Predoctoral Internship in Child Psychology
Texas Child Study Center
A collaboration between Dell Children’s Medical Center and University of Texas
Educational Psychology
The Texas Child Study Center
The Texas Child Study Center has been in operation since September, 2008, and was created in response to the need for pediatric mental health services and training for current and future mental health practitioners in the Austin area. The Center was founded by William Streusand, MD, Medical Director, and Kevin Stark, Ph.D., Director of Psychological Services, and is a collaboration between Dell Children's Medical Center of Central Texas and The University of Texas at Austin Educational Psychology Department. The Center is currently located in Central Austin, 4 miles from the Dell Children's Medical Center.
Services at the Center are provided by a multidisciplinary team that includes psychiatry and psychology. The Center considers interdisciplinary collaboration and consultation of primary importance. Further, because youth are embedded within many social contexts, the team achieves optimal results by working with multiple systems, including families, schools, and communities.
The Center provides evidence-based treatment for children and adolescents with emotional, behavioral, and developmental disabilities, ranging from adjustment difficulties to more chronic conditions including psychotic, mood, and developmental disorders. The Center has developed specialized assessment and treatment programs to address autism spectrum disorders, pediatric obesity, anxiety disorders (including Social Phobia, Specific Phobias, Separation Anxiety, Generalized Anxiety, Post Traumatic Stress Disorder, and Obsessive Compulsive Disorder), and depression. The Center's approach includes ongoing assessment to evaluate the impact of treatment on patients' symptoms and functioning, and feedback to patients and families on their progress.
Staff and trainees collaborate with physicians at Dell Children's Medical Center to provide psychological support to children coping with acute and chronic medical conditions. The Center provides assessment and treatment for children and adolescents presenting with a range of conditions, including epilepsy, cystic fibrosis, diabetes, obesity, and traumatic injuries to address co-occurring mental health issues, difficulty adjusting to a new medical diagnosis, developmental challenges that result from medical conditions, and/or difficulty coping with pain.
Patients seen at the Center come from all socioeconomic strata and ethnic and racial backgrounds. Approximately 30% of patients are seen on a charity basis. These patients are primarily Medicaid insured and/or from low socioeconomic status. Approximately 20% of patients have a parent who is a Seton employee, and are seen through the Seton Insurance Plan. The remaining patients pay for services out of pocket.
Philosophy and Training Model
The Texas Child Study Center includes trainees from psychology, including psychology interns, postdoctoral fellows, and practicum students, and psychiatry, including psychiatry residents and child psychiatry fellows. The internship program is meant to prepare interns for future practice as skilled and ethical child psychologists. Individualized attention and training is valued by the Center; thus the program is tailored to the individualized needs of each intern to address the goals of the trainee as well as gaps in previous training. The training program emphasizes the integration of research and practice; thus interns receive training in evidence-based treatment and are expected to integrate evidence-based treatment techniques into their clinical work when appropriate.
Applicants are expected to have completed basic coursework in psychodiagnostics, psychopathology, and psychotherapeutic interventions prior to internship training.
Goals
- Interns will be able to conduct a detailed initial evaluation, make a DSM-IV clinical diagnosis, formulate a biopsychosocial formulation which includes development, family systems, culture, and design an appropriate treatment plan.
- Interns will develop and refine skills in psychotherapy in an outpatient setting, including individual, family, and group therapy, using a range of therapeutic techniques.
- Interns will receive specialized training in evidence based treatment of internalizing and externalizing disorders in youth, particularly anxiety (including OCD, PTSD), depression, and disruptive behavior disorders. Interns will be able to integrate these principles into their case conceptualizations and treatment plans.
- Interns will develop and refine skills in psychological assessment, including testing, feedback, and report writing.
- Interns will learn to individualize and modify therapeutic strategies for special populations (e.g. medically ill populations, overweight/obese children, children on the autism spectrum).
- Interns will become familiar with cultural issues and the impact of culture and race on clinical work with patients.
- Interns will become thoroughly familiar with ethical and professional issues in the practice of psychology, including APA ethical principles and code of conduct. Interns will demonstrate ethical and professional conduct in all interactions during their internship year.
The Training Program
The internship program includes a range of activities including diagnostic evaluations, individual, group, and family therapy, and psychological assessment. The core of the program is outpatient service units (described below) in order to expose the intern to a range of children and families, treatment modalities, and assessment experiences. The training program begins September 1st. The intern's weekly activities are roughly as follows:
| Outpatient Therapy/Pediatric Outpatient | 15 hours |
| Pediatric Consultation Service/Emergency Dept | 5-8 hours |
| Assessment | 5 hours |
| Supervision | 3-4 hours |
| Didactics | 4 hours |
| Staff Meetings | 1-2 hours |
| Record Keeping/Report Writing/Tape Review | 3-5 hours |
| Research | 0-5 hours |
The program is a 2,000 hour internship designed to occupy 40 hours per week of a trainee's time, although actual time may vary due to extra time needed to complete reports and other paperwork, make telephone contacts, attend special meetings such as school meetings, or provide home-based interventions.
