Didactics

The Mount Sinai Morningside-Mount Sinai West (MSMW) Internship Training Program contains two tracks:

• The Adult Track trains students interested in specializing in the treatment of adults (defined as roughly 18 and older by our program), and
• The Child Track trains students interested in specializing in the treatment of children (defined as prenatal to 17 by our program) and their families.

The schedule for clinical work and didactics for both of these tracks is detailed below. Within each track, trainees have morning and afternoon rotations and didactics seminars. Most of the rotations are track-specific, with the exception of the CARES rotation, which is offered in both tracks. Some of the didactic seminars described below are offered in our CORE training series and are attended by both Child Track and Adult Track interns. Other didactics are track-specific.

Orientation Seminars

• New Beginnings: This is an orientation organized by Mount Sinai in which the Health System’s fundamental aims and policies are reviewed. Both child and adult interns are required to attend this orientation on the first day of the internship.
• Internship Core Competence Orientation: This orientation is required of all interns (child and adult) on the second day of the training year. This orientation is run by the Director and the Associate Directors of Education and Training. During this orientation, interns meet one another as well as key personnel in the training program. They also are given a copy of the Internship Handbook (uploaded to the portal associated with this Standard) which is reviewed at that time. Finally, interns divide up by track and meet with the relevant Director/Associate of Training to discuss their upcoming orientation week, as well as their daily schedules for the summer months and going forward.
• Adult-Specific Orientation: The orientation for the adult track is conducted during the first few weeks of the internship. This includes: a specific orientation to the Adult Outpatient Clinic (AOPC) conducted by AOPC faculty and attended by Psychiatry residents, Psychology interns and Psychology fellows) and formal didactics on: learning the charting software (EPIC), the Mental Status Examination, important charting requirements, how to manage the difficult outpatient, how to manage the violent inpatient, disposition and treatment planning, etc.
• Child-Specific Orientation: Orientation trainings and seminars for child interns occur over the first two months of internship. Orientations to the Child Outpatient Clinic as well as the CARES program are provided in the first two weeks of training. Orientations cover information regarding clinical practice, clinic policies, suicide/violence/risk assessment and intervention, management of agitation, safety planning, child maltreatment, ethics, legal issues and billing/documentation. Child Track interns also receive intensive didactics in dialectical behavior therapy, substance use monitoring/treatment, infant mental health and milieu intervention during the summer.

Ongoing Didactic Seminars and Workshops    

Note: Syllabi and reading materials (in list form as well as e-copy format) for each of the below courses are emailed to each trainee and also uploaded to a training drive, which is easily accessible to all trainees.

