Adult Psychology Track (155217)

This track offers an array of clinical opportunities for trainees who are interested in evidence-based assessments and treatments for adults with a range of psychopathology, including but not limited to depressive/anxiety disorders, conditions requiring psychiatric hospitalization, and/or couples and families with relationship dysfunction. Settings include outpatient mental health for civilians (SATRP) and students (CBT-CAPS), outpatient mental health for veterans (CBT Clinic; Couples & Family Clinic), primary care for veterans (PCMHI), and psychiatric inpatient for civilians (CIPS). Each setting/rotation is supervised by faculty member(s) guided by the scientist practitioner model and well versed in a wide range of evidence-based approaches.

• CBT Clinic for Emotional Disorders (CBT-VA)
• CBT-Counseling & Psychology Service (CAPS)
• Couples & Family Clinic
• Primary Care Mental Health Integration (PCMHI)
• Sleep & Anxiety Treatment and Research Program (SATRP)
   

Cognitive Behavioral Therapy Clinic for Emotional Disorders — VAMC (CBT-VA)

The CBT Clinic for Emotional Disorders is a specialized psychotherapy clinic with an integrated staff of psychologists and social workers. The clinic serves veterans with diagnoses of emotional disorders (major depressive disorder, dysthymia, panic disorder, social phobia, PTSD, OCD, specific phobia, and GAD) from referring providers throughout the VAMC mental health service. The CBT Clinic focuses evidence-based psychotherapies, including various versions of behavioral and cognitive therapies (e.g., PCT, PE, CPT, ERP) and newer adaptations (e.g., DBT, mindfulness, ACT). Because comorbidity is extremely common in this population, transdiagnostic approaches to psychotherapy are emphasized.

The scientist-practitioner/clinical scientist model is highly valued by the staff within the CBT Clinic and plays an important role in clinical practice, supervision, and related research projects. Although the CBT Clinic primarily serves as a treatment service within VAMC, there are several recent and ongoing research projects within the clinic. To date, these projects have focused primarily on better understanding prevalence, severity, and diagnostic comorbidity of the emotional disorders and adapting evidence-based psychotherapies to real-life clinical practices (e.g., effectiveness, dissemination, and implementation research). Past interns also have been successful in publishing case studies resulting from the complex cases treated during the clinic.

Interns rotating within the CBT Clinic will receive both individual and group psychotherapy experiences in addition to supervision and training in evidence-based psychotherapies. Given the large number of referrals and opportunities, the CBT Clinic supervisors attempt to match/address an intern’s individual training needs with specific patient characteristics, diagnoses, and/or treatment practices or modalities.

After completing the CBT Clinic rotation, interns will be able to:

• Accurately diagnose and assess veterans with emotional disorders and related comorbidities.
• Develop evidence-based treatment plans for addressing disorder-specific and transdiagnostic symptoms related to the emotional disorders.
• Deliver evidence-based psychotherapy for the emotional disorders, including several different disorder-specific and transdiagnostic CBT protocols.
• Assess treatment progress via evidence-based assessment practices.
• Communicate and coordinate assessment/treatment findings through direct interactions with providers and via documentation in patient medical records.

Location of Rotation 

Ralph H. Johnson Veterans Affairs Medical Center

Faculty

• Daniel F. Gros, Ph.D., associate professor
• Rachel LeVine, Ph.D., assistant professor
• Nina Sarver, Ph.D., assistant professor
• Derek Szafranski, Ph.D., staff psychologist, clinical assistant professor

Cognitive Behavioral Therapy — Counseling and Psychological Services Center (CBT-CAPS)

CBT-CAPS provides psychological assessment and individual and couples therapy for students in the six health-related colleges. These students experience problems which are representative of the wide spectrum of adjustment and mental health disorders.

Assessment: Comprehensive intake assessments; assessments of mood and anxiety disorders; behavioral problems, and assessments of issues affecting learning and academic performance.

Outpatient Individual Therapy: Individual psychotherapy ranging in duration and scope from brief cognitive behavioral work to longer-term therapy, couples therapy

Psychoeducational Groups: Educational presentations are developed for specific needs and may include conflict resolution, stress management, grief, sleep hygiene, or relationship enhancement, for example.

Interns may elect to conduct research with the clinical population at CBT-CAPS. There is an extensive database available for use by the interns.

