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General Internship Experience (GIE) Tracks

Overview

Comprised of the general and trauma tracks, the general internship experience is designed to provide broad training in the practice of professional psychology.  Interns gain experience in diagnostic assessment and the application of intervention modalities for a range of behavioral health concerns and psychological disorders. Emphasis is placed on applying theoretical and empirical knowledge to understanding and addressing complex real-world clinical problems and conditions.

General Track

Based primarily at Grady Health System (GHS), the general track supports 3 interns per year and is comprised of three 4-month rotations in the areas of adult psychology, child/youth psychology, and an elective experience.  Each intern begins the year in one of these three general areas and rotates through the remaining areas through the course of the internship year. Within each of the three rotations, interns conduct clinical activities across a range of service settings under the supervision of faculty in each setting. 

Adult Rotation

The adult rotation provides experiences in psychodiagnostics interviewing, psychological testing, psychotherapy, crisis management, and case management across the developmental spectrum of adulthood. Interns on the adult rotation spend time working in each of the following GHS settings: Nia Project, Behavioral Health Outpatient Center, Integrated Behavioral Health Service, Crisis Intervention Service, and Inpatient Psychiatric Service

The Nia Project provides culturally responsive clinical services and resources for women who have experienced trauma, particularly intimate partner violence, and/or have a history of suicidality. Interns working in this setting conduct clinical intervention services that primarily involve the provision of individual and group therapy. The Nia Project offers approximately 20 groups per week.  These include support groups (e.g., suicide, domestic violence, spirituality), process groups (e.g., interpersonal), and evidence-based group interventions (e.g., Dialectical Behavior Therapy, Seeking Safety, Acceptance and Commitment Therapy).  Interns also have opportunity to gain experience using an evidence-based meditation intervention, Cognitively-Based Compassion Training, which was developed at the Emory Center for Contemplative Science and Compassion-Based Ethics.  Interns attend weekly clinical team meetings and have opportunities to participate in clinical research endeavors.

Interns conduct adult psychological testing at the Behavioral Health Outpatient Center, which is an outpatient community-based behavioral health clinic. Assessment batteries are individually tailored to meet the referral questions, and thus there is not a “standard battery” that is used. Typical questions center on cognitive and personality functioning, along with differential diagnosis. In their adult testing work, interns gain experience in conducting clinical interviews, test administration, test interpretation, report-writing, and feedback of test results.

The Integrated Behavioral Health Service provides an opportunity for interns to work as behavioral health providers embedded within an interdisciplinary team in a primary care clinic setting. Practicing within a stepped care model, interns conduct brief assessments/screenings and brief individual and group interventions to address a variety of behavioral health concerns, including traditional mental health and physical health-related concerns. Additionally, interns offer consultation to the primary care team regarding the implementation of behavioral interventions to encourage health-promoting behavior and adherence to medical treatment. 

A 24-hour psychiatric observation service, the Crisis Intervention Service receives patients directly from the Grady Memorial Hospital Emergency Department who are presenting with a range of acute psychiatric conditions and require crisis stabilization and/or are awaiting disposition to inpatient psychiatric hospitalization. Interns provide brief group interventions in this setting focusing on crisis stabilization and management of acute psychiatric symptoms.

On the Inpatient Psychiatric Service, which houses a 24-bed acute care psychiatric treatment program, interns provide skills-based psychotherapy groups (e.g., coping skills, stress management) for adult patients presenting with a range of disorders, including severe mood disorders, psychotic disorders, and personality disorders. Interns also participate in weekly “walk rounds” in which a psychologist supervisor conducts a live patient interview followed by a discussion of diagnostic and treatment considerations.

Child/Youth Rotation

The child/youth rotation provides experiences in child, adolescent, young adult, and family assessment, psychotherapy, and consultation. Interns on the child/youth rotation spend time in the following GHS service settings: Pediatric Infectious Disease Program, Psychosocial Rehabilitation Clinic, and Behavioral Health Outpatient Center. Interns also spend time at the Children’s Healthcare of Atlanta Egleston Hospital Campus (CHOA at Egleston).