• Core Competency Seminar (50 minutes/ week): This weekly seminar is required of both Child and Adult interns and includes topics in the core competency syllabus, which are central to important learning for both tracks. A complete schedule for this seminar is uploaded here. Modules in this course include: (i.) several lectures on ethics, (ii.) a once-monthly Diversity Seminar where interns present cases to the Chief Psychologist at Mount Sinai Morningside and Mount Sinai West. These cases are discussed and considered through the lens of diversity and multicultural awareness, (iii.) A core testing module, which includes an overview of: Projective tests, Neuropsychological tests, MMPI and NCMI, (iv.) a diversity workshop, where trainees are encouraged to explore and discuss their own experiences with microaggressions vis-à-vis diversity and cultural differences, and (v.) specialized clinical topics such as: features of the psychodynamic approach (the frame, therapeutic rupture, enactment, etc.), addictions treatments (harm reduction), LGBTQ- sensitive treatments, trauma treatments, and models of supervision. See Core Competency Lectures Series.
• Family Seminar (75 minutes x2/month): (Child and Adult interns together) This seminar is led by a licensed psychologist with specialized training in family and couples therapy. After a few weeks of family and systems theoretical training, interns are encouraged to present a family case that they are currently treating and then invited to bring that family to be treated for 1 to 2 sessions behind a one-way mirror. The treatment team (which includes the two co-leaders and the other interns) sits in the observation room and telephones in with their comments and suggestions. This is live-interactive supervision. Following this session, the team sits with the intern-therapist and discusses their impressions in light of the system theories previously taught. Interns attend this seminar twice a month.
• Process Group (60 minutes/week): We have two traditional process groups: one for the Adult Track interns and one for the Child Track interns. The theory associated with group technique is reviewed in the first few weeks of the process groups. After that, the group functions with strict adherence to the group models. By design, there is no contact between the Director/Associate Directors of Training and the leader of the process group except if a trainee asks to leave the group, is in danger or is posing a danger to someone else. (Trainees have asked to leave the group but no one has ever been in danger or posing a danger to another person.)
• Departmental Grand Rounds (75 minutes/week): Both Child and Adult interns are invited to attend the weekly departmental Grand Rounds.
• Didactics Specific to the Adult Track:
  • Yearlong course in CBT/DBT and other evidence-based modalities (50 minutes/week): This team-taught weekly course aims to expose students to a series of diagnosis-specific evidence based treatment protocols. In the first half of the year, lecturers review these treatment manuals using slides, lectures, and other didactic approaches including workshops and role-plays. This half of the year reviews: motivational interviewing, CBT for panic disorder and generalized anxiety disorder, CBT for obsessive-compulsive disorder,  CBT for depression, CBT for psychosis, CBT for social phobia, and several other diagnosis specific protocols. As the first semester of this course progresses, students are encouraged to bring in examples from cases they are treating as they are relevant to and help to explicate the protocols being taught. The second semester of this course is entitled “CBT in the Trenches—Applying the Protocols in the Real World”. This half of the course is run as a case conference, where trainees present cases they are treating and are encouraged to think about the cases in light of the protocols taught earlier in the year. Protocols are written by researchers in “pure” settings, where numerous diagnostic exclusions are permitted. In our OPC, we treat real-life “imperfect” cases, which require adaptation and modification of the protocol to fit the patient. Here we try to teach patient-driven treatment rather than simply applying the protocol to a patient who meets diagnostic criteria.
  • Yearlong course in psychodynamic therapies (50 minutes/week): This course is divided in to two semesters. During the first semester (July to mid-December), themes and theories of different psychodynamic treatment approaches are reviewed and discussed. These therapeutic approaches are located in history and in the larger “overarching map” of therapeutic approaches. The second semester of this course (mid-January to May) led by a trained analyst is run as a case conference for psychodynamic theory and thinking. Each student is expected to present audiotapes from sessions with a selected patient. Interestingly, the presenter is not allowed to comment or discuss their perspective during these presentations. The seminar leader and other interns discuss the tapes and give feedback to the intern treating the case.
  • Adult Outpatient Clinic (AOPC) Case Conference (60 minutes/x2 per month): This is a seminar where high-risk outpatients are presented and interviewed and treatment options are suggested and discussed. This seminar is run by the Adult Outpatient Clinic and is led by Marianne S. Goodman, MD, Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai. Dr. Goodman is involved in treatment research on borderline personality disorder and coordinates the medical student education program for the department of Psychiatry at the Bronx VA Medical Center. Her research focuses on Dialectical Behavioral Therapy treatment for borderline personality disorder and childhood trauma antecedents. Interns are invited to attend and to present in this seminar at least once in the course of their training year.
  • Modular Course—Other Clinical Topics of Interest (50 minutes/week): In this yearlong weekly course, a team of different faculty presents topics in which they are expert. These topics include: biofeedback, integrated treatment of character disorder, relational psychoanalysis, groups and systems, Lacanian theory and therapy, IPT, and using the termination in your treatment. In each case, the research and clinical evidence on which the treatment has been tested and developed is presented. Students are encouraged to question and challenge these methods and to ask questions informed by the patients they are treating. There is also a professional development component to this series in which former trainees come back to the hospital to talk about their current work and also speak about how to start a private practice. 
• Didactics Specific to the Child Track:
  • Once weekly (60 minutes/week) Psychotherapy Course, a core course on evidence-based treatments for the major presenting problems of child and adolescent patients—internalizing and externalizing behaviors, anxiety and developmental trauma disorders, and substance use disorders. Topics include: working with caregivers; play therapy; treating externalizing disorders; treating internalizing disorders; treating trauma; treating substance use disorders; group therapy; working with schools; transference/countertransference; and termination. Modules are designed to progress in depth and skill level as the year progresses, in an effort to parallel the interns' practical experiences with patients. This course is attended by Child Psychology interns and Child Psychiatry first-year fellows, which helps to facilitate their interdisciplinary collaboration.
  • Once-weekly (60 minutes/week) Testing Course/Supervision related to the assessment of children and adolescents with possible learning and developmental disabilities. Interns participate in this course/supervision for approximately two months while they are completing psychological assessments.