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CHA Psychology Postdoctoral Options for 2020-2021

Option I: Adult Neuropsychology (two years)

Option II: Adult Outpatient Services/Population Mental Health Research

Option III: Primary Care-Behavioral Health/Mindfulness and Psychotherapy

Option IV: Child and Adolescent Acute Services

Option V: Program for Psychotherapy (two years)

Option VI: Psychological Assessment Services/Program for Psychotherapy

Option VII: Adolescent Risk Assessment and Violence Prevention

Option VIII: Victims of Violence Program

Adult Neuropsychology Service

This two-year program provides intensive training in clinical Neuropsychological assessment at the Neuropsychological and Psychological Assessment Service (NAPA) in the psychiatry department at CHA. The overall goal of training is to provide fellows with a broad range of neuropsychology training experience and prepare them to be Board-eligible in neuropsychology.

Our NAPA service provides care to a range of adult outpatient populations, including those with primary medical, neurological and psychiatric disorders. Medical and psychiatric inpatient consultations are also performed. Referrals include evaluations of patients who present with a variety of neurological disorders, such as head trauma, seizure disorders, dementia, vascular disorders, metabolic disorders, sleep disorders, headaches, and movement disorders. Psychiatric referrals range from mood and anxiety disorders to severe and persistent psychotic disorders, complex trauma, and polysubstance abuse. Patients with neurodevelopmental disorders such as learning disabilities, attention-deficit disorder, and Asperger's disorders are also evaluated.

In the first year, fellows participate in seminars in adult neuropsychology, behavioral neuroanatomy and a clinical case seminar (using a fact-finding platform), as well as psychiatry grand rounds, neuroscience grand rounds, monthly testing rounds and the Professional Development Seminar. In their second year, fellows participate in a neurology rotation in which they shadow a neurologist in clinic. They also participate in a brain cutting seminar, psychopharmacology seminar, behavioral neuroanatomy seminar, and a case seminar.

Individual supervision is provided weekly. Opportunities for training in psychological assessment are also available and multidisciplinary interaction with psychiatry, neurology, and geriatrics is typical. Fellows are provided with teaching and mentoring opportunities. A clinical research component is also a requirement culminating in a professional poster or paper submission at the end of the two-year training. Extensive didactic opportunities are available within the hospital and Harvard Medical School.

Adult Outpatient Services/Population Mental Health Research

This fellowship will include a half-time clinical rotation through one of the following sites, to be mutually agreed upon by the applicant and CHA according to the applicant’s background and interest: Primary Care/Behavioral Health Integration, Gender and Sexuality Clinic, Linguistic Minority Clinics (LatinX, Portuguese, Haitian or Asian Mental Health Clinics), Victims of Violence Program, or the Program for Psychotherapy. He or she will also attend the Fellows' Professional Development Seminar (and other didactics related to the selected outpatient service).

This fellow will also work half-time in research focused on key priorities of the CHA Accountable Care Organization behavioral health program, with particular attention to underserved minorities. Under the mentorship of the Clinical Director of Population Behavioral Health and department leadership, the fellow will join existing teams working on analysis of data indicators of areas of high need in the ACO population and implementation of computerized adaptive testing mental health screening to guide clinical and population health decision making. The fellow will have access to research mentors working throughout CHA.

Qualifications for this fellowship include a doctoral degree in psychology, engagement with public sector mental health, a defined interest in health psychology, strong quantitative skills, willingness to learn how to develop programs, and the personal qualities of flexibility and good collaboration skills.

Primary Care-Behavioral Health/Mindfulness and Psychotherapy

The fellow in this one-year track will work half-time in the Primary Care Behavioral Health Integration (PCBHI) Program at one of CHA's 13 primary care clinics. The fellow will conduct psychiatric intake evaluations, triage to appropriate settings of care, individual and group psychotherapy, multidisciplinary consultation, and warm hand-offs and risk assessment. The fellow will gain experience in assessing and treating patients with a wide range of psychiatric and adjustment issues, as well as promoting behavioral management of chronic medical conditions. Additional fellowship opportunities include clinical teaching to medical residents and co-leading group medical visits for addictions, chronic pain, weight management, and/or diabetes management. The fellow will attend multidisciplinary medical team meetings at the primary care site, as well as PCBHI team meetings with therapists, psychiatrists, and mental health care partners. The fellow will also attend the Integrated Care Seminar and the Fellows Professional Development Seminar..

The fellow will also work half-time with the Center for Mindfulness and Compassion, a national leader in research on and implementation of evidence-based approaches to integrating mindfulness and compassion practices into primary and mental health care. Under supervision, fellows would learn to co-lead structured Mindfulness-Based clinical groups following empirically supported protocols. Fellows would participate in the Mindful Mental Health Service weekly team meeting and Mindfulness Training in Primary Care group supervision when leading groups. Mindfulness-Oriented Psychotherapy Training (approximately 8 hours/week): Trainees would provide individual psychotherapy for approximately 6 clinical cases/week, receiving approximately 2 hours/week of clinical supervision from IMP/CHA/CMC faculty through the Mindful Mental Health Service clinic specializing in such interventions.

