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TRAINING SITES AT CAMBRIDGE HEALTH ALLIANCE
Adult Neuropsychology Service
This service provides clinical neuropsychological assessment to
of a range of adult inpatient and outpatient populations, including
primary psychiatric, neurological and medical disorders. Typical
referrals include evaluations of patients who present with psychiatric
symptoms who also have a variety of neurological disorders, including
head trauma, seizure disorders, sleep disorders, migraine, motor
system disorders, learning disabilities, attention-deficit disorders,
and dementia. Numerous didactic, teaching, and research opportunities
are also available within the hospital and Harvard Medical School,
including individual supervision and seminars in Child Neuropsychology
and Adult Neuropsychology, as well as a Clinical Case Seminar led
by staff neuropsychologists.
Child Neuropsychology Service
The Center for Child and Adolescent Development (CCAD) is a multidisciplinary
clinic that brings together professionals in psychiatry, psychopharmacology,
social work, neuropsychology, and developmental psychology. The
clinic works with the whole child, and works with the child's environment
to maximize outcome. This includes working the child's family (including
support groups for parents) and with their school (including school
outreach). The clinic serves patients with a wide range of presenting
concerns - including medical disorders, learning disabilities, psychiatric
difficulties, and developmental disorders. Current research conducted
in the clinic includes an examination of medical aspects of Pervasive
Developmental Disorder, and neuroimaging and neuropsychological
studies of children who are at risk for bipolar disorders and psychotic
disorders. The fellowship includes individual supervision and seminars
in Child Neuropsychology and Adult Neuropsychology, as well as a
Clinical Case Seminar led by a staff neuropsychologist.
Autism and Developmental Disability Team
The number of children identified with autism spectrum disorders
is estimated to be 1 in 150, and the number of children with other
significant developmental disabilities such as Mental Retardation
is also large and estimated to be 15/1000. There are many roles
for psychologists in the lives of these children and their families
including: diagnosing of young children with autism, providing therapy
for parents and siblings coping with the impact of having children
with these disabilities, providing behavioral and play therapy and
parent guidance to high functioning children around emotional, behavioral
and social challenges, providing consultation to early intervention,
preschool and school programs, providing developmental testing of
children, and participating in intervention research.
This fellowship is based on an apprenticeship model, through which
the fellow learns many of the above tasks. This fellowship prepares
fellows for work in hospitals and program consultation, in addition
to private practice. The candidate will work closely with the interdisciplinary
staff of the Autism and Developmental Disability Team including
Neuropsychology, Developmental Psychology, Social Work, and Psychiatry.
The candidate will have the opportunity to attend the many autism
and developmental disability related seminars and lectures offered
through the Harvard Medical School community. There are also opportunities
for involvement in multiple research projects taking place especially
with children with Autism spectrum disorders.
Behavioral Medicine Program
Behavioral Medicine clinicians strive to consider an individual's
symptoms within the context of psychological (psychiatric diagnosis,
cognitive-behavioral, psychodynamic and systemic formulations),
social (socioeconomic factors, social support network, cultural
background, social reinforcement of symptoms), and biological (organic
processes, psychophysiological arousal patterns, disease process,
and somatopsychic) variables. General treatment goals are to increase
patients' use and awareness of more adaptive coping styles as well
as to modify underlying patterns that maintain their symptoms and
distress. Techniques of change include cognitive-behavioral therapies
(e.g., cognitive restructuring, behavioral self-management, exposure
and desensitization, skill acquisition), hypnosis, and biofeedback.
Other treatment components include psychopharmacology, supportive
psychotherapy, systemic interventions, and coordination with medical
treatment.
Training in the Behavioral Medicine Program provides an opportunity
for clinicians seeking to understand the impact of physiology on
psychiatric and medical conditions. It also will provide fellows
with training in shorter term, symptom-focused treatment utilizing
cognitive, behavioral, and physiological techniques. A Behavioral
Medicine Fellow provides consultations and liaison with psychiatric
care services and ancillary medical personnel as well as providing
individual and group assessment and treatment. Thirteen of the hours
are spent in supervision, conferences or seminars, including seminars
on the Clinical Applications of Behavioral Medicine, Hypnosis, and
Fundamentals of Cognitive-Behavior Therapy.
