Psychiatry and Behavioral Sciences
Adding Elective Rotations to Customize Your Training
As mentioned elsewhere on this site, we pride ourselves in being able to offer our interns tremendous flexibility in and around the core rotations of all three Specializations. In fact, there is almost no limit to the number of ways in which the internship year at Montefiore Medical Center can be customized! For example, an elective rotation may be added in order to fill a gap in an your training (e.g., working in the psychiatric Emergency Room as an elective for interns in the Child and Adolescent Specialization) or to expand upon your existing knowledge, skills, and abilities (e.g., learning how to apply CBT for patients with Insomnia through an elective in our behavioral sleep medicine program). Each intern matching with us will be encouraged to think of his or her own specific interests and/or training needs and goals when considering which (if any) electives to add to the core rotations.
In addition to choosing which electives to add, interns are also able to choose how to structure certain electives, depending on the Specialization. For example, interns in the Adult Specialization, the electives usually occupy either a half or full day per week for 6 months during the Adult Outpatient Psychiatry Department rotation, but certain electives can also be made (or combined) into full-time rotations for up to 1-2 months (with a corresponding reduction in the time spent on one or more of the other core rotations). For interns in the Child and Adolescent Specialization and the Combined Specialization, electives usually take place one day per week during the first 11 months of the academic year, and many can also be made into a more intense, 2-3 day rotations during the last month of the internship.
|2012-13 Interns and Faculty at the First Day Orientation Meeting.|
Addiction Psychiatry Consultation Service in Psychosomatic Medicine
The Addiction Psychiatry Consultation Service in Psychosomatic Medicine provides consultation liaison services to medically complex patients with admixtures of physical, mental, social and health problems admitted to the general hospital with substance use related-co-morbidity. During this rotation, interns learn specific evidence-based interventions for substance abuse, including Motivational Interviewing and Harm Reduction and Relapse Prevention, while in the role of a consultant. Interns also learn how to screen for addiction problems, differential diagnosis (e.g., delirium versus toxicity), withdrawal management, use of appropriate psychotropic medications, pain management in the addicted patient, and how to formulate and implement an appropriate treatment plan for patients with co-occurring medical and substance use problems. Interns are part of a busy and visible teaching service team, including Psychiatry Residents, Addiction and Psychosomatic Fellows, and first year medical students and psychology externs, and interact with a range of other disciplines and treatment teams throughout the hospital. Individual supervision of at least one hour per week is provided by a licensed psychologist: Dr. Brenda Chabon.
Adolescent Depression and Suicide Program (ADSP)
The ADSP is a specialty outpatient program serving depressed and suicidal teens (ages 12-19) and their families. Many of these adolescents have experienced significant abuse and have comorbid anxiety, substance-related, personality and disruptive behavior disorders. When selected as an elective rotation, interns would carry 1-2 Dialectical Behavior Therapy cases and join the DBT consultation team. Individual supervision of at least one hour per week is provided by one of the adherent DBT therapists on staff, such as: Dr. Alec Miller and Dr. Heather Smith.
Adult Psychiatric Inpatient Unit
The Inpatient Psychiatric Unit is a locked 22-bed unit within the general hospital for adult psychiatric patients. This rotation provides an excellent opportunity for interns to be exposed to severe psychopathology, to work within a multi-disciplinary treatment team and to hone their psychological assessment skills. Psychology Interns serve as primary therapists for patients presenting with a range of affective, psychotic and neuropsychiatric disorders. Interns are responsible for conducting the initial diagnostic evaluation, providing individual and family psychotherapy, and working in close collaboration with the attending psychiatrist and social worker to monitor patients' responses to treatment and formulate disposition plans. Interns also participate in the unit's group therapy program, as group leaders and peer supervisors. During this rotation, interns have the opportunity to perform brief psychological and neuropsychological assessments and to observe patients with unusual neurological and neuropsychiatric conditions. This service is also a training unit for psychiatrists, neurologists, social workers, medical students, nurses and art therapists. Individual supervision of at least one hour per week is provided by a licensed psychologist: Sharon Spitzer, PsyD.
Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center
The Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center provides interns with the opportunity to learn about the diagnosis and treatment of patients who have severe or long standing problems associated with sleep and waking. Interns can participate in the evaluation of patients who have insomnia, circadian rhythm disorders, nightmares, nocturnal panic disorder, narcolepsy and CPAP compliance difficulties, and learn cutting-edge treatments, such as CBT-I and Imagery Rehearsal Therapy (IRT) for Chronic Nightmares. Though mostly focused on work with adults, child and adolescent patients are occasionally seen. Interns can also observe polysomnography sleep studies. Interns are also given the opportunity to attend a weekly sleep-wake case conference. Individual supervision of at least one hour per week is provided by a licensed psychologist who is board-certified in behavioral sleep medicine: Shelby Harris, PsyD, C.BSM.
Butler Child Advocacy Center (CAC)
The Butler Child Advocacy Center (CAC) of Montefiore Children’s Hospital offers interns the opportunity to develop an essential awareness of the field of child abuse treatment, as well as familiarity with the functioning of child protective services. Interns will learn about cases during the fact finding phase, through observation of forensic interviews, conducted by a multidisciplinary team of pediatricians and nurse practitioners, social workers, ACS workers, NYPD detectives (special victims unit) and Assistant District Attorneys. Interns then carry cases in the mental health assessment and treatment phase. The model of intervention is Trauma-focused Cognitive Behavior Therapy (TF-CBT). There may also be opportunities to participate in leading adolescent or parent groups. Individual supervision of at least one hour per week is provided by two licensed psychologists: Nicole Cox, PsyD and Rachel Sheffet, PsyD.
Children’s Hospital at Montefiore (CHAM) Behavioral Consultation Team
The Children’s Hospital at Montefiore (CHAM) Behavioral Consultation Team gives interns the opportunity to develop an understanding of the ways in which acute and chronic medical illness affect the lives of children and their families, using an ecological developmental model. Interns can choose from several different clinical opportunities which may include the creation and co-leadership of outpatient groups for children with chronic illness, conducting individualized CBT and DBT interventions for patients struggling to adhere to their medical regimen or adjust to illness, and consulting to the medical team to provide education about psychosocial issues in the pediatric population. Interns will also provide psychological assessment and consultation to children, families, and medical teams in the inpatient setting. Opportunities for research participation are also available on several ongoing projects (e.g., DBT for medical non-adherence, neuropsychological assessment of sickle cell disease). Individual supervision of at least one hour per week is provided by two licensed psychologists: Becky Hashim, PhD and Leslie Cunningham, PhD.
Child Outpatient Psychiatry Department (COPD)
The COPDs treat a heterogeneous group of children and adolescents (ages 4-17) with diagnoses ranging from disruptive behavior disorders, anxiety and depressive disorders, and psychotic disorders to adjustment disorders and learning disabilities. When selected as an elective rotation, interns would carry 1-2 child or adolescent cases and receive comprehensive, one-on-one supervision of at least one hour per week from licensed psychologists in the clinics with either psychodynamic, cognitive behavioral, dialectical behavioral, or integrative perspectives. Interns also learn how to liaison with schools, foster care agencies, the Committee on Special Education and other relevant organizations. Individual supervision of at least one hour per week is provided by one of the licensed psychologists on staff, such as: Dr. Alec Miller, Dr. Heather Smith, Dr. Jenny Seham, Dr. Michelle Lupkin, or Dr. Laura Goorin.
Comprehensive Services Model (CSM) Program
The CSM is a program funded by New York City's Human Resources Administration (HRA) to provide evaluation and case management services to substance abusing public assistance recipients in the Bronx, with the goal of assisting them to engage in treatment, become clinically stable, and ultimately self-sufficient through employment. Interns selecting this rotation are able to conduct evaluations for employability, as part of a comprehensive case management program for substance abusing welfare applicants. Interns can also learn about disability and employability criteria and decision-making. Individual supervision of at least one hour per week is provided by Joanne Pearl, CSW.
