Primary Internship Rotations

The Internship is a two-track (i.e., child and adult track) program, housed in the Psychology Education and Training Division of the Department of Psychiatry and Behavioral Health. At the time of application, each intern indicates whether they are applying to either the adult or child track. There are five adult track interns and four child track interns.

The adult and child tracks are anchored in the program's core commitment to integrationist philosophy, evidence-based evaluation and intervention, and ethno-cultural competence. Both tracks offer training in intervention and assessment, and both embrace a highly participatory teaching style—in shared and separate core courses. Each track is staffed by several general internship faculty and some track-specific faculty. Both tracks place interns in clinical services for rotations, generally between two months to one year in duration.

Within each clinical rotation, interns have an opportunity to develop their skills in various forms of evaluation and treatment. This allows them to gain clinical experience with patients from different ethnic and socioeconomic backgrounds with a wide range of psychopathology, as well as to learn about treatment systems by becoming an integral member of a treatment team. Comprehensive Adolescent Rehabilitation and Education Service (CARES) is open to interns in both tracks; otherwise the two tracks offer different clinical rotations—designed to provide relevant clinical experience with their respective populations.

The following is a list of the Mount Sinai Morningside and Mount Sinai West Clinical Psychology Internship Rotations. It should be noted that this list emphasizes diagnostic diversity, but the populations in all clinics are diverse and multicultural in a variety of ways, including race, gender, sexual orientation, sexual identity, age, SES, religion, and disability.

