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TRAINING SITES AT CAMBRIDGE HEALTH ALLIANCE
Adult Neuropsychology Service
This two-year program provides intensive training in clinical Neuropsychological
assessment at the Neuropsychological and Psychological Assessment
Service (NAPA) in the psychiatry department at CHA. The overall
goal of training is to provide fellows with a broad range of neuropsychology
training experience and prepare them to be board-eligible in neuropsychology.
Our NAPA service provides care to a range of adult outpatient populations,
including those with primary medical, neurological and psychiatric
disorders. Medical and psychiatric inpatient consultations are also
performed. Referrals include evaluations of patients who present
with a variety of neurological disorders, such as head trauma, seizure
disorders, dementia, vascular disorders, metabolic disorders, sleep
disorders, headaches, and movement disorders. Psychiatric referrals
range from mood and anxiety disorders to severe and persistent psychotic
disorders, complex trauma, and polysubstance abuse. Patients with
neurodevelopmental disorders such as learning disabilities, attention-deficit
disorder, and Asperger's disorders are also evaluated.
Individual supervision is provided weekly. They typically work
on an assessment team with psychological assessor to coordinate
patient care and also integrate comprehensive assessments. Extensive
didactic opportunities are available within the hospital and Harvard
Medical School.
In the first year, fellows participate in seminars in adult neuropsychology,
behavioral neuroanatomy and a clinical case seminar (using a fact-finding
platform), as well as psychiatry grand rounds, neuroscience grand
rounds, and testing rounds monthly. In their second year, fellows
participate in a neurology rotation in which they shadow a neurologist
in clinic. They also participate in a brain cutting seminar, psychopharmacology
seminar, behavioral neuroanatomy seminar, and a case seminar.
Opportunities for training in psychological assessment are also
available and multidisciplinary interaction with psychiatry, neurology,
and geriatrics is typical. Fellows are provided with teaching and
mentoring opportunities. A clinical research component is also a
requirement culminating in a professional poster or paper submission
at the end of the two-year training.
Behavioral Medicine Program
The Behavioral Medicine Fellowship is for trainees interested in
developing a clinical career in the area of behavioral medicine
with an emphasis on pain, sleep, and psychological co-morbidities
of physical health problems.
Training in the Behavioral Medicine Program provides fellows with
training in shorter term, symptom-focused treatment utilizing cognitive,
behavioral, and physiological techniques. The behavioral medicine
fellows provide consultation and liaison with medical services as
well as providing assessment, individual and group treatments.
Training components include individual and group supervision, conferences
and seminars on the clinical applications of behavioral medicine,
hypnosis, biofeedback, psychopharmacology, and fundamentals of cognitive-behavior
therapy. Clinical research is encouraged, but not required.
Child and Adolescent Acute Services
This fellowship consists of rotations on three different services
within Cambridge Health Alliance. These include the Child Assessment
Unit (CAU), the Adolescent Assessment Unit (AAU), and the Psychiatric
Emergency Service at the Cambridge Hospital campus. The CAU is a
13 bed locked inpatient unit serving children ages 3-13 located
at the Cambridge campus. The AAU is an 18 bed locked inpatient unit
serving adolescents ages 12-18, located at the Somerville campus.
Both units have a patient population that is quite diverse ethnically
and diagnostically, and operate within a collaborative interdisciplinary
team framework. In 2003, the CAU earned the Gold Achievement Award
from the American Psychiatric Association for its innovative practices
in eliminating seclusion and restraint, developing compassionate
ways of dealing with children's anger, and partnering with families.
Psychodynamic, cognitive-behavioral, and family systems approaches
are emphasized. The AAU employs a similar model of care that is
tailored to the adolescent population and also offers training in
an adolescent inpatient DBT group.
Psychology Fellows receive training in assessment, treatment planning,
and treatment with children and adolescents, within the context
of intensive assessment units. During the inpatient rotations, fellows
gain experience working with children and adolescents in individual,
family, and group therapy. Our trainees also work with collateral
service providers (e.g. DSS, DMH, schools, outpatient treatment
teams). Additionally, psychology fellows conduct psychological testing
batteries, write reports with supervision, and gain experience giving
testing feedback to patients, families, and referring clinicians.