The training program at the Texas Child Study Center holds itself to the highest standards of ethical and professional conduct, as outlined in the APA "Ethical Principles of Psychologists and Code of Conduct." Training program staff and supervisors are considered professional role models, and interns are entitled to fair treatment and due process, should grievances arise.
Clinical Services
Each intern will carry an outpatient caseload that includes 12-15 outpatient cases which will include 3-6 specialty cognitive behavioral cases. Interns are expected to complete 2 assessments per month. Each intern spends one day a week in one of our multidisciplinary clinics (obesity and concussion). Finally, interns will have year long experiences with the Dell Children's Medical Center Emergency Department and Consultation and Liaison Service.
Outpatient Therapy Program
General outpatient cases include children with a wide range of presenting issues that range from adjustment disorders to chronic disorders including mood disorders, psychosis, and autism. Through the Outpatient Program, interns will gain experience in providing diagnostic evaluations, designing integrative treatment plans, and providing intervention to a diverse caseload. For cognitive behavioral cases, interns are expected to follow evidence based protocols for anxiety disorders, disruptive behavior, and depression. Examples include exposure and response prevention for OCD, parent-child interaction therapy or didactic parent training for disruptive behavior, exposure therapy for phobias, interoceptive exposure for panic, and cognitive behavioral therapy for depression.
Assessment Program
Referrals for the assessment program originate from a variety of sources, including internal referrals from other TCSC clinicians, physicians in the Seton Family of Hospitals, and other community agencies and practitioners. Referral questions include diagnostic clarification, assessment of learning disorders, and questions about executive functioning. Interns will interview, observe behavior, administer, score and interpret a variety of measures, formulate diagnoses and recommendations, write a comprehensive report based on their findings, and provide oral feedback to patients and families. Assessment sessions will be scheduled on an individual basis in each intern's schedule.
Pediatric Services:
Emergency Department
Each intern will have one 6 month rotation providing consultation and triage within the Emergency Department at Dell Children's Medical Center. This experience provides training in the management of psychiatric emergencies, including diagnostic interviewing, formulation, triage, and the hospital admission process. Additionally, crisis intervention skills will be utilized as needed to support children and families within an emergency context.
Consultation and Liaison Service: Each intern will have one 6 month rotation with the Psychiatry Consultation Service providing mental health consultation and liaison to medical teams at DCMC. Psychology interns will also engage in therapeutic interventions such as behavioral medicine techniques, coping skill building, and family support as needed within the hospital setting. Consultation for children with acute and chronic illnesses include but are not limited to medically unexplained pain, gastrointestinal illness, asthma, cystic fibrosis, renal disorders, toxic ingestion, and eating disorders. Within the consultation service, a multidisciplinary team has been created for the medical stabilization of patients with eating disorders that is lead by the Psychiatry Service. Interns will have the opportunity to actively participate as members of this team.
Obesity Program: TCPTCO (Texas Center for the Prevention and Treatment of Childhood Obesity)One intern will have the opportunity to participate in a training experience with the Texas Center for the Prevention and Treatment of Childhood Obesity at Dell Children's Medical Center (Dr. Jane Gray is director of psychology). TCPTCO offers interdisciplinary evaluation and treatment for children presenting with obesity and associated medical and psychiatric comorbidities. The interdisciplinary team includes experts in pediatrics, nutrition, physical therapy, social work, and psychology. Interns will have the opportunity to learn obesity-specific cognitive behavioral intervention, participate in an interdisciplinary group program for overweight youth which includes nutrition, physical activity, and mental health components, provide individual and family therapy to children and families, and participate in multidisciplinary team meetings and trainings
Concussion Program
One intern will have the opportunity to participate in a training experience through The Concussion Program at Dell Children's Medical Center (Dr. Emily Greenspahn is the consulting neuropsychologist for the program). The Concussion Program provides multidisciplinary evaluation including follow up neurological exam, computerized neurocognitive assessment, and formal assessment of balance and postural stability to determine if a patient has recovered from their injury. The interdisciplinary team of specialists consists of practitioners from neurosurgery, neurology, neuropsychology, and physical therapy. When indicated, patients are referred for mental health services at TCSC, which can include comprehensive neuropsychological evaluation, psychotherapy, and/or psychiatric medical care. The intern will have the opportunity to participate in weekly concussion clinic reviewing cases with the multidisciplinary team. They will then provide individual and family therapy for some of the children and families that are identified as needing psychotherapy services. As their patients are followed through the clinic they will have the opportunity to report on their progress in psychotherapy and address any barriers to treatment that could be addressed by the team.
