Program Information

Location

Our internship is housed within the Children’s Hospital Michigan Department of Psychiatry/Psychology which is located at University Health Center, Suite 4B on the Detroit Medical Center Campus. Interns are provided offices with phones and computers. Telehealth equipment such as webcams and headsets for telehealth are included. Outpatient therapy patients and psychological assessment cases are primarily seen within the same suite. The Children’s Hospital of Michigan inpatient units are available via tunnel. Other training activities occur at sites within walking distance including the Children’s Hospital of Michigan Specialty Center and The Children’s Center of Wayne County.

The City of Detroit has been experiencing a significant renewal over the past 10 years. Our downtown area has become home to many young professionals who have found housing in both brand new apartment buildings and refurbished historic buildings. Our recent interns have enjoyed living in the city. Our downtown is home to four professional sports teams, museums, theaters, riverfront walking and biking trails, award-winning restaurants and hotels, shopping, year-round festivals, and the QLine streetcar. We are located just across the river from Canada, 30 minutes from Ann Arbor, Michigan, and less than 5 hours from Chicago, Toronto/Niagara Falls, Cleveland, and Pittsburgh. The state of Michigan offers some of the most beautiful outdoor and lakeshore scenery in both the Lower Peninsula (the “mitten”) and in the Upper Peninsula (the “U.P.”). In fact, Michigan has the nation’s longest freshwater coastline including two National Lakeshore Parks (Sleeping Bear Dunes and Pictured Rocks). You can find more travel information about Detroit here and about Michigan here.

Training Tracks

The internship offers two training tracks with many similarities but different emphases. Interns start the year focused in their specialty area. The second half of internship continues key specialty activities, but also includes key experiences from the other track.

• Pediatric Psychology Interns (track 1):
  • First Rotation: focused on Pediatric Psychology activities including working in three multidisciplinary specialty clinics per week (e.g. Pain, Burn, HIV, Oncology, Myelomeningocele, Developmental Assessment Clinic), half day in each clinic, and extra inpatient consult experience in Burn and Trauma cases.
  • Second Rotation: continued work in select specialty clinics plus neurocognitive training activities.
• Pediatric Neuropsychology Interns (track 2):
  • First Rotation: focused on Pediatric Neuropsychology activities including outpatient Pediatric Neuropsychology evaluations at CHM, CHM Concussion Clinic, and Neurodevelopmental Disorders clinic at The Children’s Center of Wayne County.
  • Second Rotation: continued work in neurocognitive activities of interest plus experience in multidisciplinary specialty clinic(s).

Twelve Month Activities

• Inpatient Pediatric Psychology Consultations: average one consult per week. Pediatric Psychology interns complete more and also have weekly Trauma/Burn consult experience.
• Child and Adolescent Therapy: minimally 100 contact hours of intervention (e.g. 4-6 contacts per week). Those served includes inpatients as well as outpatients. Interns have multiple therapy supervisors. Caseloads can be focused on areas of interest.
• Inpatient Rehabilitation Services: teams made of an intern from each track complete up to two assessments per month
• Didactic Seminars: Pediatric Psychology, Pediatric Neuropsychology, CHM Pediatric Grand Rounds (when applicable); 2-3 hours didactics per week.
• Monthly Conferences: Psychiatry/Psychology Case Conference (including intern case presentations), Pediatric Psychology Journal Club, Intern Research/Dissertation Presentations, Diversity, Equity, and Inclusion seminars, Intern Wellness.
• Diversity, Equity, Inclusion: Didactics and experiential application of DEI principals are a key competency.
• Intern Wellness: Wellness activities and didactics are built into the internship.
• Supervision and Mentoring: At least two hours per week individual and two hours per week of group supervision. All supervision is face-to-face or over secure video conferencing. Interns choose a mentor to help guide their training.
• Research Elective available with Dr. Deborah Ellis at Wayne State University.

Detailed Description of Program

Overview

The interns complete two six-month rotations: the Clinics Rotation and the Neurocognitive Rotation. Each of the interns begins the training year immersed in their primary areas of interest in order to provide extensive exposure and training which will enhance their preparation for post-doctoral position applications. During the second half of the training year, interns will be exposed to additional opportunities to round out their training experience. Year-long activities include therapy cases, inpatient psychology consultations, attending supervision, and didactic seminars.

Children’s Hospital of Michigan has received a Health Resources and Services Administration (HRSA) Graduate Psychology Education (GPE) grant (#D40HP33377) which supports intern stipends and provides enhanced education and training to interns and faculty in telehealth, motivational interviewing, trauma, pain management, and opioid/substance use disorders within an interdisciplinary setting. Trainings include collaborations with Pharmacy, Child Life, and other disciplines. The internship Training Director, Jill Meade, Ph.D., serves as Program Director on the grant.

