Major Rotations
Child Track
Child Psychiatry Program
Primary Supervisors: Sherri MacKay, Ph.D., Kenneth J. Zucker, Ph.D.
The Child Psychiatry
Program is newly organized, incorporating the Child and Family Studies Centre
and the Family Court Clinic, both long-standing services at the Clarke Institute
of Psychiatry. The Child Psychiatry Program is now formally merged with the Division
of Child Psychiatry at the Hospital for Sick Children and several staff psychologists
engage in clinical and research activities at both sites, thus allowing interns exposure
to an even larger and more diverse clinical population.
Interns will receive training in clinical assessment and diagnosis, psychological
testing, and therapeutics. Such training includes intensive experience in clinical
interviewing of children and families and diagnostic formulation, which includes
a strong focus on the use of the DSM-IV. Because many patients seen in our program
have more than one diagnosis, interns have the opportunity to work with complex children
and families and thus gain a great deal of experience with the well-known clinical
phenomenon of co-morbidity. Assessment and psychological testing includes objective
tests, projective tests, observational techniques, neuropsychological tests, and
structured diagnostic interviews. Such training includes development of integrated
psychological report writing and the process of providing clinically sensitive feedback
to parents and children. Therapeutic approaches include individual psychotherapy,
cognitive-behavior therapy, and parent counseling and psychotherapy.
Interns can gain experience in a broad range of child psychopathologies, including
the internalizing and externalizing disorders, learning and neuropsychological disabilities,
firesetting and arson, affective disorders, anxiety disorders, pervasive developmental
disorders, psychotic disorders, and gender identity disorders. At present, the program
is organized as an outpatient setting, including a developing linkage with programs
at the Hospital for Sick Children.
Supervision is on an individual basis. There are two bi-weekly seminars: one seminar
focuses on a range of topics, including new research in clinical child psychology,
in which both staff and interns make presentations; the second seminar focuses on
clinical issues. The service itself also provides a range of educational opportunities.
These seminars allow for group interaction and discussion about the major research
and clinical issues that are of interest to staff and interns.
Adult Track
Cognitive Behavior Therapy:
Depression
Primary Supervisors: Mark A. Lau, Ph.D., Zindel V. Segal, Ph.D.
This rotation is conducted in the Cognitive
Behaviour Therapy (CBT) Unit of the Mood and Anxiety Program of the Clarke Division.
The CBT Unit is a clinical/research out-patient treatment clinic that offers specialized
training in short-term cognitive therapy for depressive based disorders (patients
are seen over 20-weeks). Assessment of suitability for cognitive therapy is conducted
as part of an initial evaluation procedure. The goals of the CBT Unit involve the
provision of highly refined and well-researched clinical services. Investigations
are conducted to evaluate treatment methods and to investigate vulnerability to psychological
disorders. Given the clinical research role of this unit, patients are often concurrently
participating in research trials which have a focus on the investigation of relapse
and recovery following treatment. A current orientation of this unit is towards the
study of vulnerability to major depressive disorder and the identification of cognitive
markers. This unit also serves an important academic and teaching function for continued
training of psychiatric residents and other mental health professionals who are interested
in learning about the cognitive model of emotional disorders.
Training opportunities on the Cognitive Behaviour Therapy Unit involve developing
familiarity with 1) diagnosis of Axis I affective disorder; 2) cognitive assessment
of these disorders; 3) administration of a short-term cognitive therapy protocol;
and 4) the selection interview for determination of suitability for cognitive treatment.
In addition, an emphasis on case formulation using a cognitive model of emotional
disorders is stressed.
There is also an emphasis on understanding the interaction between pharmacotherapy
and psychological treatment of the disorder, the role of interpersonal factors in
depression, and considerations relevant to treatment format selection (i.e., short-term
or long-term in nature). Opportunities for participation in research are also available,
but these may be limited by the interns' caseload and demands related to clinical
service.
