Clinical and Didactic Training Activities

Clinical Rotations

• Outpatient Rotation, 15-25 hrs/wk (12 months). Depending on which electives they are doing, interns have approximately 8-12 hours of direct patient care (face-to-face and telehealth) in the outpatient clinic per week, involving both diagnostic assessment and individual and group therapy for children, (ages birth-18) with a wide range of psychopathology. In order to provide the best training experience, interns are asked to provide frequent input to their supervisors and the clinic director regarding what populations and presenting concerns for whom they would like to provide care in the outpatient setting.  Due to the high demand for services in our region, the clinic receives referrals for a wide variety of patients with different cultural and religous backgrounds, gender identities and sexual orientations, spoken languages, SES, and presenting concerns.  Interns will regularly conduct diagnostic evaluations, which involve obtaining collateral information from parents/families, schools and medical professionals in order to develop family-centered treatment plans. All of the therapy rooms used by interns are equipped with AV recording systems that allow for interns and supervisors to review recorded sessions together in supervision. In addition to individual/family therapy, interns co-lead group therapy sessions at the clinic.  Currently, our clinic is running 25 different groups, including social skills, CBT for anxiety, multi-family group, and the ALLY group for LGBTQ teens.  As a part of their outpatient time, interns also participate in weekly clinic-wide multidisciplinary treatment team meetings where they can elicit or provide recommendations regarding patient care.  interns can also elect to participate in specialty treatment teams (medical comorbidity; sexual and gender diversity). The clinic consists of providers from several different disciplines, including psychologists, psychiatrists, nurse practitioners, nurses, social workers, marriage and family therapists, creative arts therapists, mental health counselors, and case managers. The outpatient clinic hosts many social events and has an active Promoting Racial Justice Initiatives team that interns can join. For more information about Diversity, Equity and Inclusion initiatives at Pediatric Behavioral Health and Wellness, you can view this recent Grand Rounds presentation here.
• Inpatient Rotation, 6 months (20-25 hrs/wk). The Child and Adolescent Psychiatric Inpatient Unit provides assessment and crisis stabilization for approximately 25 children and adolescents who are admitted for a variety of reasons, including risk of harm to themselves or others, behavioral instability, deterioration in functioning, and psychosis. Throughout this rotation, the intern works closely with the inpatient psychologists and other members of the multidisciplinary team to provide psychological assessment, consultation, and individual, group and sometimes family therapy. Groups are both structured / skill based (e.g. Mindfulness) and process-oriented (Teen Expressions Group). Interns facilitate approximately four- six groups per week. Acceptance and Commitment Therapy is integrated into our therapeutic interventions, allowing interns to enhance skills in this modality.
• Pediatric Behavioral Health Rotations, 6 months (4-8 hrs/wk). During the 6-month block opposite the Inpatient Rotation, interns have the option to spend 4 hours/week as members of the integrated Pediatric Behavioral Health Service at Perinton Pediatrics, a community practice. Interns at the General Pediatric Practice will deliver direct clinical service to underserved youth and families; provide consultation to other members of the interdisciplinary health care team; and participate in medical team teaching and didactics. Interns at Perinton Pediatrics will complete co-visits with medical team providers, participate in daily huddles, in addition to completing integrated clinical services. Interns will also have the opportunity to participate in shadowing experiences 2 half-days per month in order to gain additional exposure to integrated pediatric specialty clinics including: Adolescent Medicine, Craniofacial, Endocrinology/Diabetes, Feeding Disorders, Gastroenterology, Inpatient Consultation/Liaison Service, Neurology/Headache, Pulmonary, Sleep Medicine, Breastfeeding & Lactation, Rheumatology, Hematology / Oncology, FASD, and Genetics.
• Psychological Testing, 12-months. Interns perform psychological evaluations throughout the training year, though often the majority of evaluations take place during the six-month Inpatient Rotation; interns also complete between 2-3 evaluations at Pediatric Behavioral Health & Wellness (outpatient clinic). Test batteries are constructed based on the individual referral questions. Commonly used instruments include: objective measures (e.g., MMPI-A-RF, MACI/M-PACI, CDI/BDI, R-CMAS), projective measures (e.g., Rorschach - Exner System, Roberts Apperception Test, Incomplete Sentences) and parent report measures (e.g., BASC, Conners). When cognitive assessments are needed, commonly used instruments include the WISC-V (administered via iPads), WASI-2, and WAIS.

