Elective Rotations

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 four 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 your training or to expand upon your existing knowledge, skills, and abilities. Each intern matching with us will be encouraged to think of their own specific interests and/or training needs and goals when considering which (if any) electives to add to the core rotations, and we will do our best to tailor them to meet your personal objectives.

Note: Interns typically select one or two electives for the year. Electives typically occupy either a half or full day per week for 4-6 months. Certain electives, however, can be made into a more intense (e.g., 2-3 day) rotations, extended in duration, and/or woven into the week, rather than planned as “carved out” days.

2018-19 Interns and Faculty at the First Day Orientation Meeting.

Current Elective Rotations

Anxiety and Mood Program (AMP)/Dialectical Behavior Therapy Program (A-DBT)

Note: Required for the Child and Adolescent Track but can be made into an elective for interns in the other tracks.

The Anxiety and Mood Program (AMP) at Montefiore Medical Center's Child Outpatient Psychiatry Division is a specialty program that offers evidence-based interventions for youth with primary and comorbid anxiety, mood, and related disorders. AMP serves children, adolescents and emerging adults, ages 4 to 21 years old, and families from the surrounding Bronx communities. In this elective, interns will have the opportunity to conduct as least two comprehensive intake assessments (e.g., ADIS) and will serve as primary therapists for up to two youth cases of experiencing anxiety (e.g., social anxiety disorder, generalized anxiety, separation anxiety disorder, panic disorder, phobias, OCD, PTSD), depression, tics, trichotillomania, and/or related concerns. To the extent possible, elective cases can be selected for intern’s training preferences. During this rotation, interns will provide and receive weekly supervision on 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, Arts and Integrated Medicine Groups, or College Readiness and Transition Groups for graduating high school seniors. 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 (A-DBT) Program 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 elective, interns learn to conduct comprehensive diagnostic interviews and Dialectical Behavior Therapy. Interns serve as primary therapists for at least one individual DBT case and have the opportunity to co-lead DBT multi-family skills groups. As part of this elective rotation, interns learn crisis intervention skills and learn to facilitate DBT consultation team. Interns will receive individual supervision and participate in multidisciplinary rounds and DBT consultation team.

Autism and Obsessive Compulsive Spectrum Program

For interns interested in working with children, adolescents or adults with autism, Prader-Willi Syndrome (PWS) and OCD spectrum patients, they may be involved in assessing patients who are considering entering a clinical trial in the Autism and Obsessive-Compulsive Spectrum Program. If interested, interns may also create a more intense research elective experience that would include participating in research studies and administering behavioral rating scales on cannabinoids in autism and PWS, oxytocin in PWS, and a novel GABAA-a5 receptor modulator and digital biomarker study in autistic adolescents and adults. Interns will participate in seminars and case conferences and scholarly activities. There are also projects on social media and mental health in youth. Supervision is provided by psychiatrist Dr. Eric Hollander and neuropsychologist Dr. Bonnie Taylor.

Becoming an Emerging Adult at Montefiore (BEAM) Program

The Becoming an Emerging Adult at Montefiore (BEAM) Program is a 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. Sandra Pimentel and Dr. Amanda Zayde.

Behavioral Health Integration Program (BHIP)

The Pediatric Behavioral Health Integration Program (BHIP) provides evidence-informed, integrated behavioral health care for children and their families within Montefiore’s primary care network. We provide HealthySteps programming for prevention and intervention in children ages birth through age five, and treatment of mild to moderate anxiety, depression, attention/disruptive behavior disorders and trauma-related issues in school-aged and adolescent children. The program is in various pediatric primary care sites which serve an estimated 90,000 children. Working alongside pediatricians, a multidisciplinary team of psychologists and psychiatrists provide evidence-informed behavioral health services across the pediatric lifespan (birth through 21 years of age). The emphasis is on population health, and thus all pediatric patients receive mental health screens during routine medical appointments which allows the program to identify children with mild to moderate behavioral health symptoms and intervene in a preventative fashion.

