The Southern Vermont Doctoral Internship in Psychology program provides advanced training in the area of adult mental health with a specialized focus in clinical neuropsychology and the assessment of older adults. Interns are also encouraged to discuss any interests they may have that are not readily available within the internship program. Further opportunities can be sought in the community to provide the intern with a training experience that best matches his/her interests and future goals and allows him/her to gain exposure to a more diverse clinical population. Examples of programs developed by former interns have included working with children as part of the Head Start program, seeing clients at a local medical center, and working with teenagers at a local high school. Appropriate supervision is arranged for all of the above experiences.
Initially, each intern participates in a month long orientation comprised of didactics, observation and extensive individual and group supervision. All incoming interns are required to read scholarly materials discussing relevant issues in assessment of adult and geriatric populations, including “Memory Loss: A Practical Guide for Clinicians”, which is a comprehensive guide to assessment and diagnosis of memory impairments. Each intern also participates in a 2-hour training seminar on the establishment of differential diagnoses of dementing disorders. Interns review the handbook on protocol administration and observe licensed psychologists performing semi-structured intake interviews and neuropsychological assessments. Interns also attend didactic seminars in which protocol administration, scoring and interpretation of subscales commonly used in the neuropsychological evaluations are discussed. Prior to interacting with patients, interns are required to complete NIH Protection of Human Subjects in Research and HIPPA training modules.
To gain proficiency in report writing, interns review prior evaluations and assist with the preparation of evaluations for the patients he/she observed. Periodic individual and group supervision sessions are implemented to address questions regarding assessment. Once a sufficient level of proficiency is established, the intern performs assessments under the observation of a licensed psychologist and writes comprehensive neuropsychological evaluations with the designated supervisor.
Self and supervisor evaluations of intern’s proficiency in five core competency domains (outlined in Program Goals and Objectives) are performed during orientation and are used to create an individualized training experience that promotes the intern’s professional development.
Interns undertake a number of weekly and monthly didactic activities during their internship training. These include, but are not limited to, the following:
The Weekly Neuropsychology / Assessment Seminar
- Provides an overview of neuropsychological testing as well as other instruments that are often incorporated into an evaluation such as intellectual and personality assessments
- Training, discussion and review of specific instruments such as the Wechsler scales, ADAS-COG, DKEFS, and MMPI
- Overviews of Frequent Neuropsychological Diagnosis
- Behavioral Assessments
- Forensic Assessments
- Mood Assessments
- Pharmacological Interventions
- Assessment in evidenced based research & practice
- Cultural issues in assessment
Weekly Case Conference & Presentation
- Interns participate in a weekly group presentation of a recent case including history, evaluation, formulation, differential diagnosis and treatment recommendations
Monthly Topics in Psychology Seminar
- The Role of Culture and Diversity in Psychology
- Ethics in Practice
- Professional Development (consultation, licensure, teaching, board certification, forensics)
- Evidenced Based Practice
- Differential Diagnosis
- Caregiver Support
In addition to the didactic trainings, interns are required by SVDIP to complete a series of mandatory on-line trainings that are required of all staff and clinicians. For example, interns must compete the National Institutes of Health, “Protecting Human Research Participants,” online module. Interns are also invited to attend and participate in a range of optional lectures and presentations held at nearby institutions such as Williams College and Southern Vermont College where staff hold faculty appointments. Additionally, interns are required to help facilitate community memory screening days in the surrounding community. Interns also have the option to attend and present at any meeting or conference at which their work has been accepted.
Assessment and Intervention Activities
Following the training period, interns participate in direct client contact through assessment and intervention activities. A comprehensive assessment is performed on each new patient and abbreviated assessments are performed on follow-up patients. In terms of assessment, an average weekly caseload for each intern is 2 to 3 new patients and 5 to 6 follow-up patients. Interns also provide supportive therapy to individuals diagnosed with depression and anxiety and family members/caregivers of patients referred for memory impairments. Interns are typically assigned 2 to 4 long-term therapy clients.
Assessment is an integral part of the internship. Given the location of the internship program, referrals for assessment are accepted from practitioners throughout Vermont, New York and western Massachusetts. Upon receipt of a referral, the intern will be paired with a supervisor who oversees all evaluative care of the patient. Each intern is supervised in the following clinical activities of the assessment process:
- Review of medical records
- Clarification of the presenting problem
- Performing intakes and clinical interviewing with clients and family members
- Selection of the appropriate assessment battery
- Administration and scoring of psychological and neuropsychological assessments
- Interpretation of assessment results
- Qualitative analysis of client behavior during the clinical interview and evaluation sessions
- Observation of neurological exams and review of MRI imagining findings by the neurologist
- Writing comprehensive reports that integrate medical records, clinical history, behavioral observations, psychological and/or neuropsychological assessment results and differential diagnosis and include recommendations for treatment and/or additional evaluation
- Consultation with patient and family/caregiver, referring physicians and other healthcare providers to communicate evaluation findings and recommendations
The Memory Clinic also offers free counseling to patients diagnosed with depression or anxiety associated with dementia as well as family members/caregivers. Depending on need, interns are typically assigned 2 to 4 long-term therapy patients. The intern is responsible for conducting an intake interview, formulating a diagnosis and establishing an empirically supported treatment plan under the supervision of a licensed psychologist. The SVDIP program is also in the process of establishing a supportive group therapy for caregivers, which will be lead by an intern and a licensed psychologist.
Cultural Sensitivity and Awareness
The SVDIP program is committed to training diverse groups of interns who will be prepared to provide mental health services as well as conduct research, in order to strengthen the professional capacity of psychology to address the needs of the increasingly diverse populations of both Vermont and the United States. The Memory Clinic is based in a rural setting in Southern Vermont and is the only specialty clinic within a 150-mile radius. As such, the clinic receives referrals from individuals residing in both urban and rural settings with diverse educational, vocational and religious backgrounds. An integral part of the training program is promoting culturally sensitive practices of mental health care.
Interns spend a minimum of 4 hours per week participating in individual and group supervision. Each intern is assigned a supervisor for supervision of assessment and intervention activities and participates in one hour of supervision for each on a weekly basis. Supervisors are also accessible for informal supervision during the week if questions or issues arise. In addition, interns participate in group supervision for at least 1 ½ hours per week where intakes and client assignments are discussed. Once the intern demonstrates competency in assessment and diagnosis he/she will be permitted to assist in the training and supervision of undergraduate interns majoring in psychology.
- Individual Supervision — Each intern receives a minimum of 2.5 hours of individual supervision weekly from licensed psychologists. These supervisors maintain full responsibility for each intern’s work.
- Group Supervision — Interns receive 1.5 hours of group supervision per week by one of the programs supervisors.
- Seminar Presentations — Throughout the internship, interns receive group supervision, during seminar based case presentations. These presentations are drawn from their own cases and focus on issues of assessment, treatment planning, intervention, cultural competence and ethics.