Adult Track Rotations

  • Center for Intensive Treatment of Personality Disorder (CITPD): which treats character pathology (mainly Narcissistic Personality and Borderline Personality) using a dialectical behavior therapy (DBT)-informed model (as originally delineated by Marsha Linehan, PhD), combined with more traditional psychodynamic and psychoanalytic treatment modalities. These evidenced-based models offer our interns a scholar-practitioner approach to the treatment of a complex and severe personality disorders. Interns treat two to three individual patients, co-lead groups, and weekly attend staff meetings on this rotation.
  • Mount Sinai's World Trade Center Mental Health Program (WTCMHP) is part of the larger WTC Health Program, offering free, comprehensive, and confidential medical examinations, ambulatory and inpatient treatment, and benefit counseling services to WTC responders who participated in rescue, recovery, and clean-up efforts after the September 11, 2001, attacks. A psychology intern rotating at the WTCMHP can expect to hone their clinical skills working within a psychoanalytically informed frame that addresses not only trauma but the personality structures that underlie symptomatic presentations. The rotation cultivates a safe and supportive environment that encourages clinicians to work together and learn from one another from different disciplines. An intern is expected to be part of weekly intake conference and treatment planning meeting, as well as all staff meetings. This provides critical insight into how a team can work together, to conceptualize treatment planning and how a clinic functions. Clinically, interns will be exposed to a unique form of deep psychological work that will challenge trainees to consider not only a patient’s imagery, metaphors, and emotional experience but their own as well. Each intern is expected to work with one to two acute risk patients in a twice weekly modality as part of the program’s Crisis and Distress Team (CDT). They will also maintain a case load of three to four short-term individual patients and co-lead one group. Interns are supervised by highly skilled licensed staff psychologists both individually and in a group format.
  • The Addictions Institute at Mount Sinai West treats dually-diagnosed adult patients using an approach based in the Harm Reduction Model. While other addictions models (such as the 12-step approach) are reviewed and discussed, the Harm Reduction Model, and the clinical evidence on which it is based, serve as the backbone of the treatment in this training clinic. Interns treat individual patients and co-lead groups in this rotation, which is housed in the day treatment program and the halfway house associated with the Addictions Institute at Mount Sinai West. Interns are closely supervised by licensed clinical psychologists who specialize in substance abuse and comorbid illness.
  • The adult psychiatric inpatient units (7G or Clark 8) are where adults in acute crisis with a broad range of DSM-V diagnoses are evaluated, stabilized, and treated. Here trainees learn to diagnose and treat patients with a broad range of DSM-V diagnoses using a multimodal approach, which includes medications, individual psychotherapy, group psychotherapy, milieu treatment, and psychological assessment. Interns carry two individual patients, run inpatient groups, and do short-term, rapid-turn-around assessments to assist with patient care and discharge planning. Interns are closely supervised by licensed psychiatrists and psychologists who specialize in inpatient treatment.
  • Cognitive Behavioral Specialty Clinic: This rotation, which is housed in the Adult Outpatient Clinic, offers interns an opportunity to hone and sharpen their CBT skills. Interns treat two patients supervised by a CBT specialist. They also co-lead two groups (a CBT for Psychosis group and a CBT for Insomnia group) both under the supervision of CBT-trained supervisors. This rotation dovetails well with the CBT didactics, wherein specific diagnosis-specific CBT protocols are reviewed. As part of this rotation, interns also conduct weekly intakes in our Access Center with hour-for-hour supervision and participate in Mount Sinai’s Trans Clinic, where they evaluate and treat adolescents undergoing gender-related transitions. The clinical work in the Trans Clinic is supervised by a licensed psychologist who specializes in transition- related psychological issues.
  • Consultation Liaison Service Mini-Rotation: The consultation-liaison psychiatry team at Mount Sinai Morningside consists of two attending psychiatrists, a consultation-liaison psychiatry fellow, and a PGY4 psychiatry resident. Mount Sinai Morningside operates one of Manhattan's few Level-1 trauma services and has 523 hospital beds. Psychology interns will broaden their exposure to the psychology of illness through supervised psychological evaluation and care of both acute and chronic medically ill patients admitted to the med-surgery floor as well as multiple subspecialty units, including neurosurgery, intensive care, intensive cardiac care, geriatrics, and physical medicine/rehabilitation. This past year, a four month rotation in our Emergency Room was added to this mini-rotation.
  • Interns also rotate five days a week for 12 months through the Adult Outpatient Clinic: where psychiatric outpatients with a broad spectrum of DSM-V diagnoses are treated. Here interns are trained in a number of evidence-based approaches to treatment including: case management, supportive treatment, psychodynamicallly-informed treatments, interpersonal psychotherapy (IPT), dialectical behavior therapy (DBT), CBT for depression and anxiety, and motivational interviewing. In the supervision of each case, an effort is made to modify and tailor the treatment models/approaches and protocols in a patient-specific fashion. Interns also co-lead an outpatient group under supervision and treat one to two families with specialized supervision and one-way-mirror interactive consultation.

Child Track Rotations

Child interns participate in two yearlong primary rotations in the following settings:

