Overview of the Child Psychology Internship

Three full-time internship slots are offered by the Clinical Psychology Department in this area. The training year has, as its core, six training experiences: (1) long-term child outpatient psychotherapy; (2) adolescent inpatient treatment; (3) child (ages 5-12) inpatient treatment; (4) psychodiagnostic evaluation and assessment; (5) pediatric consultation/liaison and inpatient stabilization via a four-month rotation at Connecticut Children’s, and (6) seminars.

The training year will consist of three primary four-month rotations: one on the child and adolescent inpatient service, one at Connecticut Children’s pediatric service, and one focusing on psychological assessment.

The training objectives for the child/adolescent internship program are centered on the premise that a sound grounding in both behavioral and psychodynamically informed developmental models of psychopathology and treatment will best prepare interns for successful careers working with the widest spectrum of patients. The continuum of care offered by the interns is designed to expose the intern to treatment settings in which competencies in individual, group, and family therapies can develop. In addition, consultation to a variety of medical-pediatric departments and psychological testing will allow the intern to expand beyond the traditional psychiatric system and begin learning skills that will allow them to pursue careers interfacing with the medical establishment. Perhaps most importantly, the internship program, through its use of an apprenticeship/mentoring structure, provides each intern the contact with senior psychologists necessary for the development of a professional identity as a psychologist

Core Training Rotations

Child and Adolescent Inpatient

The Child and Adolescent Inpatient Service consists of a 14-bed adolescent unit and a 9-bed child unit, and is staffed by psychiatrists, psychiatric nurse practioners, psychologists, social workers, nurses, occupational 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.

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. Each intern functions as primary therapist for two patients in the service, split between the child and adolescent units during rotations on each unit. 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 and often involve multiple family meetings during the week. Each intern will complete a four-month rotation on this service and receive a minimum of two hours of supervision each week.

Training objectives include a thorough learning of DSM-5 diagnoses and Interns will develop competency in a repertoire of interventions, including development of advanced focal and intensive psychotherapeutic interventions, group therapy, psychopharmacology, family therapy, milieu therapy, and behavioral/ cognitive-behavioral/DBT techniques. Interns will also receive specific training in process-oriented group psychotherapy and suicide prevention-focused group psychotherapy with adolescents, and social-skills group therapy with children.

Pediatric Consultation Service

Each intern will spend four months providing consultation and brief therapy intervention to pediatric patients hospitalized at Connecticut Children’s. Connecticut Children’s, along with Hartford Hospital and The Institute of Living, has a long tradition of training psychologists.

This rotation is designed to introduce interns to the role of clinical psychology in a primary care setting and will prepare interns to work within a medical model health system. The interns’ primary responsibilities involve the provision of psychiatric consultation services to the medical departments throughout the hospital. Consultation to oncology, cardiology, rehabilitation, pulmonary, pain, and other departments are usual. The intern will also provide both short-term and long-term individual and family therapy to patients in need of adjunctive care. Interns will be trained in a variety of empirically based treatments that utilize cognitive-behavioral methodologies.

Psychological Assessment Rotation

Each intern will perform evaluations throughout their 12 months at the IOL. Moreover, each intern will spend four months being the primary tester in the assessment service, providing assessments for child and adolescent inpatients and outpatients. In addition, the intern will test students attending our on-site therapeutic school (Grace Webb School) for purposes of diagnostic and educational planning. Interns may also pursue as a minor elective exposure to neuropsychological assessment. Testing responsibilities will consist of 2-3 batteries per week while on this rotation, one per month while on the inpatient service and 1-2 per month while on the consultation/liason rotations. Interns gain experience in test administration, scoring, interpretation, report writing and in communicating test findings to relevant stakeholders (e.g., patient, family, treatment team). In addition, during this intensive assessment rotation each intern will have up to 4 hours per week to pursue elective interests.

Consistent with our training mission, interns will be required to integrate relevant psychodynamic models of interpretation with objective and cognitive data, and further develop their ability to communicate test findings in written and oral form. 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. Child interns test predominantly child and adolescent inpatients, but may on occasion be asked to test adult patients. Interns will be expected to complete between 25-40 assessments during the training year and will receive at least one hour of supervision per case.

Other Core Experiences

Child Outpatient Psychotherapy

Each trainee will carry at least 1 long term psychotherapy patient, referred from IOL programs (Child and Adolescent Outpatient Clinics), as well as 1 long term medically referred patient from Connecticut Children’s during their training year. Interns can use elective time during the training year to see patients presenting at the Anxiety Disorders Clinic, where standardized treatment protocols will be learned; at the Grace Webb School with students enrolled in our on-site therapeutic school; or may treat patients presenting at Connecticut Children’s, using a variety of empirically supported methodologies. The interns participate in a wide variety of clinical programs and receive training in intake evaluation and diagnosis, treatment formulation, psychotherapy, and liaison with school systems.

Each intern receives up to two hours per week of psychotherapy supervision from the child psychology staff. These case assignments often involve active collaboration with other providers and community agencies.

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, interns may involve themselves in elective training experiences throughout the training year. Opportunities include:

  • Adult Outpatient Psychotherapy

  • School-based group psychotherapy

  • 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

  • Group Psychotherapies in one of our Partial Hospital/Intensive Outpatient Programs

Seminar Program

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

• 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)
• Connecticut Children’s Grand Rounds
• Psychosis Seminar
• Focal Therapy and Case Conference (Required)
• Diversity Seminar (Required)
• Psychiatry Journal club (monthly)