Jon Ebert, PsyD, Associate Professor of Clinical Psychiatry and Behavioral Sciences
Tarah Kuhn, PhD, Assistant Professor of Clinical Psychiatry and Behavioral Sciences
Number of Positions: 1
Term: July 2, 2018 - June 28, 2019
National Matching Service (NMS) Number: 245414
The Child and Adolescent Psychiatry division in the Department of Psychiatry & Behavioral Sciences at Vanderbilt School of Medicine has offered an APA‐approved Psychology Internship for more than 20 years. The Child and Adolescent Psychiatry division consists of child and adolescent psychiatrists, psychologists, and trainees from several mental health disciplines. The department provides inpatient psychiatric hospital services, partial hospitalization services, as well as a broad range of outpatient services. It operates as both a major mental health services provider for Middle Tennessee and a regional training center. Psychology Interns with a primary placement in Child and Adolescent Psychiatry will have a particular focus on providing clinical services in the Vanderbilt Mental Health Center (MHC) and the Vanderbilt Center of Excellence for Children in State Custody (COE). Vanderbilt’s MHC provides integrated outpatient mental health services to children and families in Middle Tennessee and surrounding areas. The Vanderbilt COE is part of a statewide network funded under an agreement with the State of Tennessee to improve the public health by enhancing the quality of care provided to children in or at-risk of entering the child welfare or juvenile justice systems. This is done through the provision of consultation, assessment and training around best practices in clinical services and child welfare practices. The Vanderbilt COE is unique in its structure, serving as a consultant to the State regarding complex clinical cases, and as experts in best practice and systems intervention. Children and families present to both clinics with a range of psychiatric concerns including depression, anxiety, conduct or behavioral disturbances, adjustment problems and symptoms of psychotic disturbances. Of particular focus in both clinics is working with youth and families who have been exposed to trauma. This includes a variety of adverse childhood experiences, including but not limited to, abuse, neglect, family and environmental stress. As such, Psychology Interns will gain competencies working directly with clients ranging in age from early childhood to late adolescence who are from diverse racial and ethnic backgrounds. Additionally, Interns will gain significant exposure to and understanding of the many child-serving systems involved in the care of these complex children and families. Faculty and staff affiliated with the internship program aim to provide exemplary clinical service, as well as to serve as leaders at the local, state, and national level across domains including implementation of trauma-informed care, research, interdisciplinary education and professional training, program development and dissemination of evidence-based practice.
The goal of the internship experience in Child and Adolescent Psychiatry is to provide supervised clinical training, as well as didactic teaching, to prepare graduates to assume roles as clinical academic psychologists. Additionally, trainees can expect to receive specialty training in the assessment, treatment and consultation for maltreated or traumatized children and their caregivers.
Objectives for this placement include development of foundational skills in child and adolescent clinical psychology across domains such as assessment, intervention, consultation, supervision/teaching, research/evaluation, and administrative leadership. More specifically, interns will have the opportunity to develop their confidence and competence in various domains including, but not limited to: reflective practice; multidisciplinary collaboration and consultation; understanding relevant ethical and legal principles arising in the treatment of children and adolescents; and developing sensitivity in providing services to racially, culturally, and socio-economically diverse populations.
Throughout their training, interns will gain familiarity and competence in delivering a range of evidence-based treatment approaches to address a variety of child, adolescent, and family concerns. Additionally, interns will develop abilities to work collaboratively with multiple systems of care impacting children and families.
Interns’ time in this program will be divided between the Vanderbilt Mental Health Center (MHC) and the Vanderbilt Center of Excellence for Children in State Custody (COE). Within the MHC, interns will provide psychotherapy with children, adolescents and families and participate in a multidisciplinary intake clinic. Interns will also participate in a family therapy seminar, which trains professionals from various disciplines through in vivo supervision of family therapy sessions.
At the COE, interns’ primary responsibilities include psychological assessments and clinical case consultation with multiple child-serving systems. Psychological evaluations are conducted for a variety of presenting concerns across ages and developmental stages, but typically include a trauma assessment component. Clinical consultation is a primary intervention for the COE and through this, intern’s will have a distinctive opportunity to learn skills related to the negotiation of difficult systems dynamics, balancing differing agendas, facilitating discussion, formulating and delivering recommendations that can speak to varying levels of the child serving community.
The COE and MHC both emphasize the provision of evidence‐based assessment, treatment, and other best practices. Specifically, interns can expect to interface with various evidence-based practice and protocols including cognitive behavior therapy (CBT); trauma-focused CBT (TF-CBT); Attachment, Self-Regulation, and Competence (ARC); Child-Parent Psychotherapy (CPP); and parent management protocols such as Parent-Child Interaction Therapy (PCIT). Training and supervision of evidence‐based practices are incorporated into the program for interns, fellows, students, and other professionals. For example, the Vanderbilt COE assists with training, disseminating, and implementing TF-CBT among master’s level clinicians in the community across the state. As interest and time permits, interns will be able to attend introductory-level or specialized trainings and can gain experience with dissemination science.
In addition to direct clinical service via assessment, intervention, and consultation, interns will have the opportunity to participate in research with faculty members at the COE. Ongoing research projects currently include topics related to: dissemination and implementation of evidence-based practice or trauma-informed care; sibling sexual abuse and reunification; trauma and emotion dysregulation; mental health needs in the juvenile justice population; and infant mental health.
Interns will receive at least two hours of individual supervision per week. Additionally, interns participate in weekly group supervision with staff therapists and trainees from multiple disciplines. Further didactic offerings include monthly seminars on topics related to complex trauma, as well other offerings through the Department of Psychiatry & Behavioral Science and its affiliates (e.g. lectures, grand rounds, psychiatry fellows’ seminar series). The theoretical orientation of program supervisors includes a combination of behavioral, cognitive-behavioral, family systems, interpersonal, and developmental approaches. Supervision is a valued component of the internship program, as it supports interns’ continued professional development and growth. Supervision includes use of videotaping, one-way observation windows, and co-therapy and consultation with staff therapists or psychologists.
This training experience does not provide opportunities for extensive work with individuals with eating disorders and intellectual disability and/or autism spectrum disorders. Additionally, although we see parents as an adjunct to our work with children or adolescents, we do not typically work with adult clients.
A secondary placement through the Vanderbilt Center of Excellence is available for interns with primary placements in other sites with the Department of Psychiatry and Behavioral Sciences. The secondary placement with the COE will be focused on clinical consultation with the child welfare system and other child serving agencies to provide assistance regarding complex clinical cases.
Applicants frequently wonder about a typical day and how they would spend their time on internship. A summary of the anticipated weekly schedule can be seen below. Please note interns rotate through clinics weekly and remain with each placement through the entire training year. Previous interns have estimated they work approximately 40 hours per week across clinics. Hours include time spent engaged in clinical activities, individual supervision, team meetings, preparation, report writing, didactic seminars, reading, and research. Additional training opportunities are available (e.g. attending a multiday TF-CBT workshop) and will present throughout the year.
With so many opportunities, it can be difficult for interns to be selective in choosing which available opportunities and experiences are most valuable to their training. The Child and Adolescent Psychiatry intern will work closely with his/her supervisors to develop a specific training plan that meets the aforementioned objectives, develops core competencies, and considers the intern’s individual needs or interests.