When selected as an elective rotation, the intern will be assigned to a specific primary care site and learn to work collaboratively with a team of pediatric medical and behavioral health providers. Interns will be expected to complete brief assessments and conceptualizations based on the use of appropriate screeners and clinical interview, and conduct short term interventions for mild to moderate mental health problems. Coordination of care between the intern and primary care provider (PCP), as well as relevant systems such as school and community resources, will ensure a comprehensive approach to assessment and treatment. As community and health system guidelines continue to evolve, BHIP services will continue to be a blend of both face-to-face and telehealth services. Individual supervision of at least one hour per week will be provided by a licensed psychologist.

Butler Center for Children and Families

The Butler Center for Children and Families is a dual-licensed clinic for primary care and mental health, specializing in trauma and child abuse and neglect. The mental health clinic, a satellite of COPD (Child and Adolescent Psychiatry) is a full service OMH clinic with a psychiatrist, a psychologist, and three clinical social workers. A one day a week rotation with the OMH clinic at the Butler Center offers Psychology interns the opportunity to develop an essential awareness of how to treat trauma, whether it takes the form of sexual or physical abuse, exposure to domestic and/or community violence, a perilous immigration journey, or the living conditions of urban poverty. The ensuing symptoms of PTSD, anxiety disorders, depressive disorders, and behavioral problems, including problematic sexual behaviors are addressed with evidence-based interventions such as: TF-CBT or Trauma-focused CBT, and PSB-CBT or Problematic Sexual Behavior CBT, a treatment that can be administered in a group or individual family format. Services are offered in English and Spanish responding to the needs of recent immigrants. Interns will also be able to familiarize themselves with the forensic part of the process of addressing abuse by observing some interviews conducted by a multi-disciplinary team (child protective service workers, forensic interviewers, pediatrician, nurse practitioner, detectives, social workers and ADAs or Assistant District Attorneys) although the bulk of the forensic phase now takes place mostly off-site. A licensed psychologist is available to provide individual supervision for at least one hour a week.

Child Welfare Programs

The Montefiore/ University Behavioral Associates child welfare programs 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 these programs 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 child welfare program will receive clinical 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, to co-facilitate voluntary groups (e.g., parenting groups) for families, to facilitate structured Family Team Conferences, to provide in-vivo supervision to case management and therapeutic staff during in-home visits, and to create and deliver clinical trainings to staff. Interns will serve as an integral part of an interdisciplinary team, committed to maintaining the safety and well-being of children and families in the Bronx. One hour of individual supervision per week will be provided by licensed psychologists and other trainers in the program.

The Cognitive Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center

The Cognitive Behavioral Sleep Medicine (CBSM) Program at the Sleep-Wake Disorders Center provides interns with the opportunity to learn about the diagnosis and treatment of patients who have problems associated with sleep and wake. Interns can participate in the evaluation of patients who have insomnia, hypersomnia, narcolepsy, circadian rhythm disorders, nightmares, and difficulty adjusting to PAP therapy for sleep apnea. Interns will learn cutting-edge treatments, such as Cognitive Behavior Therapy for Insomnia (CBT-I), Systematic Desensitization for PAP Adherence, and Imagery Rehearsal Therapy (IRT) for Chronic Nightmares. Though mostly focused on work with adults, child and adolescent patients are occasionally seen. 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 clinical psychiatrist who is a behavioral sleep medicine specialist.

The Connecting and Reflecting Experience (CARE) Program

Note: Required for the Combined Track but can be made into an elective for interns in other tracks.

CARE is an innovative specialty program that offers a mentalizing-focused group intervention to parents and other primary caregivers who experience parent-child relational stress and difficulties in their capacity to reflect upon the mental states that underlie their own and their children’s behavior. Developed and located at Montefiore Medical Center’s Child Outpatient Psychiatry Department - Wakefield Division, the bigenerational, transdiagnostic program integrates perspectives from attachment theory and developmental psychopathology and serves caregivers of children enrolled in outpatient services, typically ranging in age from 6 to 18. In initial studies, CARE has been found to reduce parenting stress, improve caregiver reflective functioning, and strengthen youth-reported attachment security. This elective rotation is ideal for interns who are interested in group therapy, mentalization-based therapy, attachment theory, parenting interventions, and/or gaining a deeper understanding of how clinical work and research can inform and enrich one another. During this rotation, interns receive training and weekly group supervision in the CARE model and will co-facilitate a parenting group. In addition, CARE offers interns the opportunity to engage with an ongoing program of clinical research. There may also be opportunities to assist with program development and training. Supervision is provided by licensed psychologists.