The following are sample schedules of the Inpatient rotation (top), and the Outpatient rotation (bottom).  Actual schedules will vary depending upon the chosen electives.

Clinical & Research Electives

• School Mental Health (Supervisor: Melissa Heatly, Ph.D.)
  UR Medicine's Expanded School Mental Health Initiatives (ESMH) is a framework in which community behavioral health providers support school efforts in promoting children's behavioral health through training, consultation, and direct clinical care.  ESMH utilizes community behavioral health providers as partners with schools and families to augment existing school supports, to build school capacity to support children's behavioral health needs, and to provide a more comprehensive array of care within the school setting. Interns who participate in the ESMH rotation will collaborate on the development and delivery of universal behavioral health training for educators that support all students, selective consultation and technical assistance for staff who support students with more complex behavioral health concerns, and indicated intervention services such as clinical assessment and treatment.  This rotation will include providing therapy to students in the school setting, consulting with teachers, and collaborating around program development. One of our recent interns collaborated with Dr. Heatly on creating a program to support educator resilience following COVID-19 with Restorative-Justice Oriented Community-Building Circles, and was able to submit a poster to the National Center for School Mental Health related to this work. For more information about the Expanded School Mental Health Initiative, you can view this recent Grand Rounds presentation here.
• Pediatric GI (Supervisor: Colette Stenz, PsyD)
  The Intern on the Pediatric GI elective will obtain supervised experience providing evidenced-based clinical care to children and adolescents who present with disorders of the gut-brain interaction (irritable bowel syndrome, inflammatory bowel disease, functional abdominal pain, rumination syndrome, cyclic vomiting syndrome and functional constipation/encopresis). A portion of the intern's outpatient caseload at East River Road will include patients with these types of presenting concerns, and the intern on this elective will also co-lead at least one round of Caregiver-Child Encopresis Group with Dr. Stenz. The intern on this elective will also shadow providers from Golisano Children's Hospital Pediatric Gastroenterology Clinic and can also schedule shadowing opportunities in other related pediatric settings (e.g., C-L, feeding clinic).  The intern can also participate in the monthly Rome Foundation pediatric GI case consultation meeting and medical comorbidity treatment teams at PBHW. This elective experience will be a 6-month or 12-month experience depending on interest. 

• Social Network-based Suicide Prevention Program (Supervisors: Peter Wyman, Ph.D. and Ian Cero, Ph.D.)
  This rotation would involve exposure to multiple programs that use adolescents' social networks to disseminate health coping norms and build positive social bonds. One such program is Acute Youth Connect, which is a post-discharge intervention in which adolescent suicide attempters nominate 3-4 trusted adults to serve as a social support team for them after discharge from acute services. Another program is Above the Influence of Vaping, which is being tested through an ongoing randomized trial in 20 middle-high schools funded by National Institute of Drug Abuse. A final program, Sources of Strength, is an upstream schoolwide intervention to promote healthy coping of entire high school social networks through peer-led dissemination.
• Autism Elective (Supervisor: Jessica Keith, Ph.D.)
  The Intern on this 6-month elective will obtain supervised experience conducting evidence-based assessments for autism spectrum disorder (ASD) using the ADOS-2, SCQ, SRS-2, and semi-structured parent interview. They will also gain experience providing consultation to other clinicians and treatment for children presenting with symptoms of autism spectrum disorder and related developmental concerns. The intern will also have the opportunity to co-lead an evidenced-based group for youth with ASD (PEERS Program). The intern will be able to shadow providers in Developmental Behavioral Pediatrics, Complex Care and the Feeding Disorders Clinic; there will also be opportunities to work collaboratively with local non-profit organizations that support those with ASD.??
• Infant and Early Childhood Mental Health Elective (Supervisors: Karyn Hartz-Mandell, PhD, Kenya Malcolm, PhD, Lauren Mutignani, PhD)
  The Intern on the Infant and Early Childhood Mental Health (IECMH) elective will obtain training and supervision in the evaluation and treatment of families seeking IECMH-related mental health services through Pediatric Behavioral Health and Wellness, including individual assessment and therapy as well as group therapy (child and/or caregiver groups). The intern will attend a monthly IECMH clinician reflective supervision/consultation group. The intern will also have the opportunity to participate in the IECMH Basics training through SPCC's Mary Ellen Institute. Shadowing opportunities in multiple early childhood settings are available, including childcare consultation, Parent-Child Interaction Therapy (PCIT), and Breastfeeding Medicine Consultation. This elective can be a 6-month or 12-month experience. For more information about Infant and Early Childhood Mental Health at URMC, you can view this recent Grand Rounds presentation here.

