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| Interns at a private lunch with Dr. Jonathan Abramowitz after his presentation in the Department of Psychiatry Grand Rounds |
The AOPD for our Adult Specialization is a general catchment area clinic located on the ground floor of the Klau Pavilion on the Moses Campus. It serves a heterogeneous group of approximately 1,300 adult outpatients presenting with a variety of psychiatric disorders, including mood and anxiety disorders, personality disorders, psychotic disorders, and psychiatric disorders associated with chronic medical conditions and infectious diseases. Patients are seen in individual, group, couples or family therapy, and many receive psychopharmacologic treatment as well.
Interns are responsible for all phases of outpatient psychiatric care, including at least 5 structured diagnostic intake evaluations, treatment planning, and provision of psychotherapy – which often includes sharing care with psychiatrists or psychiatry residents who are prescribing medications (when necessary). Interns in the AOPD rotation typically see approximately 16 patients for weekly appointments during this six-month rotation, but also carry 2-3 AOPD patients when off-service, for longer-term care.
There is no single therapeutic approach or orientation in the AOPD. Interns receive comprehensive, one-on-one supervision from licensed psychologists with expertise in cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), psychodynamic (PD) therapy, acceptance and commitment therapy (ACT), mindfulness, integrative perspectives, and more. Interns may request supervisors with expertise in a specific theoretical orientation. Otherwise, interns are assigned to a variety of supervisors so that they may be exposed to a range of therapeutic approaches.
During this rotation, interns also co-lead 1 group, attend a weekly case conference, and complete at least one neuropsychological assessment. Interns are also assigned to a multidisciplinary treatment team led by an attending psychiatrist, with an attending psychologist, social workers and psychiatric residents all part of the team. They also participate in the Adult Dialectical Behavior Therapy (DBT) program via attending a weekly DBT consultation team meeting, and have the option to receive individual DBT supervision, serve as primary therapist for individual DBT cases, and co-lead a DBT skills group.
The Psychiatric Observation Suite (POS) is a 5-bed unit within the psychiatric emergency room of the Emergency Department (ED) at the Moses Campus. It constantly ranks as one of the country’s busiest EDs and is the most-visited in the state of New York! Patients are seen either in the POS or as a psychiatry consult in the medical or pediatric ER. Patients, most of whom are acutely ill, are seen for immediate evaluation, crisis intervention, and disposition. The length of stay in the ED is largely dependent on bed availability for admission, which could be a little as a few hours or at most a few days. As such, interns learn to quickly diagnose patients, make triage and referral decisions, perform suicide and violence potential assessments, and do crisis interventions. Patients are assigned to interns by the medical director, Dr. Paul Jayson and are supervised closely by Dr. Jayson and the other attending psychiatrists. Interns also work closely with the Chief Resident, nurses and social workers and attend daily rounds and meetings.
The Addiction Psychiatry Consultation Service in Psychosomatic Medicine provides consultation liaison services to medically complex patients with a range of medical, psychological, and social issues, admitted to the general hospital with substance use related-co-morbidity.
During this rotation, interns learn how to screen for substance use disorders, 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 issues.
Specific evidence-based interventions that are modeled and taught include Motivational Interviewing, CBT for Substance Use Disorders, Harm Reduction, and Mindfulness-Based Relapse Prevention. A busy and visible teaching service, interns are part of a team that includes Psychiatry Residents, Addiction and Psychosomatic Fellows, and medical students and interact with a range of other disciplines and treatment teams throughout the hospital.
The service averages 80-100 patients per month, and interns typically conduct 10-15 written consultation reports and 2-3 follow-up visits with each patient during the hospital stay. Dr. Brett Simpson provides supervision of interns in their clinical evaluation of patients, as well as in their consultative role to other providers.
All interns are required to participate in research and will have protected research time for a <b> minimum </b> of 1 day per week for 4 months (with the option to extend to 1 day per week for up to the entire internship year).
