The Traumatic Stress track offers unique opportunities to work with both military and civilian populations. Treatment settings are diverse and include a Veterans Administration Medical Center, a hospital-based outpatient clinic, a community child advocacy center, and variety of community-based outreach settings. Applicants with interests in either adult or child traumatic stress are welcome.
The Community Outreach Program — Esperanza (COPE) is a specialty clinic within the National Crime Victims Research & Treatment Center. COPE provides community-based assessment, referral, and treatment services to children who have been victimized by crime (e.g., sexual and physical abuse, domestic violence) or have experienced other traumatic events (such as a natural disaster or a serious accident). Services are provided in the child's community (e.g., home, school). COPE attempts to reach victim populations that have traditionally been underserved by office-based mental health care programs, especially rural populations and racial/ethnic minorities.
Although open to children from all racial/ethnic minority groups, a significant proportion of referrals involve children of Hispanic descent. In addition to direct services, COPE offers consultation and in-service training to local and state service agencies (e.g., Department of Social Services, public health centers, schools) in order to increase community awareness of the special needs children who have been victimized. Interns have the opportunity to be involved in all aspects of COPE services. Clinically, interns are trained in behavioral and cognitive behavioral treatment interventions, with a particular focus on adapting evidence-based interventions for use in community settings. Interns develop expertise in the assessment and treatment of posttraumatic stress disorder, other anxiety disorders, depression, and disruptive behavior disorders. Finally, interns are encouraged to become involved in ongoing research and/or to participate in related research endeavors.
After completing the rotation, interns will be able to:
National Crime Victims Research & Treatment Center, MUSC
A freestanding children’s advocacy center, DNCAC has a multidisciplinary staff representing psychology, social work, case management, and forensic interviewing. We also have co-located physicians, nurses and fellows from the MUSC division of child abuse pediatrics. Each year, the DNCAC provides direct services to over 1,500 child maltreatment victims, including both forensic and clinical (i.e., assessment and/or treatment) services. Children served at our program identify as African American (42 percent), Caucasian (33 percent), mixed race (6 percent), Hispanic/Latino (8 percent), and other/unknown (11 percent). Approximately half (59 percent, N = 690) of the children we serve have experienced child maltreatment, including physical abuse (31 percent), exposure to domestic violence (20 percent), and sexual abuse (16 percent).
Psychology interns receive didactic and experiential training in evidence-based assessments and treatments for children who have experienced child abuse or trauma. The treatments provided at DNCAC include Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT), Parent-Child Interaction Therapy (PCIT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and Sexual Behavior Problem — Cognitive Behavioral Therapy (SBP-CBT). Psychology interns predominantly conduct mental health assessments and provide AF-CBT and PCIT. Interns have the opportunity to observe forensic interviews. Psychology interns on this rotation collaborate with many multidisciplinary partners, including pediatricians, social workers, child protective services, law enforcement, and prosecutors. There are also shared training activities with interns from social work and clinical counseling programs.
By the end of the rotation, interns will be able to:
Dee Norton Children's Advocacy Center, Charleston, South Carolina
Interns function as part of an integrated behavioral and physical health team that serves children who are currently in foster care placements in Charleston and Dorchester Counties. Interns perform a variety of duties, including consultation with pediatricians on behavioral health issues; brief, targeted psychological assessments; provision of evidence-based interventions (e.g., Trauma Focused-Cognitive-Behavior Therapy, Parent-Child Interaction Therapy); and short-term crisis stabilization counseling (using the Child-Family Traumatic Stress Intervention) with foster children and their families. Interns participate in case staffings with the FCSC team (pediatrician, nurse-practitioner, social worker, and psychologist), which will jointly determine the service plan for each child. Interns round with pediatricians and nurse practitioners to provide some brief interventions “on-the-fly” during clinic and also have scheduled clinics in which they provide more traditional outpatient psychotherapy (based on referrals and case needs from the FCSC team).
The rotation also provides an excellent opportunity to develop skills for effective interaction with community and public agencies, like the child protection and foster care service systems.