At the Pediatric Infectious Disease Program, interns participate as members of an interdisciplinary team and provide psychological services for children, adolescents and young adults in an outpatient pediatric primary care clinic specializing in care for youth living with HIV and their families. Interns offer developmentally tailored psychotherapy services, serve as consultants to the medical staff regarding behavioral diagnosis and management, and make recommendations for follow-up care. Interns also provide formal psychological assessments, including the administration, scoring and interpretation of test batteries that may include measures of cognitive abilities, achievement, and personality functioning.  As part of the child testing experience, interns write interpretive reports, give feedback to parents and the referring medical provider, and make recommendations that may involve consultation and coordination with schools and/or other agencies.

The Psychosocial Rehabilitation Clinic provides outpatient day treatment focusing on consumer empowerment, successful community reintegration, and relapse and re-hospitalization prevention. Consumers are present at least 5 hours per day for 3 to 5 days per week. Interns provide individual and group psychotherapy services for a late adolescent and young adult clientele between the ages of 18 and 25 who are living with chronic and persistent mental illnesses, with the most common diagnoses being schizophrenia spectrum disorders, major depression, and bipolar disorder.  Interns also gain experience in consultation with the treatment team and other mental health providers. 

Interns working in the Behavioral Health Outpatient Center provide diagnostic interview evaluations of patients seeking behavioral health services.  Presenting concerns range along a continuum of clinical severity from adjustment disorders to severe mood and psychotic spectrum disorders.

At CHOA at Egleston, interns provide pain management consultation in an inpatient pediatric setting.  Related concerns, such as depressive and anxiety symptoms, may also be addressed as part of this work. Patients may be hospitalized for a variety of reasons, including elective surgery (e.g., spinal fusion), physical trauma (e.g., motor vehicle accident), or a range of chronic conditions (e.g., Crohn’s disease, lupus, juvenile idiopathic arthritis, migraines). Interns evaluate contributing factors to pain (e.g., anxiety) as well as provide treatment primarily through teaching biobehavioral strategies for managing pain (e.g., diaphragmatic breathing, guided imagery, distraction).  Interns also serve as consultants and liaisons to interprofessional colleagues within the medical setting (e.g., physicians, nurse practitioners, social workers, nurses) and serve as part of an interdisciplinary pain team that includes a physician and nurse practitioner.    

Elective Rotation

The elective rotation is designed primarily to give interns a chance to pursue clinical training experiences in which they have a special interest.  Where applicable, it also provides opportunities for interns to obtain additional supervised experience in clinical areas and/or profession-wide competency domains that may require additional development. It is comprised of both elective time in clinical settings selected by the intern and required time working in the GHS Behavioral Health Outpatient Center, where interns provide diagnostic interviews, brief psychotherapy, and consultation with interdisciplinary behavioral health staff. 

Approximately 16 hours per week is allocated to the elective portion of the rotation.  Interns have the option to divide these hours into major and minor elective experiences so that they may participate in more than one elective activity during the rotation. Interns may choose to spend their elective time in one of the child or adult clinical service areas that are part of the required rotations or develop an elective experience outside of the required rotations based on individual clinical or research interests.  Examples of elective experiences include but are not restricted to the following:

  • Administration
  • Advocacy
  • Behavioral Health/Primary Care Integration
  • Clinical Research
  • Consultation Liaison
  • Infectious Diseases (Adult and Pediatric HIV)
  • Family/Couple Therapy
  • Family Violence (NIA Project) 
  • Forensic Evaluation
  • Group Therapy
  • Neuropsychology
  • Psychodynamic Psychotherapy

Trauma Track

The trauma track, based primarily at Grady Health System (GHS), supports 1 intern per year. Interns complete a year-long trauma major rotation experience and minor rotations that include adult psychological testing and elective experiences. 