After completing the CAPS-CBT rotation, interns will be able to:

• Conduct focused intake assessment using a semi-structured interview and objective measures.
• Formulate treatment plans based on relevant empirical and theoretical literature for students seeking (or referred for) psychological treatment for a variety of problems, including depression, anxiety, substance abuse, relational problems, academic problems (including ADHD), problems with professional conduct, etc.
• Demonstrate competencies in drug/alcohol abuse assessment and treatment in the student population at MUSC. Such competencies include evaluation, understanding of MUSC drug and alcohol policies, referral for laboratory drug/alcohol testing, administration of breathalyzer, use of motivational interviewing techniques, and knowledge of related community resources.  
• Provide evidence-based treatment to address presenting problems and monitor symptoms and to evaluate effectiveness of the intervention(s).              
• Effectively participate in an interdisciplinary team, evidenced by consultation with psychiatrists and other physicians regarding medications, making appropriate referrals for evaluation for psychotropic medications, and addressing other medical issues that may impact symptoms or treatment.  
• Provide effective and sensitive mental health consultation and psychoeducational presentations to the university community, parents, and outside agencies, when requested.
• Demonstrate proficiency in the use of templates for documentation in the electronic medical record (point and click).

Location of Rotation

Medical University of South Carolina

Faculty

Alice Q. Libet, Ph.D., clinical associate professor

Couples & Family Clinic — VAMC

On this rotation, interns attain proficiency in thoroughly working up couple and family relationships through the multi-systemic assessment of behaviors, attitudes, and feelings via semi-structured interviews, self-report measures, and observational assessments.

Interns serve as co-therapists, primarily with the rotation supervisors, but also occasionally with other interested and proficient intern or post-doctoral fellow colleagues. The primary intervention focus in the Couples Clinic is dyadic therapy via Jacobson’s and Christensen’s Integrated Behavior Couples Therapy (IBCT), which is a sophisticated unification of “classical” Behavioral Marital Therapy (i.e., communication skills, problem solving skills, and increasing positive event density) and Emotion Focused Therapy, leading to additional key intervention techniques around emotion (“Empathic Joining”) and cognition (“Unified Detachment”). Additional couples interventions include Behavioral Couples Therapy for SUD and Cognitive Behavioral Conjoint Therapy for PTSD.

Consistent with national trends in primary care and managed care, brevity of intervention (typically an 8 to 10 session span) is stressed. Couples are also typically invited to participate in a VA multi-center clinical research outcome study. Additionally, interns with research interests in prevention and/or in relationship strategic planning, life balance development, and/or in empirically examining interaction data will find ample opportunity to participate in clinical research in the Couples & Family Clinic.

After completing the Couples Clinic rotation, interns will be able to:

• Administer, score, and interpret comprehensive interview, assessment, and observational data.
• Conduct functional behavioral assessments of couple dysfunction and use this information to tailor treatment plan.
• Functionally analyze, verbally and in writing, the etiology and maintenance of maladaptive inter-spouse behavior/cognitive chains.
• Communicate intake findings, conclusions, recommendations to couples and develop treatment plans to address these.
• Demonstrate appropriate and effective use of specific couples therapy techniques, including nurturing support, challenging, confronting, coaching, demonstrating, and modeling.
• Demonstrate modeling and effective teaching of behavioral intervention skills, including specific praise, effective commands, limit setting, time-out, planned ignoring, and cost-response systems.
• Demonstrate effective use of emotion-regulating tools.

Location of Rotation

Ralph H. Johnson VA Medical Center

Faculty

• Julian Libet, Ph.D., associate professor
• Jenna Baddeley, Ph.D., staff psychologist   
• Karen Petty, Ph.D., staff psychologist

Primary Care — Mental Health Integration Program (PCMHI) — VAMC

PCMHI is a primary care-based rotation that serves a wide range of presenting complaints within the scope of depressive, anxiety, adjustment, and mild substance use disorders. PCMHI patient referrals are based upon patient request, primary care provider recommendation, and/or cutoff scores on the VA primary care measures of depression and PTSD. Referred patients meet with a co-located mental health provider and complete a brief clinical interview, and self-report measures. Based on their level of impairment and interest in treatment, patients are offered a medication consultation with a PCMHI psychiatrist and brief evidence-based psychotherapy with a PCMHI psychologist, intern, or social worker. Patients with more severe psychopathology and/or impairment are referred directly to more intensive interventions in the mental health clinic. All patients within the PCMHI program also are followed by a social worker serving as a care manager. In addition, PCMHI staff (psychiatrist, psychologists, social workers, and nurse practitioner) work closely with their patients’ primary care providers to coordinate the patient's physical and mental health needs.

