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    Training Tracks

    Core Training

    The CPMC Outpatient Mental Health Clinic is a low-fee, hospital-based outpatient psychiatry clinic that serves as the primary training location of the internship. Many of the trainings and supervisions are provided at this central location and all interns carry a caseload of outpatient therapy patients. All Interns receive core training in psychodynamic and psychoanalytic theory and intervention. We are fortunate to have a large, dedicated volunteer faculty, some of whom have decades of experience, that enables us to provide a wealth of dynamically-oriented didactic trainings, case conferences, and supervisions. The proportion of time each intern spends in the outpatient clinic varies by position, but this aspect of the internship provides grounding for the program and allows for a unique and cohesive training experience.

    The outpatient clinic is staffed by Department of Psychiatry faculty, psychology interns, and psychiatric residents. The clinic serves approximately 400 patients each year, of whom two thirds are female, 20% are age 65 or older, and 16% are age 17 or younger. The patient population is ethnically diverse with 54% Caucasian, 20% Asian/Pacific Islander, 14% Latino, 4% African American, and 8% identifying as mixed race. We treat patients with anxiety, depression, psychosis, PTSD, ADHD, and other mental health conditions. Interns are assigned a range of cases, including patients struggling with chronic mental illness and higher-functioning individuals dealing with stressful life events. Opportunities for couples counseling, family therapy, group therapy, and psychological testing are available.

    In addition to the core training and clinical work in the Outpatient Mental Health Clinic, each intern’s area of specialization offers the unique opportunity to have breadth as well as depth during the internship year. For instance, our Adult Track offers specialized training in inpatient psychiatry, health psychology, neuropsychology, women’s mental health, or program administration. These placements involve partnerships with various CPMC programs and departments and all offer unique and intellectually stimulating experiences. Our Child and Adolescent Track includes specializations in outpatient psychotherapy and assessment, neuropsychological and educational testing, inpatient consultation-liaison services, or placement in community-based pediatric health clinics. These positions involve collaboration with the Kalmanovitz Child Development Center, the largest multi-disciplinary center in Northern California, which has provided services to infants, preschoolers, school-age children and adolescents, and families for over 50 years. More information about the training and clinical opportunities for each areas of specialization can be found below.

    Adult Training Track

    The Adult Training Track consists of five positions, each with a combination of core training in dynamically-oriented psychotherapy and with one of the following areas of specialization:

    1. Inpatient Psychiatry
    2. Adult Neuropsychology
    3. Health Psychology
    4. Women's Mental Health
    5. Program Administration
    Inpatient Psychiatry
    In addition to carrying a modest caseload of patients in the Outpatient Mental Health Clinic, the intern in this position works on the Inpatient Psychiatry Unit, a 16-bed locked facility providing 24-hour evaluation, stabilization, and treatment for adults with acute psychiatric illness. Patients on this unit are typically hospitalized for a brief period of time (between 5-10 days) and approximately 700 patients are admitted per year. The patient population varies widely by socioeconomic status and is diverse for ethnicity (45% Caucasian, 30% Asian, 15% African American, and 10% Latino), and psychiatric disorders (50% mood disorders, 40% psychotic illnesses, 10% organic disorders, and large proportion of co-morbid substance abuse disorders).

    The Inpatient Psychiatry intern is a member of an interdisciplinary team, comprised of psychiatry supervisors and residents, psychiatric nurses, social workers, occupational therapists, and medical students. The intern participates in daily team conferences, follows patients for individual psychotherapy, leads therapy groups, and provides support to family members. Supervision is provided by Stephanie Wilson, MD, Medical Director of the Inpatient Psychiatry Unit; Paul Chin, MD, attending psychiatrist; and psychology internship supervisors with expertise in working with patients with acute psychiatric disorders. Additional opportunities for psychological testing are available per individual interest.

    Adult Neuropsychology
    The Adult Neuropsychology intern splits time between a relatively small caseload at the Outpatient Mental Health Clinic and more extensive work at the Ray Dolby Brain Health Center, an innovative memory clinic for individuals with cognitive changes, early memory loss, or dementia. Serving mostly an adult geriatric population, the Brain Health Center staff specialize in diagnosing memory disorders and providing education and support to patients and their families to successfully adjust to a diagnosis of dementia or a neurological disorder. The interdisciplinary team consists of neurologists, neuropsychologists, nurse practitioners, social workers, and neuropsychology fellows, interns, and practicum students.

    The Adult Neuropsychology intern conducts comprehensive neuropsychological evaluations, including a clinical interview, test administration, and report writing, and shadows neurologists to review imaging studies and observe neurological evaluations. Along with neuropsychology fellows and practicum students, the intern participates in weekly didactics, case conferences, and journal clubs. Supervision is provided by Lynn Shaughnessy, PsyD, Director of Neuropsychology. Additional opportunities exist to participate in clinical research and to provide therapeutic interventions for patients with memory disorders in the Outpatient Mental Health Clinic. Interns are encouraged to apply for our two-year post-doctoral fellowship in clinical and research neuropsychology following the internship.