  • The Comprehensive Adolescent Rehabilitation and Education Service (CARES), which is a therapeutic school embedded in a milieu treatment unit that treats dually-diagnosed, at-risk high school students. At CARES, interns are immersed in two primary evidence-based approaches that are integrated throughout the program: Dialectical Behavior Therapy and Motivation Enhancement Therapy. Interns are also exposed to evidence-based trauma informed treatments (e.g. trauma-focused CBT, seeking safety) as well as CBT and psychodynamic approaches to treating severe pathology in adolescents.
  • The Child Outpatient Department (OPD), where children, adolescents, and families with a broad range of DSM-V diagnosis are treated. In the Child OPD, interns are trained in a variety of evidence-based treatments for children and adolescents including: CBT for depression and anxiety disorders, DBT for adolescents, parent management training, trauma-focused CBT, and parent-child psychotherapy, among others. Interns are supervised by staff psychologists skilled in evidence-based psychodynamic and cognitive behavioral interventions for children and their families. As part of their Child OPD experience, interns are offered the option to participate in one or more of our specialty electives in the following subspecialty clinics: the Parent-Infant Center, the Parent Child Interaction Therapy (PCIT) elective, the FUTURES Program, and the DBT elective.
    • The Parent-Infant Center (PIC) elective. PIC allows interns to gain additional exposure to working with at-risk caregivers and their babies and toddlers, up to age 6. Interns also see one or two parent-infant dyads for child-parent psychotherapy and receive one hour per week of supervision.
    • Parent Child Interaction Therapy (PCIT) is an empirically-supported treatment aimed at treating children with disruptive behavior disorders between the ages of 2 and 7 and their families. The focus is on improving patterns of interaction with active skills training and assessment to improve parent-child relationships by teaching parents positive play and attention skills, clear communication, and consistency. In the PCIT elective, interns will be paired with Amanda Templeman, PhD, as one of their outpatient supervisors and will be able to engage in co-treating one to two PCIT cases (via telehealth) with Dr. Templeman.
    • FUTURES elective. The FUTURES program provides short-term assessment and treatment for adolescents in the clinic presenting with substance use and trauma-related symptoms. Interns interested in this experience can work with Margaret Rauen, PhD, to see individual patients, run groups, and/or complete intakes within the FUTURES program.
    • DBT elective: The DBT team is a multidisciplinary treatment team housed within the OPD that provides individual therapy and multifamily skills group interventions to adolescents and their families. Interns on this elective will typically carry one to two DBT cases, run multifamily skills groups, and participate in weekly DBT Consultation team. The elective is led by Genevieve Izzo, PhD.

Child interns also participate in two short-term rotations throughout the year in the following settings:

  • An inpatient child/adolescent psychiatry unit, where children and adolescents in acute phases of major psychiatric illness are treated. On the unit, interns are trained extensively in risk assessment, safety planning, and diagnostic assessment based on DSM-V diagnoses.
  • A pediatric psychological assessment service, where interns observe and conduct psychiatric assessments of children and adolescents. On this service, interns learn how to administer, score, and interpret a wide range of evidence-based tests for children and adolescents. They also build and refine skills in writing comprehensive neuropsychological assessments.

For interns in both tracks, outpatient individual, group, and family therapy is a yearlong rotation, which is a major component of the Internship clinical experience.

ADULT TRACK 
In the Adult Outpatient Clinic, each intern carries a caseload of: 8 to10 individual patients, one group and one family, with a broad range of psychiatric diagnoses, demographic characteristics, and ethnic, cultural and sexual identities, and life situations. Interns receive supervision in each of the following areas: group psychotherapy; individual (psychodynamic therapy, dialectical behavior therapy, supportive therapy) case management and crisis intervention (two hours/week, delivered by two supervisors); individual cognitive behavioral therapy (one hour/week, within a small group of interns); and family therapy (two hours/week, delivered in real-time, using a one-way mirror, and shared by the intern class, serving as consultants). Interns are also trained to conduct intake evaluations and treatment screenings.

CHILD TRACK 
In the Child Outpatient Department, each intern carries a caseload of: one group (co-led with a staff member); one or two families; and several individual patients with a broad range of psychiatric and developmental problems, ages, demographic characteristics, ethnic, cultural and sexual identities, and life situations. The target population is children/adolescents, ages zero to eighteen, and their families. Interns receive individual supervision in each of the following areas: systems/group psychotherapy (one hour/week); individual psychotherapy (e.g., psychodynamic therapy, dialectical behavior therapy, cognitive behavior therapy, parent-infant therapy), crisis intervention, etc. (Two hours/week, delivered by two supervisors); and family therapy (one hour per week in group, sometimes using real-time, one-way mirror-assisted feedback) for a total of four hours per week. Interns may also conduct intake evaluations. Interns will have the opportunity to design individualized caseloads based on their specific areas of interest.

