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CORE ROTATIONS

Adult Inpatient

Supervisors: Kris Chapleau, Ph.D., Sarah Landsberger, Ph.D., Jenifer Vohs, Ph.D.

The Adult Services program at Larue Carter Memorial Hospital provides inpatient mental health services to adults of all ages with severe mental illnesses, and includes 94 adult beds with an approximate nine month average length of stay. The program adheres to a biopsychosocial approach to mental illness and serves a diverse clinical population from across the State of Indiana. Over half of the patients are diagnosed with psychotic spectrum disorders (e.g. schizophrenia, schizoaffective disorder), about a quarter are diagnosed with major mood disorders and the rest hold a variety of diagnoses such as personality, eating, and anxiety disorders. Co-morbid substance use disorders and intellectual disabilities are prevalent.

There are four units for adult patients at Carter Hospital (ranging from 17 to 29 beds) offering treatment activities and areas of specialization adapted to the needs of the particular patients on those units. Each unit has its own unique interdisciplinary treatment team (comprises professionals from psychiatry, nursing, social work, rehabilitation therapy, nutrition and dietetics, chaplaincy) as where psychology is always represented and important to its functioning.

Diverse and medically complex patient populations are well represented on each of the units. Adult patients are typically drawn from all over the state of Indiana including urban and rural settings. Most patients have numerous psychosocial stressors (e.g., limited finances, lack of social supports, homelessness, multiple medical problems, legal issues) in addition to their psychiatric conditions.   Carter Hospital is also the designated institution within the State of Indiana system for the provision of mental health services to those with severe mental illness and limited English proficiency (e.g., the deaf and hard-of-hearing, newly immigrated individuals, other communication barriers).  A number of patients have other disabilities (e.g., deafness, blindness, intellectual disabilities, physical disabilities) in addition to longstanding serious mental illness. Forensic patients in need of competency restoration or transitioning between the correctional system and the community are also present in the Carter patient population.

The intern will be assigned to a supervisory psychologist and join a multidisciplinary treatment team on one of three adult units and assume a wide range of clinical activities. Specifically, interns will gain experience with co-leading and leading specialized psychoeducational groups using evidenced-based practices adapted for populations with serious mental illness (e.g., Illness, Management and Recovery, Dialectal Behavior Therapy, Social Skills Training), conduct individual psychotherapy with a caseload of 5–7 patients, perform psychological assessments on newly admitted patients and provide consultation to the treatment team regarding behavior management. The intern may also have the opportunity to supervise psychology graduate students and to initiate and/or collaborate with ongoing research projects. As all supervisory psychologists at Carter Hospital are IU School of Medicine faculty members, each of the supervisors are supportive and active in some type of research activities. Interns are welcome to participate with faculty in research and publication efforts. Most recent publications and research results have focused on the assessment and treatment of those who are deaf/hard-of-hearing, and treatment outcomes with patients with psychotic disorders.

Child and Adolescent Inpatient

Supervisors: Melissa Butler, Ph.D., John Spanke, Ph.D.

The Child and Adolescent Program at Larue D. Carter Memorial Hospital provides intensive multidisciplinary inpatient treatment to seriously disturbed boys and girls, ranging from eight to eighteen years of age. The program consists of a 13-bed adolescent boys unit, an 18-bed adolescent girls unit, and an 11-bed unit for elementary school and middle school age boys and girls. Patients admitted to the Child and Adolescent Program typically have complex diagnoses, family problems, and systems of care issues. Prior to their placement at Larue D. Carter Memorial Hospital, many of these children and adolescents have previously participated in residential treatment programs, acute inpatient and partial hospitalizations, and outpatient therapy. A broad range of disorders may be treated but, in general, these are children and adolescents with disruptive behavior and mood disorders. The average length of stay for patients in the Child and Adolescent Program is typically to six months to one year. Patients attend a fully accredited school located on the hospital grounds. Parents are expected to participate in adjunctive conjoint and family therapy. Social-learning, cognitive-behavioral, and family-systems are the predominant theoretical orientations.

