Pre-doctoral Internship in Clinical Psychology
Clinical Experiences and Other Training Opportunities
This track offers training at the following primary sites: Metropolitan Children and Youth Services Clinic, The Tulane Infant Team/Parenting Education Program, and Tulane University Hospital and Clinic, including Tulane Hospital Behavioral Health Clinic. These sites and the clinical training acquired at each are discussed in detail below.
Metropolitan Children and Youth Services Clinic
The Metropolitan Children and Youth Services Clinic, located at 719 Elysian Fields Avenue in New Orleans, is a community-based, outpatient mental health clinic. The clinic serves children, adolescents, and their families who reside on the East Bank of Orleans Parish in the city of New Orleans. Individuals ages 0 to 18 years are seen at the clinic for behavioral, emotional, psychological, and/or psychiatric difficulties. This licensed community mental health center provides an array of services: screening and assessment; emergency crisis care; individual evaluation and treatment; medication administration and management; clinical casework services; specialized services for children and adolescents; and individual, dyadic, family and group psychotherapy.
Staff at the Clinic include Tulane University School of Medicine faculty members from the Department of Psychiatry and Behavioral Sciences, Section of Child Psychiatry. The mental health disciplines represented at the clinic include social work, psychology and psychiatry. Trainees from psychology and psychiatry rotate through the clinic. The Clinic offers a continuum of care for various levels of acuity. Comprehensive evaluations are conducted once a patient is referred to one of the services offered by the Clinic. The clinic is open Monday through Friday. The interns conduct various interventions at the clinic. Depending upon the needs of the patient, these may include intake evaluations, psychological testing, consultation, and psychotherapy. The clinic is comprised of three specialty clinics: Infant Mental Health, Trauma and ADHD. The interns will see clients from any of the three specialty clinics.
As part of this rotation, the interns will:
- Evaluate and suggest appropriate treatment for the child and family of a patient presenting to the Metropolitan Children and Youth Services Clinic.
- Develop competence in the intake process. This includes defining the presenting problems, making the first contact, ascertaining commitment on the part of parents or caregivers, helping promote a firm commitment from the patients and family, planning the evaluation, and identifying and dealing with mental health emergencies.
- Develop competence in the evaluation process. This includes involving both parents or caregivers, if possible, taking complete individual, relationship, and marital histories, as appropriate, taking and recording the child's developmental history, formulating a working diagnosis and case conceptualization, and handling the evaluation sessions.
- Develop an understanding of the importance of family dynamics in psychopathology.
- Discuss the use of conjoint approaches, family therapy approaches, and the referral of family members to other therapists, if appropriate.
- Develop developmentally appropriate skill in the use of play techniques to facilitate emotional expression and contribute to the therapeutic process.
- Develop skills to evaluate children and families in an outpatient clinical setting, formulate reasonable differential diagnoses and recommendations for treatment and/or follow up information, and convey results of evaluations to mental health or allied professionals also assigned to the cases.
- Develop the ability to competently perform the treatment and other intervention services the child, caregivers, and/or other family members require for symptom remediation and improvement in functioning.
- Document all work according to State and accreditation standards.
Interns on the Child Track with a focus on Infant Mental Health rotate here 2 days a week all year. Interns on the Child Track with a focus on Pediatrics rotate here 1 day a week all year.
Primary Supervisor: Dr. Valerie Wajda-Johnston
Pediatric Psychology Rotation
The intern who chooses to focus on Pediatric Psychology will spend three days per week providing services to children with medical and developmental problems. Inpatient pediatric medical services are located within Tulane Lakeside Hospital for Women and Children and clinics. Children are referred for specialty as well as general pediatric medical problems from throughout Louisiana and the Gulf South. The pediatric psychology intern may provide services to children who are medically hospitalized on the general child/adolescent inpatient unit or the pediatric intensive care unit, or who are receiving outpatient medical or emergency services as well as behavioral health services.
The intern will also provide services to the Tulane Center for Autism and Related Disabilities (TCARD). TCARD is an interdisciplinary clinic that provides diagnostic assessments, treatment planning, social skills groups, and Applied Behavior Analysis for individuals with a diagnosis of Autism Spectrum Disorder (ASD). Children are referred by pediatricians, neurologists, geneticists, early interventionists, and parents from all parts of Louisiana and Mississippi.The intern will be responsible for the following:
- conducting developmental interview
- administering psychological tests
- providing feedback to families
- writing interdisciplinary reports
- participating in weekly case conferences and monthly journal clubs
The intern may have the opportunity to provide parent training sessions, social skills groups, or other psychoeducational groups for children and families affected by ASD.
Referrals on the Pediatric Psychology rotation for child, adolescent and/or family assessment and treatment services may come directly through TCARD, the Tulane/Lakeside Behavioral Health Clinic, or through the Pediatric Psychiatry Inpatient Consultation-Liaison service. Most of the children and adolescents who are referred on this rotation have some type of serious and/or chronic illness and/or also demonstrate significant developmental, social, emotional, or behavioral problems that warrant assessment and/or psychotherapeutic services. Psychopharmacological consultation is available to the intern's inpatients and outpatients from child psychiatry residents.
