Albany Psychology Consortium Internship

Albany Medical Center Department of Psychiatry Inpatient Psychiatry Service – E2 On the Albany Med inpatient psychiatry unit, interns work closely with senior faculty in a multidisciplinary setting providing assessment and consultation services, and brief psychotherapeutic interventions (including group therapy). Patients may present with a broad spectrum of psychiatric diagnoses including schizophrenia, severe mood disorders, personality disorders, and or substance dependence. The average length of stay is approximately 7 to 10 days; however, some patients will receive treatment for a number of weeks.

Inpatient Transitional Program – Unit E (CDPC) Interns work on an inpatient psychiatric unit populated by individuals manifesting a broad range of psychiatric difficulties including psychotic disorders, mood disorders, personality disorders, and cognitive disorders who are exhibiting behavioral dyscontrol. Presenting problems include adaptive functioning deficits, suicidal behaviors, and forensic patients who have been found not responsible for a crime by way of mental disease or defect. Patients on this unit are considered to be actively working towards discharge. Interns function as part of a multidisciplinary treatment team and more specifically provide individual therapy and co-lead therapy groups. They also conduct psychological assessments that include intellectual, personality, and neuropsychological evaluations.

Inpatient Admissions Unit – Unit M (CDPC) The admissions unit is responsible for assessing the individual needs of each patient as they enter the (CDPC) hospital. Initial screening assessments are completed with each admission to determine treatment needs and the need for psychological testing based on hospital specific criteria. Interns would work with an interdisciplinary treatment team to assist in making treatment decisions and recommendations for patients with a wide variety of mental health concerns, including psychotic disorders, mood disorders, characterological disorders, cognitive disorders and those who have legal/forensic issues. Opportunities exist to co-lead groups, to offer individual therapy (generally brief in nature, but there are options to work with patients on a longer-term basis) and to evaluate patients for cognitive functioning and diagnostic clarification.

Albany Medical Center Department of Psychiatry Outpatient Clinic In the Albany Med outpatient clinic, the training clinic of the Albany Med Department of Psychiatry, interns work closely with psychiatry residents, faculty and staff. A primary focus of this rotation is psychological assessment, with an opportunity to utilize therapeutic as well as traditional models of assessment (Finn & Tonsager, 1997). Interns also conduct intake evaluations and carry a select number of psychotherapy clients (5-8). Psychotherapy supervision focuses primarily on brief psychodynamically informed treatment models. Opportunities may exist for group therapy, couples and/or family therapy. Patients present with a range of psychiatric issues including trauma, anxiety and mood disorders, personality disorders, substance use disorders, and co-morbid health related issues (e.g., HIV). Interns may participate in ongoing department treatment outcome research initiatives while on rotation.

Stratton VA Medical Center Mental Health Clinic Interns serve as staff clinicians working in an active VA outpatient Mental Health Clinic. With an average caseload of between 6-10 patients, interns provide psychotherapy and psychological assessment services. Interns conduct primarily individual therapy while on rotation; however, referrals for couples and family therapy are not uncommon. Opportunities exist for working with veterans with a range of psychiatric problems (e.g., combat related PTSD, mood and anxiety disorders, and personality disorders).

Child and Adolescent Psychiatry (CDPC) Interns are primary therapists for children, adolescents and their families. They receive experience in play therapy, family therapy, and child assessment, as well as consultation to schools and family court. Interns also have the opportunity to consult at secure detention facilities for behaviorally disordered adolescents. As consultants, they may provide diagnostic assessments, supportive therapy, and didactics for facility staff. Interns may participate in off-campus opportunities to complete PINS evaluations and other administrative evaluations with affiliated CDPC child psychologists.

Post-Traumatic Stress Disorder Program (VA Medical Center) The PTSD program is a short-term intensive program designed to provide outpatient treatment for Veterans with combat related readjustment problems, with an emphasis on treatment and management of PTSD. As substance abuse is a problem afflicting the majority of this population, a close relationship exists between the PTSD program and chemical dependency programs. Services provided by the PTSD program take three basic forms: 1) consultation services regarding the diagnosis and treatment planning, 2) a 16-week outpatient treatment program designed to address skill deficits which frequently interfere with adaptive function, and 3) individual treatment focusing on desensitization and the emotional processing of traumatic memories via intensive exposure-based psychotherapy. Interns work closely with faculty and staff in providing these psychological services.

Chemical Dependency Rehabilitation Program (VA Medical Center) Interns serve as a member of a multidisciplinary treatment team consisting of professional and paraprofessional staff devoted to the treatment of veterans with alcohol and drug dependence. A multimodal treatment approach is used, which includes individual and group therapy, psycho-education, 12-step meetings, and experiential tasks. Interns work as co-therapists in group therapy, conduct screenings and assessments, and carry 1-2 individual patients. As mentioned above, this treatment program is closely integrated with the PTSD program, thus allowing interns to focus on the integration of substance use disorders and trauma (as well as other anxiety, mood, and personality disorders).

Health Psychology (VA Medical Center) This rotation may include individual and group psychotherapy, family interventions, psychological and cognitive assessment, behavioral interventions, education to staff on inpatient medical units (i.e., sub-acute rehabilitation, inpatient Hospice & extended care medical units). Interns work in concert with medical providers, physical and recreation therapists, nursing staff, administration, behavioral health providers and all members of the multidisciplinary team. A subcomponent of the rotation includes an opportunity for experience with the Home Based Primary Care (HBPC) program, providing exposure to interdisciplinary and innovative care practices, enabling a view into the homes of patients who may typically be seen only in office settings. Additional areas of intervention are likely to include grief and loss, life transitions, pain and health behavior management, and capacity/competency and memory assessment. Interns may also rotate within the VAMC pain management team, consulting and working within a multidisciplinary setting managing chronic pain issues for veterans of all ages. In many years, interns have worked with the Director, Assistant Director, and supervising faculty in order to customize the rotation to fit specific intern interests.