Family Treatment and Rehabilitation Program
The Family Treatment and Rehabilitation Program (FT/R) is dedicated to providing comprehensive child-centered, family-focused and strengths based services designed to address the safety and well-being of children and families in the Bronx impacted by a range of challenging family situations, including mental health and/or substance abuse concerns, domestic violence, trauma and poverty. The ultimate goal of the FT/R program is to support families whose children are at-risk for foster care placement. This is accomplished by bringing together formal and informal networks of individuals and agencies that work to support and strengthen families own capacity to meet its needs and nurture and care for their children in their homes. All families accepted into our FT/R program receive a comprehensive family assessment, intensive case management, ongoing monitoring, and supportive service referrals. This rotation offers a broad array of clinical training opportunities, including opportunities to conduct comprehensive clinical assessments with adults and children, provide ongoing supportive services to families, and serve as an integral part of an interdisciplinary FT/R team, committed to maintaining the safety and well-being of children and families in the Bronx. Interns are also able to gain experience in doing supervision, by accompanying the case management staff conducting home visits and sitting in on weekly onsite supervision meetings of the case management staff. Individual supervision of at least one hour per week is provided by a licensed psychologist, Anita Jose, PhD.
Interns interested in working with older psychiatric patients may request cases from the Geriatrics service of the Adult Outpatient Psychiatry Department. Interns in all specializations with a particular interest in geriatric psychiatry may also create a more intense elective experience that can include providing care at area nursing homes, conducting home visits, and participating in an array of inter-professional seminars and case conferences conducted in collaboration with the training program of the Division of Geriatric Medicine. Interns choosing this elective would also have opportunities to work with Holocaust survivors and participate in NIMH-sponsored research. Individual supervision of at least one hour per week is provided by one of two geriatric psychiatrists: Gary Kennedy, MD and Alessandra Scalmati, MD.
Managed Addiction Treatment Services (MATS) Program
MATS is an innovative case management program designed for the highest utilizing substance abusing Medicaid patients in the Bronx. The aim of the program is to help stabilize substance abusing patients by coordinating their care so that they remain in treatment rather than using inpatient detoxification services. Interns would learn about accountable care and health care reform during this rotation. Individual supervision of at least one hour per week is provided by Don Bux, PhD.
Neuropsychology Assessment Service
Interns may elect to perform additional neuropsychological testing with adult, child, or pediatric inpatients and outpatients referred to the Neuropsychology Assessment Service. The Neuropsychology Service provides assessment and diagnosis of the cognitive and behavioral effects of various neurological and psychiatric disorders, including traumatic brain injury, dementia, stroke, multiple sclerosis, brain tumors, lupus, epilepsy, learning disabilities and attention deficit disorder. These batteries are supervised by a licensed psychologist who is board-certified in neuropsychology: Bryan Freilich, PsyD, ABPP.
Psychiatry AIDS Connected Ambulatory Program/HIV Clinic (PACAP)
Interns interested in working with patients with HIV disease or their significant others may be assigned cases in the Psychiatry HIV Program. Cases involve a wide range of Axis I and II pathology not limited to health-related concerns, and are treated with a similarly wide range of therapeutic interventions. Individual supervision of at least one hour per week is provided by a licensed psychologist who is board-certified in clinical psychology: Loren Soeiro, PhD, ABPP
Psychiatric Observation Suite (POS) - Psychiatric Emergency Room
The Psychiatric Observation Suite (aka the “Psych ER”) is a five-bed crisis intervention service within the general Emergency Department, which is the busiest of all the city's hospitals, and the second-busiest emergency room in the nation. This rotation introduces interns to patients that are in an acute state of decompensation and distress. Interns learn to quickly diagnose patients, make triage and referral decisions, perform suicide and violence potential assessments, and do crisis intervention. Interns work closely with psychiatrists, nurses and social workers. Individual supervision of at least one hour per week is provided by the medical director, Paul Jayson, MD.
