Core Components of Internship Across Tracks

Professionals in the Pritzker Department of Psychiatry and Behavioral Health are dedicated to promoting the mental health of children, adolescents, and their families through the provision of state-of-the-art psychological services, public education, and advocacy. Our mission includes providing national leadership in the education of health care professionals and advancing knowledge through research. Children of all ages and from every socioeconomic background are treated in the department for a wide variety of problems including adjustment disorders, emotional problems related to pediatric health disorders, trauma, psychoses, mood disorders, anxiety disorders, developmental delays, autism spectrum disorders, externalizing disorders, and learning disabilities.

The department currently includes 42 pediatric psychologists, clinical child psychologists, and neuropsychologists. Most staff psychologists hold clinical appointments in the Department of Psychiatry and Behavioral Sciences, faculty appointments in Northwestern University’s Feinberg School of Medicine, and are licensed to practice clinical psychology in the State of Illinois. The entire psychology faculty participates in the internship program through direct supervision, presentation of seminars, and/or involvement in the intern application process. During the year, each intern can work with many of the psychologists on the staff, with flexibility to pursue specialty interests.

Beginning with the 2023-2024 Internship Class, we will support four full-time, twelve-month internships of two interns each in two tracks: the Pediatric Psychology Track and the Clinical Child Psychology Track. This change will allow interns to pursue more focused specialty training while building on our decades of exceptional training. Applicants may apply to both tracks but must indicate their first preference in their cover letter.

Interns will participate in year-long outpatient services focused on cases aligned with their specialty track, three rotations within their chosen track for 3-months each, one 6-month rotation conducting assessments with the neuropsychology team, and associated efforts in research, program evaluation, and advocacy. The three-month rotations aligned with the chosen track will consist of one required acute care rotation (the Partial Hospitalization Program for Clinical Child interns, the Psychiatry & Behavioral Health Consultation Service for Pediatric Psychology interns), two rotations chosen by the intern within their dedicated track, and one 3-month choice rotation from the opposing track to encourage breadth of training. The year-long internship experience allows interns to pursue both short and long-term cases while the rotations provide intensive experience on a variety of other services. Cohort cohesion is supported through one half day each week of in-person didactics attended by all four interns and co-located private offices.

In addition to internship training, the department supports practicum student and postdoctoral fellowship training. Currently five postdoctoral fellowship positions are available, one in Outpatient Therapy and Consult Service work, one in Outpatient Therapy with a focus on trauma and community based mental health services, one in research and treatment of children and adolescents with diabetes, one in the Gender clinic, and one focused on Early Childhood. Preference for filling these positions is given to current interns.

The internship is administered by the director of training with ongoing support and cooperation from the chief psychologist, other staff psychologists, the chair of the Pritzker Department of Psychiatry and Behavioral Health, and staff from all other participating disciplines in the department.

Outpatient and Assessment Services

The largest of the department programs, Outpatient Services, meets the needs of children and their families in approximately 20,000 visits each year. Children are referred for virtually every reason, including disruptive behavior disorders, anxiety disorders, psychoses, school problems, mood disorders, trauma, developmental delay, cognitive challenges, and a range of adjustment problems. All psychologists and interns in Outpatient Services see a variety of children, presenting concerns, and diagnostic presentations during the year.

Psychologists and interns make decisions regarding the most appropriate assessment or therapy approaches to cases in conjunction with other members of the Outpatient Services staff. Psychological involvement might include traditional assessment, behavioral assessment, individual relationship-based therapy, family therapy, behavioral therapy, cognitive-behavioral therapy, or group therapy. Decisions regarding assessment and treatment are generally determined based on the psychological needs of the case, the current research literature, and the theoretical orientation of the psychologist and other professionals involved. The Psychology Training Program Supervisors are committed to the use of empirically supported treatments and to the ongoing measurement of outcomes. Each intern devotes approximately six to eight as a primary therapist and two hours a month are devoted to intake and diagnostic evaluations. In addition to in-person evaluation and treatment, telehealth videoconferencing software is utilized to provide telehealth services. Interns are supervised by two outpatient supervisors.

Interns will spend one day per week for six months with the Neuropsychology Testing Service. This rotation is scheduled during choice rotations. The Neuropsychology Service conducts evaluations of patients referred from both psychiatric and medical settings for questions regarding cognitive functioning and its relationship to underlying neurologic dysfunction. Referrals span a broad age range and include concerns such as developmentally based deficiencies of attention and learning, anomalies of neural development, seizure disorders, traumatic head injuries, toxin exposure, brain tumors, and systemic medical disorders, among others. Depending on the supervisor, the assessment day may occur at the main hospital or at our Deming location. A complementary shuttle runs multiple times daily between the two locations.

Subsumed under Outpatient Services are several specialty clinics, such as the Trauma Team Service, and group opportunities including group to treat traumatic stress (including Structured Psychotherapy for Adolescents Responding to Chronic Stress: SPARCS), anxiety groups (largely based on the Unified Protocol for Children and Adolescents), adolescent depression groups, disruptive behavior disorders groups (including a preschool group), and social skills groups for different ages (including Flexible Thinking groups). Interns are required to participate in at least one group treatment during their training. Groups may occur via telemedicine, at the main hospital, or at the Dayton location.

Didactics

Interns attend approximately 5 to 10 hours of didactics per week. The seminar load is heaviest during the first two to three months of the internship when interns require more didactic learning to acquire the information necessary to be clinically effective as the year proceeds and clinical loads increase. The didactic experience includes a combination of seminars exclusively for our psychology program trainees as well as multidisciplinary didactics.

Most didactics exclusive to the psychology training program are held in-person during a single half day block each week to support dedicated learning and professional growth without the interruption of clinical services and to promote intern cohort cohesion and camaraderie.