The psychology faculty at Montefiore are currently involved in research in number of different areas, including: anxiety and depression, personality disorders, behavioral health services utilization, psychological assessment, cognitive behavior therapy, dialectical behavior therapy, adolescent suicide, and eating disorders. Interns may select a faculty member from our Research Mentor List or request an alternate mentor (e.g., a professor from their graduate institution) with whom the intern already has – or would like to form – a mentor-mentee relationship.
Research mentors provide a minimum of 1 hour per week of supervision to the intern during their research rotation. Mentors may help the intern develop and carry out a new project or may have an existing project which the intern can contribute to in a substantial way. Examples of scholarly projects include hypothesis-driven studies, descriptive studies (e.g., chart reviews, questionnaire administration), secondary analyses of existing data sets, and literature reviews. Surveys, QI projects, or program design, implementation, and evaluation projects that benefit our patients or services will also be considered. Regardless of the type of project, the intern should be able to take ownership of a significant aspect of it, and it should lead to a “deliverable" (e.g., manuscript suitable for journal submission or abstract suitable for conference submission) at the local (including the host institution), regional, or national level by the end of the internship year.
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| Interns at a private lunch with Dr. David Moscovitch after his presentation in the Department of Psychiatry Grand Rounds |
The Child Outpatient Psychiatry Department is located in its own building just minutes from the entrance to the Moses Campus. It serves a heterogeneous group of children, adolescent and emerging adult patients (ages 4-21) with diagnoses ranging from disruptive behavior disorders, anxiety and depressive disorders, psychotic disorders, adjustment disorders, and learning disabilities. Interns in the COPD will serve as primary therapists for individual and family cases (patients will be assigned across all ages and diagnoses), co-therapists for group therapy, and will conduct evaluations of children, adolescents and emerging adults. During this yearlong rotation, interns receive intensive training and supervision in family therapy, cognitive behavior therapy, dialectical behavior therapy, psychodynamic therapy and group therapy. Interns participate in multidisciplinary team meetings and also learn how to liaison with schools, foster care agencies, the Committee on Special Education and other relevant organizations.
The Anxiety and Mood Program (AMP) at Montefiore Medical Center’s Child Outpatient Psychiatry Department is a specialty program that offers evidence based interventions for children, adolescents, and emerging adults with primary and comorbid anxiety, trauma, mood, and related disorders. AMP serves children, adolescents, and emerging adults, ages 4 to 21 years old, and families from the surrounding Bronx communities. Interns will learn to conduct comprehensive intake assessments (e.g., ADIS) and will serve as primary therapists for youth experiencing anxiety (e.g., social anxiety disorder, generalized anxiety, separation anxiety disorder, panic disorder, phobias, OCD, PTSD), depression, tics, trichotillomania, and related concerns. During this rotation, interns will provide individual and family-based cognitive behavioral treatments (e.g., Coping Cat, Exposure/Response Prevention, Trauma-Focused CBT, Comprehensive Behavioral Intervention for Tics, Parent Management Training), and can elect to serve as co-leaders in Cognitive Behavioral Group Therapy for socially anxious adolescents, Behavior Regulation Movement Groups, or ADHD Skills Groups. Interns will participate in multidisciplinary team rounds, and collaborate with teachers, school personnel, pediatricians, or other providers who may be involved in the child or teen’s care. Interns also have the opportunity to participate in scholarly activities, including authoring articles, presenting at conferences, conducting research and leading workshops and in community service events for local groups.
The Adolescent Dialectical Behavior Therapy Program (A-DBT) is a specialty outpatient program within the Anxiety and Mood Program that serves depressed and suicidal teens and emerging adults (ages 12-21) and their families. Many of these adolescents have experienced significant trauma and have comorbid anxiety, substance-related, personality and disruptive behavior disorders. During this rotation, interns learn to conduct comprehensive diagnostic interviews and Dialectical Behavior Therapy. Interns serve as primary therapists for individual and family cases and co-therapists for DBT multi-family skills training and graduate groups. Interns also learn crisis intervention skills. Interns will receive individual supervision and participate in DBT consultation team.