    Health Psychology
    The CPMC Health Psychology Program specializes in the integration of psychology services with outpatient, ambulatory clinics to form interdisciplinary teams, with current training opportunities in Oncology, Cardiology, and GI. The Health Psychology intern is closely supervised by Jeremy E. Bornstein, Ph.D., Director of Psychology Training, and experienced clinical supervisors. The intern also works closely with and receives mentorship from our post-doctoral fellows. The training for this position includes weekly seminars, individual and group supervision, and interdisciplinary team meetings specific to health psychology.

    Working in collaboration with various healthcare teams, the Health Psychology intern performs consultations, evaluations, targeted behavioral interventions, and short- and long-term psychotherapy to address a range of psychosocial problems. Depending on interest and available opportunities, the intern may perform cognitive screenings, provide educational lectures to patients, and develop in-service training for healthcare providers. There are also opportunities for clinical research and program development projects. The Health Psychology intern is encouraged to apply to our post-doctoral fellowship training program following internship.

    Women's Mental Health
    This intern works full-time in the Outpatient Mental Health Clinic and serves as the coordinator for the CPMC Perinatal Health and Wellness Program, an interdepartmental collaboration between Women and Children's Services and the Department of Psychiatry. In this innovative program, women at risk for postpartum depression and other mental health issues are referred by their medical team to the Outpatient Mental Health Clinic for psychology consultation. The Women's Mental Health intern provides outreach and works closely with physicians (OB-GYN or pediatricians), nurses, psychiatrists, and other healthcare providers to coordinate care.

    The intern selected for this position provides outpatient consultation-liaison and psychotherapy services (both short- and long-term) to women with a range of issues, including anxiety, postpartum depression, marital or infant-child relationship issues, pre-conception planning, assisted reproduction, miscarriage, infant loss, and pregnancy termination. During the initial consultation, the Women's Mental Health intern determines whether the patient is appropriate for mental health treatment, other CPMC supportive services, or referral to specialists within the local community. Supervision is provided by Samantha Powell, MD, the Medical Director for the Women's Mental Health Program; Catherine Mallouh, MD; and other supervising psychologists. There is a year-long Women's Mental Health seminar and case conference and ample opportunities to work with infant-mother dyads and provide couples therapy.

    Program Administration
    One intern is selected to work full-time in the Outpatient Mental Health Clinic and perform a range of administrative duties, including responsibilities of the Chief Intern. The Program Administration intern is involved with the training curriculum, caseload assignments, intern and supervisor evaluations, and other areas of interest. This intern functions as a liaison between the intern group and the faculty, representing interns at administrative meetings and working to maintain good communication and healthy working relationships within the intern cohort.

    This position is appropriate for interns with strong organizational and communication skills who have interest in program administration and possibly assuming a leadership role in the future. This intern works closely with Jeremy E. Bornstein, PhD, Director of Psychology Training; Janos Zahjaszky, MD, Medical Director of the Outpatient Mental Health Clinic; and other chief interns/residents to learn the "inner workings" of the training program and to provide input and assistance with ongoing administrative projects. There are ample opportunities to work on special projects, including research, grant writing, accreditation requirements, program evaluation, and program improvement efforts. The specific duties and responsibilities of the Program Administration intern are based upon individual interest and available opportunities.

    Child and Adolescent Training Track

    Under the leadership of Kathleen Fahrner, PhD, Director of Child and Adolescent Training, the Child and Adolescent Training Track consists of five positions, offering breadth and depth of training at two or more locations. In the CPMC Outpatient Mental Health Clinic, interns receive broad-based education, develop the skills and competencies needed for professional practice, provide outpatient therapy to children and adolescents, and perform collateral work with teachers, parents, and family members. Interns are also assigned a small number of adult outpatient therapy cases, receive our "core training" in psychodynamic and psychoanalytic theory and intervention, and are assigned dynamically-oriented supervisors to facilitate the intern's learning.

    In addition, Child and Adolescent Track interns work at the Kalmanovitz Child Development Center (CDC) a comprehensive, multi-disciplinary outpatient clinic that serves children ages 3 to 17 with a wide array of developmental, learning, behavioral, and emotional issues. The training model of the CDC is integrative and combines behavioral, cognitive behavioral, and family systems models of treatment. The population served by the CDC reflects the enormous diversity of the city of San Francisco, including a varied socio-economic and ethnic/cultural mix. Patient diagnoses include disruptive behaviors (including ADHD), depression or dysthymia, anxiety disorders (including PTSD), and autism spectrum disorders. Each year there are approximately 20,000 outpatient visits to the CDC, served by a large and experienced interdisciplinary team of pediatricians, child psychologists and psychiatrists, and educational specialists, as well as physical, occupational, and speech therapists.

