Competence and Confidence in Evidence-Based Treatments and More
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Psychiatry and Behavioral Sciences

Competence and Confidence in Evidence-Based Treatments and More!

Program graduates and internship directors at the annual graduation ceremony at the New York Botanical Garden.

We view the internship year as a pivotal time in a graduate student's career, and pride ourselves in being able to offer a rigorous and stimulating training program that affords students the opportunity to develop further their professional identity, which ultimately enables them to handle a wide range of clinical issues and responsibilities and to function independently in variety of health service psychology settings, while also demonstrating the ability to critically evaluate, conduct, and disseminate research and/or other scholarly activities.

In service of this, interns can complete clinical rotations and electives in a variety of settings in the Montefiore Health System, affording them the chance to further their learning through the observation of, and collaboration with, medical professionals in other disciplines (e.g., transplant, sleep medicine, behavioral health integration, etc.), frequently to the benefit of the intern, the institution, and the patients we serve.

And while we pride ourselves on being able to provide training and supervision on the most advanced evidence-based psychological treatments, it should be noted that the Psychology Internship Training Program at Montefiore Medical Center does not adhere to a single theoretical orientation.

In fact, our faculty members represent all of the major schools of psychological thought and are diverse in their backgrounds, training, and areas of expertise. What unites the faculty is our belief that psychological practice should be scientifically informed. As such, interns can receive supervision in Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Prolonged Exposure, Cognitive Processing Therapy, Written Exposure Therapy, Acceptance and Commitment Therapy, Interpersonal Psychotherapy, Motivational Enhancement Therapy, and Panic-Focused Psychodynamic Psychotherapy. In addition, in keeping with Fonagy (2006), we believe that one unfortunate implication from the movement towards evidence-based psychotherapies has been that a "lack of evidence is evidence of a lack of effectiveness."

We believe that by having a diverse faculty who are passionate about their interests but also open-minded and accepting of alternate opinions, we can offer interns a stimulating environment in which they check and challenge their preconceived notions of psychopathology and its treatment may be conceptualized and treated and, in so doing, can further their professional identity development as they progress through the internship year. Our faculty members have been actively involved in the development and promulgation of evidence-based treatment protocols, strong proponents of adapting these protocols to more complex and diverse populations (i.e., effectiveness), and advocates for the use of evidence-based principles where no protocol exists.

In addition to clinical work, we believe that the internship year should provide opportunities for interns to demonstrate the ability to critically evaluate and disseminate research and other scholarly activities independently. As such, the psychology internship training program provides interns with the opportunity to pair up with a faculty mentor who is either conducting research and/or can assist the intern in making a scientific contribution to the field through a scholarly project (e.g., invited article or chapter, conference submission, etc.). This scholarly work is frequently focused on applied clinical issues pertaining to the disadvantaged and culturally diverse population who we serve, which leads to enhanced learning of the impact that issues of diversity and social determinants of health may play on the implementation of evidence-based treatments, as well as of the unique clinical challenges and needs faced by patients in the Bronx. Through all these research and clinical opportunities, coupled with intense training, supervision and collaboration, the delivery of care to patients is enhanced - not only at the point of service but ultimately (when studied and shared with our colleagues) - in settings around the nation.

Thus, we can create an experience that is sequential, cumulative, and of graded intensity and complexity, and based on the specific interests, background, experiences, and professional goals of each intern. We believe that this allows us to maximize our program's ability to prepare interns to develop and refine the APA Profession-Wide Competencies they need as part of their preparation for practice in health service psychology - while not feeling overwhelmed in the process. And by allowing training considerations to take precedence over billable service delivery, our interns have more input/control over the intensity of their experience, more time to think about both their research and clinical interests, and more time to process their internship experience - with other trainees, team members, supervisors, and mentors. This ultimately enables graduates of our internship training program to feel confident that they can handle a wide range of clinical issues (assessment and diagnosis, formulation and treatment, risk assessment, crisis management, etc.) and responsibilities and function independently at a high level in different roles (therapist, assessor, consultant, etc.), in a variety of settings (inpatient, outpatient, ER, research, etc.), and with diverse populations. Perhaps most importantly, our interns learn that they can accomplish this while also maintaining a healthy lifestyle comprised of hard and intense work during the day balanced with protecting time outside of work to invest in their personal life (e.g., relationships, physical fitness, sleep, exploring all the fun that New York City has to offer, etc.).

In sum, ultimately, we believe that our interns should graduate with a solid understanding of psychopathology and the various psychological theories and principles of how to treat it, as it is this knowledge - along with strong skills in assessment, conceptualization, and formulation – that can then be used to guide the selection of the specific interventions and techniques with a particular patient that will hopefully lead to a positive treatment outcome. By the time they graduate, our interns report that they are highly confident that the APA Profession-Wide Competencies that they acquired and strengthened during their internship year will allow them to perform effectively in their next position; that they can work collaboratively with health care professionals from other disciplines and participate effectively on inter-professional health care teams; that they will stay informed about advances in psychology; that they will actively participate in professional organizations; and perhaps most importantly, that they have all the relevant background and knowledge to prepare them effectively for the state licensing examination!