Cognitive Behavior Therapy: Anxiety
Disorders
Primary Supervisor: Neil A. Rector, Ph.D.
This rotation is conducted in the Anxiety
Disorders Clinic (ADC), located in the Mood and Anxiety Program of the Clarke
Division. The ADC is a clinical and research unit staffed by individuals from a wide
range of disciplines including psychology, psychiatry, social work, and nursing.
The clinic sees about 500 new referrals per year, many of whom are treated in cognitive-behavioral
and pharmacological treatment programs. The principal disorders seen in the clinic
include panic disorder, agoraphobia, social phobia, and obsessive compulsive disorder,
although opportunities to work with individuals with other anxiety-related difficulties
exist. Training of psychology interns includes opportunities to develop skills in
clinical assessment, diagnostic interviewing, and cognitive-behavioral treatment
(individual and group) of anxiety disorders. Although most clients seen are outpatients,
inpatient experience may be available as well, especially with obsessive compulsive
disorder. Also, interns are expected to become familiar with the relevant research
literature.
In addition to offering clinical services, the Anxiety Disorders Clinic is among
the most active anxiety research centres in Canada. Research interests of clinic
staff members include the development of short-term, cost effective assessments and
treatments for anxiety as well as the role of cognitive-behavioral factors, biological
factors, and their interaction in the etiology and treatment of anxiety disorders.
Depending on the intern's interests and experience, opportunities to participate
in clinical research projects or to develop new projects are available as time permits.
Supervision includes weekly individual meetings as well as less frequent case
conferences that include all clinic staff.
Psychological Assessment Service
Primary Supervisors: R. Michael Bagby, Ph.D., Bruce K. Christensen, Ph.D.
The Psychological Assessment Service (PAS) is co-directed by Dr. Michael Bagby
and Dr. Bruce Christensen. The PAS provides psychological and neuropsychological
assessments and consultation services to inpatient units and outpatient clinics at
the Clarke site to the following Divisions: Addictions, Schizophrenia and Continuing
Care, General Psychiatry, Mood and Anxiety, and Society, Women and Health. The service
is also staffed with two Master's level psychometrists.
Personality and Psychopathology
Dr. Bagby coordinates the referrals for the assessment of personality pathology and
psychopathology. This part of the service utilizes a number of objective measures
of personality and psychopathology, including the MMPI-2, the Personality Assessment
Inventory, the revised NEO Personality Inventory, and a number of other tests or
specialized assessments. Assessments also include structured and semi-structured
assessment measures, including the Structured Clinical Interview for DSM-IV Axis
I (SCID-I) and Axis II (SCID-II) and the Structured Interview for the Five-Factor
Inventory. Computerized scoring and interpretation are available.
Clinical Neuropsychology
Dr. Christensen coordinates the referrals for neuropsychological assessment. This
service provides comprehensive assessment of the cognitive functioning and neurological
integrity of psychiatric patients. The recently established Neuropsychology Laboratory
is well-equipped with both conventional and experimental neuropsychological measures
which are used to assess a variety of patients including those with schizophrenia,
mood/anxiety disorders, previous or current neurological injury/disease (e.g., brain
injury, stroke, dementia), substance abuse problems, and forensic complications.
The service emphasizes the neurobiological underpinnings of psychiatric illness and
attempts to integrate neuropsychological findings into the diagnostic and treatment
considerations of the multidisciplinary team. The Neuropsychology Laboratory is also
an integral research component of the Schizophrenia and Mood/Anxiety Divisions and
is involved in numerous studies concerning the neuropsychology, neuropathology, and
neuropharmacology of psychotic disorders and depression. In this context, members
of the Neuropsychology Laboratory work closely with other scientists and clinicians
from the Schizophrenia and Mood/Anxiety Divisions in combining neuropsychological
data with other experimental test results (e.g., MRI structural morphometry, PET
functional imaging, psychopharmacology, event-related brain potential (ERP) methods).
