Training on the neuropsychology track expands the intern';s existing knowledge base in general clinical psychology, psychopathology, neuroanatomy, neuropathology, and the neurosciences and fosters the intern';s development as a psychology scientist-practitioner. Through experiential and didactic training, interns develop a strong understanding of brain-behavior relationships and knowledge in basic psychological principles, psychometric issues, and general clinical psychology, as well as practice and professional issues. This is accomplished via participation in major rotations that focus primarily on neuropsychological assessment and minor rotations that focus on intervention in neurological rehabilitation and psychiatric settings.
The neuropsychology track offers two separate concentrations. The adult/geriatric training concentration involves a focus on both adult and geriatric populations, and is most appropriate for those applicants with strong experiences working with adult populations, and/or those with a particular interest in geriatric populations.
The adult/pediatric training concentration involves a major focus on experiences with both adult and pediatric populations. This training concentration will be most appropriate for those applicants with strong practicum experiences working with both adult and pediatric populations, and/or those with a particular interest in pediatric populations.
Applicants should note that there is a separate match number for the Adult/Geriatric and Adult/Pediatric training concentrations. Applicants to the neuropsychology track may submit rankings and be considered for both of these neuropsychology track training concentrations if they so wish.
Interns on the neuropsychology track complete two 6-month major diagnostic neuropsychological assessment rotations in which they provide comprehensive evaluation of cognitive and affective disorders arising from neurologic injury and disease. All interns complete a major rotation at the Emory Rehabilitation Hospital (ERH). Interns in the adult/geriatric training concentration also complete a major rotation at the Emory Brain Health Center, while interns in the adult/pediatric training concentration complete a major rotation at Children's Healthcare of Atlanta (CHOA).
On their major rotations interns gain extensive experience in neuropsychological assessment of adult, child and geriatric patients with acquired brain injury, neurodegenerative diseases, stroke, epilepsy, neoplasm, and other neurological conditions. The diagnostically diverse patient populations and combination of settings are major strengths of the internship. Under the supervision of neuropsychology faculty interns learn: (1) diagnostic interview techniques for neurological populations; (2) design of flexible test batteries to address referral questions; (3) neuropsychological test administration, scoring, and interpretation; (4) differential diagnosis of neuropsychological syndromes and disorders; (5) production of oral and written reports for lay persons and health care professionals; and (6) development of rehabilitation plans and recommendations. Supervised experience in conducting Wada Tests and Cortical Language Mapping in temporal lobe epilepsy surgery candidates is available primarily in the child rotation, although occasionally in the adult rotation as well. Interns learn effective interview techniques with neurologically-impaired clients and become proficient in selection of tests, administration and scoring of tests, interpretation of results, and oral and written communication of findings. Interns examine persons with acute neurologic disorders in inpatient settings, as well as persons presenting with chronic residuals of neurologic disorders in outpatient settings.
Interns are trained in consultation with medical staff members, health care teams, families, administrative systems, and persons with neurological disorders. Consultation emphasizes communication and education. Interns are involved in clinical consultation to physicians and health care teams in formal settings such as medical rounds and team conferences. Interns regularly provide consultative education to patients and families as well as case managers and health care administrators.
Interns complete two 6-month minor treatment-oriented rotations that provide opportunities to gain experience in psychotherapeutic and behavioral health interventions in neurological rehabilitation and psychiatric settings. Options for the minor rotations include rotations in rehabilitation psychology at the ERH or CHOA, and at several clinical sites that are part of the Grady Health System. These rotations provide experience in psychotherapy, cognitive rehabilitation, team consultation with inpatients and outpatients undergoing neurological rehabilitation and/or crisis intervention and intervention with psychiatric patients.
Pediatric Minor Rehabilitation Psychology Rotation
On this rotation, interns have the opportunity to engage in psychological intervention with patients at CHOA at Scottish Rite in the Comprehensive Inpatient Rehabilitation Unit (CIRU), and on occasion, at the Day Rehabilitation Program (DRP). The CIRU is a licensed and accredited 28-bed floor that is dedicated to acute rehabilitation. The CIRU serves acutely ill and injured patients who require intensive medical care, but are able to participate in three hours of rehabilitation per day. The DRP is a transitional day program for patients that do not require 24 hour medical care. Interns have opportunities to assist with diagnostic interviews with caregivers, assess patients' emotional and behavioral functioning, and assist in developing and implementing individual and family interventions. Interns also have the opportunity to learn and assist with providing intervention within the interdisciplinary teams in the CIRU and DRP (PT, OT, SLP, medical team). The patient population (infancy to age 21 years) presents with a variety of acute and chronic diagnoses including: traumatic and acquired brain injuries, tumors and cancer, stroke, meningitis/encephalitis, spinal cord and orthopedic injuries, cerebral palsy, developmental and genetic disorders, burns, amputations, chronic pain, conversion disorders, and others.
Adult Minor Rehabilitation Psychology Rotation
This rotation offers the opportunity for interns to gain experience conducting diagnostic interview and psychotherapy with adult neurological rehabilitation inpatients and outpatients. Patients on this service have experienced recent onset of a neurological condition (mainly stroke or traumatic brain injury although other diagnoses are possible), and are undergoing a program of comprehensive rehabilitation including physical, occupational, and speech therapy, on either an inpatient or outpatient basis. Psychological interventions focus on dealing with depression, anxiety, and other adjustment issues that may be affecting their rehabilitation. Family and a limited degree of sexual counseling may also be needed.The rotation also provides an opportunity to consult and work with the interdisciplinary rehabilitation teams that are treating the patients.