    Areas of Concentration for Child and Adolescent Track

    The CPMC Child and Adolescent Track is comprised of five areas of concentration: two that focus on a mix of testing and psychotherapy, one that focuses on hospital-based consultation work, and two that integrate psychology services in community-based health centers with underserved patients. The areas of concentration are as follows:

    1. Neuropsychology and Educational Testing
    2. Child Psychotherapy and Assessment
    3. Pediatric Consultation-Liaison Service
    4. Pediatric Primary Care (Cantonese-speaking preferred)
    5. Pediatric Community Health (Spanish-speaking preferred)
    Neuropsychology and Educational Testing

    The primary responsibility of this intern is to conduct neuropsychological and educational assessments with children and adolescents referred to the CDC for diagnostic workups, evaluation of strengths and weaknesses, and recommendations for the home and/or school environment. This intern is responsible for all aspects of the assessment process, including clinical interview, test administration and scoring, report writing, and feedback. Referral questions may include neurodevelopmental disorders, learning difficulties, attentional impairments, executive dysfunction, and emotional and behavioral problems. This intern works with Pediatric Neuropsychologist, Brianna Coffino, PhD, for weekly assessment training and supervision.

    To provide well-rounded training, this intern also sees a small number of children, adolescents, and families for psychotherapy services both through the CDC and the Outpatient Mental Health Clinic. There is opportunity to treat a wide range of mental health concerns, including anxiety, depression, ADHD, learning or behavioral difficulties, and social or coping skill deficits, which complements the primary emphasis on neuropsychological and educational testing.

    Child Psychotherapy and Assessment
    The Child Psychotherapy and Assessment intern works with children, adolescents, and families at the CDC and carries a caseload of patients in the Outpatient Mental Health Clinic. The intern selected for this position provides services to address a range of mental and behavioral health concerns, including anxiety, depression, attention deficit disorders, autism spectrum disorders, learning difficulties, and poor social skills. There is opportunity to utilize a wide range of therapeutic approaches, including behavioral, cognitive-behavioral, and dynamic therapies within individual, family, group, and play therapy settings. This intern is supervised by Suzanne Giraudo, EdD, Clinical Director of the CDC.

    The Child Psychotherapy and Assessment intern also conducts psychological assessments at the CDC and is responsible for all elements of the assessment process, including clinical interview, test administration and scoring, report writing, and feedback. Referral questions may include learning difficulties, attentional impairments, and emotional and behavioral problems. The intern is encouraged to provide ongoing consultation with parents, caregivers, teachers, and treating providers to support the implementation of recommended interventions.

    Pediatric Consultation-Liaison Service
    Our Pediatric Consultation-Liaison Service intern provides consultation and intervention services to children and adolescents admitted to the pediatric medical-surgical unit. The intern plays a central role on the interdisciplinary team; works with physicians, nurses, social workers, case managers, and ancillary staff; and is an active participant in hospital rounds, providing input and consultation to staff. This consult service is supervised by Whitney Clarke, PsyD, child and adolescent psychologist.

    Services by the Pediatric Consultation-Liaison Service intern include evaluation of mental health and behavioral issues, development of behavioral management plans, delivery of targeted psychological interventions, and referrals for follow-up mental health services. All services are provided to patients and their families at the bedside. Opportunities to provide staff trainings are available per individual interest. The intern attends weekly Pediatric Psychosocial Rounds.

    Pediatric Primary Care
    The Pediatric Primary Care intern serves low-income Asian children and families seeking care at community health clinics. Through a partnership with the CDC, this intern provides psychological services at North East Medical Services, a community-based healthcare clinic for low-income Asian children, adolescents, and adults in San Francisco. Patients present with a range of mental health issues, including developmental disorders (e.g., Autism Spectrum Disorder, ADHD), learning disabilities, behavioral issues, anxiety, and depression. The intern collaborates with physicians, nurses, and social workers to provide evaluation and intervention services.

    The intern selected for the Pediatric Primary Care concentration provides services in both English and Cantonese. Bilingual applicants are strongly preferred. Services include developmental screenings, psychological and educational assessments, consultation, and brief psychotherapy. The intern works closely with social workers to provide referrals for mental health services and specialists in the local community. This placement is supervised by Suzanne Giraudo, EdD, and other CDC psychologists.

    Community Health Clinic
    The Community Health Clinic intern provides psychological services at St. Anthony Medical Clinic, a community-based healthcare clinic for adults, children, and families in the Tenderloin neighborhood of San Francisco. Over 30% of the patients served in the Clinic are children and nearly all of the patients live below the Federal Poverty Level ($23,550 for a family of four). In addition to primary care for adults and children, the clinic also provides an array of mental health services. The intern collaborates closely with physicians and other healthcare providers to provide interdisciplinary care, focusing on the mental health needs of underserved children and their families.

    The intern selected for the Community Health Clinic concentration provides services in both English and Spanish. Bilingual applicants are strongly preferred. Patients present with a range of mental health issues, including but not limited to complex trauma, behavioral issues, anxiety, depression, and relationship issues. Services include consultation, solution-focused interventions, time-limited psychotherapy (usually six sessions), family therapy, and screening-level psychological assessments as needed. The intern works closely with a clinic social worker to provide referrals for longer-term mental health services and specialists in the local community. This placement is supervised by Joe Gumina, PhD and CDC psychologists.