The Eating Disorders Program at Montefiore (EDPM)

The Eating Disorders Program at Montefiore (EDPM) is a multidisciplinary program between the Department of Psychiatry and the Department of Adolescent Medicine at the Children’s Hospital at Montefiore Einstein (CHAM). Our program was formed due to the lack of availability of specialized treatment for patients with public insurance presenting to our clinics with eating disorders. At this time, to our knowledge there are no other outpatient clinics in New York City (all five boroughs) that provide specialized treatment for eating disorders for child and adolescent patients who have Medicaid. Additionally, our medical unit is one of the few in the area equipped to treat patients presenting with medical instability related to severe eating disorders. The EDPM provides evidence-informed care for children and adolescents (ages 5 – 23) presenting with Anorexia Nervosa, Bulimia Nervosa, Avoidant Restrictive Feeding and Eating Disorder (ARFID), and Other Specified Feeding and Eating Disorder (OSFED). In addition to interventions that target primary eating disorders, we provide comprehensive care that may also include treatment for depression, anxiety, PTSD, and personality disorders.

Interns doing an elective rotation in the EDPM may have the opportunity to work with patients on our inpatient medical unit (CHAM 6) and within our outpatient department. Our inpatient unit admits patients with eating disorders presenting with medical instability. Once on this unit patients receive comprehensive medical and psychiatric assessments. Interns working on CHAM 6 will participate in every phase of treatment on the unit including initial assessment, individual and family therapy, and ongoing consultation with the medical team In our outpatient setting, interns will be assigned cases with primary diagnosis of an eating disorder. Our treatment program uses multiple evidence-based approaches including Family-based Treatment (FBT) and Dialectical Behavior Therapy (DBT). Interns may also participate in monthly rounds with the Adolescent Medicine team. Individual supervision of at least one hour per week will be provided by a licensed psychologist.

Einstein Student Mental Health Clinic (ESMHC)

The Einstein Student Mental Health Clinic (ESMHC) The Einstein Student Mental Health Clinic (ESMHC) serves culturally diverse medical students, PhD students, and postdoctoral trainees at Albert Einstein College of Medicine on Montefiore Medical Center’s Jack and Pearl Resnick Campus. This elective offers interns in all three specializations a unique opportunity to join a programmatic effort at Montefiore/Einstein to promote mental health literacy and increase the accessibility and suitability of mental health services to a culturally diverse and often highly stressed clinical population. The ESMHC employs a brief psychotherapy framework for most patients, which therefore requires efficient assessment, case conceptualization, and treatment planning, as well as a strong background in, and commitment to using, short-term evidence-based treatments such as CBT, DBT, and/or ACT. Interns will serve as the primary therapist for 5-10 individual therapy cases. Opportunities may also exist for interns to participate in program planning and implementation, assist in clinic initiatives to coordinate with Einstein to promote healthy mental health practices via campus outreach, co-lead a therapy group, and participate in scholarly activities, including authoring articles and presenting at conferences. Individual supervision of at least one hour per week is provided by a licensed psychologist.

Forensic Psychology Elective: EAC Diversion and Reentry Programs: Brooklyn, Bronx, Queens, Manhattan, and Staten Island

EAC, a not-for-profit agency with a large criminal justice division, provides court-based diversion (alternative to detention and incarceration) and jail-reentry services for individuals with serious mental illness involved in the criminal justice system. EAC's program is designed to clinically assess defendants charged with felonies or misdemeanors for the presence of psychiatric and/or substance use disorders, refer eligible defendants to treatment in the community, monitor their progress, and communicate this progress to the court and other criminal justice partners. The goal of both the diversion and reentry programs is to help offenders with serious mental illness into appropriate community care, focusing on individualized approaches to rehabilitation and risk management.

