The general and trauma tracks of the general internship experience (GIE) are based primarily in the Division of Psychology within the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine/Grady Health System. In addition to the doctoral psychology internship program, the Division provides practicum training to graduate students from a number of local and regional doctoral programs in psychology. The Division also supports a large and active postdoctoral fellowship training program in psychology in a variety of areas including but not limited to adults with serious psychiatric disorders, women's health, domestic violence, and child and pediatric psychology.
The link to the postdoctoral fellowship program is: http://www.psychiatry.emory.edu/education/fellowships/professional_psychology/index.html.
Applicants should note that there is a separate match number for the general track and trauma track of the general internship experience. Applicants may submit rankings and be considered for both of these tracks if they so wish.
The general track is structured into three four-month rotations in the areas of adult psychology, child 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. Interns also have opportunities to supervise psychology graduate students completing clinical practicum rotations under the direction of faculty. There are three interns on the general track in a given internship year.
During the adult rotation interns work in the Crisis Intervention Service, the Milieu Inpatient Unit, the Grady Nia Project, and the Adult Outpatient Behavioral Health Primary Care Service at Grady Health System. The Crisis Intervention Service (CIS) is a 24 hour psychiatric services program that receives patients from the Grady Memorial Hospital Emergency Department who are presenting with a range of clinical conditions. The role of the CIS is to provide crisis stabilization, acute observation, and/or disposition to inpatient psychiatric hospitalization. Interns typically provide group psychotherapy, crisis intervention services, and brief psychotherapy for individuals (and their families as appropriate) on the CIS. Patients on this service sometimes are admitted to a psychiatric hospital, or have an outpatient follow-up plan to address their particular psychiatric needs
On the Milieu Inpatient Unit, interns provide group psychotherapy for patients hospitalized for treatment of acute psychiatric disorders. They also conduct both brief and comprehensive psychological testing with the adult inpatients (about 2/month) on this service. Assessments are individually tailored to meet the referral questions, and thus there is not a "standard battery" which is used. Typical questions center on cognitive and emotional functioning, along with differential diagnosis. Interns also participate in weekly "walk rounds" involving a faculty-led clinical interview with a hospitalized inpatient and discussion of diagnostic and treatment considerations. Additionally, interns participate in a weekly interdisciplinary case conference where they present psychological testing findings. In their inpatient work, interns typically have opportunities to work with patients presenting with varying types of psychopathology and levels of psychological functioning.
Interns conduct clinical intervention services on the Grady Nia Project that primarily involve the provision of individual, group, and couple/family therapy. The Grady Nia Project provides culturally responsive clinical services and resources for women who have experienced intimate partner violence and attempted suicide. The Grady 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 groups (e.g., Dialectical Behavior Therapy, Seeking Safety, Acceptance and Commitment Therapy). The Grady Compassion and Mediation Project (Grady CAMP), which is associated with the Grady Nia Project, includes compassion meditation intervention for men and women who have attempted suicide. Interns attend the weekly Grady Nia Project team meetings and have the opportunity to participate in clinical research endeavors.
The Adult Outpatient Behavioral Health Primary Care Service, located at the Grady Health System Behavioral Health Outpatient Program at Park Place, provides an opportunity for interns to work as interdisciplinary team members in a primary care clinic. This clinic is co-located within a community mental health center setting that primarily serves patients living with severe mental illness. Interns conduct brief individual psychotherapy and health-related psycho-educational group interventions. 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.
During the Child Rotation, interns work in several child- and youth-focused service settings at Grady Health System and CHOA Hughes Spalding. Specific training sites include the Grady Infectious Disease Program, Grady Psychosocial Rehabilitation Clinic, and the CHOA Hughes Spalding Stephanie V. Blank Center for Safe and Healthy Children and the Attention Deficit Hyperactivity (ADHD) Clinic.
At the Grady Infectious Disease Program pediatric mental health consultation service, 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.
Interns working in the Grady Psychosocial Rehabilitation Clinic provide 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. Located in the Grady Behavioral Health Outpatient Program at Park Place, the Psychosocial Rehabilitation Clinic provides outpatient day treatment focusing on empowerment of the consumer, 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 short-term individual psychotherapy (16 or fewer session with a caseload of 2 to 3 consumers), family therapy, and group therapy. Interns also conduct psychological testing and evaluation primarily for diagnostic clarification, cognitive functioning, and strengths assessment. Additionally, interns gain experience in consultation with the treatment team and other mental health providers and provide clinical supervision of a psychology practicum student.
At the CHOA Hughes Spalding Stephanie V. Blank Center for Safe and Healthy Children, a child advocacy program that provides services to identify, assess, and prevent child abuse, interns offer parent consultations and 2 to 4 session diagnostic evaluations of children and adolescents. Interns also work as part of an interdisciplinary pediatric team in the CHOA Hughes Spalding ADHD Clinic, where they offer diagnostic evaluations for co-occurring psychological concerns, brief child psychotherapy, and interprofessional care team consultation.