Internship Clinical Activities

Multidisciplinary Specialty Clinics Experience

Interns gain experience providing behavioral health services within multidisciplinary clinics. Pediatric Psychology interns begin the year immersed in this experience, and Pediatric Neuropsychology interns participate in some clinic work during second rotation. These activities address the following two Program Specific competencies of our internship:

• Develop skills in working with multidisciplinary teams.
• Develop understanding and treatment skills for the treatment and prevention of chronic illness in children and adolescents.

Most of the clinics served are chronic illness clinics where interns become familiar with the unique medical and psychological aspects of a specific chronic illness, as well as empirically-based assessment and treatment of that disease. Together with the supervisor, the intern learns to conduct psychosocial screenings with the patients and families in each clinic, including assessing mental health functioning, coping with illness, regimen adherence, school functioning and developmental status, peer functioning, and family functioning. Brief interventions and/or referrals are provided as needed, and information is shared with team members. These clinics are by definition multidisciplinary, with the core team comprised of physicians, social workers, nurses, dieticians, psychologists, and more. The exact clinics available have varied slightly from year to year depending upon intern feedback, scheduling, and staffing. Clinics served by the interns may include Pain Management, Burn Clinic, Oncology, Pediatric and Youth HIV, Myelomeningocele, Developmental Assessment Clinic, and others.

Neurocognitive Activities

Neurocognitive-focused internship activities include participation in neuropsychological assessments and providing services within a neurologically-focused multidisciplinary specialty clinic. Pediatric Neuropsychology interns begin the year immersed in these experiences, and Pediatric Psychology interns will participate in select activities during the second half of the year. These activities address the following Program Specific competency of our internship:

• Neuropsychological Testing skills- selecting, administering, scoring and interpreting neuropsychological tests, providing feedback to referral sources and families, and writing reports.

In the CHM Pediatric Neuropsychology lab, interns learn, administer, and interpret neuropsychological test batteries for children with various neurologic disorders, developmental disorders, and chronic medical conditions. They will receive guided instruction in all the professional aspects of neuropsychological evaluation including test interpretation and report writing, and providing feedback to families. Interns may have the opportunity to observe intracarotid amobarbital procedures, language and motor electrical stimulation mapping, fMRI studies, and to participate in multi-disciplinary team evaluations of children undergoing epilepsy surgery (all pending occurrences of each).

Interns’ work at the Neurodevelopmental Disorder (ND) Clinic at The Children’s Center of Wayne County includes participation in comprehensive assessments of children suspected of having autism spectrum disorders and/or other neurodevelopmental disorders, including medically complex cases with an emphasis on differential and comorbid diagnoses. Interns are trained to use a range of validated measures to assess autism spectrum disorders and developmental disabilities, and they participate in formulating and recommending educational and behavioral interventions for the children whom they have evaluated.

The CHM Concussion Clinic is a multidisciplinary clinic co-staffed by neurologists, physiatrists, and nurses. Here interns will learn to evaluate and manage the cognitive and emotional symptoms of concussion. Patients are typically first seen when facing acute symptoms and then are followed in the clinic as their symptoms resolve and they return to full contact sports, school, and social participation.

Second Rotation Activities

As noted in the descriptions above, interns will be able to continue key activities from first rotation into the second half of the internship year. In addition, interns will participate in key activities from the other track in order to meet CoA and internship competencies. The internship is focused on helping interns meet their specific training needs. Interns will work with their mentors to plan activities to meet training goals.

Twelve-Month Activities

Inpatient Psychology Consultation Liaison

Throughout the internship year, interns participate in inpatient consultation-liaison services. Quantity of consults can vary year-to-year, ranging from 2-6 per month. These consultations involve psychological screening, evaluation, and recommendations for the Children’s Hospital of Michigan inpatients at the request of the medical teams. Inpatient teams may ask psychology to evaluate patients for mood or anxiety disorders, pain or illness coping, or need for therapy. Often interns can follow these patients for therapy after discharge. Consults may also involve providing treatment while patients are in the hospital for such things as eating or feeding disorders, adjustment to injuries, trauma, behavior problems, depression/anxiety, pain management, and/or Somatic Symptom and Related Disorders. Pediatric Psychology interns will receive additional training in Medical Trauma and Burn consults.

Child and Adolescent Therapy

Interns are required to have and document a minimum of 100 hours of therapy to graduate from our internship. We have found that interns must maintain a case load of 4-6 cases in order to have 3-4 hours of actual therapy sessions per week and attain the 100 or more therapy contact hours. Most of the cases come from the Children’s Hospital of Michigan specialty clinics, or inpatient consults. Interns can request cases in their area of interest. Supervision in Empirically-Based Treatment is provided by internship faculty.

