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Neuropsychology Track

Overview 

The neuropsychology track supports 4 interns per year.  This includes 2 adult/geriatric neuropsychology concentration interns and 2 adult/pediatric neuropsychology concentration interns. 

All interns across concentrations complete two 6-month diagnostic neuropsychological assessment major rotations with an emphasis on training in the comprehensive neuropsychological evaluation of persons living with neurologic injury and disease. Interns train in a range of clinical settings with diagnostically diverse patient populations living with neurological conditions such as acquired brain injury, neurodegenerative diseases, stroke, epilepsy, and neoplasm. Specifically, 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. Interns also are trained in consultation with medical staff members, health care teams, families, administrative systems, and persons with neurological disorders. Specifically, interns are involved in clinical consultation with physicians and health care teams in formal settings such as medical rounds and team conferences. They also regularly provide consultative education to patients and families as well as case managers and health care administrators.

Neuropsychology interns across concentrations also complete two 6-month intervention-focused minor rotations that provide opportunities to gain experience with behavioral health interventions in neurological rehabilitation and/or psychiatric settings. These include experience in the provision of psychotherapy, cognitive rehabilitation, team consultation with inpatients and outpatients undergoing neurological rehabilitation, and/or intervention with psychiatric patients.

Adult/Geriatric Neuropsychology Concentration

The adult/geriatric neuropsychology concentration provides training experiences focusing on both general and older adult populations. Rotation settings include the Emory Rehabilitation Hospital, Emory Brain Health Center, and Grady Health System

Major Rotations

Interns complete a 6-month general adult major rotation at the Emory Rehabilitation Hospital (ERH) and a 6-month geriatric major rotation at the Emory Brain Health Center (EBHC). In their general adult rotation at the ERH rehabilitation neuropsychology program, interns conduct outpatient comprehensive neuropsychological assessments.  Also, they receive training in formal cognitive rehabilitation using a manualized treatment program. 

During their geriatric major rotation at the EBHC neuropsychology program, interns gain experience conducting outpatient neuropsychological assessments primarily with older adult outpatients with dementia, mild cognitive impairment, epilepsy, and movement disorders. Interns also spend time in the memory clinic at the Grady Health System Marcus Stroke and Neuroscience Center, where they conduct brief evaluations of neurological memory disorders, consult with the neurology team on the results of these evaluations, and provide feedback to patients on evaluation findings.

Minor Rotations

Adult/geriatric concentration interns complete two 6-month minor intervention-focused rotations. Interns have elective choice of clinical settings and populations for both minor rotation experiences.  

Among the available options is the adult rehabilitation psychology minor rotation at the ERH. In this training experience, interns work with rehabilitation inpatients and outpatients undergoing a program of comprehensive rehabilitation, including physical, occupational, and speech therapy for neurological conditions that typically are of recent onset (mainly stroke or traumatic brain injury although other diagnoses are possible). Interns provide diagnostic interviewing and psychotherapy to address depression, anxiety, and other adjustment issues that may be affecting patient rehabilitation. Family therapy and a limited degree of sexual counseling may also be needed. Interns also consult and work with the interdisciplinary rehabilitation teams.

Interns also have the option of completing minor rotations in general psychiatric settings at Grady Health System (GHS).  Interns can select from among multiple options, examples of which include: psychiatric diagnostic interview assessments and brief psychotherapy intervention at the Behavioral Health Outpatient Center; evaluation and intervention with individuals living with severe and persistent mental illness in the Psychosocial Rehabilitation Clinic; trauma-focused intervention in the Nia Project; evaluation and intervention with patients under observation for acute psychiatric conditions (e.g., severe depression, acute mania, psychotic episodes) in the Crisis Intervention Service (CIS); and psychiatric diagnostic interviewing, intervention, and interdisciplinary consultation in an HIV primary care setting at the Infectious Disease Program. Additional minor rotation options at GHS also are possible depending on the interests and training needs of interns and the availability of faculty supervisors for these training experiences.