Grady Health System
There are several options for minor rotations through the psychiatry program at the Grady Health System. These provide the intern with the opportunity to gain experience with diagnosis and treatment of major psychiatric disorders. The intern selects one minor rotation experience based on training interests and needs. Available settings include the Adult Outpatient Service, located in the Grady Behavioral Health Outpatient Program at Park Place. At this site, the intern conducts initial biopsychosocial interview assessments, provides individual and group psychotherapy, consults with interdisciplinary team members, and offers appropriate disposition planning. Often patients being seen for initial evaluation have recently been discharged from an inpatient service. At the Psychosocial Rehabilitation Clinic, also located in the Grady Behavioral Health Outpatient Program at Park Place, interns have opportunities to provide evaluation and intervention with individuals living with severe and persistent mental illness in a day treatment setting. On the Crisis Intervention Service (CIS), interns interview and intervene with individuals in the midst of a psychiatric emergency. All levels and categories of adult psychopathology are represented. The CIS is a 24-hour psychiatric services program that receives patients from the Grady Memorial Hospital Emergency Department. Finally, in the Infectious Disease Program, interns provide individual and group therapy in an HIV primary care setting for adults or children with a wide range of co-occurring psychiatric difficulties. Interns also provide consultation services to primary care providers in this setting. Additional minor rotation options at Grady Health System also are possible depending on the interests and training needs of interns, and the availability of faculty supervisors.
Additional Training Experiences
Neuropsychology interns carry one long term psychotherapy case throughout the training year. These are typically patients with a combination of neurological and psychiatric disorders with long term adjustment issues related to their physical, emotional, and cognitive disabilities. Long-term cases may be treated from a variety of therapeutic frameworks, depending upon their clinical presentation, including behavioral, cognitive-behavioral, and insight-oriented psychodynamic approaches.
Intern Supervision of Junior Trainees
While on their rotation at ERH, all neuropsychology track interns also have opportunities for training as a clinical supervisor of a graduate practicum student in neuropsychological assessment. This includes supervising the student on test administration and scoring, as well as data integration and possible report writing. This "nested" supervision model is a way to introduce interns to practical aspects of being a supervisor in an environment where they can get training and feedback in preparation for their eventual role as a supervisor upon completion of their doctorate. Part of the intern';s individual supervision time with faculty will be spent on these training issues.
The extensive supervision provided during the internship year is a major strength of the program. At the beginning of each rotation, interns meet with their supervisor(s) to discuss clinical responsibilities and supervisor/intern expectations. 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 these problems. Interns also have the opportunity to complete written evaluations of their supervisors.
Interns are assigned a primary faculty supervisor for each major neuropsychology rotation. Depending upon the rotation, supervisors will be experienced in child, adult, or geriatric neuropsychology. We currently have 8 neuropsychologists certified by the American Board of Professional Psychology / American Board of Clinical Neuropsychology across the child, adult, and geriatric rotations. Each week, the intern will receive at least 2 hours of individual assessment supervision in addition to approximately 2 hours of group supervision as part of the weekly Neuropsychology Case Seminars. Individual supervision provides an opportunity for intensive, one-on-one discussion and case conceptualization with a faculty member. Group supervision provides an opportunity to interact with neuropsychology residents (fellows), practicum students, and faculty. Additional informal supervision regularly occurs as the intern manages the demands of clinical services.
The format for supervision during the minor treatment rotations varies with the setting, the supervisor, and the intern';s needs, and may include individual or group supervision, review of process notes, use of audio or videotapes, and 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 clinical decision-making. The long term psychotherapy cases are supervised on an individual basis, or in a group format (1 hour weekly group supervision).
A variety of didactic training opportunities are available, including a weekly Neuropsychology Case Seminar during which interns regularly present cases and discuss the relevant neuropsychological literature. Faculty lectures throughout the year provide advanced instruction in areas relevant to the practice of clinical neuropsychology and guest lecturers provide introductions to neurological and neuroradiological examination techniques including magnetic resonance imaging (anatomical and functional) and electroencephalography. Interns also participate in the weekly Psychology Intern Core Seminar with the general and trauma track interns. Interns also may attend Neurology, Rehabilitation Medicine, and Psychiatry Grand Rounds, a Pediatric Epilepsy Surgery Conference (during the child rotation), and clinical brain dissections in the Emory Pathology Department (during the adult rotation), and a multi-disciplinary Dementia Diagnosis Consensus Conference (during the geriatric rotation).
Participation in the Neuropsychology Case Seminars, Psychology Intern Core Seminar, and brain dissection is mandatory. Interns must also select and attend a minimum of one additional training activity each week.
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 eventual academic careers. Interns are familiarized with ongoing funded and unfunded faculty research and are encouraged to develop a mentor relationship with one or more faculty. Interns may elect to work with faculty on ongoing or new research projects outside of their normal clinical hours. Interns who are interested in applying to the Pediatric Neuropsychology Postdoctoral Fellowship through CHOA are encouraged to develop a research area of interest.