The EAC team collaborates with the District Attorney's office, the defense bar, and the treatment courts in all 5 boroughs to identify and evaluate individuals who may be appropriate for mental health diversion services. Using empirically-validated testing batteries, EAC provides in-depth diagnostic evaluation of the defendant including diagnostic, cognitive, personality, malingering, and violence risk assessment, and identifies appropriate treatment resources that can meet the needs of the individual. Results of the assessments are communicated to the courts via formal forensic reports.

Psychology interns will be part of interdisciplinary teams of master’s level forensic case managers, a clinical social worker, and a licensed psychologist. Trainees will be mostly involved in diversion cases although could also be involved in re-entry cases with clients who are difficult to engage or require psychological testing. Doctoral interns will conduct forensic psychological evaluations for the courts with a special focus on violence risk assessment, present cases to the psychologists during clinical meetings and supervision and become involved in treatment planning. Once a defendant has been accepted for diversion, interns may be responsible for making referrals to treatment providers, monitoring the individual for progress and compliance, and providing the courts with regular updates on treatment progress. Trainees will be involved in communications with defense attorneys, prosecutors and treatment providers involved in their clients' cases. Weekly didactics will cover a range of topics relevant to mental health and the criminal justice system. Individual supervision of at least one hour per week is provided by a licensed psychologist.

Geropsychology

For interns interested in working with older psychiatric patients, they may be assigned cases in the Geriatrics service of the AOPD. If interested, however, interns may also create a more intense elective experience that would 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 and comprehensive dementia assessments at the Center for the Aging Brain. Interns choosing this elective would also have opportunities to work with Holocaust survivors and participate in NIMH-sponsored research. Supervision is provided by geriatric psychiatrists.

Klau 2, Adult Inpatient Psychiatry

Klau 2 is a 22-bed, adult acute psychiatric unit within the main medical center. Klau 2 serves adults, ages 18 and over, presenting with a wide range of serious mental illness. These patients represent the most underserved psychiatric population in the area. Patients are offered a multi-disciplinary treatment approach that includes a broad range of traditional mental health services, as well as other wellness-oriented treatments designed to enhance recovery for those with mental illnesses. Individual, family, and group psychotherapy, creative arts, recreational, milieu and pharmacological therapies are employed in accord with the specific needs of the patients and assessed on an ongoing basis in treatment team meetings.

Upon admission, each patient is assigned to a primary therapist, a Psychology Intern, or a Psychiatry Resident. Additionally, patients are assigned to a team comprised of an attending psychiatrist, psychologist, social worker, integrative behavioral therapists, nurses, mental health assistants, and trainees of various disciplines. As the primary point person for the patient, Psychology Interns are the patient’s main advocate. Your multidisciplinary team collaborates with the patient to create an individualized plan throughout treatment. As primary therapist, you take the lead in involving the patient's family and/or significant others (based on patient's needs and wishes), as well as outpatient treatment providers, in order to ensure a comprehensive disposition plan, so that the patient is returned to the community in a safe and expeditious fashion.

Psychology Interns on Klau 2:

For many psychology interns, the inpatient unit rotation provides a novel opportunity to work with patients during their most vulnerable psychiatric phase, and to serve the underserved. Since this may be an Intern’s first or last opportunity to work with an inpatient psychiatric population, this experience provides unique training where Psychology Interns learn more flexibility, creativity, and real-life intensive psychotherapy as they bear witness to a patient’s recovery from acute illness to discharge. By providing both assessment and treatment in this multidisciplinary setting, Interns learn how to apply their clinical knowledge base to this population, honing their skills in creatively collaborating with their supervisor and multidisciplinary treatment team, adapting evidence-based treatment to match patients’ current acute therapy needs, and assisting them through the most acute phases of mental illness towards their recovery.

During their rotation, Psychology Interns will acquire or further develop their skills in: comprehensive admissions assessments and differential diagnosis; acute individual, group, and family psychotherapy; crisis intervention, as well as case formulation; treatment planning; case presentations; and preparation of progress notes and discharge summaries.