Interns on this rotation are expected to conduct assessments, write reports, provide
family and team members with relevant test results, and provide clients with feedback
on their evaluation. Interns are expected to attend a bi-weekly Neuropsychology Seminar,
which focuses on clinical and technical aspects of neuropsychological assessment.
Interns may also participate in research seminars with the Schizophrenia or Mood/Anxiety
Divisions. Opportunities for participation in research are also available.
Law and Mental Health Program
The Law and Mental Health Program was one of the first forensic centres established
in the country (as part of the Clarke Institute of Psychiatry) and continues to be
at the forefront of research and treatment innovations. The Law and Mental Health
Program specializes in the assessment and treatment of individuals who have ongoing
involvement with the legal system.
Adult Forensic Outpatient Service
Primary Supervisor: John Arrowood, Ph.D.
The Adult
Forensic Outpatient Service is a clinical and research outpatient unit which
specializes in the assessment and treatment of individuals involved criminal and
civil legal proceeding as well as occupational discipline procedures. Clinical activities
in which interns are involved include diagnostic assessment, assessment of Posttraumatic
Stress Disorder, assessment of psychopathic personality, clinical and actuarial assessment
of risk for reoffense, and assessment of risk for violence in the workplace. These
assessments sometimes include evaluation of police officers for fitness for duty
as well as evaluation of physicians and attorneys for fitness for practice. Interns
will become familiar with the psycholegal standards in forensic and in reporting
to attorneys and the courts. Interns also have opportunity to take on individual
psychotherapy clients and to take part in sex offender and/or anger management group
treatment programs. Supervision is provided on an individual basis. Additionally,
interns will have the opportunity to attend the Forensic Division seminar series.
Possibilities also exist for participation in clinical research as time permits.
Assessment and Triage Unit
Primary Supervisor: David Nussbaum, Ph.D.
The Assessment
and Triage Unit (ATU, previously the Metropolitan Toronto Forensic Service) is
a specialized inpatient assessment unit which provides consultation to the courts
on wide-ranging pre-trial and pre-sentence issues. In addition, the ATU maintains
an important academic role in research and the advanced training of psychologists
and psychiatrists. The primary training offered at the ATU is in the assessment of
complex clinical and psycholegal cases. Patients often have co-occurring Axis I and
Axis II disorders, many of which are superimposed on substance abuse disorders. These
patients provide a rich opportunity for diagnostic and personality assessment. Referral
questions concern fitness (competency) to stand trial, criminal responsibility (insanity),
and Dangerous Offender applications. Specialized clinical activities in which interns
are involved include the assessment of psychopathic personality, malingering, posttraumatic
stress, and the clinical and actuarial prediction of dangerousness. Interns will
become familiar with the psycholegal standards involved in forensic assessment and
reporting to the courts.
In addition, interns may have the opportunity to take part in outpatient forensic
assessment of risk for violence in the workplace, in both blue and white collar employees.
These assessments sometimes include evaluation of police officers for fitness for
duty as well as evaluation of physicians and attorneys for fitness for practice.
Interns also have opportunity to take on individual psychotherapy clients and to
take part in sex offender and/or anger management group treatment programs. Supervision
is provided on an individual basis. Additionally, interns will have the opportunity
to attend the Forensic Division seminar series. Possibilities also exist for participation
in clinical research efforts as time permits.
Clinical Sexology Program (Phallometric
Laboratory)
Primary Supervisor: Ray Blanchard, Ph.D.
Phallometric testing is a psychophysiological method for the assessment of erotic
preferences in human males. In this procedure, a man's penile blood volume changes
are monitored as he experiences a standard, prerecorded set of potentially erotic
stimuli. The Clarke Division Phallometric Laboratory was established by Kurt Freund,
M.D., D.Sc., the first clinical sexologist to use penile plethysmography to assess
erotic preferences in men. It is the oldest laboratory in North America for the phallometric
assessment of sex offenders and paraphilics, and its instrumentation for the collection
and processing of phallometric data is still the most sophisticated in North America,
or indeed, in the world.
