Psychology Internship

Frequently Asked Questions

1. What changes do you expect in the program over the upcoming internship year?

The program has made many positive changes over the past four years, most notably being the move from the Department of Psychiatry to the College of Health Professions and the hiring of new faculty.   The changes have assisted the internship in providing substantial training in Health Psychology.  It is likely that no major changes will be forthcoming for this year.  It is always possible that services may be added, depending on changes at our training sites. For example, the addition of Drs. Foster and Napolitano has allowed the intern the opportunity to work at the Obesity Center. The interns now spend more time with Dr. Repetz-Ciccolella due to a tremendous growth in her service.  Dr. Weisman no longer works in the Psychiatric Emergency Room, but rather on the Consult and Liaison Service in the Hospital, so interns now train with him in this setting, etc.  Thus, while we may have minor variations on a theme, we fully expect that the main structure of the Internship (e.g., three major rotations and outpatient therapy/assessment experiences) will remain the essentially the same.

2. What is the relationship between Psychology and Psychiatry? Between Psychology and other disciplines?

The relationship between Psychiatry and Psychology is generally a good one, founded on mutual respect. Psychiatry residents are sometimes supervised by psychologists, and psychology interns are periodically supervised by psychiatrists. Psychologists are generally well respected by Psychiatrists (and vice-versa!).  Seemingly, any conflicts that do arise are more attributable to the personalities involved rather than credentials, but this is not a frequent occurrence.

In addition, we view Psychology less in terms of the “traditional” Psychology-Psychiatry dynamic and more as an integral member of many primary and secondary care services.  Psychology has a number of ties to departments throughout the hospital. Psychology provides the bulk of the clinical services for the pulmonary transplant, physical medicine and rehabilitation, trauma, neurosurgery, pediatric, and bariatric services. We like to believe that our reputation for good service has provided a firm foundation for numerous inter-departmental relationships.

3. How are the rotations assigned? Are they fixed or flexible?

Since each intern participates in all three rotations during the course of the year, the assignment of the first rotation often revolves primarily around comfort level.  Incoming interns state their ranked preferences and the DCT determines the best solution to meet the preferences and needs of the interns and the internship as a whole. To help the incoming interns adjust, the first rotation for each intern is usually assigned based on that intern's strengths and prior experiences.

4. Is there a standard assessment battery?

No. With a few exceptions, the assessment battery is tailored to the referral question for each patient. However, a standard battery has been developed for some services to ensure comprehensive assessment and facilitate comparisons for research purposes. For example, most traumatic brain injury and bariatric patients receive a core battery of measures. Even this battery, however, is subject to addition or modification based on the individual patient's presenting history, symptoms, and dynamics.

We use a number of measures routinely and interns are instructed in the administration and interpretation of these tests in the assessment seminar and during individual supervision. Intellectual assessment is conducted with the WAIS-III. Projective assessment is carried out with the Rorschach (using the Exner Comprehensive system), although the call for projective testing across services continues to wane with each new year. Objective assessment is conducted with the MMPI-2 and the PAI. Neuropsychological evaluation relies heavily on measures from the Benton laboratory and the Halstead-Retain battery.

Temple Children’s Hospital psychology clinic has multiple assessment instruments that can be used for educational, developmental, and psychological evaluations. Examples of these instruments include WISC-IV, WASI, TONI, WIAT-II, W-J – III, CPT, NEPSY,CDI, RCMAS, BRIEF, CBCL, SIB-R, and Conner’s Rating scales.

5. I have little or no experience with testing. Will you consider me as an intern applicant? Will this put me at a disadvantage during the internship?

In a word, perhaps.  Part of the core competencies of the internship involve gaining competence in the areas of intelligence testing (e.g., WAIS-III, WISC-IV) and objective personality assessment (e.g., MMPI-2, PAI, etc.).  Therefore, we recommend that applicants with little or no background with testing gain some experience during the spring prior to starting the internship year. This can be accomplished through attending workshops or obtaining supervised experience.   While these tests are reviewed in the Assessment Seminar, having a basic knowledge of these instruments prior to internship will allow the intern to feel comfortable from Day 1 and devote time to other training areas.

With regard to projective testing, we do not presuppose experience with the Rorschach.  As the internship has moved towards more of a “Health Psychology” focus, the need for projective testing has declined significantly. Interns who have no previous experience with projectives may find themselves learning as they go along if such a need arises, which can be difficult considering the numerous other responsibilities placed on them.

6. Where will I have the opportunity to conduct neuropsychological assessment?

Neuropsychological assessment is a key component for many rotations and services.  For example, trainees will frequently perform outpatient neuropsychological batteries, which can range from brief to extended in their scope. On the Physical Medicine and Rehabilitation (PM&R) and the Consultation and Liaison minor of the Behavioral Medicine rotations, interns will perform both rapid bedside cognitive screenings as well as full neuropsychological test batteries. Patient populations include (but are not limited to) cardiac and lung transplant, dementia, stroke, orthopedic, and epilepsy, and traumatic brain injury patients.  Outpatient referrals for neuropsychological testing are also common. Lastly, the intern on the Pediatric rotation will often perform evaluations of intelligence, learning potential and cognitive status.