Treatment and supervision focus on the use of evidence-based treatment models, modified, and adapted to the setting and population, as part of a recovery-oriented model of care. Treatments include integrated treatment for co-occurring disorders, time-limited interpersonal therapy, strengths-based therapy, motivational interviewing, crisis intervention, social skills training, dialectical behavior therapy, cognitive behavior therapy, illness management and recovery, family psychoeducation, and psychopharmacology.

Elective Options:

Psychology Interns have the opportunity to participate on Klau 2 via two options:

1. 4 Day/week rotation (2-4 months):

This 4-day/week rotation enables the Psychology Intern to fully become part of the treatment team, work in intensive therapy (individual and milieu) with a variety of patients presenting with (complicated and fascinating) acute mental illness and hone their clinical and creative skills outside of the standard therapy format. The 4-day Psychology Internship rotation allows interns to serve as the Primary Therapist for 2-3 patients at a time. This includes daily individual psychotherapy sessions, twice weekly group therapy, daily communication with multidisciplinary treatment team and collaborating in the development of their patient’s milieu treatment. This 4-day rotation includes the following:

Clinical Patient Care:

• As Primary Therapist for 2-3 identified patients during their hospitalization, Interns will initiate daily individual therapy and collaborate with the team in family meetings, behavior plans and milieu treatment.
• As part of the Klau 2 trainee Cohort (including psychiatry residents and creative arts interns), the Psychology Intern will:
• Co-lead Inpatient Interpersonal Group Therapy
• Co-lead an additional Group Therapy (choice of orientation)
• Co-lead daily Patient Community Meetings

Team meetings:

• Participate as Primary Therapist in Nurses’ morning report, multidisciplinary treatment team, sign out/consultation with Attending Psychiatrist

Supervision:

• Participate in regular, frequent individual supervision with Psychologist (Dr. Sharon Spitzer) and weekly group therapy supervision with all Klau2 trainees (psych residents and interns)
• Participate in weekly Chief Resident supervision with all Klau2 trainees
• Participate in weekly PBL (Participant Based Learning) rounds
• Participate in weekly case conferences

2. 3 Day part time rotation (2-4 months):

This 3-day rotation allows Psychology Interns to become an adjunct team member on the multidisciplinary treatment team. Interns will have the opportunity to work with patients on an individual and group basis and will hone their therapy skills with this unique population. Interns will gain increased understanding and practice in working as part of a multidisciplinary team and participate on Klau 2 as follows:

• Clinical Patient Care:
• Meet each day with 2-3 identified patients for psychotherapy during their hospitalization
• Co-lead Inpatient Interpersonal Group Therapy
• Rotate into leading Patient Community Meetings
• Team meetings:
• Participate as Primary Therapist in Nurses’ morning report, multidisciplinary treatment team, sign out/consultation with covering resident and Attending Psychiatrist
• Supervision:
• Participate in individual supervision with Psychologist (Dr. Sharon Spitzer) and weekly group therapy supervision with all Klau 2 trainees (psych residents and interns)
• Possible Additions:
• Participate in weekly Chief Resident supervision with all Klau2 trainees
• Co-lead an additional Group Therapy (choice of orientation)
• Participate in weekly case conferences
• Participate in weekly PBL (Participant Based Learning) rounds

Neuropsychology Assessment Service

Note: Required for the Neuropsychology Track and Adult Track but can be made into an elective for interns in other tracks.

Interns may elect to perform additional neuropsychological testing with adult and/or pediatric 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, cancer, sickle cell disease, lupus, epilepsy, learning disabilities and attention deficit disorder. These batteries are be supervised by licensed neuropsychologists.

OnTrackNY

The OnTrackNY program at Montefiore is a multidisciplinary outpatient treatment team serving adolescents and young adults with early psychosis. The OnTrack team provides comprehensive mental health services including individual and group psychotherapy, medication management, peer support, education/employment assistance, and family support. During this rotation, interns are trained in the evaluation and treatment of patients with a recent onset of psychotic symptoms such as hallucinations, delusions, and disorganized thinking. Interns carry individual psychotherapy patients, attend team meetings, and learn to utilize the recovery model of treatment and shared decision-making process with patients and their families. Supervision is provided by a licensed psychologist.