Inpatient Rehabilitation Services

Twice per month (pending patient referral volume), intern teams conduct assessment of children hospitalized for traumatic brain injury, orthopedic problems, spinal cord injuries, spina bifida, and other rehabilitation issues. Each team consists of one pediatric psychology intern and one neuropsychology intern. Assessment follows a recovery model in which the timing and components of the neuropsychological battery are tailored to the recovery status of the child and to the specific referral questions that are being addressed. Interns will learn to write targeted consultation reports and to provide recommendations based on the recovery status of the child. The interns also participate in inpatient rehabilitation team rounds. The rounds allow them the opportunity to learn about acute phases of brain injury, as well as rehabilitation treatments and programs. On the Rehabilitation Unit, pediatric psychology consultation and treatment focus on identifying and treating psychological factors that interfere with a child’s participation in rehabilitative therapies.

Didactic Seminars

Weekly Pediatric Psychology Didactic Seminar involves presentations by faculty members and outside speakers on a variety of topics related to the medical specialty and pediatric psychology clinics and consults that the interns encounter in our setting. Psychopharmacology, ethics, professional issues, self-care and cultural/ethnic topics are also covered. Interns each present their dissertation to the department. MonthlyPediatric Neuropsychology Seminar and Case Conference includes a combination of topic presentations, fact finding, case consultation, and practice with blind interpretation of test data to develop skills in the interpretation of cognitive deficiency patterns (including the WISC-V and a full range of neuropsychological tests). Children’s Hospital of Michigan Psychiatry/Psychology Case Conference allows interns to formally present cases and engage in multidisciplinary discussions. Interns also have opportunities to attend the weekly Children’s Hospital of Michigan Pediatric Grand Rounds when applicable.

Diversity, Equity, Inclusion Training

Diversity is a central competency in the eyes of the CoA of APA, and is critical to successful work at our site. The program addresses this competency through monthly training seminars, case conferences, assigned readings, and most importantly, supervised experience working with patients from the highly diverse population in south eastern Michigan that seeks healthcare at Children’s Hospital of Michigan.

Intern Wellness

Intern wellness and group connections are an important part of coping with internship. The internship offers a regular wellness seminar with various experiential and educational activities focused on self-care. Each intern class is different, so intern preferences are a major guiding force in designing wellness activities for each training year.

Supervision & Mentoring

Interns receive a minimum of two hours of individual and two hours of group supervision per week. Supervisors often are in the room with the interns during medical specialty clinic patient encounters, so that supervision takes place instantaneously after the patient visit. Interns will be able to practice supervising others such as peers and practicum students within group therapy supervision, neuropsychological assessments, and multidisciplinary clinic work.

Across all clinical activities there is a sequential process of learning. The supervisor models the interview; then, the intern conducts part of the interview with assistance from the supervisor; later, the intern conducts the entire interview and receives feedback afterwards from the supervisor. With regard to testing, the supervisor at first watches the intern administer various psychological tests to the patients. When the supervisor is satisfied that the intern is competent with test administration, the supervisor no longer observes the testing, but reviews it afterwards with the intern. The supervisor reviews all of the reports, case notes, and treatment forms completed by the intern and provides the intern with constructive feedback.

Interns each choose a Mentor within the first month (or so) of internship. Mentors assist in planning training activities to meet intern goals. Mentors are also available to provide guidance regarding post-doctoral applications and to provide support throughout the year.

Research Elective

Interns can participate in research by developing a Research Elective in place of some clinical activities. Interns can explore research opportunities with our partners at Wayne State. Deborah Ellis, Ph.D. serves as research mentor. Generally, interns who opt to complete a research elective leave with at least one publication in a peer-reviewed journal or a chapter coauthored with a faculty member.

Evaluations

We have three mechanisms of providing interns with formal written feedback in a timely manner: Clinic Checklists: Most of our clinical activities have an associated Clinic Checklist. The supervisor observes a specific interaction between you and a patient/family, and the checklist is used to rate your interactions with the patient and family. Progress Reports: At the 3 and 9 month intervals in the internship, each supervisor completes a Progress Report. The Rotation Competency Evaluation (RCE) is completed at the end of each rotation (end of February and end of August). Both the Progress Reports and the RCE assess interns on the nine CoA Core Profession-Wide Competencies and the three program specific competencies.

The interns anonymously evaluate the faculty at the six- and 12-month intervals. In addition, faculty elicit intern feedback during quarterly meetings to help the faculty customize their teaching and supervision to the needs of the interns.