7. What are the opportunities for group therapy? Couples therapy? Family therapy?

There are opportunities to conduct group-based CBT for weight management at the obesity center, as well a group for teenagers with spinal cord injuries at Shriner’s Hospital.  On the PM&R Service, working with couples and families may come into play in daily encounters with the hospitalized patient and also through leading the Lung Transplant Support Group. Working with couples and families is possible in our outpatient department. Of course, working with families is a key part of our Pediatrics rotation.

In the past, interns (sometimes along with medical or psychiatric residents) have developed groups to treat patients with specific problems (i.e., anger management). These interns and residents have enlisted supervisors, recruited patients, developed treatment protocols, and led these newly created groups. Any motivated intern is encouraged to start such a group, and will likely be recruited to become a therapist in ongoing groups. Past groups have included an inpatient heart transplant candidates group, an outpatient lung transplant candidates group, an outpatient group for those coping with schizophrenia, a mindfulness-based CBT group for depression, and a sleep disorders group.

8. How many long-term therapy clients does an intern carry?

In addition to any rotational responsibilities that involve patients, each intern carries a long-term outpatient caseload of approximately ten short and/or long-term patient hours per week. Interns are assigned a number of cases within the first week of the year. Of course, some patients will "graduate" or be terminated during the following months, so the intern will have a caseload that varies in length of therapy.

As mentioned, this component of the internship is year-long and distinct from the three major rotations.

9. How many psychotherapy supervisors does an intern have? How are these supervisors assigned?

Psychotherapy supervision is determined mostly by the presenting problem and age of the client being seen.  In addition, if a client is being “carried over” from one internship year to another, the prior supervisor will continue in this capacity.  The psychotherapy supervisor helps the intern manage his or her outpatient psychotherapy caseload, and also acts as an administrative resource and mentor for the new trainee. 

Thus, interns will have more than one psychotherapy supervisor. In addition, interns are urged to acquire additional supervisors at any time if they want exposure to other orientations or if a particular patient would be best treated by a certain therapeutic modality (i.e., behavior therapy, psychoanalysis). Past interns have carried as few as two to as many as eight supervisors.

10. What are the theoretical orientations of the psychotherapy supervisors? Is there a predominant orientation?

We do not perceive ourselves as having a predominant theoretical orientation. Cognitive-behavioral, behavioral, psychodynamic, and combinations of these orientations are represented among the psychotherapy supervisors. As we come from a scientist-practitioner philosophy of training, due emphasis is given to treatment modalities with solid empirical support. However, that does extend beyond traditional CBT to interpersonal therapy, and emotion-focused therapy where appropriate.  That being said, we are, above all, pragmatic given the unique patient population at the health sciences center with which we work on a daily basis.  While not fitting the “textbook” of many empirically supported treatments, such a population will teach an intern how to merge textbook knowledge with real-world realities.

11. What is a typical workday like?

In a word - busy. Interns usually start the day about 8:00 AM and finish at about 5:30 PM.

Interns generally keep on the move. A typical day may start with a few hours of rotational work, followed by supervision. Right after lunch, an educational seminar may meet. In the afternoon, patient rounds may be followed by an outpatient for psychotherapy. The day may end with performing a neuropsychological assessment, bedside supportive work with a hospital patient, research, or report writing.

The typical day varies between the rotations. Although seminars, meetings, research time, and most rotational responsibilities are locked into the intern's schedule, the intern also has the flexibility to schedule therapy patients, supervision, and testing cases. As you might surmise, time management skills are very important.

12. Where do your interns go after finishing their internship?

It used to be that about one-third of our interns returned to their home programs to finish their dissertations. Over the past few years, however, most of our interns have finished their dissertation by the time they leave internship.  Hence, approximately two-thirds of graduates take a post-doctoral fellowship.  The remaining one-third goes into various types of academic positions, research positions combined with clinical activities, or clinical jobs that are usually hospital-based. After experiencing the fast-paced, never-dull life in a hospital setting, many clinically oriented interns have a hard time settling for anything else!

13. Can I finish my dissertation during the internship year?

As stated above, this seems to be the current norm and is strongly encouraged as part of your professional development.  The internship is a busy one, but interns who have been willing to invest the time have completed their dissertations during the internship year. As with other parts of the internship, the key is time management, as the intern is also expected to spend approximately one day per week in research activities that will produce a presentation and/or paper at the end of the internship year.

14. What type of intern fits well with your program?

When this question is asked during interviews, the standard response is "the four C's." Historically, the best matches with our program have been with interns who can Conceptualize well, who are Compassionate, who demonstrate Competency, and who are Cool. Naturally, the faculty aspires to internalize these same four attributes (with varying degrees of success).  As a generalist program, we also look for individuals who desire a broad training experience.