The elective rotation is designed primarily to give interns a chance to pursue clinical training experiences in which they have a special interest as well as to provide opportunities for interns to obtain additional supervised experience in clinical areas that may require additional development. 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. The elective rotation can be divided into a major and minor elective and consists of approximately 16 hours per week. Examples of elective experiences include but are not restricted to the following:
During the elective rotation, the intern also spends up to 16 hours per week in the Adult Outpatient Service located in the Grady Behavioral Health Outpatient Program at Park Place. In this setting, the intern is responsible for the initial assessment and case management of outpatient adults, consultation with other staff, psychotherapy follow-up, and appropriate disposition planning of their patients. The intervention services typically consist of brief psychotherapy and treatment focuses on targeting specific symptoms and extensive after care planning.
The trauma track, also based at Grady Health System, consists of a year-long experience working in major rotations on the Grady Nia Project and in the Emory Needlestick Prevention Center. Each year there is one intern on the trauma track. The Grady Nia Project offers comprehensive biopsychosocial services to low-income African American women with histories of abuse and suicidality. An associated project is Grady CAMP, which serves African American male and female suicide attempters. The Emory Needlestick Prevention Center provides consultation services to healthcare providers throughout the entire Emory Healthcare System and affiliated hospitals who experience blood/body fluid exposures through needlesticks and other means.
On the Grady Nia Project interns gain experience on an interdisciplinary team providing crisis risk evaluations, case management services, assessments, and trauma-focused individual, group, and couples/family therapy. Interns also engage in community outreach efforts, participate in clinical research activities, and supervise junior clinical team members The individual and couple/family therapy efforts are guided by a culturally-informed integrative theoretical model that incorporates interpersonal, cognitive-behavioral, third wave cognitive-behavioral, mindfulness, existential/humanistic, attachment-oriented, and systemic-based perspectives. Group therapy opportunities 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, Compassion-Based Meditation, Dialectical Behavioral Therapy, Seeking Safety, Skills Training for Affect Regulation), and process groups (e.g., interpersonal). Clinical research activities include data collection, manuscript preparation, giving presentations, and grant writing.
Trauma track interns also are responsible for coordinating and implementing psychological prevention and intervention programs for health care workers for the Emory Needlestick Prevention Center, a program that operates under the auspices of the Department of Medicine - Division of Infectious Diseases. Specific responsibilities include: contacting all individuals exposed to bodily fluids or contaminated hospital equipment, assessing the mental health status of these individuals, offering and providing psychotherapy as needed, helping coordinate service,; and serving as a psychological consultant to the interdisciplinary team.
In addition to these two year-long major rotations, trauma track interns also have the opportunity to participate in minor rotations one half day per week in other service settings on a rotational system (adult, child, elective). The clinical experiences will vary depending on the needs and preferences of the intern and are described above in the general track rotation descriptions.
Additional Training Experiences
In addition to their rotation experiences, all GIE interns (general and trauma tracks) carry two supervised ongoing psychotherapy cases, including one child or adolescent case and one adult case. During the course of the year and across their rotations, a training focus on evidence-based practice is emphasized with the appropriate modifications based on the clinical needs of our patient populations.
Interns also participate in the Family Therapy Case Conference, a 6-month weekly training experience involving live supervision of systemically based family therapy. Additional psychotherapy training experiences are available as electives, including a 6-month weekly Brief Dynamic Psychotherapy seminar and supervision group.
Intern Supervision of Junior Trainees
During the internship training year interns gain experience as clinical supervisors of junior trainees in their clinical rotation settings. Typically, interns supervise psychology graduate students in clinical or counseling psychology who are enrolled in intervention practicum experiences at Grady Health System. These intern clinical supervisor training experiences are overseen by faculty who provide supervision on the supervisory process.
The extensive supervision provided during the internship year is a major strength of the program, and typically ranges from 6-9 hours of supervision per week. Interns have at least one supervisor for each service setting on a given rotation. 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 deficiencies are noted, the supervisor and intern jointly develop a plan for remedying them. Interns also have the opportunity to 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. In addition to its focus on clinical skill development, supervision also emphasizes consideration of contextual, cultural, and relational factors as they relate 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 the internship program's developmental training framework, supervision typically progresses over the course of the training year from a more didactic focus on specific clinical skill building processes to an increased focus on supporting the development of professional autonomy and increasingly independent clinical decision-making. Rotation experiences are supervised through ongoing contact with the on-site supervisor. Psychotherapy cases are supervised individually or in a group format.
All interns across the GIE and neuropsychology 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. Interns may also attend Child Psychiatry Grand Rounds. Finally, the Emory Department of Psychiatry and Behavioral Sciences Division of Psychology at Grady Health System sponsors several half-day psychology continuing education workshops throughout the year covering a variety of topic areas that interns attend.
Because the internship experience is primarily a clinical training year, participation in research is not a requirement of the program. However, as Emory is a major research institution, research opportunities do exist for interns interested in pursuing them. The clinical research elective option allows interns to participate in supervised research activities as part of their elective rotation. Interns also may choose to participate in research outside of their regular internship work hours. 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.