The Child and Adolescent Assessment Service within the COPD helps interns develop proficiency in child/adolescent psychological, diagnostic, and neuropsychological testing. At a minimum, interns administer five comprehensive psychological evaluations during the year, with more available for those interested in developing special expertise. Referral questions typically include assessing for the presence and type of learning disabilities, assessing for the presence of a wide range of diagnoses and the potential need for medication, differential diagnosis, and evaluating the presence of neuropsychological deficits. Supervision highlights the impact of cultural differences and bilingualism, and employs a developmental framework. Exposure to more traditional instruments, as well as newer, empirically-driven and computerized instruments, is offered.
The A-DBT Program is a specialty outpatient program within the Anxiety and Mood Program at the COPD that serves depressed and suicidal teens and emerging adults (ages 12-21) and their families. Many of these adolescents have experienced significant trauma and have comorbid anxiety, substance-related, personality and disruptive behavior disorders.
During this rotation, interns learn to conduct semi-structured diagnostic interviews (e.g., ADIS) and to intervene intensively as primary therapists for individual and family cases, co-therapists for group therapy, and multi-family skills training, using dialectical behavior, cognitive behavior, brief psychodynamic and family systems therapies, as well as crisis intervention. Various group therapies are also employed, including multifamily skills and graduate skills groups. Some patients receive concomitant psycho-pharmacological treatment.
Interns also have the opportunity to participate in academic activities, including authoring articles, presenting at conferences, conducting research and leading workshops at local schools regarding adolescent suicide.
The Child and Adolescent Assessment Service within the COPD helps interns develop proficiency in child/adolescent psychological and neuropsychological testing. At a minimum, interns administer five comprehensive psychological evaluations during the year, with more available for those interested in developing special expertise.
Referral questions typically include assessing for the presence and type of learning disabilities, assessing for the presence of a wide range of diagnoses and the potential need for medication, differential diagnosis, and evaluating the presence of neuropsychological deficits.
Supervision highlights the impact of cultural differences and bilingualism, and employs a developmental framework. Exposure to more traditional instruments, as well as newer, empirically-driven and computerized instruments, is offered. Training in the cross-battery approach to defining learning disabilities is integrated with more conventional theories.
The Becoming an Emerging Adult at Montefiore (BEAM) Program is a new multi-site specialty program that offers developmentally-informed, evidence-based interventions for emerging adults with a wide range of presenting concerns. The program offers assessment, treatment, consultation, education and training to improve our ability to meet the needs of emerging adults as they present to and transition among clinics across our health system. Interns who participate in this elective will receive specialized training in the unique developmental needs of emerging adults in both child and adult outpatient settings and how to adapt their treatment appropriately. Interns will serve as the primary therapist for individual emerging adults and will also have the opportunity to participate in scholarly activities, including authoring articles, leading trainings for staff throughout the hospital, and presenting at conferences. Supervision is provided by Dr. Amy Kranzler, Dr. Sandra Pimentel, and Dr. Amanda Zayde.
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| Interns at a private lunch with Dr. Stefan Hofmann after his presentation in the Department of Psychiatry Grand Rounds |
Adult Outpatient Psychiatry Department (AOPD)
The AOPD for our Combined Specialization is located in the Farrand building, just minutes from the entrance to the Wakefield Campus. It serves a heterogeneous group of adult outpatients presenting with a variety of psychiatric disorders, including mood and anxiety disorders, personality disorders, and psychotic disorders. Patients are seen in individual and/or group therapy, and many receive psychopharmacologic treatment and/or have comorbid substance abuse issues.
Interns are responsible for all phases of outpatient psychiatric care, including structured diagnostic intake evaluations, treatment planning, and provision of psychotherapy – which includes “sharing care” with psychiatrists who are prescribing medications (when necessary). Interns in the AOPD rotation will typically see adult outpatients for weekly appointments, co-lead DBT skills group, participate in weekly DBT consultation team meeting, and administer psychological testing for patients in the AOPD (as needed), as well as patients on the adult inpatient unit (as requested). Interns in the Combined Track will treat patients in the AOPD for the entire year, while simultaneously seeing patients in the Child Outpatient Psychiatry Department (see below).