In addition, we do have minimal standards that all intern applicants must meet in order to be considered and include:  currently attending a Clinical or Counseling Psychology program with preference going towards those enrolled in an APA accredited graduate program; enrollment in a Ph.D. or Psy.D. program with the Scientific-Practitioner model being preferred; having accrued at least 100 intervention and assessment hours and at least 1000 practicum hours by the start of internship; completion of comprehensive examinations by the application deadline; and an approved dissertation proposal by the start of internship.  Lastly, we prefer applicants with a Master’s Degree.

15. What type of intern does not fit well with your program?

The internship is a generalist training program in the area of behavioral medicine.  The intern is expected to devote the vast majority of time to patient care and trainees who are not interested in meeting these goals will not fully benefit from our training.  Also, those who only have experience in and/or the desire to learn only one specific area of psychology will also not find the challenges of our generalist internship to be rewarding.  Lastly, those with minimal training and/or interest in research need to consider the fact that they are expected to spend 20% of their time in this scholarly activity.

16. Do you conduct phone interviews in place of the on-site interview?

For the most part, no. We believe that it’s important that we meet our future interns and junior colleagues in person. Although we are mindful of the expenses involved for applicants as they interview at multiple sites, we believe that it is ethically imperative to meet any person who will be working with our patients. Equally as important is the fact that it is doubtful that you can truly get the “feel” for an internship site solely via the phone or a brochure.  We do try to accommodate applicants as much as we can in scheduling interviews and our interview dates and policies are explicitly posted in this brochure.  It is expected that interested intern applicants will attend to this policy in order to increase the likelihood that they obtain their desired interview day.

17.  How does the selection process work?

The intern selection process is a sequential one. When applicants’ supporting materials are complete and the DCT determines that they have met the minimum standards outlined above, they are distributed to internship faculty for review. Each applicant’s background is considered along a number of dimensions, such as psychotherapy experience, assessment skills, neuropsychological experience and stated interest in working with diverse medical and psychiatric populations. Applicants are rated by the faculty and those who receive multiple positive votes are then invited for an interview. The internship typically receives about 100 applications a year and invites approximately 25 –30 individuals for an interview.  This means that many qualified applicants are not invited for interviews and this is often for reasons that have to do more with “supply and demand” than any notable weaknesses in their applications.  More information about notifications regarding interview decisions is included on page 29.

Given the potential for the form and content of the interview to vary widely, one standard experience is shared by all applicants. When applicants arrive they are given a series of clinical vignettes to review and are told that they will be asked to discuss one briefly (for 5-10 minutes) during the course of the interview. The interview process consists of the applicant meeting with 2 faculty members (separately) for approximately 45 minutes, one of which reviews the vignette with the applicant. Applicants also have a chance to informally meet the other faculty during the lunch hour and after. 

Following each interview, the candidate meets with one or more interns and tours the facilities. Candidates are informed that the meeting with the intern is not part of our evaluation process (i.e., for their own information only) and are encouraged to ask questions freely.  We believe that this is the most meaningful portion of the interview day in that it allows the applicants to hear unbiased reports as to the program’s strengths and weaknesses.

At the completion of the interviews, the applicant is then rated on numerous dimensions by the faculty interviewers. These ratings are then used to construct a tentative match list. Following completion of all interviews a final match list is then constructed, adjusting the rankings to achieve balance among many factors (e.g., career interests, diversity of the incoming class, etc.).

18.  What is the benefits package like?

The current stipend is $20,000 per annum and health insurance is provided. Interns are allotted two weeks (10 days) vacation and ten sick days

19.  Any other “fringe benefits”?

Besides the good-hearted nature of the faculty… actually, yes!  Each intern is allotted a small stipend towards educational activities.  This stipend can be utilized to finance attendance at a conference, towards buying books or journals, or most any other reasonable educational activity.  In the past, most every intern has attended (and often presented at) a conference during the course of the internship year and such funds are useful as a means to defray costs.

20.  Do interns have an office, internet access, computers, etc.?

Each rotation provides an individual office to our trainees, complete with voicemail and computing capabilities.  In addition, treatment rooms are available in Jones Hall (part of the CHP) for outpatient evaluations and treatment sessions.  While audio taping equipment is available, faculty will often “sit in” during sessions and provide live supervision.  The interns are also free to use the Director of Training’s office or a CHP conference room for larger group or family therapy sessions if advanced arrangements are made.

Interns are provided with a desktop computer, voicemail, access to the university’s libraries and computing systems (including searchable databases), and Internet accounts; departmental computing resources are also made available.  Consultation services are available for computing, word-processing, slide-making, and statistics.  Copying and faxing equipment are available on each rotation and in the outpatient clinic.  While the interns are responsible for most of the clerical aspects of the outpatient component of the internship, clerical support is available on rotation.

21.  Are there any more FAQ’s?

No.