Program Description and Curriculum

At the beginning of the training year, each intern is assigned to several faculty members for weekly one-to-one supervision of individual adult outpatient cases, adult inpatient cases, patients seen within elective rotations, and small group supervision of child and family cases. To provide a high quality training experience, interns receive a Minimum of 6 hours of clinical supervision per week. Theoretical orientations of supervisors vary and include psychodynamic, interpersonal, cognitive-behavioral, DBT, attachment, family systems, integrative and short-term approaches. The insights gained from this diversity of perspectives are constantly integrated in case conferences and seminars. Great care is taken to provide trainees with a range of treatment cases suitable to the application of different therapeutic approaches. Regular consultation regarding pharmacotherapy and other medical issues is available from an attending psychiatrist and psychiatry residents. Interns' progress toward identified training goals throughout the internship is evaluated formally twice a year, after the completion of rotations, and informally on an ongoing basis. Interns also formally evaluate their training experiences following each rotation and feedback about their internship experiences is solicited on a monthly basis.

The Outpatient Rotations represent the core of the intern's experience at Mount Sinai Beth Israel since trainees are assigned to these services on a half-time basis for the entire year. These rotations have a primary focus on providing psychotherapy for adults, children, and families who are seen throughout the year.

Psychiatric Outpatient Services for Adults Rotation
The typical weekly outpatient caseload for an intern consists of 8-10 hours of adult individual or couples treatment (some persons are seen more than once a week), weekly intake evaluations and two or three ongoing groups. Interns are scheduled to conduct weekly intake interviews with new clinic patients for four months and as part of the clinical rotations. The intake process is a closely supervised experience, with live supervision during the initial interview. The interns will be responsible for making differential diagnoses, collecting collateral information, designing treatment plans, and presenting their cases to an interdisciplinary disposition team.

Child and Adolescent Outpatient Rotation
Interns participate in a four month rotation on the Child and Adolescent Outpatient Service, during which they conduct intake evaluations and psychological assessments. As part of their work with children and adolescents, interns regularly collaborate with various members of the child's school or other community agencies, such as child welfare. The patient population provides exposure to a wide-range of disorders and very complex family and cultural backgrounds. Interns become proficient in various psychotherapy modalities including play therapy, parenting skills training, family therapy, and cognitive behavior therapy. Interns are also introduced to trauma informed interventions for children with complex trauma histories. All treatments are offered with respect for the individual's particular family and cultural background. When possible, treatment approaches are grounded in evidenced-based practices. 

Interns carry two individual child cases, one of which is a complex trauma case, as well as one family case. In addition, interns conduct one child intake per week and complete one child psychological testing battery during the child rotation. 

Psychological Testing
Interns perform psychological assessments across a variety of clinical settings at the hospital.  An intern can expect to complete at least four testing batteries per year, with cases referred from adult and child outpatient services.  One or two of the four required testing batteries will be completed on inpatient cases during the inpatient rotation described below. The testing cases may include cognitive, behavioral, and projective assessment. 

Specialized Training
Both the Multicultural Family Therapy Training Program and the Brief Psychotherapy Research Program described below serve as integral parts of the outpatient experience and occur throughout the entire year.

Multicultural Family Therapy Training Program
Interns meet as a group every week for supervision of their family cases. All family treatments are videotaped weekly. Families are asked to come in to the clinic for a session/with live supervision on a quarterly basis. During live supervision, one or two interns work with the family, while the remaining interns and the supervisor observe behind a one-way mirror, functioning as part of a treatment team to understand family process within the cultural context. During supervision, interns learn to apply interventions based on systemic theory and current developments in attachment and object relations treatment approaches. This seminar has a didactic component as well. Each month, an intern selects a peer reviewed article or book on multi-cultural practices in family therapy, and presents it during the seminar, and leads the discussion. 

Brief Psychotherapy Research Project
All interns are trained in a manualized, time-limited treatment model (Alliance-Focused Treatment) developed in the Brief Psychotherapy Research Program. The training model involves an integration of principles from cognitive, humanistic and relational psychotherapies, and from contemporary research on emotion and attachment. Each intern carries several cases that are videotaped, participates in weekly case seminars, and receives intensive supervision on his/her cases (also on a weekly basis). Opportunities to conduct research is offered as part of the Brief program elective.

Interns spend four months, half-time, on an adult inpatient psychiatry service. A supervising psychologist on each unit provides regular supervision for all of the intern's inpatient responsibilities. Interns are assigned to a general adult/dual diagnosis substance abuse service or a combination geropsychiatric/general adult service. The typical caseload for interns assigned to these services is two patients at any one time.

On all units, interns organize, coordinate, and provide services for their assigned patients in the context of the multi-disciplinary treatment team. Ample opportunities for individual and family interventions as well as psychological and neuropsychological evaluations are available for interns on inpatient rotations. Medication and other biological treatments are managed by the intern's medical back-up, generally a senior psychiatric resident. Interns' observations and recommendations about such treatment, however, are integral components of patient care. Interns also co-lead with a psychiatric resident one inpatient psychotherapy group per week, an important aspect of the unit's milieu treatment program. In addition, interns have the opportunity to develop skills in clinical supervision by serving in the role of co-supervisor with the inpatient psychologist for a small group of psychology externs who lead weekly psychotherapeutic groups on the inpatient unit.