Psychology interns will participate with other treatment team members in the assessment of newly admitted patients and their parents, provide consultation to the treatment team regarding behavioral management, and function in the role of primary therapist for select patients. In the role of primary therapists, psychology interns typically provide individual therapy, participate in family therapy and coordinate the efforts of other members of a multidisciplinary treatment team including direct care and nursing staff, child psychiatrists and child psychiatry residents, social workers, activity therapists, and special education teachers. Psychology interns may also participate in and co-lead therapy groups and unit meetings.

Adult Outpatient Clinic

Supervisors: Yelena Chernyak, Ph.D., Natalie Dattilo, Ph.D.

The adult outpatient rotation takes place at the Adult Psychiatry Clinic and Study Center at Indiana Neuroscience Center. The IU Neuroscience Center is a tertiary care facility with nationally and internationally recognized programs in specialized medical care. General psychiatry residents as well as psychology interns rotate through the clinic, located on the IU School of Medicine campus. The clinic offers psychiatric services, including consultation-liaison services, and outpatient psychological testing and treatment. The clinic is staffed by IU faculty physicians and psychologists, social workers, and trainees in each of these disciplines. Clinicians specialize in the treatment of mood disorders, anxiety disorders, personality disorders, geriatric disorders, somatoform disorders, behavioral health issues, and women's issues. Specialty training in areas of health psychology such as psycho-social oncology and behavioral sleep medicine is offered. Additionally, interns often have the opportunity to train in consult-liaison psychology.

Interns on this rotation may have the opportunity to conduct clinical interviews and diagnostic assessments, provide individual and group psychotherapy, receive individual and group supervision, and provide supervised supervision to doctoral students in clinical psychology.

Child and Adolescent Outpatient

Supervisors: Bill Kronenberger, Ph.D., Ann Lagges, Ph.D., Eric Scott, Ph.D.

The Riley Child and Adolescent Psychiatry Clinic offers outpatient mental health services to families with children and adolescents under the age of 19. Families present to the clinic with a wide range of psychiatric and co-morbid medical conditions and often with complex social situations. The child outpatient rotation is divided among a number of the specialty clinics that exist under the larger umbrella of this general clinic. Interns on this rotation will typically spend a full day in the headache clinic, a half day in the pain clinic, a full day in an intensive testing clinic, a half day in the mood disorders clinic, and one and a half days seeing general psychiatry outpatients. In all components of this rotation, the intern may have the opportunity to supervise a practicum student.

In the headache and pain clinics, interns will gain experience working as part of a multidisciplinary medical team. The headache clinic is a joint venture with Pediatric Neurology; interns will learn assessment of patients with headache, CBT intervention for headache as well as basic and advanced biofeedback skills. The pain clinic involves collaboration with anesthesiology, and provides interns with experience assessing patients with chronic pain, providing CBT and biofeedback interventions.

The pediatric testing clinic provides interns with experience providing intensive, full-day assessments to children and adolescents with complex issues involving cognitive abilities (approximately 90% of cases) and at times, issues involving personality/symptom assessment (approximately 10% of cases) . The intern is responsible for some test administration, behavior observation and test interpretation.

The pediatric mood clinic provides therapy services to children and adolescents with Depressive Disorders, Mood Disorder, NOS and occasionally, Bipolar Disorder. Co-morbidity is the rule rather than the exception; common comorbid diagnoses include ADHD, ODD/Conduct Disorder, Anxiety Disorders and Autism Spectrum Disorder. Co-occurring medical conditions are also common, and families often present with complex social situations. Treatment is conducted based on the Evidence Based Practice guidelines; individualized treatment plans are developed that incorporate, as appropriate, CBT, IPT, Behavioral Parent Training, and Family Systems interventions.