Child and Adolescent Acute Services

This one-year fellowship consists of rotations on two inpatient CHA inpatient units: The Child Assessment Unit and the Adolescent Assessment Unit, as well as an outpatient rotation in the Autism and Developmental Disabilities evaluation clinic in the Child Outpatient Psychiatry Department. The child unit (CAU) is a 13-bed locked inpatient unit serving children ages 3-12. The adolescent unit (AAU) is a 14-bed locked inpatient unit serving adolescents ages 13-19. Both units have a patient population that is quite diverse ethnically and diagnostically, and operate within a collaborative interdisciplinary team framework. While on the inpatient units, fellows serve as the primary clinician for two cases in which they provide individual, family and systems assessment and interventions. Fellows also complete 6-8 psychological assessment batteries during the two inpatient rotations, using a collaborative/therapeutic assessment (C/TA) approach. Supervision emphasizes psychodynamic, attachment, trauma-informed and family systems approaches. Fellows also co-lead therapy groups on each unit, guided by approaches including DBT, mindfulness, trauma-informed, strength-based and psychodrama approaches.

During the outpatient rotation, fellows participate in an intensive 4-month tutorial designed to expand awareness/expertise in developmental disabilities, within which Autism Spectrum Disorders are a primary emphasis. Fellows shadow the neurodevelopmental specialist, observing and conducting comprehensive evaluations of toddlers, children, adolescents and their families. Tailored didactics cover normative development from infancy through early adulthood, genetic and neurodevelopmental disorders, and formal and informal assessment techniques, with an emphasis on interactions of culture, medicine, social systems, and mental health. Throughout the year, fellows receive three hours of weekly, 1:1 supervision, and participate in 3 weekly seminars, including Psychological Assessment of Children and Adolescents, Family Therapy (which involves both theory and live supervision of family therapy consultations) and, on the inpatient unit, a live individual and family therapy seminar conducted by expert consultants, as well as the Professional Development Seminar..

Program for Psychotherapy

This two-year fellowship 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 and group supervision by a psychoanalyst, and they attend reading seminars in Theory and Technique of Psychoanalytic Treatment and Object Relations and Psychoanalytic Theories. The fellowship also includes five hours of research time on the PFP's psychodynamic psychotherapy outcome study. and once monthly case conferences, presentations by a senior faculty clinician, and in-service trainings. Fellows also participate in the Professional Development Seminar during the first year and may select additional optional seminars.

Adult Psychotherapy and Psychological Assessment Services

This one-year fellowship provides a half-time intensive psychotherapy experience in the Program for Psychotherapy (PFP) combined with half-time advanced psychological assessment training in the Neuropsychological and Psychological Assessment Service (NAPA). In the PFP, fellows provide long-term psychodynamic psychotherapy of adult outpatients for which they receive intensive supervision, as well as the opportunity to participate in two seminars in psychotherapeutic technique (please see above description). At NAPA, fellows receive supervision and training in projective and objective assessment techniques within a Therapeutic Assessment model of care and participation in a psychological assessment seminar. Fellows in this rotation have the option of attending a variety of neuropsychological testing seminar offerings. There is also limited opportunity to gain experience in neuropsychological assessment. Assessment frequently require multi-disciplinary delivery of care and coordination with neuropsychologists of neuropsychological assessments. Through their roles in both clinics, the fellows may provide therapeutic psychological assessments for patients in the PFP. Assessment patients for this fellowship include adults with a wide range of psychiatric conditions, including mood and anxiety disorders, severe and persistent psychotic disorders, complex trauma, and polysubstance abuse. Patients with medical, neurologic, and neurodevelopmental disorders such as learning disabilities, attention-deficit disorder, and Asperger's disorders are also evaluated for co-morbid psychiatric conditions. Fellows are provided with teaching and mentoring opportunities throughout the year, including the Professional Development Seminar.

Adolescent Risk Assessment and Violence Prevention

This one-year fellowship consists of specialized training in juvenile risk assessment as well as violence prevention treatment for adolescents and young adults. The fellow selected for this position will provide consultation to the Cambridge Police Department through the Safety Net Collaborative. Safety Net is a partnership between the Cambridge Health Alliance and Cambridge Police designed to integrate mental health services into juvenile policing and has been recognized by the International Association of Chiefs of Police as a promising approach to the prevention of juvenile delinquency.

The fellow will also conduct safety assessments for the Cambridge Public Schools. There are also part-time rotations through the year in the Juvenile Court Clinic in either Lowell or Cambridge. The fellow will provide individual and family therapy through the Child/Adolescent Outpatient clinic at the Cambridge Health Alliance and will conduct at least one group utilizing a violence prevention curriculum developed to address retaliatory violence in youth. There is also an opportunity for research through the ongoing program evaluation of the Safety Net Collaborative. Seminars are available through the Court Clinic, and the fellow will also attend the Professional Development Seminar.

Victims of Violence Program

The Victims of Violence program offers a one-year post-doctoral fellowship with 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, and community crisis response services. Fellows may also receive training in homicide bereavement and asylum evaluations. Seminars include a trauma seminar and the Professional Development Seminar.

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