Acute Services with an emphasis in Child and Adolescent Psychiatry
This fellowship consists of rotations on three different services
within Cambridge Health Alliance. These include the Child Assessment
Unit (CAU), the Adolescent Assessment Unit (AAU), and the Psychiatric
Emergency Service at the Cambridge hospital campus. The CAU is a
13 bed locked inpatient unit serving children ages 3-13 located
at the Cambridge campus. The AAU is a 15 bed locked inpatient unit
serving adolescents ages 12-18, located at the Somerville campus.
Both units have a patient population that is quite diverse ethnically
and diagnostically, and operate within a collaborative interdisciplinary
team framework. In 2003, the CAU earned the Gold Achievement Award
from the American Psychiatric Association for its innovative practices
in eliminating seclusion and restraint, developing compassionate
ways of dealing with children's anger, and partnering with families.
The AAU employs a similar model of care that is tailored to the
adolescent population.
Psychology Fellows receive training in assessment, treatment planning,
and treatment with children and adolescents, within the context
of intensive assessment units. During the inpatient rotations, fellows
gain experience working with children and adolescents in individual,
family, and group therapy. Our trainees also work with collateral
service providers (e.g. DSS, DMH, schools, outpatient treatment
teams). Additionally, psychology fellows conduct psychological testing
batteries, write reports with supervision, and gain experience giving
testing feedback to patients, families, and referring clinicians.
Fellows also do brief rotations on the Autism and Developmental
Disability Team (please see above for description) and the Psychiatric
Emergency Service (PES) at the Cambridge campus. During the PES
rotation, fellows perform evaluations of children, adolescents,
and adults, determine the appropriate level of care needed, and
arrange dispositions. Throughout the year, fellows receive individual
supervision, and participate in Clinical Case Conferences and ongoing
seminars, including Psychological Assessment of Children and Adolescents,
Child Psychotherapy, and Psychopathology, and a live Interviewing
Conference led by a group of senior clinicians.
Couples and Family Clinic
Clinicians in the Couples and Family Program conduct evaluations,
short- and long-term couples and family therapy, and present their
work in a clinical setting. Evaluation and treatment of cases is
based on a biopsychosocial-systemic model representing a broad range
of couple and family problems including both adults and children.
Assessment includes strength and resources as well as problems at
both systemic and individual levels.
Fellows attend a weekly multidisciplinary team meeting every week
at which intakes, evaluations, and treatment plans are discussed.
Training experiences also include case consultation in front of
a one-way mirror, with the benefit of experienced consultants who
may interview the clients themselves or consult with the therapist
and family. Individual and group supervision is offered, as well
as seminars in Integrative Family Therapy, and Illness and Health:
Working with Medical Providers and Families.
Cultural/Linguistic Specialty Clinics
In accord with its mission to provide comprehensive and culturally
sensitive care, Cambridge Health Alliance has four specialized outpatient
clinics that provide service to patients from a range of cultural
and linguistic communities. In general, staff and trainees working
in these clinics must be fluent in the appropriate language. Fellows
who do their ambulatory work in one of these services will also
have a tutorial or seminar in Cross-Cultural Psychodynamic Treatment,
as well as supervision from psychologists from the relevant clinic.
Latino Mental Health Clinic: The Latino Mental Health
Clinic provides a full range of outpatient services to Spanish-speaking
persons, including evaluations, psychological testing, and individual,
group, child/adolescent, couples, and family therapy. The community
is comprised of persons who emigrated from Central and South American
Countries, and from the Caribbean. Many patients have been traumatized.
Trainees work as part of a multidisciplinary team. The examination
of cross-cultural issues is an ongoing part of the training. Proficiency
in Spanish is required.
Portuguese Mental Health Clinic: Part of Cambridge Health
Alliance's Adult Psychiatry Ambulatory Service, the Portuguese
Mental Health Clinic provides a full range of outpatient services
to monolingual Portuguese-speaking persons, including evaluation,
psychological testing, and individual, child/adolescent, and family
therapy. The community is comprised of persons who emigrated from
Portuguese-speaking countries around the world, with the majority
of persons coming from Brazil and the Azores. Trainees work as
part of a multidisciplinary team, and carry a varied caseload.
The consideration of cross-cultural issues is an ongoing part
of the weekly supervision and team meetings. Proficiency in Portuguese
is required.