Fellows also receive training at the Psychiatric Emergency Service
(PES) at the Cambridge campus. During the PES rotation, fellows
perform evaluations of children, adolescents, and adults, determine
the appropriate level of care needed, and arrange dispositions.
Throughout the year, fellows receive individual supervision, and
participate in Clinical Case Conferences and ongoing seminars, including
Psychological Assessment of Children and Adolescents, Child Psychotherapy,
and Psychopathology, and a live Interviewing Conference led by a
group of senior clinicians.
Adult Psychotherapy and Psychological Assessment Services
This new one-year program provides a half-time intensive psychotherapy
experience in the Psychodynamic Research Clinic (PRC) combined with
half-time advanced psychological assessment training in the Neuropsychological
and Psychological Assessment Service (NAPA).
In the PRC, fellows are provided with in-depth psychotherapy supervision
for a small number of patients, as well as the opportunity for a
seminar in psychotherapeutic technique. At NAPA, fellows receive
supervision and training in projective and objective assessment
techniques, within a Therapeutic Assessment model of care. Through
their roles in both clinics, the fellows may provide pre-treatment
therapeutic psychological assessments for patients in the PRC. There
is also limited opportunity to gain experience in neuropsychological
assessment, as well as in coordinating with neuropsychologists for
comprehensive assessments.
Assessment patients for this fellowship include a wide range of
psychiatric conditions, including mood and anxiety disorders, severe
and persistent psychotic disorders, complex trauma, and polysubstance
abuse. Patients with medical, neurologic, and neurodevelopmental
disorders such as learning disabilities, attention-deficit disorder,
and Asperger's disorders are also evaluated for co-morbid psychiatric
conditions.
Fellows in this rotation have the option of attending a variety
of neuropsychological testing seminar offerings, and play an integral
role in leading monthly testing rounds. They are provided with teaching
and mentoring opportunities throughout the year. For those who are
interested, a clinical research component is a possibility, culminating
in a professional poster or paper submission at the end of the training
year.
Program for Psychotherapy
This two year fellowship offers long-term psychodynamic psychotherapy
of adult outpatients. The Program for Psychotherapy is a multidisciplinary
training program that includes advanced fellows in psychiatry and
social work as well as psychology. Fellows receive intensive individual
supervision in psychodynamic treatment and group supervision by
a psychoanalyst, and they attend two reading seminars: Theory and
Technique of Psychoanalytic Treatment (first year), and Object Relations
and Psychoanalytic Theories (second year). The fellowship also includes
five hours of research time on the PFP's psychodynamic psychotherapy
outcome study. and once monthly case conferences, presentations
by a senior faculty clinician, and in-service trainings.
Victims of Violence Program
The Victims of Violence program offers a two year post-dotoral fellowship
with comprehensive psychological services to adult victims of recent
and/or prior crimes of physical and sexual violence. The program
also extends services to survivors of war-related political trauma,
family and friends of victims, and community settings distressed
by violent traumatic events.
The program is staffed by a multidisciplinary team who offer clinical
training and supervision to advanced students in psychology, social
work, nursing, and psychiatry. Program services include crisis intervention,
individual and family evaluation, individual and group treatment,
case consultation, psychological testing, and community crisis response
services. Psychology Fellows in the VOV program conduct individual
and (as appropriate) family evaluations. They also provide individual,
group, and occasionally, family psychotherapy to patients referred
to the VOV program and are responsible for approximately 2 hours
per week involvement in short-term crisis intervention. In addition,
Fellows in the VOV program are expected to devote eight hours per
week of their time to participate in VOV research activities.
Psychology fellows in the VOV Program receive individual supervision
for individual evaluation and treatment cases, group supervision
for crisis intervention, and supervision for group therapy. Weekly
seminars include a Victims of Violence Crisis Seminar, a Trauma
Seminar, a Group Treatment Seminar, and a Clinical Group Supervision.
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