PCMHI interns are trained in a range of clinical activities including brief evidence-based psychotherapy, integration of behavioral health practices into psychotherapy, and coordination of treatment within a multidisciplinary team of primary care and mental health providers. Regarding psychotherapy, interns may be trained in a wide range of brief evidence-based practices, tailored to the 30 minute sessions and 3-6 session PCMHI format (e.g., Problem-solving therapy, brief behavioral activation, and CBT for insomnia). Given the primary care setting, behavioral health practices (e.g., smoking cessation, weight management, reduction of alcohol consumption) also will be included in the training and treatment practices of interns. And finally, interns are trained to function successfully within a multidisciplinary team.

After completing the PCMHI rotation, interns will be able to:

• Accurately identify and assess psychiatric symptoms in veterans within primary care settings.
• Develop evidence-based treatment plans.
• Deliver brief versions of evidence-based psychotherapy for depressive and anxiety disorders.
• Provide brief interventions for related disorders and conditions (stress management, anger management, sleep disturbance, mild substance abuse).
• Assess treatment progress via evidence-based assessment practices.
• Communicate and coordinate assessment/treatment findings through direct interactions with providers and via documentation in patient medical records within the VA Primary Care and PCMHI programs.

Location of Rotation

Ralph H. Johnson VA Medical Center

Faculty

• Daniel F. Gros, Ph.D., associate professor
• Rachel LeVine, Ph.D., assistant professor
• Jennifer Wray, Ph.D., assistant professor
• Ashley Barroquillo, Psy.D., staff psychologist

Sleep & Anxiety Treatment and Research Program (SATRP)

The SATRP is an adult outpatient clinic providing state-of-the-art evidence-based treatments for various sleep and anxiety disorders. The clinic serves patients with primary diagnoses of social anxiety, obsessive-compulsive disorder, panic disorder, specific phobias, and generalized anxiety disorder. In addition, the clinic provides state-of-the-art sleep studies and behavioral and psychopharmacological interventions for sleep disorders (insomnia, narcolepsy, and restless leg syndrome). Interns rotating at SATRP develop expertise in cognitive behavioral approaches to the treatment of anxiety and sleep within a multidisciplinary environment alongside social workers, psychiatrists, and psychiatry residents. Interns use semi-structured assessment batteries to assist with diagnoses. Treatment approaches typically include exposure-based behavioral, cognitive-behavioral, and acceptance and mindfulness-based interventions. Individual and group therapy training are provided. Interns participate in weekly individual and group supervision with psychiatry residents and the supervising psychologist. Because this rotation serves a cross-section of the community, interns are expected to be available to work in an evening clinic one day per week until approximately 8 p.m.

Further, interns are invited to engage in ongoing collaborative anxiety research projects with psychiatry and psychology faculty. Current projects include the relationship between sleep disorders and anxiety and optimizing existing anxiety interventions.

After completion of the SATRP rotation, interns will be able to:

• Accurately assess and diagnose anxiety disorders using semi-structured assessment batteries.
• Accurately assess and diagnose sleep related problems using semi-structured assessment batteries.
• Effectively deliver evidence-based cognitive behavioral protocols for anxiety disorders (including but not limited to exposure treatments (EX), exposure and response prevention (EX/RP), and acceptance and mindfulness ACT)
• Effectively deliver evidence-based cognitive behavioral protocols for sleep problems such as insomnia, parasomnia, narcolepsy, and hypersomnia.
• Document the delivery of services and patient response to services appropriately in each patient's electronic medical record.
• Integrate appropriate modifications to assessment and intervention of sleep and anxiety difficulties based upon unique needs of patients with culturally diverse backgrounds (e.g., race/ethnicity, gender, SES, sexual orientation, etc.).
• Collaborative effectively with a multidisciplinary team of clinicians, psychologist, and psychiatrists.

Location of Rotation

MUSC Department of Psychiatry and Behavioral Sciences

Faculty

• Alyssa Rheingold, Ph.D., professor
• Melissa Milanak, Ph.D., assistant professor
• Thomas Uhde, M.D., professor and chair
• Allison Wilkerson, Ph.D., assistant professor