Didactics in this section include:

  • The Medical Psychology Seminar
  • The Trauma Treatment Service Learning Collaborative
  • The Motivational Interviewing (MI) and Acceptance and Commitment Therapy (ACT) Intensives
  • The Neuropsychology Seminar
  • The Supervision Seminar

The seminars under the rubric of Topics and Treatment in Child Psychiatry and Psychology meet 1-2 times per week throughout the year and include blocks of seminars in the areas of clinical assessment, community issues including schools, diversity and cultural competence, the psychotherapies, forensic and ethical issues, and trauma assessment and treatment.

Additional workshops are presented at the beginning of each training year to address the use of empirically supported treatments for specific presenting problems. Staff at Lurie Children’s are strongly committed to training interns in empirically supported treatments for a wide range of disorders. Specific workshops, training seminars and/or supervision are provided in the treatments such as:

  • Cognitive-behavioral therapy for anxiety and depression based on the Unified Protocol for Children and Adolescents
  • Parent-management training including Parent Child Interaction Therapy (PCIT)
  • Trauma treatments including Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Attachment Regulation and Competence (ARC) therapy, Cognitive Behavioral Intervention for Trauma in Schools (CBITS), and Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS)
  • Motivational Interviewing (MI)
  • Acceptance and Commitment Therapy (ACT)
  • Principles of Dialectical Behavior Therapy (DBT)
  • Comprehensive Behavioral Intervention for Tics (CBITS)

Interns participate in a bi-weekly Multi-Disciplinary Case Conference (MDCC) and present cases for discussion and expert consultation. Daily rounds or required meetings during clinical rotations provide additional case based didactic experiences. Finally, interns attend Grand Rounds in the Department of Psychiatry and Behavioral Sciences at Northwestern University’s Feinberg School of Medicine.

Supervision

Interns are assigned two supervisors for their outpatient cases and one supervisor for their assessment cases. Typically, interns receive at least one hour of supervision for every three to four cases they see. Supervision for the Intern Choice Rotations is provided by the attending working on that service while supervision for Partial Hospitalization cases is provided by the Clinical Director of this Service. While on the Consult Service, interns are supervised on a rotating basis by all the Attending Pediatric Psychologists and the Attending Psychiatrists. Thus, each intern receives a minimum of four to five hours of supervision per week. Although most of the supervision is done by psychologists, interns also receive supervision by members of other disciplines.

Video recording units and observation rooms are available in the department for use by interns and their supervisors. All interns are expected to videotape at least some of their therapy sessions during the year.

The Pritzker Department of Psychiatry and Behavioral Health serves a large and diverse patient population including Chicago’s Latinx community. Interns who are bilingual in Spanish are highly recruited. Supervision for treatment of Spanish speaking families is provided by bilingual psychologists, Rebecca Ford-Paz, PhD, Edna Romero, PhD, or Anna Ros, PhD, who conduct supervision in Spanish for these cases.

Research & Program Development

The Internship Program has a strong commitment to training students as scientist-practitioners. This is an ideal setting in which to teach students how to integrate research and clinical practice. In addition to allowing access to several populations (e.g., medically ill children) who are otherwise difficult to study, this setting provides students with a unique opportunity to study the effectiveness of a variety of treatment approaches with children and families. Once they have completed their dissertation work, interns at Lurie Children’s will become involved in an ongoing research, program evaluation, or advocacy project in the department.

As the field of psychology moves increasingly towards accountability and the use of empirically supported treatments, this becomes a critical component of training at the doctoral level. Once they have completed their dissertation work, all interns at Lurie Children's are encouraged to get involved in an ongoing research project in the department. They will be assigned a research mentor, based on their particular interest, to help guide them through this process. Interns are encouraged to spend approximately four hours per week working on their chosen research or program development project.

Professional Development

All interns meet with the Training Director who provides support, mentorship and seminars on ethics, professional development including postdoctoral processes, and supervision. These meetings are held weekly during the summer to promote onboarding, belonging, and provide additional support during orientation period and held at least bi-weekly through the remainder of the training year. These meetings also provide an informal forum for addressing intern concerns and grievances. Interns may choose to join select postdoctoral fellowship professional development seminar sessions on a range of topics including work-life balance, diverse career paths in clinical child and pediatric psychology, and job negotiation skills.

All interns are assigned an individual mentor with whom they can meet on an as needed basis to discuss career objectives, the stresses of internship, dissertation matters, and more. The assigned mentor is someone who does not have an evaluative role with the intern to reduce power imbalances. Interns have the option to request a pairing with a mentor with intersecting identities. The variety of ages, backgrounds, interests, and approaches to balancing life and work among the Lurie Children’s psychology faculty provides a broad range of role models and mentors for the interns.

Evaluation

Interns are formally evaluated by all of their supervisors. Following the completion of each major rotation, rotation supervisors complete evaluation forms. Outpatient supervisors complete formal evaluations at mid-year and end-of-year. Less formal student evaluations take place during psychology training program supervisor meetings; students receive feedback about any concerns raised during these meetings in their monthly one-on-one meetings with the Training Director. All evaluations, grievance and due process procedures are outlined in the Intern Handbook and distributed during orientation. Twice a year, the Training Director sends an evaluation letter to each Intern’s Director of Clinical Training.

Interns are also asked to formally evaluate their rotation supervisors at the end rotations, their outpatient supervisors two times a year and the overall program twice a year. Seminars are evaluated after the completion of each presentation.

Successful completion of the internship requires that, by the end of the internship year, students obtain competency grades of 3 or above (on a 5-point scale) on all items in their outpatient evaluations. Similar competency ratings are required on evaluations at the completion of all rotations.