Lisa Settles, Psy.D. is the primary supervisor for the Pediatric Psychology internship rotation, including TCARD. In addition, the intern will work under guidance from the medical director of the inpatient Pediatric Psychiatry Inpatient Consultation-Liaison service. Because of the complex nature of the medical conditions of the children served, the intern must work closely and collaboratively with the pediatric and child psychiatric staff and trainees and within the multidisciplinary teams to provide coordinated patient care, staff support, and education (liaison activities). Further, over the course of the internship, the intern is expected to become more independent in providing clinical and liaison services for medically ill children and for children with autism.
As part of this rotation, the intern will:
- Develop an understanding of the current and long-term effects of chronic or severe illness on child development and family functioning.
- Develop a systematic strategy for assessing children with autism and related disorders.
- Provide competent psychological assessment of medically ill children and their families.
- Develop a range of psychotherapeutic intervention skills appropriate for medically ill children and their families, including behavioral and cognitive behavioral strategies, parenting and family interventions, as well as liaison approaches to modify the team/setting/structural issues that may impact the child's response to illness and treatment.
- Develop intervention skills for children with autism and their families.
- Develop experience in providing liaison services (support, guidance, education) to non-mental health medical providers, including physicians, nurses, social workers, child life, and other health care professionals.
General expectations of the psychology intern include:
- Timely and appropriately responding to consults and other clinical activities.
- Actively and clearly communicating with team members and supervisors to clarify and coordinate responsibilities and expectations for patient care activities
- Seeking appropriate client-related and medical diagnosis-related information and input from other team members to guide assessment and treatment
- Maintaining current, clear, thorough documentation in the medical record
- Taking responsibility for his/her own learning, including developing knowledge of relevant medical terminology, diagnoses and interventions, with focus on evidence-based approaches for the medically ill child
- Participating actively in team educational and liaison activities
- Maintaining cognizance of legal and ethical issues that are relevant to clinical work in pediatric psychology
- Following policies and procedures of the rotation and psychology internship
- Developing knowledge of cultural, ethnic, and linguistic influences on pediatric health and mental health
- Increasing self-awareness of the intern’s behaviors and attitudes on patient care as well as interactions with other professionals and colleagues
- Conducting oneself in a professional, collegial manner at all times
The intern receives weekly supervision by Dr. Lisa Settles, and on-site supervision by the Child Psychiatry faculty on the service.
On the Child Track (with Pediatric Psychology Focus) three days per week of the intern’s time all year is spent at the Tulane Hospital for Children and the Tulane Hospital Behavioral Health Clinic, and the Tulane Center for Autism and Related Disabilities.
Infant Mental Health Rotation
Tulane Infant Team/Parent Education Program
The Tulane Infant Team/Parenting Education Program (T-PEP) provides intensive intervention for maltreated infants/young children and their caregivers in Jefferson, Orleans, and other parishes in Southeast Louisiana. The team works collaboratively with a variety of systems to provide assessment and treatment for a high-risk population. All referrals to the team come from the Department of Children and Family Services (DCFS, the state Child Protection Agency) and involve cases of suspected or validated abuse and neglect of children ages birth to 60 months. Children who are referred for T-PEP services may remain in their homes. For these families, intervention is provided to assist in preserving the placement with biological parents. Alternatively, when safety issues are of significant concern, DCFS places children in foster homes while the biological parents address the impediments to their safe, effective parenting. T-PEP is located at 1555 Poydras Street, across from the Mercedes Benz Superdome, about one mile from Tulane University Medical Center.
The Infant Team/Parenting Education Program is staffed by a multidisciplinary group of faculty and trainees from Tulane University School of Medicine, including child psychiatrists, clinical and developmental psychologists, clinical social workers, pediatricians, parent educators, and paraprofessionals, all of whom have expertise in infant and child development and developmental psychopathology. There is a weekly clinical case conference, which includes the entire T-PEP team and, at times, Department of Children and Family Services case workers and supervisors, Bureau of General Counsel attorneys, and senior administrators. Clinicians present a case to the group, including videotape excerpts selected for the illustration of individual, dyadic, and family characteristics. This conference is used to develop specific recommendations about what will be required to intervene with a young child and his or her biological and/or foster parents. Clinical decision-making skills are modeled at the weekly case conference. Interns are also exposed to the forensic process and, on rare occasions, may have the opportunity to testify in Juvenile Court.
The interns receive weekly individual supervision, in addition to weekly group consultation with the entire team. Didactic and hands-on-training in the procedures used by the team occurs on a daily basis.
As part of this rotation, the interns will:
- Acquire skills in the evaluation techniques used by the team, including intake interviews, caregiver-child interaction procedures, caregiver perception interviews, possibly home visits to biological and foster parents' domiciles, and various ancillary assessments.
- Develop skills in various treatment interventions, which may include individual play therapy with children, individual psychotherapy with caregivers, dyadic caregiver-child psychotherapy, couples psychotherapy, group therapy and family therapy. Evidence-based and evidence-informed treatments are provided when indicated, including Parent-Child Interaction Therapy, Child-Parent Psychotherapy, Cognitive Behavior Therapy for PTSD, Attachment and Biobehavioral Catch-up, and Circle of Security Intervention.
- Learn to work on a multidisciplinary team.
- Gain experience collaborating or consulting with professionals from other agencies including DCFS, substance abuse counseling, developmental and special education services, and adjunctive therapies to strengthen family functioning.
- Document all work according to State and accreditation standards and produce reports for forensic and legal consumers.
The Child Track interns with the focus on Infant Mental Health work here 2 days a week all year.
Primary Supervisors: Dr. Angela Breidenstine and Dr. Julie Larrieu