Core Didactic/Experiential Learning

• Welcome to Rochester (6 hours). The overall goals of this two-part required learning activity are to: a) learn the story of the Haudenosaunee and honor their legacy and the contributions they have made over the last 2000 years to the arts, culture and society; b) enhance trainees’ understanding of the city of Rochester and the University of Rochester Medical Center’s historical context as it relates to racial/social injustice and how past and current policies impact people from historically marginalized groups today; and, c) appreciate and honor the diverse ways that individuals from historically under-represented groups have contributed to and continue to contribute to the community or Rochester. Trainees view a video and complete readings regarding the history of Rochester and current healthcare disparities and about influential Rochesterians. For the second part and then participate in a group meeting to share reflections. For the second part, trainees will meet at the Ganondagon historic site for a guided tour with reflection.
• Diagnostic Clinic (2.5 hours/week). Diagnostic Clinic in the Child and Adolescent Outpatient Service is designed to provide live supervision of diagnostic work involving children and parents in a collaborative and supportive environment. The interns participate on a "diagnostic team" and are observed by the supervising faculty and other members of the team through one-way viewing facilities. When interns are acting as primary clinician for a specific diagnostic case, they work alongside another trainee or staff clinician in the room with the family.  All of the members of the diagnostic team rotate roles during the training year, allowing for each member to get a chance to gain experience in those roles. Interns often continue to provide treatment to patients seen in Diagnostic Clinic if appropriate.  When acting as observing participants on the team, interns contribute to all discussions about the case, assist with obtaining collateral information from outside sources, and share their observations about the clinical interactions.  Typically, diagnostic clinic consists of 5-7 different patients/families, which each include 3 intake appointments.  This allows for each intern to act as primary clinician with one patient/family, and then participate as a member of the observation team for the remainder of the training experience.  Previous interns have shared that diagnostic clinic is an excellent opportunity to get feedback on their own clinical work, as well as expand their clinical repertoire by observing their fellow trainees. They have also identified that diagnostic clinic is a great way to get experience providing peer supervision to others, since the team typically consists of some members with less clinical experience than that of the psychology interns.
• Psychotherapy Seminar (1.5 hours/week, Aug-June). The goal of this seminar is to enhance general therapy skills and build competency in the delivery of select empirically based treatments for children and adolescents (ACT, SPACE, Parent Management Training, Collaborative and Proactive Solutions). Each section of the seminar includes a didactic component and a supervision component, which utilizes videotaped recordings of therapy sessions.
• Department of Psychiatry Grand Rounds, (weekly 1-2 hours). This weekly forum features research and clinical presentations by local, regional, and national experts in selected areas of psychiatry and psychology. In addition, our Office of Diversity, Inclusion, Culture and Equity hosts several presentations to maintain a steady focus on celebrating diversity and engaging in anti-racist activities. Occasionally, the speaker will meet with interdisciplinary trainees for an extra discussion session. Interns may also choose to attend other Grand Rounds relevant to their training goals (i.e., Pediatrics, Internal Medicine and Public Health Sciences).
• Professional Development Seminar, (some meetings combined with fellows). This seminar features a wide range of topics pertaining to both professional and academic development presented by selected psychology faculty, including community-based psychologists. Topics include Psychologists in Medical Centers, Diverse Career Paths of Psychologists, Fellowship and Job Search Strategies, and Psychologists as Administrators.