In their general psychiatry clinic time, interns will see patients from the general clinic population. Diagnoses include a wide range of typical (e.g. ADHD, ODD, Separation Anxiety) and less commonly seen (e.g. selective mutism, conversion disorder) psychiatric conditions. Co-occurring medical conditions are common.

Child and Adolescent Consultation Liaison Service

Supervisor: Amy Williams, Ph.D.

The Riley Pediatric Consultation and Liaison services offers inpatient mental health services hospital-wide. Consultation requests are received from various services including Hematology/Oncology, Rehabilitation, Gastroenterology, Neurology, Pulmonology, Neurosurgery, General Surgery, Developmental Pediatrics, Critical Care, Endocrinology, Emergency Medicine, Hospitalist and Adolescent services, and the burn unit. Our service also consults for various acute psychiatric emergencies in the outpatient pediatric specialty clinics. Psychology interns will be involved in consultation requests involving diagnostic assessment, pain management, behavioral interventions, family conflict, biofeedback, coping with chronic or terminal illness, feeding issues, pre- and post-transplant evaluations, Somatoform disorders, altered mental status and psychosis, and overdose/ingestion cases. Interns will carry an average of 4-6 cases per day, including new initial assessments and follow-up therapeutic interventions. The Pediatric Consultation and Liaison team is a multidisciplinary team which includes a full-time psychologist, psychiatrist, and two social workers. In addition, the intern will have the opportunity to work with psychiatry and triple board residents and medical students. Opportunities for supervision of graduate students and medical students are available. 

Autism Core Rotation

Supervisors: Jill Fodstad, Ph.D., Noha Minshawi, Ph.D.

The Christian Sarkine Autism Treatment Center (CSATC) is a comprehensive, hospital-based and university-affiliated treatment center engaging in clinical care, research, education and outreach activities in the state of Indiana. We are actively serving over 2,000 individuals with Autism Spectrum Disorders (ASD) of all ages, abilities, and developmental levels. The CSATC is one of only five sites in the country involved in a research study funded by the National Institute of Mental Health that is focused on parent management training for individuals with autism. Additionally, the CSATC has received government funding for a study on the relationship between social skills training and medication management for high functioning children with ASD.

Psychology interns have the opportunity to participate in a variety of clinical opportunities that include both assessment and treatment of individuals with ASD. Assessment experience will include diagnostic interviews and standardized testing experiences. The treatment focus of the CSATC is behavioral in nature with a specific emphasis on the science of Applied Behavior Analysis (ABA). Interns will carry therapy caseloads that will include multiple modalities (e.g., individual therapy, parent training), as well as a variety of presenting problems (e.g., aggression, self-injury, social skills deficits, adaptive skills training). In addition to treatment experience, interns can pursue opportunities to expand their research skills on several ongoing studies based on time and interest.

 

SPECIALTY ROTATIONS

Adult Outpatient

Supervisor: Natalie Dattilo, Ph.D.

This rotation is a half or full day per week.  Interns will have the opportunity to conduct diagnostic assessment and psychotherapeutic treatment for mood, anxiety, and personality disorders in a hospital-based outpatient treatment setting. Interns will have the opportunity to interact with multi-disciplinary treatment team members, including nurses, social workers, physicians, and psychologists. 

Adult Inpatient

Supervisors: Kris Chapleau, Ph.D., Sarah Landsberger, Ph.D., Jenifer Vohs, Ph.D.

This rotation is a full day per week.  The intern learns through observation and practices the functions of psychology in a multi-disciplinary inpatient setting. The intern, under the supervision of a Carter faculty member, will provide assessment, individual and group therapy, as well as experience treatment team participation. The patient population is varied and dependent on unit assignment, but can include patients with psychotic disorders, mood disorders, and personality disorders, The ages of the population range from age 18 through the elderly. Units are co-ed and include a diversity of cultural and ethnic heritage.

General Adult Inpatient/Applied Clinical Research

Supervisor: Jenifer Vohs, Ph.D.