Many of the psychology faculty members at Montefiore Medical Center are active in research or writing on topics such as anxiety and depression, personality disorders, behavioral health services utilization, cognitive behavior therapy, dialectical behavior therapy, adolescent suicide, neuropsychology, and applied clinical research using case studies or groups treated with evidence-based therapies and assessed using empirically-based measures. Interns interested in clinical research opportunities can elect to protect time for mentored research, with proportionate reductions in their clinical case loads. Interns have historically participated in all aspects of research including: literature review, study design, subject recruitment and data collection, data analysis, and dissemination of findings. Interns also frequently present at scientific conferences and in the community, and have also served as co-authors on numerous scholarly papers and book chapters. Research mentors include: Drs. Alec Miler, Scott Wetzler, Simon Rego, and Miguelina Germán.
Substance Abuse Treatment Program (SATP)
The SATP treats opioid dependent patients in a comprehensive methadone maintenance program and provides outpatient treatment to adults with addictions to various substances. Interns may gain experience in assessment, consultation, individual therapy, and group treatment, including the use of Acceptance and Commitment, Cognitive Behavioral, Motivational Interviewing and Psychodynamic interventions. Individual supervision of at least one hour per week is provided by Katherine Mitchell, PsyD and Vicky Brady, PsyD.
Supporting Healthy Relationships Program
This is a unique opportunity to gain experience working on a federally-funded marriage education research program serving couples in the South Bronx. The program, called Supporting Healthy Relationships (SHR), is designed specifically to enhance relationship skills and strengthen relationships for low-income couples in the greater NYC area. The curriculum utilized is John and Julie Gottman’s Loving Couples Loving Children which was shaped by Gottman’s many years of research on marital functioning. This rotation offers a broad array of clinical training opportunities, including: conducting clinical assessments with couples and individuals, co-leading relationship education groups, designing and leading groups on topics of the intern’s choice, providing ongoing supportive services to couples, as well as contributing to marital research/program evaluation projects (as available). Individual supervision of at least one hour per week is provided by Jantra Coll, PsyD.
Transplant Surgery Programs
The psychosocial service to the Transplant Surgery Programs provides consultation to all the solid organ transplant teams at the medical center. Psychiatrists, psychologists, consultation liaison fellows, and social workers are key participants in the multidisciplinary team that evaluates patients with congestive heart failure, liver diseases, and kidney failure. Interns will have the opportunity to carry a small caseload of transplant patients for individual psychotherapy, meet weekly for supervision, attend meetings for psychiatric/medical consult (when needed), attend selection meetings, observe and participate in multidisciplinary teams as they make crucial decisions related to transplant listing and treatment planning, participate in bedside evaluations/interventions, co-lead existing intervention/support groups, lead one or two psycho-educational group meetings on a topic of interest to them and pertinent to the patient population (mindfulness, reward planning, cognitive restructuring, insomnia, weight management, interpersonal effectiveness, etc.), and attend multidisciplinary psychiatric didactic meetings. The schedule for this rotation is flexible, and, within reason, can be tailored to an intern’s availability. The psychologist is on site Tuesdays, Wednesdays, and Thursdays, so the intern must be available for supervision on one of those days. Individual supervision of at least one hour per week is provided by Meredith Townes, PsyD and Paula Marcus, MD.
University Behavioral Associates
University Behavioral Associates is an innovative managed care company founded by the Department of Psychiatry at Montefiore Medical Center which delivers behavioral health services to a large population in the Bronx. Interns choosing this elective learn about models of health care reform, managed care, utilization review, and reimbursement methodologies. Interns may also get involved with any of the ongoing research projects being run at UBA. Individual supervision of at least one hour per week is provided by Scott Wetzler, PhD.