Objectives for the Pediatrics-Psychology Internship
The mission of the University of Minnesota is to achieve excellence in research, education, and service. The Internship is designed to promote the establishment and refinement of competencies in psychological assessment, intervention, and consultation and the development of professional and ethical conduct.
More specifically, the Internship aims to prepare psychologists with the requisite knowledge and skills for post-internship career activities, entry to the profession, and into the practice of health service psychology. Internship training promotes the acquisition and refinement of the Profession-Wide Competencies for which interns must demonstrate competence by the conclusion of the Internship in:
- Research and Scholarly Inquiry
- Ethical and Legal Standards
- Individual and Cultural Diversity
- Professional Values, Attitudes, and Behaviors
- Communication and Interpersonal Skills
- Consultation and Interprofessional/Interdisciplinary Skills
The focus of this Internship is on children and adolescents. Whereas the primary objective is to facilitate the development of interns' clinical skills, interns also are encouraged to pursue professional and scientific interests to establish strong foundations for diverse career directions with an emphasis on health care. A training philosophy balancing scientific and professional practice elements along with ethical reasoning underlies the program. The scientific objectives of the Internship are primarily to enhance knowledge related to the psychological and biomedical literatures and to promote broader understanding of the results, limitations, and clinical implications of scientific research. Scientific foundations may be enhanced secondarily through participation in faculty research activities.
Most of the Internship faculty are engaged in research and scholarship. Whereas research participation is encouraged during the internship, it is not required due to the inherent limitations for completing substantive programmatic research during a time-limited training experience which emphasizes the refinement of clinical proficiencies. Overall, the focus of the Internship is the promotion of clinical skills and proficiencies as informed by scientific and related professional developments. Training at the University of Minnesota Medical School fosters the development of competent, responsible, professional, and ethical conduct while exposing interns to the rich clinical opportunities, intellectual stimulation, and demands of professional practice in an academic medical setting.
The high penetration of managed care in Minneapolis has created an environment which demands that professionals develop highly efficient work patterns to provide quality clinical services which achieve targeted outcomes. Managed care also creates challenges to practice and training. These can be surmounted through the collaborations of Internship faculty and interns to take advantage of clinical opportunities to achieve training objectives. The managed care environment also promotes a sophisticated understanding of health care organizations and current practices within an evolving health care system. Interns gain exposure to the practice requirements of multiple third parties and are prepared to provide clinical services within a managed care framework and according to prevailing standards of practice. Further description of the three clinical emphases is provided by clicking the gray tabs below.
Psychological assessment is a fundamental component of professional psychologists roles. Assessment is emphasized as the primary training focus in all of the rotations of the Internship. Assessment skills including behavioral observation, interviewing, mental status examination, objective and projective assessment techniques, and use of computerized testing methods are refined during the course of the year. Assessment training also includes selection of appropriate assessment methods, test administration and scoring, data interpretation, acquisition and integration of information from medical records and collateral sources, preparation of written reports, and oral communication of findings and recommendations to patients, families, and professionals.
The extent and diversity of interns assessment training and experience varies on each rotation according to the clinical assessment activities and patient populations served by that clinical unit. The greater a particular rotations assessment activities, the more interns can expect to be involved in clinical assessment. It is expected that interns will receive the training necessary to achieve mastery of the basic psychological assessment approaches utilized in their rotation settings. The comprehensiveness of assessments varies among rotations. On inpatient psychiatric services, assessment is usually a primary responsibility, with attention to personality and cognitive functioning, treatment, and prognostic issues. In pediatric medical clinics and hospital units, assessment activities typically address psychological adjustment to medical conditions and treatment and to diverse social circumstances including school and family problems. Evaluation of intrapersonal, interpersonal and situational resources is a complex process that integrates personal data and psychological principles in formulating recommendations as well as planning and implementing treatment. Neuropsychological assessments are conducted to clarify diagnostic and treatment issues through comprehensive assessment of cognitive and psychomotor development, attention, learning, intellectual functioning, memory, abstract reasoning, problem solving, and personality functioning. Neuropsychological assessments address central nervous system status and often yield educational, dispositional, and rehabilitation recommendations.