This rotation is a full day per week.  The intern who selects this specialty rotation will have the opportunity to, as a member an interdisciplinary team, perform adult inpatient psychological and cognitive assessments (as needed), co-lead / lead one inpatient group intervention for persons with severe mental illness, and be assigned 1-2 individual psychotherapy cases. The intern will be guided in the process of evidence based practice in determining and implementing all therapeutic interventions. In addition to clinical work, this specialty rotation will offer the opportunity for exposure to applied clinical research through the Indiana University Psychotic Disorders Program.

Adult Neuropsychology

Supervisor: Fred Unverzagt, Ph.D. and Dan Rexroth, Psy.D.

This rotation can be a full day or half day per week.  The rotation includes neuropsychological testing in the clinic in which the intern will have an opportunity to conduct testing and generate clinical consult notes.  The apprenticeship model of clinical supervision is used.  Depending on their level of experience, interns may begin by observing, and will likely spend time practicing administration with other team members including post-doctoral fellows in neuropsychology, and experienced testing technicians. The exact nature of the experience will be determined, in part, by the intern’s goals.  If an intern desires basic exposure to neuropsychology, a half-day per week for one rotation will likely be sufficient.  If an intern intends to pursue neuropsychology as part of their career, and is perhaps contemplating a post-doctoral position in neuropsychology, completing two to three rotations of a specialty in this area for a full day per week would be recommended, and the experiences over the two to three rotations would clearly be developed to be sequential in nature rather than a repetition of the same experience. 

Adult Psychosocial Oncology

Supervisor: Yelena Chernyak, Ph.D.

This rotation is a full day per week.  Please note, this rotation is part of the Adult Outpatient Core Rotation, and so interns who complete that core rotation, will already have this specialty rotation included.  Outpatient psychosocial services are provided as part of the Indiana University Simon Cancer Center Complete Life Program. The treatment team, which consists of a psychiatrist, psychologist, social worker, dietitian, and chaplain, meets on a weekly basis for rounds and staffing. Psychological services provided include individual, couples, and group therapy using CBT and other empirically-supported interventions for skills building, symptom management, behavior modification, and support. Interns will have the opportunity to work with a medically diverse clinical population, provide consultation services, and help develop specialized group treatment programs.

Pediatric Psychology Testing Clinic

Supervisor: Bill Kronenberger, Ph.D.

This rotation is a full day per week and is only available on Thursdays.  Please note, this rotation is part of the Child Outpatient Core Rotation, and so interns who complete that core rotation will already have this specialty rotation included.  Psychological testing is conducted two days per month, with one patient per day.  Contact hours average 6-8 hours per child.  Approximately 90% of testing cases involve evaluation of cognitive abilities (intelligence, achievement, memory, executive functioning, etc.), and 10% of testing cases involve personality testing (projective and/or objective).  The other two days per month are used for didactics, additional supervision, learning new tests, test interpretation, and review of results.  The intern is responsible for some test administration, supervision of a graduate student, behavior observation, and test interpretation; there is no report-writing.  Supervision is provided by live observation of test administration, individual meetings to discuss results, and didactics covering major topics.

Child and Adolescent Mood Clinic

Supervisor: Ann Lagges, Ph.D.

This rotation is a half day per week, Wednesday mornings.  Interns will gain experience in the Evidence Based Practice of Psychology as applied to pediatric mood disorders.  This may include use of ESTs, but the majority of the time, due to the complex nature of patients presenting to the clinic, will involve making use of the best available research to develop individualized treatment plans for each patient and family.  Experiences will include diagnostic assessments and therapy.  Interns will most likely have the opportunity to assist in supervision of practicum students.  Patients present with a wide range of diagnoses including depressive disorders, mood disorder not otherwise specified, and bipolar disorder as well as ADHD, ODD, Pervasive Developmental Disorders, Anxiety Disorders and Mental Retardation.  Complex social situations in families are very common. 