Interns receive comprehensive, one-on-one supervision from licensed psychologists with cognitive behavioral, dialectical behavioral, psychodynamic, and integrative perspectives. Interns may request supervisors with expertise in a specific theoretical orientation. Otherwise, interns are assigned to a variety of supervisors so that they may be exposed to a range of therapeutic approaches.
Interns attend a weekly staff meeting (which often includes either an educational component or case conference), and are assigned to a multidisciplinary treatment team led by an attending psychiatrist, attending psychologist, and social workers.
The Adult Dialectical Behavior Therapy (DBT) Program – Wakefield Campus is a specialty program providing DBT for adults with behavioral and affect dysregulation. Individuals participating in the program may be diagnosed with a range of diagnoses including mood and anxiety disorders, trauma and stress related disorders, and substance use disorders. During this rotation, interns will co-lead DBT skills group with Dr. Katrina McCoy and participate in weekly DBT consultation team. Interns may also serve as primary therapist for a DBT case. Interns have the opportunity to contribute to research conducted within the Multisite DBT Clinical Research Collaboration – a research program run by Dr. Amy Kranzler and Dr. Katrina McCoy.
The COPD for our Combined Specialization is currently located in the Farrand building (just minutes from the entrance to Wakefield Campus). The Child Outpatient Psychiatry Department treats a heterogeneous group of children, adolescents, and emerging adults (ages 4-21) with diagnoses ranging from disruptive behavior disorders (e.g., ADHD, ODD, CD), anxiety, adjustment, and mood disorders, complex trauma, personality disorders, and psychotic disorders to learning disabilities. Interns will conduct intake evaluations of children, adolescents, and emerging adults and administer psychoeducational assessments for patients as needed. Interns in the Combined Track will treat patients in the COPD for the entire year, while simultaneously seeing patients in the Adult Outpatient Psychiatry Department (see above).
Interns in the COPD will serve as primary therapist for individual and family cases (patients will be assigned across all ages and diagnoses). During this rotation, interns will co-lead a mentalizing-focused parenting group and have the opportunity to lead a BEAM college-readiness group with Dr. Amanda Zayde.
Interns will receive comprehensive training and supervision from licensed psychologists with expertise in psychodynamic psychotherapy, family therapy, cognitive behavior therapy, dialectical behavior therapy, mentalization-based therapy, play therapy, group therapy, and parent management training. Interns will be assigned to a variety of supervisors so that they may be exposed to a range of therapeutic approaches. Interns also learn how to liaison with schools (e.g., review IEPs to make sure the patient has appropriate academic accommodations at school), foster care agencies, the Committee on Special Education and other relevant organizations, and are assigned to a multidisciplinary treatment team led by an attending psychiatrist, attending psychologist, social workers, creative arts therapists, and a psychiatric nurse practitioner.
The CARE clinical and research program is a developmentally informed, evidence-based, transdiagnostic specialty program that offers mentalizing-focused group treatment to parents of children from birth - 18 years of age. CARE’s mission is to facilitate the intergenerational transmission of secure attachment in racially, ethnically and socially diverse populations with extensive trauma histories and complex psychosocial needs. Interns will be provided with specialized training in attachment science and mentalization-based therapy. Supervision is provided by Dr. Amanda Zayde and Dr. Adella Nikitiades.
Interns have the opportunity to contribute to treatment outcome research conducted within the CARE program run by Dr. Amanda Zayde.
The Becoming an Emerging Adult at Montefiore (BEAM) Program is a new multi-site specialty program that offers developmentally-informed, evidence-based interventions for emerging adults with a wide range of presenting concerns. The program offers assessment, treatment, consultation, education and training to improve our ability to meet the needs of emerging adults as they present to and transition among clinics across our health system. Interns who participate in this elective will receive specialized training in the unique developmental needs of emerging adults in both child and adult outpatient settings and how to adapt their treatment appropriately. Interns will serve as the primary therapist for individual emerging adults and will also have the opportunity to participate in scholarly activities, including authoring articles, leading trainings for staff throughout the hospital, and presenting at conferences. Supervision is provided by Dr. Amy Kranzler, Dr. Sandra Pimentel, and Dr. Amanda Zayde.