Attention to a range of assessment issues is provided, including the use of assessment techniques with ethnic, linguistic, and culturally diverse populations, legal and ethical issues in assessment of children and families, and psychometric aspects of specific tests and measurement instruments. Assessment resources may include supplemental support of psychometrists and other professionals in some settings. Interns are expected to complete psychological reports within time frames which meet the needs of consumers and referral sources, and the expectations of supervisors, generally within two weeks of patient contacts.
Estimates of the frequency of use of a variety of tests on each of the three rotations are available by clicking here.
Consultation experiences include a broad range of professional activities with patients and multidisciplinary staff in The University of Minnesota Masonic Children's Hospital and various settings. Interns are expected to work closely with their supervisors to integrate selected clinical approaches in primary, secondary and/or tertiary care settings. Interns may be involved in consultation with diverse health, mental health, and social service professionals in health care facilities, schools, public institutions (e.g., courts), and community and governmental agencies. Interns may serve as team members to specific medical (e.g., brain tumor, cystic fibrosis, FAS, genetics, oncology, PKU) and interdisciplinary treatment teams (e.g., inpatient psychiatry). The opportunities for consultation can vary over time in response to clinical, staffing, and systems factors.
A range of supervised therapy experiences and training in diverse types of interventions are available. Didactic training in psychotherapy is provided weekly in the Psychotherapy Seminar and group supervision of psychotherapy. The opportunities for psychotherapy experiences vary across clinical services so psychotherapy caseloads vary among rotations. Assignment of cases and choice of therapeutic modalities are based on patients needs, interns training needs and interests, rotations resources, and supervisors orientations. In general, interns are supervised in multiple psychotherapy modalities, drawing chiefly on cognitive-behavioral, behavioral dialectical behavior therapy, and interpersonal psychotherapy modalities and addressing non-specific factors in therapy. They may be exposed to additional specific approaches as well, such as relaxation training and supportive therapy. Therapy training includes empirically-supported treatments. Intervention experiences with children and adolescents are provided throughout the year. Interns caseloads throughout the year include primarily individual psychotherapy cases, parent training, and counseling related to medical care, with more limited exposure to family and group therapies. Interns are encouraged to arrange to continue a small number of psychotherapy patients (usually < 3) from the first rotation to the second rotation at the discretion of primary supervisors of both rotations. Similarly, interns are encouraged to arrange to obtain limited intervention experiences outside of their rotations if it becomes necessary to supplement the opportunities for intervention within their rotations (e.g., when on the Pediatric Neuropsychology rotation). In addition to conducting psychotherapy with psychiatric patients, interns may obtain intervention and consultation experiences with patients in specialized medical settings. Psychotherapy experiences can be with inpatients and outpatients, and may include exposure to a range of clinical approaches among Internship rotations.
On the Pediatric Psychology rotation, interns consult with treatment teams, provide case management and coordination of care, and provide behavioral consultation to patients and families. Limited adult intervention experiences also may be arranged based on interns interests and at the discretion of primary supervisors. Interns are encouraged to obtain sufficient intervention experiences to be prepared for post-internship clinical practice. At minimum, 80 hours of therapy/intervention is expected on the Child and Adolescent Psychiatry and Pediatric Psychology rotations and 40 hours on the Pediatric Neuropsychology rotation. It should be emphasized that interns are expected to exceed these minimal targets and usually are able to make arrangements to obtain significantly more psychotherapy experience.
Specialized Training Opportunities
Specialized Training Opportunities
The faculty are involved in several areas of professional activity. The Internship provides training related to neurotoxicology and exposure to environmental substances. Another area of effort is Dr. Robiner's work with Quality Assessment and Improvement Systems, which is an effort to develop standardized assessment tools and processes for psychology training. It may offer opportunities for research on psychology training within this internship as well as involving internships at other sites. Supervisors research is described on the supervisor section and further information is available by linking to supervisors publications on the internship website.