Psychiatric Observation Suite (POS) - Psychiatric Emergency Room

Note: Required for the Adult Track but can be made into an elective for interns in the other tracks.

The POS is a 5-bed unit within the adult emergency department for patients presenting with psychiatric complaints. Patients are seen either in the POS, the main ED or in the pediatric ED. Patients are seen for evaluation, crisis intervention, and disposition. Patients are assigned by the attendings or chief resident and supervision is provided by the attendings and chief resident. Interns will see a wide range of diagnoses and psychopathology, including mood and psychotic disorders, substance use disorders, PTSD, ADHD and ASD. Interns will conduct diagnostic interviews, safety and risk assessments and gain experience in gathering collateral from families, providers, and agencies. They will gain competence in determining indications for hospitalization vs discharge.

Psychiatric Consultation Service

Note: Required for the Adult Track but can be made into an elective for interns in the other tracks.

The Psychiatric Consultation Service rotation consists of experiences in the Psychiatry Consultation-Liaison Service and Abdominal Transplant.

While working with the transplant team, interns will learn to assess for psychological contraindications to liver and kidney transplantation and living donation, as well as provide consultations for patients hospitalized post-transplant and presenting with a variety of psychological concerns, including addictions, depression, and anxiety. Interventions used with transplant patients are based on CBT, motivational interviewing, and mindfulness. Interns are part of a multidisciplinary team including surgeons, hepatologists, nephrologists, social workers, and nurses. There are opportunities to participate in multidisciplinary team meetings with the transplant team.

The Psychiatry Consultation-Liaison Service provides the interns exposure to collaborating with a vast array of hospital based medical teams and to enhance skills in the overall management and treatment of medically and/or psychiatrically compromised patients. Psychological consultation may be requested for a number of concerns. Some of these include: pre-existing psychiatric issues, current illness-related distress, wide-ranging adjustment issues, behavioral management strategies, poor adherence to treatment, and to address capacity issues to provide informed consent and/or clearance for hospital discharge. Psychology Interns will learn the rapid assessment of medically compromised patients, the ability to render a diagnosis, and provide brief bedside evidenced based treatment in medical areas that require rapid decision-making and follow-up. Licensed psychologists provide supervision of interns in their clinical evaluation of patients, as well as in their consultative role to other providers.

Department of Rehabilitation Psychology and Neuropsychology at Burke Rehabilitation Hospital

The Rehabilitation Psychology and Neuropsychology Department provides comprehensive neuropsychological and psychological services to inpatients admitted to Burke’s 150-bed acute rehabilitation hospital and to outpatients through the Burke-Montefiore Physician Practice. Our department serves a culturally- and linguistically-diverse population of medically and neurologically complex adults and older adults at various stages of rehabilitation following injury or illness, many of whom have also have comorbid psychiatric conditions.

In this 3-month minimum elective, the intern will gain experience providing inpatient psychological and neuropsychological services, including assessment and psychotherapy, to patients admitted to Burke for acute rehabilitation. The intern will learn how to perform an efficient bedside diagnostic interview in response to consults from the multidisciplinary treatment team. Common consult questions include diagnostic clarification, concern for mood disorder or adjustment difficulty following illness or injury, and behavior management. The intern will also perform bedside cognitive screens and neuropsychological assessments to characterize cognitive status, clarify diagnosis, and guide treatment planning. As patients are often in the very early stages of injury, interns will be exposed to acute neurologic and medical presentations (e.g., delirium and acute stroke syndromes) less commonly seen in outpatient settings. Interns will follow patients during their admission to provide individual psychotherapy (typically in a CBT, ACT, or supportive modality), support the patient’s family and treatment team, and re-evaluate mood or cognition as appropriate.