Clinical Neuropsychology (VA Medical Center) This is a full-time elective rotation that provides the intern an opportunity to develop introductory to intermediate understanding of Clinical Neuropsychology in a medical setting. Interns work closely with neuropsychologically trained psychologists in responding to requests for consultation from various areas of the hospital, but most commonly from Neurology, Geriatrics and Behavioral Health. A diverse patient population presents a variety of important issues, including neurodegenerative disorders, neurodevelopmental conditions and traumatic brain injury. Interns on this rotation function as members of multidisciplinary team and assume responsibility for the delivery of psychological services. In addition to direct patient care and report writing, interns also interact with referral sources and provide education and/or brief counseling to patients and their families. Opportunities may be available for the interested trainee to assist with program development, special projects and research.

Psychiatric Emergency Room and Crisis Intervention Unit (CDPC) Interns serve as crisis team members, evaluating acutely ill psychiatric patients who present in the emergency room for treatment. In conjunction with psychiatric staff, interns coordinate patient disposition and referral. This is a part-time (approximately 15 hours) rotation that is required of all interns.

Seminars & Case Conferences The core seminar experience is provided by psychology and psychiatry faculty from consortium institutions and the community. Each week, interns are given up to four hours of didactic training in such areas as personality assessment, psychotherapy technique, psychopharmacology, neuropsychological assessment, family therapy, and group therapy. Along with seminars, case conferences are opportunities to discuss cases of educational interest. Case conference presentations are made by senior faculty, psychiatry residents, and psychology interns.

Grand Rounds Grand Rounds presentations are sponsored by the Department of Psychiatry, Albany Medical College. Interns are asked to attend weekly Grand Rounds as part of their educational experience. Lectures on a variety of topics in psychiatry and psychology are presented by Consortium faculty, as well as researchers and professionals from around the country. Interns have also been invited to present at Grand Rounds.

Teaching Days There are workshops and teaching days throughout the year. In the past, these teaching days have covered such topics as advanced psychopharmacology, anorexia nervosa, cognitive-behavioral therapy for psychosis, neuropsychology, and treatment of borderline personality disorders. In addition to the educational experiences listed above, interns may attend classes offered in the residency training program such as advanced psychoanalytic techniques, Freudian theory, brief therapy, psychopharmacology, family therapy, and hypnosis.

Experiential Process Group Another feature of the internship program is membership in a 16 week experiential process group. Training in group psychotherapy is strongly emphasized within the internship in a variety of settings and utilizing diverse group modalities. The intern process group acknowledges the longstanding tradition of experiential learning as a critical aspect of quality training in group psychotherapy. We have also found that participation in the intern experiential group contributes to a more cohesive and enriching cohort experience. The group is led by one or two of the psychologists here on faculty who have a strong interest and clinical background in group psychotherapy. The group leaders have no other role within the internship in order to prevent the occurrence of dual relationships. Group meetings are held weekly for approximately the duration of the second rotation of the internship year.

Long-Term Psychotherapy While time-limited forms of psychotherapy play a major role in contemporary clinical practice, we feel that the best way to prepare for shortening treatment is by obtaining an in-depth understanding of patients, acquired via intensive (“long-term”) psychotherapy. Once interns internalize the process of intensive psychotherapy, they can then become more efficient in therapy and subsequently work towards shortening treatment length. In the long-term psychotherapy program, interns, upon arrival, are assigned two or three carefully selected psychotherapy patients to see during the entire year. For each case, interns have a different supervisor who provides hour-for-hour supervision. These cases are seen in addition to brief psychotherapy cases associated with their outpatient rotation(s).

Supervision On each rotational assignment, the intern is assigned a principal supervisor, usually the most senior psychologist. This principal supervisor provides the bulk of the supervision and oversees the rotational experience. The supervision is close, intensive, and follows an apprenticeship model. On each rotation, interns may receive additional supervision from other psychologists as well as from other mental health professionals.

Interns are formally evaluated three times during the course of the year (at the end of each rotation). Detailed feedback is solicited from all supervisors, and the Director collates the data for a supervisory feedback meeting with the intern. When problem areas arise, plans of correction and remediation are implemented in a timely manner. Twice a year, the interns' home training programs are given written evaluations of the student's progress. The interns are also asked to provide program feedback about their training experiences twice during the year, and evaluate their supervisor at the end of each rotation. When problems arise, plans of remediation are quickly implemented to insure a responsive and supportive training experience for the intern.

The Work Week

We are a full time internship that runs from September through August. As a full-time intern, a 40-plus hour work week is expected. It is not expected that interns will ever have to work more than 45 hours (at most), and there are no weekend commitments. We are a training institute that believes the interns earn a stipend for being trained. They are not here to see large numbers of patients, or to produce volumes of reports. The only time we are concerned about numbers is when attempting to determine an optimal workload for training. Training needs come first. Service needs come second. This has always been a core value of the internship.

Fringe Benefits

CDPC funded interns receive 10 days of vacation with 11 sick/personal leave days during the course of the year as well as paid national holidays. The VA funded interns receive 13 vacation days and 13 sick/personal leave days per year with paid national holidays. Pay periods are once every two weeks, with a total of 26 pay periods per year. All interns have health insurance benefits.

Albany Medical College has a full medical library with ample resources for the intern research and scholarship needs.

Postdoctoral Training Opportunities

Albany Medical Center's Department of Psychiatry and the Stratton VA Medical Center have postdoctoral fellowship positions that often have recruited from within our internship program. The Stratton VA Medical Center is home to a postdoctoral training program with a focus on the treatment of PTSD. The program will accept two fellows each year.