At the end of the rotation, interns will be able to:
Medical University of South Carolina
The population served by the NCVC includes victims of a variety of crimes and traumatic events (sexual/physical assault, robbery, burglary), sexual and physical assault, domestic violence, witnesses to violence, and family members of homicide victims. Interns develop expertise in the assessment of traumatic events in the client's history and post-trauma adaptation, including post-traumatic stress disorder, other anxiety disorders, and affective disorders. As a therapist, the intern works with victims (and their families) utilizing evidence-based therapeutic techniques including Trauma-Focused Cognitive Behavior Therapy, Cognitive Processing Therapy, and Prolonged Exposure. Interns see patients in both the adult clinic and family and child clinic, and have separate clinical supervisors for each clinic. Interns may, if their schedule permits, co-lead a support group for surviving family members of homicide victims. 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 (currently Wednesday) until approximately 8 p.m. Their remaining work schedules are adjusted to accommodate for this evening clinic requirement.
Research opportunities are available for interns interested in understanding innovative service and training methods for trauma populations; the application of innovative technologies in the treatment of trauma victims and the training of clinical professionals; the epidemiology of trauma and its consequences; and the physiological and genetic determinants of trauma-related psychopathology.
After completing the NCVC rotation, interns will be able to:
MUSC Institute of Psychiatry outpatient clinic
This rotation provides an opportunity to work with veterans who were exposed to combat and other military trauma. The PCT is an outpatient multidisciplinary team consisting of psychologists, social workers, psychiatrists, psychiatric nurses, and trainees. The emphases are on evidence-based evaluation, innovative treatment modalities, and individual evidence-based therapy utilizing exposure and other cognitive-behavioral treatment protocols. Interns may also have the opportunity to provide treatment to veterans via telehealth and/or lead groups focused on psychoeducation about common reactions to trauma in an inpatient setting.
The intern functions as an integral part of the treatment team and is involved in every aspect of patient care. Specifically, the intern participates in the evaluation and diagnosis of PTSD and other psychological conditions using a multi-dimensional assessment approach; implements individual cognitive-behavioral treatment approaches, including exposure therapy and cognitive processing therapy; gains an understanding of systemic issues related to PTSD in the VA system (such as iatrogenic effects, secondary gain, or malingering); participates in ongoing clinic program evaluation efforts, primarily through collecting and entering data on PCT treatment initiation and primary and secondary outcome measures.
Opportunities for engagement in productive clinical research are present through on-going studies or the development of new projects. At the end of the rotation, trainees will be able to:
Ralph H. Johnson VA Medical Center
This rotation is school-based and offers broad clinical opportunities working with adolescents with internalizing and externalizing problems, trauma symptoms, and emotional regulation difficulties. Services are provided during school hours; however, interns are encouraged to meet with students’ parents as necessary before or after school. Interns on this rotation will have the opportunity to work with traditionally underserved populations, as Stall High School serves largely African American and Hispanic communities. Clinically, interns are trained in behavioral and cognitive behavioral treatment interventions, with a particular focus on adapting evidence-based interventions for use in school settings. Opportunities for group therapy are available and highly encouraged. Interns work directly with teachers and other school officials to develop treatment plans that are applicable to the classroom setting and that will address school behavior. In addition, interns are welcome to become involved in ongoing research and/or to participate in related research endeavors.
After completing the Stall High School rotation, interns will be able to:
Stall High School, North Charleston, South Carolina
The Telehealth Resilience and Recovery Program is a multidisciplinary experience that provides an opportunity to work with children and adults who experienced traumatic injury. Once enrolled in our service via our level-1 trauma center, these patients are monitored for emotional recovery and offered mental health assessment and treatment as needed. PTSD and depression are prevalent in this population. Interns provide psychoeducation in our acute care setting, assist patients in remote monitoring of emotional recovery, and conduct telehealth-based assessment and treatment for patients who develop PTSD or depression. Exposure-based treatments, behavioral activation, and other best practice interventions are used most often.
The intern functions as an integral part of the treatment team and is involved in every aspect of patient care. Specifically, the intern participates in assessment and diagnosis of PTSD, depression, and other psychological conditions using a multi-dimensional assessment approach, and then implements individual and family behavioral treatment approaches, such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Prolonged Exposure (PE), and stress management techniques, as indicated. Interns also gain an understanding of systemic issues related to continuity of care and interdisciplinary management of clinical cases. Participating interns may be involved in pilot studies and clinical trials, if appropriate, and programmatic development of the telehealth service for trauma patients.
Note: this rotation is considered both a Behavioral Medicine and Traumatic Stress track rotation.
At the end of the rotation, interns will be able to:
MUSC Emergency Department and Department of Psychiatry