Interns may also attend multidisciplinary inpatient team rounds (TBI, stroke, & mixed neurologic/spinal cord injury units), join rehabilitation didactics with our psychology externs, and observe rehabilitation therapists and physicians depending on day of attendance. For interns who opt for a 6- or 12-month rotation, outpatient individual and group psychotherapy and cognitive remediation experiences are also available. For bilingual (Spanish/English) interns, there are further opportunities to provide care to monolingual (Spanish speaking) patients with supervision by a licensed psychologist. This is an in-person externship located on site at Burke Rehabilitation Hospital, located in White Plains. This elective is best suited for interns with a strong interest in working with neurologically and medically complex populations and who have prior experience in neuropsychology or health psychology. Interns will receive individual supervision provided by licensed clinical psychologists specialized in neuropsychology and rehabilitation psychology.

Rose F Kennedy Children's Evaluation and Rehabilitation Center (CERC)

The Under 5 Trauma Services program at the Rose F Kennedy Children’s Evaluation and Rehabilitation Center (CERC), in the Department of Pediatrics at Montefiore Medical Center provides interns with the opportunity to work in the Group Attachment Based Intervention (GABI) an intensive parent-child treatment developed for families with birth to three children, when there is a concern about a parent’s ability to parent due to an array of psychosocial stressors. Families are referred to GABI by pediatricians, ACS, Family Court, and preventive agencies. GABI is part of RFK CERC which consists of a multi-disciplinary team of developmental behavioral pediatricians, psychiatrists, psychologists, and social workers, among other developmental specialists. Interns will learn how to conduct a trauma-informed clinical intake, including administering the Adult attachment Interview (AAI) for clinical understanding, the Parent and Child – Adverse Childhood Experiences Questionnaires, and behavioral health measures. Interns will participate in GABI which includes dyadic psychotherapy, parent groups, child groups and video feedback sessions. Interns will also have one individual parental mental health case. GABI sites are located in all five boroughs and involve an online training in the model, monthly all team trainings with key experts in field in addition to quarterly video sessions reviewed in supervision. Individual and Group supervision is provided by a licensed psychologist and other team members.

Substance Abuse Treatment Program (SATP)/New Directions Recovery Center (NDRC)

The Substance Abuse Treatment Program (SATP) and New Directions Recovery Center (NDRC) provide integrated substance use counseling, primary medical care, and psychiatric services to over 1,000 patients. SATP provides methadone maintenance for individuals with opioid use disorder and NDRC offers intensive outpatient treatment for a range of substance use disorders, including alcohol, cocaine, cannabis, benzodiazepines, and PCP. Interns will provide individual and group therapy, intake assessments and crisis intervention. Interns will also work closely with a team of psychologists, addiction counselors, medical providers, and other clinicians to provide integrated treatment services within a harm-reduction framework. Interns may also have the opportunity to assist with group supervision for psychology externs. The rotation is typically 1 day per week for 3 to 6 months but can be flexible. SATP and NDRC are co-located at 2058 Jerome Avenue on the Burnside Avenue stop of the 4 train. Supervision is provided by licensed psychologists.

Supporting Healthy Relationships & HERO Dads Programs

This is a unique opportunity to gain experience working on either or both of two federally funded family strengthening research programs serving couples and individuals in the South Bronx and greater NYC area. Our clinical focus has a psychodynamic base, with specific training in multicultural treatment considerations, as well as couples-, family-, and group-focused modalities.

Supporting Healthy Relationships (SHR) is designed specifically to enhance relationship skills and strengthen relationships for low-income couples who have or are expecting children. The relationship education curriculum is based primarily on Gottman’s Bringing Baby Home, which was shaped by his many years of research on couple functioning. The curriculum has also been modified to fit our diverse community by adding aspects of Dr. Sue Johnson's Emotionally Focused Couples Therapy and the Prevention and Relationship Enhancement Program (PREP by Stanley & Markman). While most clinicians work with couples using therapy as an intervention, our program encourages a clinician's role in prevention before couples are distressed.