Trauma Major Rotation

The trauma major rotation emphasizes training experiences in trauma- and stress-focused clinical work. The rotation settings include the GHS Nia Project and the Emory Needlestick Prevention Center

The Nia Project offers comprehensive biopsychosocial services for primarily low-income African American women with histories of trauma, particularly interpersonal violence, and suicidality.  Psychotherapy services are guided by a culturally informed integrative theoretical model that incorporates interpersonal, cognitive-behavioral (including “third wave” approaches), mindfulness, existential/humanistic, attachment-oriented, and systemic-based perspectives.  Interns gain experience on an interdisciplinary team providing crisis risk evaluations, case management services, interview-based assessments, and trauma-focused individual and group therapy.  Group therapy training experiences are diverse and include co-facilitating support groups (e.g., suicide, intimate partner violence, spirituality, survivors of suicide), evidence-based therapy groups (e.g., Acceptance and Commitment Therapy, Dialectical Behavioral Therapy, Seeking Safety, Skills Training for Affect Regulation), and process groups (e.g., interpersonal). Interns also have the opportunity to gain experience using an evidence-based meditation intervention, Cognitively-Based Compassion Training, which was developed at the

Emory Center for Contemplative Science and Compassion-Based Ethics. Along with psychotherapy services, interns provide crisis risk evaluations and therapeutic case management. Interns also participates in community outreach efforts. Although not required, most trauma track interns elect to participate in Nia Project clinical research activities, which may include data collection and analysis, manuscript preparation, scholarly presentations, and grant writing.

The Emory Needlestick Prevention Center, operating under the auspices of the Department of Medicine's Division of Infectious Diseases, provides consultation services to health care workers throughout the entire Emory Healthcare system and affiliated hospitals who experience blood/body fluid exposures through needlesticks and other means. Interns coordinate and implement intervention programs for health care workers. Specific responsibilities include: assessing the exposure-related stress/mental health status of all individuals exposed to bodily fluids or contaminated hospital equipment, providing psychotherapy as needed, and serving as a psychological consultant to an interdisciplinary team.

Minor Rotations

Interns on the trauma track complete both adult psychological testing and elective minor rotations. The testing experience is set in the GHS Behavioral Health Outpatient Center while the elective setting varies in accordance with intern training interests, though typically occurs at GHS clinical sites.

Intern responsibilities for the testing minor rotation involve administering individually tailored assessment batteries in accordance with specified referral questions, and thus there is not a “standard battery” that is used. Typical referral questions center on cognitive and personality functioning, along with differential diagnosis. Interns conduct clinical interviews, test administration, test interpretation, report-writing, and feedback based on testing results.

On the elective portion of the minor rotation, trauma track interns can select a training area of interest where they spend one-half day per week. This elective experience generally follows a 4-month rotation structure so that interns complete 3 clinical elective activities for 4 months each.  However, there is flexibility such that interns wishing greater immersion in particular elective areas may be permitted to complete 2 training activities of 6 months duration each. Elective experience options are consistent with those available to the general track interns listed in the above section describing the general track elective rotation.

Additional Training Experiences

Psychotherapy

Along with rotation-specific psychotherapy experiences, all GIE interns (general and trauma tracks) carry one required long-term adult psychotherapy case in one of the GHS outpatient clinics (typically the Behavioral Health Outpatient Center) for the internship year.  A range of psychological disorders are represented among these cases, examples of which are mood disorders, anxiety disorders, traumatic stress disorders, psychotic spectrum disorders, and personality disorders. Interns receive weekly long-term psychotherapy supervision conducted in a group format.

GIE interns also participate in a required Family Therapy Case Conference, which is a 6-month weekly training experience involving live supervision of systemically based family therapy. Interns can participate as part of a family therapy co-therapy team with immediate supervisory feedback and discussion and/or observe via live video feed.

