavioral management strategies for selected patients as well as diagnostic consultation when OCD or anxiety disorders may play a significant role in the hospitalization.

Psychiatric Inpatient
The Child CBT intern will consult to the IOL psychiatric inpatient unit across all three rotations. The consultative role includes collaboration with inpatient providers on behavioral management strategies for selected patients as well as diagnostic consultation when OCD or anxiety disorders may play a significant role in the hospitalization. The CBT intern will also run one to two year-long cognitive-behavioral therapy groups on the child/adolescent units. The child inpatient group was developed based on the Unified Protocol for Children. Other transdiagnostic treatment targets may include social skills, coping skills, affect regulation, distress tolerance, etc. The novel experience will be in tailoring provision of these services to the capacity of the acute inpatients.

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 department's most valued content experts. The primary focus of the core seminars is centered on the development of advanced knowledge in the core competencies for Health Service Psychologists. Intervention-related seminars are heavily focused 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)

Embracing Our Differences As Strengths

The Psychology Training Program at the Institute of Living (IOL) and Hartford HealthCare (HHC) are committed to promoting access, opportunity, and advancement for all. We value the uniqueness of each person and value a tapestry of backgrounds, opinions and experiences. We 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 cultural perspectives within clinical supervision. We do this through seminars for IOL psychology interns and postdoctoral fellows, our IOL committees (open to all trainees) and forums where open sharing is encouraged. 

We welcome applications from trainees from all backgrounds. We encourage you to inform us of any relevant life experiences in your cover letter or essays.