HERO (Healthy, Empowered, Resilient, Open) Dads, is focused on providing a wide range of services for low-income adult parents with non-custodial children. The parenting and relationship psychoeducation workshops are based on an empirically supported curriculum, 24/7 Dad, developed by the National Fatherhood Initiative. HERO Dads is based on the notion that non-custodial fathers lack models of responsible fatherhood and are subject to numerous stressors that undermine their ability to remain engaged with their children and meet their child support obligations. We believe that relationship and parenting education, coupled with access to employment services that address these stressors, will support, and strengthen fragile families.

This rotation offers interns a broad array of clinical training opportunities to increase their competency in couple- and parent-based prevention techniques (as well as some specific interventions) while serving a population that encompasses a broad variety of ages, cultures, psychiatric diagnoses, and levels of functioning. To accomplish this goal, the intern will conduct clinical assessments with couples and/or individuals, co-lead relationship and/or parenting education groups, design, and lead workshops on topics of the intern's choice, provide ongoing supportive services to couples and individuals (e.g., short-term therapy, crisis intervention, case management services), as well as contribute to program evaluation projects for either program as available. Supervision is provided by licensed psychologists as well as other trainers in the program.

Terra Firma

Terra Firma is a medical-legal partnership clinic providing integrated medical, mental health and social services to unaccompanied immigrant children all under one roof. Terra Firma’s flagship program is located in a South Bronx community health center in an immigrant-rich neighborhood. At the Center for Child Health and Resiliency, affiliated with The Children’s Hospital at Montefiore, these children are given a medical home for the first time in their lives and have access to culturally sensitive and linguistically appropriate mental health services. Working in close conjunction with on-site pro bono immigration lawyers, our clinicians provide professional testimonies used to support legal relief; preventing deportation and helping immigrant children gain lawful residency in the US.

Terra Firma complements these core services with acculturation and enrichment activities such as English language classes, photography workshops, and soccer. In this integrated model, healthcare professionals play a crucial role in improving immigration outcomes by providing a safe environment in which children can recount the painful circumstances that led them to flee their country and receive trauma-informed care, so critical to their healing. Medical and mental health professionals working with these children provide written evaluations and oral testimony that support their legal cases. This approach corroborates their histories, increases their likelihood of receiving legal protection, and mitigates re-traumatization, keeping the child’s best interests front and center. Supervision is provided by licensed psychologists.

Montefiore Einstein Center for Transplantation – Transplant Psychology Service

The Montefiore Einstein Center for Transplantation is a Center of Excellence in kidney and liver transplantation. We pride ourselves in providing state-of-the art multidisciplinary care for patients across the lifespan undergoing kidney, pancreas, and liver transplantation, as well as kidney and liver living donation. The psychology and psychiatry services are fully integrated into the transplant program and highly regarded across disciplines. Interns will also work with the transplant team to assess for psychological contraindications to liver and kidney transplantation and living donation, as well as provide inpatient assessment and therapy for patients hospitalized post-transplant and presenting with a variety of psychological concerns, including alcohol/substance use disorders, depression, and anxiety. Interventions used with transplant patients are based on CBT, motivational interviewing, and mindfulness. Interns will work closely with members of the multidisciplinary team including surgeons, hepatologists, nephrologists, social workers, and nurses to provide high-quality integrated care for transplant recipients and living donors. There are opportunities to participate in multidisciplinary team meetings with the transplant team. Clinical supervision and consultation will be provided by licensed psychologists and other team members.

University Behavioral Associates

UBA is an innovative managed care company founded by the Department of Psychiatry at MMC which delivers behavioral health services to a large population in the Bronx and Westchester. Interns choosing this research elective on behavioral population health will learn about patterns of utilization, models of health care reform, managed care, and reimbursement methodologies. Supervision is provided by a licensed psychologist.

WeCare Program

The WeCARE program is funded by New York City's Human Resources Administration (HRA) to provide evaluation and case management services to substance abusing public assistance recipients (CMS) or those with medical and/or psychiatric disorders, 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. Interns can also learn about disability and employability criteria and decision-making. Individual supervision of at least one hour per week is provided by a licensed psychologist and other team members.