Didactics
Interns will participate in approximately four hours of didactics per week, including seminars in assessment, advanced cognitive behavioral intervention, pediatric psychology, and a seminar in cultural diversity, integrated health care, and family therapy. These seminars serve the purpose of integrating clinical case material, theory, research, cultural diversity, and professional issues. Some didactics are open to trainees from other disciplines (e.g. psychiatry) and levels of trainings (e.g. practicum students and postdoctoral fellows). Additionally, trainees are provided with the opportunity to attend the Dell Children's Medical Center Psychiatry Rounds, Psychiatry Journal Club, and a monthly neuropsychology seminar held at the Austin State Hospital.
Supervision
Interns receive individual supervision for all clinical activities. Supervisory hours are adjusted to meet the trainee's needs, and all interns receive at least four hours of supervision from two different supervisors, with at least one hour per week for assessment, two hours per week for therapy cases, and one hour for group supervision. Supervision largely follows an evidence-based, cognitive behavioral framework for the specialty programs, and a more integrated approach for general outpatient therapy cases. Interns are expected to come to supervision prepared with case conceptualizations and a biopsychosocial formulation. The theoretical framework for supervision takes environmental, cultural, developmental, and family systems factors into account in case conceptualization.
Supervision is provided chiefly by psychologists, all of whom are licensed to practice in Texas. Specialized supervision in some service units may be provided by fully licensed senior social workers or staff psychiatrists.
Research
The focus of the internship year is on clinical training; however, research training and supervision are available to trainees on an individualized basis. There are many ongoing intervention research projects at the Texas Child Study Center, many of which are collaborations with physicians at Dell Children's Medical Center. Most interns will be involved in these research projects by providing the clinical services being evaluated. Interns may also have the opportunity to work directly on these projects (data collection and analysis, writing). Interns may spend approximately 5 hours per week on research by participating in ongoing research projects and/or completing dissertation research and writing.
Salary and Benefits
The yearly stipend for the internship program is $26,000. Health benefits are offered through the University of Texas. Interns receive three weeks of vacation, 1 day of sick leave per month (accrued monthly), and 3 days of professional development/dissertation release time.
Requirements for Completion of Internship:
Interns will receive a certificate of completion at the end of the internship year upon satisfaction of the following:.
- Completion of 2000 hours (12 months full time) during the internship year.
- Satisfactory performance and progress in clinical work and professional conduct as measured by bi-yearly evaluations.
- Attendance in seminar programs and clinical staff meetings.
- Satisfactory completion of a minimum of 10 assessment cases and 15 therapy cases.
Application Procedure
The application deadline is November 15, 2011. Applicants will be notified by Monday, Dec. 12th as to whether they will be offered an interview. Interviews are required in order for applicants to be considered and will be held during the month of January.
The Texas Child Study Center adheres to a policy of nondiscrimination in the recruitment of employees or trainees. We welcome and encourage applications from all qualified trainees. The internship program is open to advanced level predoctoral psychology graduate students enrolled in doctoral programs in school, clinical, or counseling psychology.
Your application should include:
- APPIC application form
- Curriculum Vitae
- Official transcript(s) of all graduate work
- Three letters of recommendation
- Sample assessment report (be sure to delete all identifying information)
All documents should be submitted through the AAPI online portal. The Texas Child Study Center is a member of APPIC and will participate in the 2012 Match.
INTERNSHIP TRAINING FACULTY
DeLeon, Rosario, Ph.D.
Neuropsychology; Chronic Illness, Oncology, Traumatic Brain Injury, Epilepsy, Learning Disorders
Gray, Jane Simpson, Ph.D.
Director of Training
Childhood Obesity, Child/Adolescent Depression, Treatment Evaluation
Greenspahn, Emily, Ph.D.
Neuropsychology; Chronic Illness, Oncology, Traumatic Brain Injury, Epilepsy, Learning Disorders
Levine, Ann, Psy.D.
Director of Assessment Services
Neuropsychology; Autism and Autism Spectrum Disorders
Patel, Puja, Ph.D.
Pediatric Consultation and Liaison, Pediatric Oncology, Cognitive Behavioral Therapy
Reeves, Shanna, Ph.D.
Pediatric Oncology, Cognitive Behavioral Therapy, School Consultation, Family Therapy
Stark, Kevin D., Ph.D.
Director of Psychological Services
Treatment Evaluation, Pediatric Trauma, Child/Adolescent Depression
Streusand, William, M.D.
Medical Director
Tieu, Cuong, M.D.
Pediatric Consultation and Liaison