Interns work a few shifts in the Behavioral Emergency Center (BEC), which is the hospital's psychiatric emergency room to gain exposure to acute psychiatric emergencies. Interns attend two 1-day training workshops sponsored by the Minnesota Association of APA-Accredited Internships (MAAPIC) that address cultural diversity issues and supervision, ethical, and legal issues.
Interns have opportunities to participate in the Foundations of Interprofessional Communication and Collaboration (FIPCC) course with other academic health center trainees as small group co-facilitators.
Supervision is an essential and valued feature of the Internship, with supervision of clinical activities comprising the primary training modality within the Internship. Supervisors are committed to assisting interns achieve their individual goals while fulfilling their responsibilities to patients and participation in the Internship as a whole. The supervisory relationship is enhanced and interns are likely to benefit maximally from contacts with supervisors when interns prepare for supervision. This includes identifying goals for the internship year and for supervision during the rotation, as well as bringing appropriate case materials to supervision sessions, and developing effective working relationships in which clinical and professional matters can be discussed constructively. Supervision involves oversight of supervisees work with the perspectives of an experienced clinician, sensitive teacher, discriminating professional, and manager of clinical services and training. The clinical aspect of supervision focuses on the professional development of supervisees skills. The administrative or managerial aspects of supervision involve directing and evaluating the work of supervisees. It is a process which is fundamentally dedicated to improving the quality of professional services which interns can provide. Supervisors and interns are expected to strive to use supervision to promote the achievement of the highest level of performance in the services interns can provide through collaborative and collegial working relationships which support and nurture progress toward this goal. Supervisors strive to find a delicate balance among multiple roles, including: advising; directing; teaching; mentoring; listening; editing; providing emotional support (but not therapy) to interns; assigning cases, and monitoring interns performance to ensure that clinical services meet clinical, training, and administrative objectives. Supervision deals with specific clinical tasks and also offers interns opportunities to discuss their reactions, questions, or concerns about the clinical work, as well as to address a broad range of matters related to their professional development.
The Internship provides a minimum of 4 hours per week of supervision (including group supervision) in accordance with current APA accreditation standards. During both rotations interns' training is coordinated by a primary, doctoral-level licensed psychologist. Interns obtain a minimum of two hours of individual supervision which may be from the primary supervisor and from other psychologists or related medical (e.g., psychiatrists, behavioral pediatricians) or allied health professionals (e.g., social workers). Postdoctoral fellows may also be involved in supervisory experiences. Exposure to other psychotherapy supervisors and orientations is encouraged; however opportunities for such diversity vary among rotations. Faculty supervisors orientations and approaches have included behavioral, client-centered, cognitive-behavioral, crisis intervention, dialectic behavioral therapy, eclectic, family systems, integrative, interpersonal, object relations, play, rational-emotive, supportive, structured short-term therapy, as well as parent counseling. In addition, training in specific interventions such as hypnosis, biofeedback, vocational and/or educational counseling may be available within certain rotations at the discretion of primary supervisors. The format for supervision varies among rotations and among supervisors. For example, on clinic days, pediatric neuropsychology supervisors provide case supervision for approximately one half hour before and one half hour after patient contacts as well as one hour per week of individual supervision. On other rotations, supervision is generally scheduled more consistently for hourly sessions.
Supervision is a topic of professional and scholarly interest to faculty members. It is discussed during the topical seminar series and Professional Development Conference. Supervision training also includes an annual 1-day workshop sponsored by MAAPIC (the APA-accredited internships in Minnesota).
Interns have limited opportunities on all rotations to be involved in the observed case-consultation of practicum students and obtain supervision on such supervisory experiences.
The internship recognizes the importance of mentoring in supporting learners personal and professional development. Interns participate in a formal mentoring program in which they establish a relationship with one of the faculty members with whom they consult individually monthly about professional development issues throughout the year.