Adult/Pediatric Neuropsychology Concentration

The adult/pediatric neuropsychology concentration provides training experiences focusing on both pediatric and adult populations. Rotation settings include the CHOA Center for Advanced Pediatrics, CHOA at Scottish Rite, and the Emory Rehabilitation Hospital.

Major Rotations

Interns complete a 6-month pediatric major rotation at the CHOA Center for Advanced Pediatrics and a 6-month adult major rotation at the Emory Rehabilitation Hospital (ERH). In their adult rotation at the ERH rehabilitation neuropsychology program, interns conduct outpatient comprehensive neuropsychological assessments, and receive training in formal cognitive rehabilitation using a manualized treatment program. 

In their pediatric major rotation, interns conduct neuropsychological assessments with children and adolescents living with a range of neuropsychological conditions. On occasion, supervised experience in conducting Wada tests and cortical language mapping in temporal lobe epilepsy surgery candidates is available. 

Minor Rotations

Adult/pediatric concentration interns complete two 6-month minor intervention-focused rotations. During their pediatric major rotation, interns are required to complete a pediatric rehabilitation psychology minor rotation. This includes experience 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, a licensed and accredited 28-bed floor dedicated to acute rehabilitation, serves acutely ill and injured patients who require intensive medical care, but can 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. 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 other conditions. Interns assist with diagnostic interviews with caregivers, assess patients' emotional and behavioral functioning, and participate in developing and implementing individual and family interventions. Interns also learn and assist with providing intervention within the interdisciplinary teams in the CIRU and DRP (e.g., physical therapy, occupational therapy, medical teams). 

During their adult major rotation, interns have elective choice of minor rotation clinical settings and populations. Interns choose one minor rotation experience from among those available in the ERH adult rehabilitation psychology program and in the Grady Health System psychiatry settings listed in the above section describing the adult/geriatric minor rotation sites. 

Additional Training Experiences

Psychotherapy

Along with rotation-specific intervention experiences, all neuropsychology interns carry one required long-term psychotherapy case at the ERH throughout the internship year. Long-term psychotherapy cases typically present with a combination of neurological and psychiatric conditions and associated physical, emotional, and cognitive challenges to adaptation and well-being. Interns receive weekly long-term psychotherapy supervision conducted in a group format.

Elective psychotherapy mini-rotations also are offered for interns who are interested in gaining experience with a specific evidence-based psychotherapy modality. These 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

Neuropsychology track interns gain experience in providing clinical supervision of junior trainees during the internship year. Supervisees typically are psychology graduate students who are enrolled in neuropsychology practicum experiences. Interns supervise practicum students on neuropsychological assessment activities, including test administration and scoring, data integration, and possible report writing.  All interns serve as clinical supervisors during their adult rotation at the ERH. When scheduling permits, adult/pediatric neuropsychology concentration interns also may have opportunities to supervise practicum students in a pediatric neuropsychological assessment setting.

Professional Mentoring

Professional mentoring of interns by faculty is incorporated as a formal element of the training experience for interns. 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. Neuropsychology track interns meet with faculty in regularly scheduled group mentoring sessions in which topics pertaining to preparation for a neuropsychology career specialization are explored. Informal individual mentoring is regularly provided as requested.

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 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 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. While not required, neuropsychology interns can elect to attend these continuing education programs.

Neuropsychology track interns also participate in a variety of specialty rotation-specific didactic activities. During their adult rotation, interns attend a weekly 2-hour clinical neuropsychology case seminar. Adult/geriatric neuropsychology concentration interns also attend this seminar during their geriatric rotation, along with a geriatric rotation neuropsychology case conference, an Alzheimer’s consensus conference, and select Department of Neurology Grand Rounds.  Adult/pediatric neuropsychology concentration interns participate in a weekly 1-hour pediatric neuropsychology advanced training seminar. They also have the opportunity to co-lead with a faculty supervisor a weekly 1-hour pediatric neuropsychology practicum student seminar.

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 neuropsychology track interns interested in pursuing them.  Interns with an interest in research involvement typically choose to participate in these activities outside of their regular internship work hours, though this is not required or expected by the training program.