The two inpatient units are structured to treat individuals age 18 years and older. Patient diagnoses include affective disorders, schizophrenia and severe character disorders. Emphasis is on rapid resolution of acute distress and return to functioning. Since many inpatients will be referred for individual or family outpatient treatment, interns sometimes have the opportunity to provide continuing care for these patients following their discharge.

The general adult/psychiatric substance abuse inpatient service emphasizes treatment of persons who have both a major psychiatric disorder and substance abuse. On this unit, the psychiatric disorder is complicated by the presence of alcohol and/or drug addiction. Interns on this rotation gain familiarity with psychiatric and neurological disorders specifically associated with substance abuse, e.g. antisocial personality disorder and substance-abuse induced psychosis. Because of the high incidence of HIV in IV drug users, interns gain training in AIDS related disorders.

The general adult/geropsychiatric inpatient service treats individuals aged 18 and above, with a specialty unit for people age 65 and older, who are diagnosed with a broad range of psychiatric disorders, particularly depression and dementia. Special efforts are made to integrate an understanding of biological, psychological and social dimensions of aging in conceptualizing the patient's illness and treatment as well as to gain experience in treatment of acute psychiatric illness.

A four month elective is chosen from a variety of ongoing services provided at the Medical Center. Potential electives currently include Brief Psychotherapy Research, Addictions Psychiatry, Comprehensive Psychiatric Emergency Room (CPEP), and Complex Child Trauma.

Brief Psychotherapy Research Program: All psychology interns participate in the Brief Psychotherapy Research Program through carrying several cases throughout the year. In addition, the intern may elect to do a specialized four month research elective in brief therapy. In this rotation, the intern will conduct a research project involving data collected under the auspices of the Brief Psychotherapy Research Program. The idea for a research project is conceived early in the internship year in collaboration with a supervising psychologist. Since the program is mainly focused on the study of the therapeutic relationship in time-limited treatment, projects typically have this focus. They are also often based on intensive, single case designs. The data base for the Brief Psychotherapy Program is rich and extensive, which permits a variety of interesting small-scale projects. The aim of this rotation is to complete a study worthy of presentation and/or publication. The intern has the opportunity to participate in the psychotherapy research seminar.

Addictions Training Program: Interns will be provided with an intensive experience in treating individuals with substance use disorders. Interns will receive training in harm reduction, motivational interviewing, CBT, abstinence-based, and psychodynamic approaches to addictions treatment. As part of the Psychiatric Outpatient Services for Adults (POSA), interns will carry up to three patients with addictions issues as part of their POSA outpatient psychotherapy caseload throughout the year. Interns will also rotate through the Addiction Institute of Mount Sinai (AIMS) on both the outpatient and inpatient rehabilitation units, where they will provide individual and group psychotherapy. As part of the group therapy component, interns will lead a dual diagnosis group for patients with co-occurring psychiatric and substance use disorders.  They will also participate in and observe lectures led by other staff members, attend morning rounds, lead morning meetings, and attend open AA meetings.

Comprehensive Psychiatric Emergency Program (CPEP): Psychology interns who choose this elective will work as part of a multi-disciplinary team (social workers, nurses, psychiatry residents, and psychiatrists) in the Comprehensive Psychiatric Emergency Program (CPEP.) The  CPEP is a primary entry point to the mental health system for individuals who seek psychiatric services on an emergent basis.  Components of emergency psychiatric treatment in the CPEP include observation, evaluation, medication management, and behavioral interventions.  Interns are involved in all steps of the process from triage and screening, assessment, stabilization and referral or diversion to an appropriate program. Interns attend morning rounds, conduct psychiatric diagnostic examinations and safety planning, obtain collateral information, and determine disposition.  Interns also hone competency in diagnostic and treatment planning and utilize brief therapeutic interventions when appropriate.  This rotation requires interns to think on their feet, flexible, be willing to take initiative and work collaboratively on a team.  Individual supervision is available by CPEP clinicians and interns participate in team learning activities as well. 

Complex Child Trauma: Interns who select this specialized rotation will have an introduction to understanding and treating child traumatic stress borrowing from four trauma-informed evidence-based models of treatment: Trauma Affect Regulation: Guide for Education and Treatment (TARGET); Attachment, Self-Regulation, and Competence (ARC); Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT); and Child Parent Psychotherapy(CPP). The treatment philosophy is also grounded in the relational approach of the Brief Psychotherapy Research Program.  The opportunities provided in this rotation include: collaborating on a research project; examining in–depth an element of clinical interest related to child trauma; program development; clinician training materials development.  The specific project that an intern undertakes is decided early in the year in collaboration with the super