Elective psychotherapy mini-rotations also are offered for interns who are interested in gaining experience with a specific evidence-based psychotherapy modality.  These optional mini-rotations typically involve a time commitment of 2 ½ hours per week (including psychotherapy provision and didactic instruction/supervision) for up to 6 months.  Psychotherapy modalities currently offered through this elective experience include Acceptance and Commitment Therapy, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders, Trauma-Focused Cognitive Behavioral Therapy, and Time-Limited Dynamic Psychotherapy.

Training in the Provision of Clinical Supervision

All GIE interns gain experience in providing clinical supervision of junior trainees during the internship year. Supervisees typically are psychology graduate students who are enrolled in intervention practicum experiences at Grady Health System. General track interns supervise practicum students on the Crisis Intervention Service and the Inpatient Psychiatric Service during the adult rotation and in the Psychosocial Rehabilitation Clinic during the child rotation. Trauma track interns provide clinical supervision of practicum students in the Nia Project setting. These training experiences are overseen by faculty who provide supervision on the supervisory process. Additionally, early in the internship year interns participate in a faculty-led supervision of supervision training group.

Professional Mentoring

Professional mentoring of interns by faculty is incorporated as a formal element of the training experience for interns. Each GIE intern is matched with a core internship faculty member who serves as a mentoring resource during the training year. The purpose of the mentoring experience is to provide opportunities for interns to explore and discuss aspects of professional development, examples of which include the internship experience, work-life balance, navigating the process of applying for postdoctoral residency training, and career-related professional trajectory issues.

Training Modalities

Supervision of Experiential Learning Activities

The extensive supervision provided during the internship year is a major strength of the training program.  Interns have at least one supervisor for each service setting on a given rotation and receive a minimum of 4 hours of supervision per week, though the number of weekly supervisory hours typically exceed this amount. The format for supervision varies with the setting, the supervisor, and the specific training needs of a given intern. At the beginning of each rotation, interns meet with their supervisor(s) to discuss clinical responsibilities and supervisor/intern expectations and training goals. Interns receive feedback on performance during weekly supervision sessions. At the conclusion of each rotation, interns receive written feedback on their performance. If competency areas requiring strengthening are noted, the supervisor and intern jointly develop a plan for addressing them. Interns also complete written evaluations of their supervisors.

Supervision modalities are varied, and may include individual or group supervision, review of process notes, use of audio or videotapes, live supervision and/or co-therapy.  Direct observation is a part of all supervised work. In addition to its focus on clinical skill development, supervision also emphasizes consideration of contextual, cultural, and relational factors as they pertain to clinical practice. Supervision may also include a person of the psychotherapist focus on addressing the trainees’ personal and professional reactions to their patients in order to facilitate an understanding of how these factors may influence clinical encounters with patients. Consistent with a developmental training framework for internship training, supervision typically progresses over the course of the training year from a more didactic focus on specific clinical skill building processes to supporting the professional autonomy and increasingly independent clinical decision-making of interns. 

Didactic Experiences

Consistent with the generalist training philosophy of the internship program, interns across all tracks attend a weekly Psychology Intern Core Seminar.  Interns also attend select Department of Psychiatry & Behavioral Sciences Grand Rounds, which include lectures by national and international leaders in the field.  Additionally, the Department of Psychiatry & Behavioral Sciences offers 4 (or more) 3-hour continuing education programs for practicing psychologists in the Atlanta region per academic year. All GIE interns are required to attend these continuing education programs.

Clinical Research Opportunities

Attention is given throughout the training year to ensuring that interns gain competency in research-informed practice across their clinical training rotations, including the ability to evaluate and disseminate independently research or other scholarly activities. Yet, because the internship experience is primarily a clinical training year, participation by interns in clinical research projects is not required by the training program. However, as Emory is a major research institution, clinical research training opportunities under the mentorship of a faculty member are available for GIE interns interested in pursuing them. For example, interns can opt to pursue supervised clinical research activities as part of the elective rotation. Interns also may choose to pursue research activities outside of their regular internship work hours, though this is not required or expected by the training program. As previously noted, the trauma track intern typically has some involvement in trauma-related research, though a clear priority is placed on clinical training activities.