Most men referred to the Laboratory have been charged with, or convicted of, sexual
interaction with minors or sexual coercion of adult women. The differential diagnosis
usually involves a determination of paraphilia versus sexual misconduct motivated
by some other factor. The central goal of this internship position is to train the
intern to administer phallometric tests and to interpret their output. Because phallometric
testing is highly technical and involves the mastery of complex instrumentation,
we will only consider applicants who will spend half of each work week in the Phallometric
Laboratory for the entire year of their internship. The highly accurate but elaborate
equipment used in the Clarke Division Laboratory often requires the examiner to supervise
the subject while he places the penile transducer on his genital or to verify the
placement of the apparatus in locating the source of equipment problems. For this
reason, only males can be hired to work in the Phallometric Laboratory (Ontario Human
Rights Commission Exemption File #257).
Clinical
Sexology Program (Gender Identity Clinic)
Primary Supervisor: Ray Blanchard, Ph.D.
Clinical experience can be expected in the assessment and diagnosis of patients
with gender identity disorders, including those who present with the expressed wish
for sex reassignment surgery, those who are exploring the possibility of surgery,
and those who wish to manage their cross-gender feelings and the expression of those
feelings while remaining in their original gender role. Experience will be offered
in history-taking, group therapy with gender-dysphoric patients, and (occasionally),
in individual counseling.
Concurrent
Disorders Service
The primary focus of training in the Concurrent Disorder Program would be gained
through psychotherapy training opportunities available within the various specialty
clinics that are situated in the Concurrent Disorders Program.
Dialectical Behavior Therapy
Clinic
Primary Supervisors: Shelley McMain, Ph.D.
The Dialectical
Behavior Therapy (DBT) Clinic is a treatment program for clients diagnosed with
borderline personality disorder. The therapy program involves a combination of weekly
individual and group skills training, in addition to after-hours telephone consultation.
Treatment entails a team approach and requires a minimum one-year commitment. Therapy
focuses on enhancing regulation of emotions, distress tolerance, and interpersonal
functioning. Interns would gain experience in individual and group therapy as well
as crisis management. Interns would participate in a weekly therapist consultation
team meeting. Interns would be expected to become familiar with the relevant research.
The DBT Clinic is an active clinical, research, and training centre. Research interests
of the DBT team include the evaluation of treatment outcome, the relation of psychotherapy
process to outcome, and the role of emotion in psychotherapy. Participation in research
activities is available as time permits.
Anger and Addiction Clinic
Primary Supervisor: Lorne Korman, Ph.D., C.Psych
The Anger
and Addiction Clinic is a Dialectical Behavior Therapy (DBT)-based clinical and
research outpatient program for individuals with concurrent anger and addiction problems.
The clinic is based in the Concurrent Disorders Service of the Addictions Program,
and offers one of few treatments concurrently addressing anger and addictions, as
well as other Axis I and II disorders. The clinic team is multi-disciplinary, consisting
of psychologists, psychiatrists, and social workers.
Treatment is based on an outpatient DBT model that has been adapted specifically
to target angry, violent, and addictive behaviors. Rotation in this clinic involves
training and supervision in the assessment of concurrent anger and addiction problems,
and the provision of individual DBT sessions, skills training groups, and DBT skills
coaching. In addition to weekly individual supervision and participation in the clinic
consultation team, training opportunities may involve live supervision of individual
and group sessions. Research interests of clinic staff members include the development
of behavioral assessments of anger and violence, and the evaluation of cognitive-behavioral
and emotion-focused treatment protocols for anger and addictions, domestic violence,
and borderline personality disorder. The clinic trains residents and fellows in psychiatry
as well as interns and practicum students in psychology. We also provide consultation
and training to other mental health professionals.
Eating Disorder and Substance
Use Clinic
Primary Supervisor: Christine M.A. Courbasson, Ph.D.
