Core Adult Outpatient Training for All CPMC Psychology Interns
All CPMC Psychology Interns, regardless of their assigned training track, spend a minimum of 50% of their time throughout the entire 12-month training program in the CPMC Outpatient Psychiatric Department (OPD). The OPD serves a diverse population with respect to race, ethnicity, gender, sexual orientation, and age. Diagnoses of the OPD patient population include mood disorders (ranging from mild to severe), anxiety disorders, thought disorders, personality disorders, ADHD, and serious chronic mental illness. Interns in the OPD also see generally high functioning patients who are dealing with a stressful life event or wish to pursue psychodynamic psychotherapy in an affordable setting. Couples therapy and group therapy are also available throughout the academic year for those interns who are interested in acquiring these clinical experiences.
With respect to delivery of services, the average intern’s total patient caseload (including patients from their specific training track) is approximately 14–16 clinical hours per week at peak times of the year. Our goal throughout the academic year is to provide each intern with a variety of training experiences with respect to demographics as well as diagnostic presentation of each patient. The intent is for each intern to have a caseload that provides a broad training experience in the delivery of clinical services. Another significant aspect of the interns’ training in the OPD is the opportunity to treat patients who are concurrently being seen by a psychiatric resident for medication management, providing the intern with the experience of collaborating with a treating physician to optimize patient care.
Adult Outpatient Track
Interns assigned to the Adult Outpatient Track will work in one of the three sub-tracks listed below during the entire academic year. (Please note that each of these sub-tracks is a year-long training assignment and not rotations for all Adult Outpatient Track interns.)
Women's Mental Health
The Women’s Mental Health and Wellness (WMHW) program at CPMC has been reaching underserved and at-risk perinatal women with its essential services in multiple departments throughout the CPMC hospital system. The WMHW program is a program for women seeking therapeutic support for pre-conception planning, assisted reproduction, miscarriage, infant loss, pregnancy termination, or depression and anxiety during pregnancy through the first year of life. The WMHW program facilitates access to a variety of clinical support services for women and their partners.
Interns assigned to this sub-track are responsible for conducting phone intakes through the WMHW triage line and assessing for perinatal mood disorders. Caseloads include individual and couples psychotherapy with pregnant and post-partum women and their partners. One intern also works in the hospital’s Neonatal Intensive Care Unit (NICU) providing support and therapy to parents with a baby on that service.
The CPMC Health Psychology Program provides psychological services to patients and families with acute and chronic medical illness. Working in collaboration with healthcare teams, interns assist in evaluation, consultation, standardized screening, and behavioral interventions to address a range of psychosocial problems. Psychology services are integrated into existing medical treatment to promote multidisciplinary treatment teams.
Interns assigned to this sub-track provide an array of psychology services to medical patients (and family members as appropriate). Training may include brief consultation work, formal psychosocial assessments, cognitive screening evaluations, individual and/or group psychotherapy, and educational lectures to patients or healthcare providers depending upon the intern’s interests and current needs of the department
Program Development, Administration and Evaluation
Many of psychologists’ careers include organizational, administrative, and leadership roles in addition to their clinical responsibilities. This track has the goal development of leadership and program development/evaluation skills in Psychology. The interns assigned to this sub-track receive supervision in this role by the Chief Psychologist/Director of Adult Psychology Training. The responsibilities require approximately 8 hours per week and caseload expectations are decreased to accommodate these responsibilities.
The functions in this service include caseload assignment and monitoring, serving as liaison between the intern group and the training leadership team, serving as the intern representative at the Training Council and Outpatient Administrative meetings, and other program-related responsibilities.
This role is particularly suited to an applicant who is interesting in working as a psychologist in a mental health setting in a leadership role. An ideal intern applicant would have excellent organizational skills. This position provides experience in hospital administration and program development and evaluation.
Adult Psychiatric Inpatient Track
Interns who train in the Adult Inpatient track work in CPMC’s Inpatient Psychiatry Department. The inpatient unit is a 16-bed unit located on the floor directly below the outpatient clinic. The clinical population for the Inpatient unit is drawn from a wide socio-economic spectrum representing the full range of San Francisco’s diverse, urban population. The inpatient unit offers a wide variety of training experiences.
The psychology intern is a member of a treatment team that consists of an attending psychiatrist, two psychiatry residents, social workers, nurses, OT therapists, and a rotating team of medical school and nursing students. The intern attends daily morning rounds and contributes observations regarding hospital course of treatment, collateral input from family and outside providers, and case formulation for the patients with whom he/she is working. Interns on this track gain significant fluency is the areas of psychopharmacology, legal documents and proceedings pertaining to hospitalization, and disposition planning.
Interns on the inpatient track participate in leading psychotherapy groups and attend several weekly case conferences with fellow team members to discuss course of treatment well as individual and group psychotherapy sessions.
Child and Adolescent Outpatient Track
Interns assigned to this track have the opportunity to gain rich experience in working with children and adolescents as well as the opportunity to build their skills in doing collateral work with parents and other family members. Interns working in the child track also provide phone screenings and conduct intake evaluations on child patients. Interns see patients in three settings: the CPMC Outpatient Clinic, the CPMC Child Development Center (CDC) and local elementary schools to which they are assigned for the duration of the academic year. Following is a brief description of the venues outside of the outpatient clinic along with interns’ typical responsibilities in these roles.
Child Development Center (CDC)
The CDC is a comprehensive, multi-disciplinary outpatient clinic serving children with a wide array of developmental, learning, and behavioral/emotional problems. The population reflects the enormous diversity of the City of San Francisco including a varied socio-economic and ethnic/cultural mix. The patient population ranges from age 3 – 17 years. The diagnoses include Disruptive Behaviors (including ADHD), Depression or Dysthymia, Anxiety Disorders (including PTSD), and Autistic Spectrum Disorder. Interns working in the CDC provide individual psychotherapy with children and adolescents and also perform collateral work with parents, caregivers, teachers, and other providers.
Elementary School Setting
Each intern assigned to this track spends approximately one half day each week working in a local elementary school where they provide services throughout the academic year. The interns typically carry a child caseload of 3 – 5 patients who are referred for treatment by teachers, administrative staff, and parents or guardians. Interns working in the schools not only develop skills in working with the children themselves, but they are also benefited by rich experiences in collateral work with parents, teachers, and other professionals.