Headache Clinic

Supervisor: Eric Scott, Ph.D.

This rotation is a half or full day per week and is only available on Mondays.  This clinical specialty rotation is within the Riley Headache Clinic which is joint venture with Pediatric Neurology is charged with providing excellent clinical care to individuals presenting with headaches. Our treatment team is comprised of a pediatric psychologist and pediatric neurologist. Specialty skills interns learn while on this rotation include assessment of patients with headache, CBT intervention for headache and basic and advanced biofeedback skills all within a collegial atmosphere.

Pain Center Specialty Clinic

Supervisor: Eric Scott, Ph.D.

This rotation can be a full or half day per week.  This clinical specialty rotation is within the Riley Pain Center which is multi-disciplinary and charged with providing excellent clinical care to individuals presenting with pain. We teach the next generation of pain providers through the pediatric anesthesia residency program, the Indiana University School of Medicine Psychology Pre-doctoral internship Consortium. We conduct clinical research evaluating the effectiveness of the treatment of chronic pain. Our treatment team is comprised of 2 pediatric anesthesiologists, 1 pediatric nurse, 1 pediatric psychologist, a physical therapist and an occupational therapist. Specialty skills interns learn while on this rotation include assessment of patients with chronic pain, CBT intervention for chronic pain, basic and advanced biofeedback skills all within a collegial atmosphere.

Juvenile Competency Evaluation

Supervisor: Ann Lagges, Ph.D.

This specialty rotation typically occurs once a month or less depending on when evaluations are ordered.  The intern will have the opportunity to observe court ordered evaluations addressing juvenile competency to stand trial, and on occasion, addressing whether the juvenile was of sound or unsound mind at the time of the alleged offense.  Opportunities to observe court testimony may also be available.  Evaluations are scheduled as they are requested by the court, and so this experience cannot be offered in a set time slot. 

Outpatient Pediatric Psychology

Supervisor: Ann Lagges, Ph.D.

This specialty rotation can be a full day or half day.  Interns on this rotation will participate in diagnostic assessment and treatment of children and adolescents with a range of medical issues who are also struggling with compliance with medical treatment, adjustment to a diagnosis or treatment, or co-morbid psychiatric issues that are interacting with their medical issues.

Adolescent Addictions

Supervisor: Eric Scott, Ph.D.

This rotation occurs on two half days per week; Thursday and Friday afternoons.  The intern would join an established treatment team in which the intern would perform initial intake evaluations. The intern will be trained in using the KSADS, which is a structured diagnostic interview. The intern would be responsible for doing cognitive behavioral therapy with individuals presenting with a dual diagnosis of at least 1 substance related disorder and one other psychiatric disorder, such as an anxiety, mood, disruptive behavior disorder or psychotic disorder. Attendance at weekly review and supervision meetings would also be a part of this rotation, where the intern would present information relevant for treatment in the interdisciplinary team. Opportunities for scholarly work such as didactic material development, patient handouts, and scholarly articles for publication are also available.

Child Inpatient

Supervisors: Melissa Butler, Ph.D., John Spanke, Ph.D.

This rotation is a full day per week.  The intern learns through observation and practice the functions of psychology in a multi-disciplinary inpatient setting. The intern, under the supervision of a Carter faculty member, will provide assessment, individual and group therapy, as well as experience treatment team participation. The patient population is dependent on unit assignment. One unit has elementary age patients and is coed. Another unit treats adolescent girls and another adolescent boys. Units include patients with a diversity of cultural and ethnic heritage. The hospital houses an IPS school for Carter patients.

Pediatric Consultation Liaison

Supervisor: Amy Williams, Ph.D.

This rotation is a full day per week.  The intern will provide psychological assessments, individual therapy, family supportive therapy, and biofeedback training to children, adolescents, and their families in an inpatient pediatric children’s hospital, work with children and adolescents with a range of medical problems.