Psychosis Track

Primary Supervisor: Neil D. Woodward, PhD, Associate Professor of Psychiatry and Behavioral Sciences

Email: neil.woodward@vanderbilt.edu

Number of Positions: 1

Salary: $25,000

Term: July 2, 2018 - June 28, 2019

National Matching Service (NMS) Number: 245420

Overview

The Psychosis track is designed to provide interns generalist training in adult clinical psychology with an emphasis on clinical assessment, intervention, and research on psychotic disorders, particularly early-stage psychosis. The program is geared towards individuals with a background in research, assessment, and treatment of psychotic disorders that plan on pursuing academic clinical and/or research careers.   Core training in psychotic disorders is complemented by training in adult clinical neuropsychology. Training is conducted through the Vanderbilt Psychotic Disorders and Early Psychosis Programs.

 

Consistent with the overall purpose of a clinical psychology internship, the primary goal of the Psychosis Emphasis track is on the acquisition of clinical skills.  Specific training objectives of the Adult Psychiatry- Psychosis Emphasis program include:

  • Provide interns with a core knowledge base of the clinical features, treatment, neurobiology, and psychosocial factors involved in psychotic disorders;
  • Provide comprehensive training and experience in the assessment and psychotherapeutic treatment of psychotic disorders;
  • Further develop the intern’s research skills and expertise in the area of psychotic disorders;
  • Provide comprehensive training in neuropsychological assessment of adults with psychiatric and neurological disorders.

At the end of the internship, the intern should be able to function competently, autonomously, and with confidence in a variety of clinical settings.  

The Psychosis track intern will spend approximately 2.5 days per week engaged in activities related to core training in psychosis and 1 day per week in adult clinical neuropsychology.  The remainder of their time will be spent at their secondary placement (1 day per week) and didactics (one half day per week). Psychosis training and complementary neuropsychology training experiences are described in detail below.


Psychosis Assessment, Treatment, and Research

Embedded within the Vanderbilt Psychotic Disorders Program and working under the supervision of clinical psychologists, the psychosis emphasis intern will be become competent in the assessment, psychotherapeutic treatment, and research of psychotic disorders.  The Psychotic Disorders Program is a multidisciplinary team comprised of clinical psychologists, psychiatrists, counsellors, and social workers who assess, treat, and study patients with a psychotic disorder.  The clinical focus of the program is on the acute stabilization of psychotic inpatients at VPH and the implementation of long-term treatment plans through outpatient services affiliated with the Department of Psychiatry.  

While interns are required to perform clinical activities in both assessment and psychotherapy, the breadth of opportunities available allows the intern to tailor their training to place greater emphasis on specific areas. 

Assessment:  The intern will become competent in the diagnostic and neuropsychological assessment of individuals with a psychotic disorder.  Specific training opportunities include training in the administration and interpretation of:

  • Semi-structured diagnostic interviews and clinical symptom rating scales commonly used in evaluating and tracking outcomes in individuals with psychotic disorders;
  • Clinical neuropsychological tests commonly used to assess individuals with a psychotic disorder.

Psychotherapy: Interns are required to provide outpatient psychotherapy and lead a weekly first episode psychosis group.  The intern may select an additional, elective psychotherapy training experience in the Partial Hospitalization Program (PHP). 

  • Outpatient psychotherapy. Individual psychotherapy places a strong emphasis on engagement skills, with a focus on cognitive-behavioral therapy (CBT) for symptom reduction.  Psychotherapy is recovery focused and plans for transition back to college/work as soon as symptoms are stabilized.  Depending on their prior training, interns may also participate in family therapy to address issues including communication/roles/boundaries, and development and utilization of crisis planning.  The diversity of psychotherapy training experiences offered allows the intern to tailor their training experiences to meet their specific goals.
  • Group Therapy.  The First Episode Group serves young adults (age 17-30) recently discharged from the inpatient setting that are experiencing psychotic symptoms including delusions, hallucinations, disorganization, cognitive deficits, and social withdrawal.  The goal of the group is to focus on recovery by identifying personal goals and tailoring the goals to highlight meaning and purpose to their young lives.  The group also provides psychoeducation, a supportive community, coping and stress management skills, anti- stigma discussions, and opportunities to share personal lived experience of psychosis.
  • Partial Hospitalization Program (PHP).  Rotation through the PHP allows the intern experience with designing and leading group therapy and skills training with adolescents or adult patients struggling from an array of symptomatology including depression, anxiety, and psychosis.  The PHP also provides opportunities for collaboration with the patient and multi-disciplinary team in formulation of treatment plans and delivery of patient care. 