Asian Mental Health Clinic: The Asian Clinic offers multilingual
outpatient psychological and psychiatric services to Asian individuals
and families in the greater Boston area. The Asian Clinic draws
on a philosophy that appreciates a wide range of Asian backgrounds,
experiences, and conflicts. Treatment attempts to address the
individual's emotional and spiritual well being in a safe and
culturally sensitive environment. Special attention is devoted
to trauma survivors. Primary services include outpatient short-
and long-term individual, family, and group psychotherapy, psychodiagnostic
testing and evaluation, psychopharmacology, crisis intervention,
case management, and community outreach. The clinic also provides
consultation to other branches of Cambridge Health Alliance, and
serves as a liaison to community-based social agencies that serve
the Asian community. Proficiency in an Asian language is strongly
preferred.
Haitian Mental Health Clinic: The Haitian Mental Health
Clinic provides culturally competent care through appropriate
languages to Haitian residents of the greater Boston area, and
to French-speaking immigrants from the Caribbean and Africa. Treatment
attempts to reduce the severity of psychosocial dysfunction in
a variety of adult and child patients, and to provide these patients
with additional coping mechanisms to better handle stressors triggered
by the experience of migration. Primary services include child
and adult individual psychotherapy, family psychotherapy, psychodiagnostic
evaluations, psychopharmacology, and crisis intervention. The
Clinic also acts as a liaison with community and social agencies
that interface with Haitian patients. French or Haitian Creole
proficiency is strongly preferred. (No applicants accepted to
this program for 2008-2009)
Combined Cultural-Linguistic Clinic or General Outpatient and
MIT Mental Health Services
This 40-hour, year-long fellowship combines two half-time placements
in the MIT Mental Health Services and either a designated cultural-linguistic
clinic or general outpatient clinic at Cambridge Health Alliance.
The general outpatient clinic at CHA conducts comprehensive psychiatric
evaluation and disposition, short and long-term individual psychotherapy
(psychodynamic, supportive and/or cognitive and skills based), group
therapy, and psychodiagnostic testing. Patients exhibit a variety
of conditions, including severe and persistent mental illness. Weekly
team meetings and case conferences sharpen skills at formulation,
diagnosis, making treatment decisions, and conducting psychotherapy.
The MIT Mental Health Service provides services to the entire MIT
community, including faculty, staff, students, and their dependents.
Evaluation, consultation, and brief treatments are available to
faculty and staff, and extended treatment services are available
to all students. At MIT, the fellow will provide intakes, individual,
couples and group therapy, emergency/crisis intervention, referrals,
consultation to the campus community, and outreach and educational
programs. A trainee seminar is required, which includes psychology
post-docs, psychiatry residents, and social work interns in training
on the service. There is an opportunity to work with patients from
all cultures, persons with eating problems, and autistic spectrum
disorders. Fellows are encouraged to develop a community program
of particular relevance to the trainee's area of interest. A weekly
didactic conference is provided, and supervision toward licensure/certification
offer opportunities to integrate theory and practice.
Program for Psychotherapy
This service offers long-term psychodynamic psychotherapy of adult
outpatients. The Program for Psychotherapy is a multidisciplinary
training program that includes advanced fellows in psychiatry and
social work as well as psychology. Fellows receive intensive individual
supervision in psychodynamic treatment, group supervision by a psychoanalyst,
and they attend two reading seminars on Theory and Technique of
Psychoanalytic Treatment (first year) and on Object Relations and
Psychoanalytic Theories (second year). The fellowship also includes
five hours of research time and once monthly case conferences, discussions
with a senior faculty member, and in-service trainings.
Victims of Violence Program
The Victims of Violence program offers comprehensive psychological
services to adult victims of recent and/or prior crimes of physical
and sexual violence. The program also extends services to survivors
of war-related political trauma, family and friends of victims,
and community settings distressed by violent traumatic events. The
program is staffed by a multidisciplinary team who offer clinical
training and supervision to advanced students in psychology, social
work, nursing, and psychiatry. Program services include crisis intervention,
individual and family evaluation, individual and group treatment,
case consultation, psychological testing, and community crisis response
services. Psychology Fellows in the VOV program conduct individual
and (as appropriate) family evaluations. They also provide individual,
group, and occasionally, family psychotherapy to patients referred
to the VOV program and are responsible for approximately 2 hours
per week involvement in short-term crisis intervention. In addition,
Fellows in the VOV program are expected to devote eight hours per
week of their time to participate in VOV research activities.
Psychology fellows in the VOV Program receive individual supervision
for individual evaluation and treatment cases, group supervision
for crisis intervention, and supervision for group therapy. Weekly
seminars include a Victims of Violence Crisis Seminar, a Trauma
Seminar, a Group Treatment Seminar, and a Clinical Group Supervision.
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