In both tracks, assessment is an important component of the internship clinical experience. Each intern will administer, score, interpret, and compose a report for at least two comprehensive assessments. These assessments will make use of cognitive tests (i.e., WAIS-IV, WISC-V, WJ-IV), objective personality tests (e.g., MMPI, MCMI, MMPI-A), projective personality tests (e.g., Rorschach), structured psychiatric interviews (e.g., SCID), academic achievement, symptom rating scales, and neuropsychological screening tests, as needed. Interns receive intensive supervision on administration, interpretation, and report writing (i.e., approximately six hours/assessment). In the Child Track, interns may focus their assessment experience in the Child and Family Institute Outpatient Psychiatry Department or in CARES.

Supervision is focused on helping the interns deepen and broaden their understanding of clinical processes and the treatment situation. A special effort is made to facilitate development of a flexible stance to respond to the needs of a culturally, ethnically, and medically diverse patient population. Supervisors in the Child and Adult Tracks are committed to providing supportive instruction that encourages the development of clinical technique and the integration of theory and scientific evidence into therapeutic practice. An integrative treatment approach—utilizing psychodynamic, cognitive behavioral, dialectical behavioral, family-systems, ethno-cultural, developmental, medical model, and other perspectives—is emphasized. Supervision must include direct observation, audio or video recording, one-way mirror observation and consultation (i.e., for family therapy). Supervisors may also join sessions, as part of supervision.

As described above, interns receive close, regular supervision during all of their rotations and clinical experiences. In their outpatient psychiatry clinic experience, they receive a minimum of five to six hours of individual, group and family supervision. Interns also participate in clinical team meetings, staff meetings, and case conferences, throughout the week. In their assessment experience, interns receive several hours of supervision, for administration, scoring, interpretation, and report-writing. All supervisors are also available, on an as-needed basis, for additional meetings or phone consultations. Interns are especially urged to contact their supervisors for emergencies.

On both tracks, Interns meet individually with the Training Directors or Associate Training Director, for overall program supervision, career guidance, evaluative feedback, and elicitation of their feedback about their Internship experience, three times per year. This occurs: early in the year; mid-year; and end of year. The Training Directors and Associate Director also conduct regular sessions, on a monthly basis, focused on interns’ ongoing experience of their clinical experience, rotations, supervision, didactics, and systems experience of the services they are part of, and of the overall internship program. These sessions are aimed at identifying program strengths and weaknesses, and making appropriate real-time adjustments. The Training Directors and Associate Director are also available, on an as-needed basis, for additional meetings or phone consultations. Interns are especially urged to contact them for emergencies.

Education in models of supervision is also the focus of a course module in the Combined Child-Adult Track Core Curriculum.

Evaluation and feedback is an integral part of the conduct of the Internship Program. Throughout the Internship year, evaluation and feedback, on a variety of levels, provides the basis for real-time self-appraisal and (as-needed) enhancement of all aspects of the Internship Program, as well as of intern work. Three times/year (i.e., early in the year, mid-year, end of year), evaluations are obtained from interns and ongoing supervisors. At the end of rotations, evaluations are obtained from interns and Rotation supervisors. Supervisor feedback is based on “direct observation” (the APA defines this as being in the room with the trainee while observing them, review of video/audio tapes) as well as review of trainee progress notes, reports, and process notes. At the end of course modules, evaluations are obtained from interns individually and as a group.

Information about supervision and courses, shared with the Training Directors or Associate Training Director, is used to identify Program strengths and weaknesses, and to make real-time adjustments. Information about intern work, shared in supervision as well as in individual meetings with the Training Directors or Associate Training Director, is used to support and enhance the intern’s ongoing experience and proficiency. Interns meet individually with the Training Directors, for overall program supervision, career guidance, evaluative feedback, and elicitation of their feedback about their Internship experience, at least three times per year. The Training Directors also conduct regular sessions, on a monthly basis, focused on interns’ ongoing experience of their clinical experience, rotations, supervision, didactics, and systems experience of the services they are part of, and of the overall Internship Program.