• Multicultural Case Conference (8-10 sessions, 1 hour). The overall goal of this seminar is to increase cultural awareness and sensitivity of psychology trainees via the lens of the APA Cultural Formulation Interview, with trainees presenting clinical case conceptualizations using the APA Cultural Formulation Interview framework. Trainees will be able to (a) recognize their own cultural identities, (b) increase their knowledge, awareness, and skills in multiculturalism, (c) recognize their personal bias, and (d) better meet the needs of a diverse patient population. This seminar will help trainees become more aware of how culture impacts clinical work, research, and teaching. 
• Ethical and Legal Practices for Psychologists (6 sessions, includes court visit). The purpose of the seminar is to provide exposure to, and information about, the types of court-related experiences psychologists may encounter in practice. Each session is facilitated by experts from mental health and legal fields who present their perspectives on a topic, followed by Q&A and discussion. Relevant Ethical Principles and Code of Conduct will be discussed. 
• Amplification and Allyship (6 hours). The overall goals of this learning activity are to: a) increase appreciation and awareness for how structural racism and systematic oppression impact members of historically marginalized groups; 2) amplify the voices/perspectives of members of historically marginalized groups and 3) provide ongoing opportunities for reflection on action and allyship. Trainees will view/listen to media that address structural racism/oppression of historically marginalized groups and social justice movements in various systems (e.g., health care, education, criminal justice) as well as content that highlights the vital importance of racial/cultural joy and then share reflections related to amplification and allyship in sharing/connecting circles.
• "SafeSide"(Suicide Prevention) Workshop (5 hours). The overall goal of this video-based education is to prepare trainees with the knowledge and skills needed to conduct person-centered, standard-of-care interviews, risk assessments, safety planning, documentation, and decisions with suicidal patients. 
• CPI: Verbal Intervention w/disengagement skills (Tier 3) (5.5 hours). Verbal Intervention training equips staff with the knowledge and skills to identify a person in crisis and verbally de-escalate disruptive behaviors. In addition to verbal de-escalation training, this curriculum includes training on how to block and move away from a strike.  This is a blended curriculum consisting of both an online component (1.5hrs) and in-person class (4hrs).
• Intimate Partner Violence and HEAL Collaborative (1 hour). This presentation reviews definitions of intimate partner, interpersonal, and domestic violence and summarizes biopsychosocial correlates.  It reviews special considerations related to telehealth, confidentiality,  documentation, safety, and provider wellness/self-care. Finally, it reviews community and URMC specific resources including the HEAL collaborative, the services provided, and how clinicians can access these services for their patients and themselves.
• Leadership Projects, 1-2 hrs/wk (10 months). Each intern, in conjunction with a faculty mentor, completes a leadership project focused on developing tailored approaches for education, intervention, prevention and evaluation initiatives in Psychology. Past projects have included: “Developing a brief curriculum on trauma, caregiver stress, and resilience of kinship caregivers,” and “Identifying an adaptation framework for a diabetes prevention program for individuals with severe mental illness”. Trainees present their leadership projects in June at the Department's interdisciplinary Education Poster Day. Please go to our Scholarly Activities page to view current and past projects.
• OPTIONAL: Assessment and Treatment of Eating Disorders (4 meetings, 12 hours). This elective opportunity is an interdisciplinary didactic series focusing on evaluation and evidence-based treatment of eating disorders, with a particular emphasis on interdisciplinary treatment team functioning and planning.

Interns present their Leadership Projects at the Department’s Interdisciplinary Education Poster Day.