Research:  As a required component of the psychosis emphasis position, the intern will be expected to become involved in on-going programs of research and complete an individual research project.  At the beginning of the internship year, the intern, working in collaboration with the intern’s primary supervisor, will select a research project that is aligned with the intern’s research interests and graduate training, and is feasible within the constraints of the internship year and resources of the program.  Interns will have access to several repositories of clinical, cognitive, and neuroimaging data collected on individuals with a psychotic disorder and healthy subjects.   A significant focus of on-going research projects is on the neurobiology, neuropsychology, and trajectory of early stage psychotic disorders.  


Adult Clinical Neuropsychology

Interns will obtain experience conducting neuropsychological evaluations of adults with a variety of psychiatric and neurological disorders.  Under direct supervision of a clinical psychologist, interns will conduct clinical interviews; administer, score, and interpret neuropsychological tests; prepare neuropsychological reports; and provide feedback to patients and families.  It is expected that interns will have some experience with the administration of neuropsychological batteries and report writing.  Referrals come mainly from the following sources:

  • Vanderbilt Psychiatry Memory and Aging Clinic (VMAC): an outpatient clinic focused on assessment and treatment of older individuals with a wide array of psychological and neurological disorders.  These include depression, mild cognitive impairment, Alzheimer’s disease, fronto-temporal dementia, stroke, vascular dementia, and dementia with Lewy bodies.
  • Vanderbilt Epilepsy Program: including patients with intractable epilepsy referred as part of their pre- and post-surgical workups, patients with cognitive impairment related to epilepsy, and patients with non-epileptic spells.  Interns may also have the opportunity to observe Wada testing and participate in multidisciplinary case conferences.

Consistent with the overall structure of the VUMC-IPP, interns will be required to select a secondary placement.  Given the emphasis on psychosis, neuropsychology, and research, interns will select a secondary placement that adds to the breadth of their training, rather than duplicating training experiences included in their primary placement.

Given the goals of the Psychosis track, applications from interns whose achievements reflect a strong commitment to pursue careers emphasizing research and training in academic/research settings will be viewed favorably.  Prior graduate training/experience and research in psychotic disorders is essential.  Consistent with the overall requirements of the VUMC-IPP, applicants should have a minimum of 550 Total Intervention and Assessment Hours as defined by the AAPI.  While not required, it is recommended that applicants have at least 150 hours of assessment experience.

Jennifer Blackford, PhD
Associate Professor of Psychiatry and Behavioral Sciences, Associate Professor of Psychology
Interests: Neural substrates of anxiety vulnerability; anxiety neurocircuitry in schizophrenia

Emma Finan, LMFT
Associate in Psychiatry
Interests: First break/early stage psychosis; CBT; family therapy

Stephan Heckers, MD
Chair of the Department of Psychiatry and Behavioral Sciences, Professor of Psychiatry and Behavioral Sciences
Interests: Psychotic disorders; neuroimaging; neuroanatomy

Ellen House, MD
Assistant Professor of Psychiatry and Behavioral Sciences
Interests: Child and adolescent psychiatry; college mental health; first episode psychosis

Monica Jacobs, PsyD
Assistant Professor of Clinical Psychiatry and Behavioral Sciences
Interests: Neuropsychological assessment

Max Schiff, MD, Ph.D.
Assistant Professor of Psychiatry and Behavioral Sciences
Interests: Psychosis; psychodynamic therapy; computational modeling

Jeffrey G. Stovall, MD
Associate Professor of Psychiatry and Behavioral Sciences
Interests: Schizophrenia; community psychiatry

Neil Woodward, PhD
Associate Professor of Psychiatry and Behavioral Sciences, Associate Professor of Psychology
Interests: Neuropsychological assessment; psychotic disorders; neuroimaging