The Eating
Disorder and Substance Use Program offers specialized outpatient treatment to
clients (both females and males) with substance abuse accompanied by an eating disorder.
The therapy focuses on helping clients meet their goals in dealing with their eating
disorder and substance use problems, relate more effectively with others, adopt a
healthy lifestyle, develop a more positive self-image and healthy identity, improve
their quality of life, know themselves better and handle feelings and tolerate distress.
Therapy involves a combination of individual and group psychotherapy for these clients.
The treatment approach involves a combination of: (1) weekly 2-hour group therapy
sessions which are gender-specific (involving both experiential therapy and coping
skills training), (2) weekly one-hour individual psychotherapy sessions, and (3)
meetings with a dietician, physician, and nurse, as needed, and. (4) after hours
telephone consultation. Clients commit to attend treatment for a minimum of one year.
Interns would gain experience in all modes of treatment and would be involved in
a weekly therapist consultation team meeting. The eating disorders and addiction
clinic is involved in various clinical, research, and training activities. Research
interests include psychological determinants of resiliency and treatment success
in individuals with concurrent disorders, coping with stress, mindfulness, expectancies
and the role of the self in eating disorders. The intern may have the opportunity
to be involved in a research project.
Educational Seminars
In addition to direct clinical experience, the internship requires that the intern
participate in a number of didactic educational experiences including the Clinical
Seminar Series and the Psychotherapy Case Conference Series. In addition, interns
are encouraged to take advantage of other professional development activities including
lectures, workshops, seminars and professional conferences, both within and outside
the Centre.
Clinical Seminar Series
Seminars are provided every week by psychology staff at the CAMH. Lectures are
typically held at the site where each psychologist provides his or her direct treatment
or assessment functions. Through these seminars, interns can gain familiarity with
the various practicing sub-sections of the CAMH even if they are not in contact with
them during their ordinary rotations. The seminars are structured to provide information
relevant to assessment and treatment issues as well as to enhance the professional
functioning of interns vis a vis the independent practice of psychology. Topics in
the seminar reflect the range of interests by staff psychologists at the CAMH (for
examples, see the research publications of primary supervisors listed below).
Psychotherapy Case Conference Series
This seminar provides an opportunity for interns to consolidate their psychotherapy
skills and to interact with members of the Department of Psychology in a mutually
trusting environment. Psychology staff members meet on a weekly basis with the interns.
Both staff and interns review audiotapes of psychotherapy sessions, with the goal
examining specific clinical phenomena related to the practice of psychotherapy. This
case conference serves as a continuing forum for the discussion and exploration of
personal issues relevant to psychotherapy process and outcome as well as serving
to model for the interns a variety of approaches to conceptualization and amelioration
of emotional disorders. The psychology staff members participating in the case conference
represent diverse perspectives and provide an important atmosphere relevant to disclosure
and honest discussion of obstacles and successes in therapy.
Acceptance & Notification
Procedures
In selecting interns, the Centre for Addiction and Mental Health follows the Association
of Psychology and Postdoctoral Internship Centers (APPIC) voluntary guidelines.
For the 2003-2004 internship year, APPIC will continue to utilize the (new) computer
matching procedure, which our program will participate in. The APPIC code number
for our internship program is 8321.
If you have any uncertainty about the new procedure, please discuss this with
an appropriate faculty member at your host university or (if short-listed) during
your interview at our site.
The CAMH sends copies of all letters confirming internship positions to the directors
of training of those students who have accepted internship positions. Any offer from
the CAMH IS CONTINGENT UPON THE APPLICANT NOT HAVING MADE A PRIOR COMMITMENT. Applicants
are not to retain more than one offer at a time. The CAMH reserves the right to withdraw
an offer if it is determined that an applicant is holding more than one offer at
a time.
Applicants will be informed if any positions have been pre-allocated. Applicants,
agencies, and programs are urged to report any violations of these guidelines to
the Chairperson, APPIC Executive Committee.
|
download the free Acrobat PDF Reader
1-800-463-6273
