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Internship Training Tracks

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A. INTEGRATED BEHAVIORAL HEALTH TRACK    
The primary focus of interns in the Integrated Behavioral Health track is to provide outpatient individual and group therapy. In addition, each intern is expected to participate in all year-long to 6-month rotations (described below), most of which serve medical and psychiatric inpatients. The Integrated Behavioral Health track provides breadth of training in the following ways. (1) Exposing interns to a broad array of patient populations (e.g., patients with chronic illness, psychiatric inpatients); medical settings (e.g., primary-care clinic, specialty clinics, acute medical inpatient unit); and psychological interventions (e.g., short-term psychotherapy, risk assessment, crisis intervention). In each setting, interns are appropriately instructed and/or supervised, and there is usually a formal didactic component tailored to the setting. A crucial aspect of interns’ experience is interfacing closely with medical teams and social workers. (2) Individual supervision. Each intern has both a primary and secondary supervisor, and may also receive supplementary supervision from staff psychologists on an ad hoc basis as appropriate. In addition, interns receive instruction and oversight by licensed psychologists and board certified psychiatrists specific to each 6-month rotation. (3) Group supervision. Interns meet as a group for two hours per week to present cases and discuss diagnosis, psychotherapy models, and other issues associated with the psychological services we offer here (e.g., coordinating with medical staff, cultural issues, etc.) (4) Supervision for group therapy. Interns are expected to design and co-facilitate several outpatient psychotherapy groups during the year. One hour per week is devoted to discussing psychotherapy groups, problem-solving, and learning group theories and practices (e.g., Irvin Yalom) to promote clinical growth in this treatment modality.

Year-long Training and Duties
Throughout the year, Integrated Behavioral Health interns carry a caseload of individual therapy outpatients, averaging 20 - 25 at any one time. In addition, interns conduct 3-4 intake evaluations per week. A majority of the clinical presentations we encounter are depression, anxiety, and adjustment disorders related to patients’ medical, psychological, and/or social issues. We also commonly encounter trauma history and related issues. (Patients with severe mental illness, acute substance use, or criminal justice involvement are referred to other, more specialized county mental health agencies.) Our patient population is very diverse, and a significant minority are monolingual Spanish speakers. For them, we provide Spanish-speaking clinicians, or telephonic interpreter services. (Interpreter services are also available in many other languages). The clinic utilizes a short-term, biopsychosocial model of psychotherapy; however, interns are also able to see a few patients for long-term treatment. On occasion, interns have the opportunity to provide couple therapy, neuropsychological evaluations, and/or personality testing according to the patients’ needs. San Mateo Medical Center integrates specialty providers and the behavioral team to offer comprehensive care to our patients with chronic illness. Interns provide short-term treatment targeting chronic medical conditions (e.g., diabetes, heart disease). We provide immediate assistance as well as treatment options (individual, group, and medication referral) to help patients to effectively manage the psychosocial issues associated with their chronic illness. Interns are available to medical staff on an on-call basis to respond to any urgent psychological patient needs. Interns utilize crisis interventions and conduct brief assessments to support the patient and/or staff member. ​

Throughout the year, Integrated Behavioral Health interns design and co-facilitate outpatient therapy groups, generally 8-12 weeks in length. Past groups include: Managing Depression and Anxiety, Mindfulness, Acceptance and Commitment Therapy (ACT), Weight Management, and Diabetes support groups. A number of groups are offered in Spanish.  

B. NEUROPSYCHOLOGY TRACK
The primary focus of interns in the Neuropsychology track is completing formal, written neuropsychological evaluations, for outpatients as well as patients hospitalized in our psychiatric and medical inpatient units. These evaluations are usually comprehensive, including an extensive diagnostic interview (conducted by Dr. Josh Vanderschaaf, with the intern present), medical record review, a full neuropsychological battery, and often intelligence and personality measures. Patients being referred have a variety of medical conditions including stroke, dementia, seizure disorders, traumatic brain injury, milder or more general cognitive impairment, and/or somatic symptom disorders. Most patients also have some comorbidity, including substance abuse, learning disorders, and psychiatric illnesses. Interns are closely supervised by Dr. Vanderschaaf. This includes training in test administration, scoring, and interpretation, as well as close review of all report preparation. After suitable training, interns typically test patients over one or more sessions independently. After the written evaluation is completed, the patient returns to review the results with Dr. Vanderschaaf and the intern in a feedback session. Training in the Neuro seminar focuses on brain/behavior relationships, neuroanatomy, and neuropsychological disorders. Neuropsychology is a broad and highly technical field, and interns are expected to educate themselves independently on particular subjects as necessary (e.g., signs of frontotemporal dementia, sequelae of TBI). Interns are expected to complete 25-30 evaluations over the course of the year.

As elaborated above, the focus of Neuropsychology Track interns is completing comprehensive neuropsychological evaluations for both outpatients and, less often, inpatients. However, because our program strives to train well-rounded clinicians, Assessment interns also receive considerable psychological intervention training and experience. Each Neuropsychology track intern: (1) carries a small caseload of individual therapy patients; (2) receives one hour of delegated (therapy) supervision per week; (3) attends all didactic trainings as well as group supervision; (4) has the opportunity to co-facilitate outpatient therapy groups; and (5) is expected to complete most clinical rotations.


San Mateo Medical Center | Integrated Behavioral Health | 222 W 39th Ave, San Mateo, CA 94403
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