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 Child Psychology


Introduction

The child psychology program provides interns with supervised assessment, treatment and consultative experience with the broad range of children, adolescents, and families treated at Duke University Medical Center.  The child psychology program provides training in both traditional child clinical and pediatric psychology concentrations.  The outpatient services of the Division of Child and Adolescent Psychiatry are the primary training sites for clinical child psychology, while the inpatient and outpatient clinics of the Department of Pediatrics and the Pediatric Psychology Service of the Division of Medical Psychology are the primary training sites for pediatric psychology.  Child psychology interns also participate with the adult psychology interns in core seminars designed to expose them to both basic and advanced concepts in clinical practice.  The available concentrations and rotations are described below.  The specific combination of rotations for each intern will be determined by matching interns with their specific clinical interests.  Applicants should elect either the Clinical Child Concentration or the Pediatrics Concentration.  Child interns do not rotate on adult rotations. 

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I. Child Clinical Psychology Concentration

Interns in this concentration generally rotate across the placements described below.  In addition, one of the Child Clinical Interns (to be determined based on interest and fit) will be able to spend 20% time in Pediatric Psychology.

A.  Family Studies Program & Clinic
The Family Studies Program and Clinic is composed of a multi-disciplinary faculty of Psychologists, Psychiatrists, and Social Workers who have expertise in family therapy, as well as a multi-disciplinary trainee group (Psychology Interns, Psychiatry Residents).  The program provides interns with supervised training in family assessment and family therapy, and couples therapy using a live, behind-the-one-way-mirror supervision model.  Supervisors and other team members observe all therapy sessions, and supervisors provide immediate call-in supervision via telephone link-up between the observation room and the therapy room.  All sessions are also audio taped for trainee review.

In addition to couples therapy and general family therapy, interns also have the opportunity to conduct Parent Management Training groups for parents of children with various disruptive behavior disorders (primarily ADHD and ODD).  Interns receive training and supervision in contemporary models of cognitive-behavioral Parent Management Training. Patients for the Families Studies Program and Clinic are referred from the adult and child psychiatry programs and from specialty services within the psychiatry department.  Families are also referred from other medical services and from the community.

Supervisor(s):  Karen C. Wells, Ph.D., P. Susan Hazlett, Ph.D., Christian Mauro, Ph.D, and Jill Compton, Ph.D.

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B. The Durham Child Development and Behavioral Health Clinic (CDBH). 

The Child Development & Behavioral Health Clinic (CDBH) is a division within The Department of Pediatrics and the faculty and interns are part of the Department of Psychiatry & Behavioral Health (Medical Psychology).  Faculty members teach in the Department of Psychology and Behavioral Sciences as well. The Community Guidance Clinic (reorganized as the CDBH in 2006) was one of the nine original clinics accredited by the American Association of Psychiatric Services for Children.  The CGC/CDBH has a long history of providing training in Clinical Psychology, Child Psychiatry, Social Work and Special Education.  Currently, the CDBH provides comprehensive outpatient services for children, adolescents and their families as well as outreach community mental health services to other healthcare facilities and to the Durham Public School System.  We also provide intensive substance abuse treatment for adolescents.  Clinical services are provided by a multidisciplinary team including child clinical psychologists, licensed clinical social workers, a child psychiatrist, a physician assistant and several developmental pediatricians.   

The CDBH provides training opportunities in the areas of cognitive-behavioral therapy and behaviorally-oriented and structural family therapy.  Interns principally work with general individual and family outpatient therapy cases through this rotation.  Cases assigned to interns present from a wide array of diagnostic categories including disruptive behavioral disorders, mood and anxiety disorders, and autism-spectrum disorders.  The clinic is also increasingly serving clients with major health-related issues, such as a childhood chronic illness. Interns with a particular interest in this area may have the opportunity to work with these clients. 

In addition to typical outpatient therapy opportunities, interns may also be involved in psychological testing.  The psychology testing service at the CDBH serves children ranging in age from 3 to 18 years and provides comprehensive assessment of learning, developmental, and behavioral and emotional disorders.  Finally, interns working at the CDBH may also have an opportunity to provide outpatient therapy services at Lincoln Community Health Center, a facility which serves primarily African-Americans and Latinos.

Supervisor(s):  Janet Whidby, Ph.D., and Kelly Anthony, Ph.D.

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C. Center for Child and Family Health – North Carolina

The Center for Child and Family Health (CCFH) is a collaborative endeavor of Duke University, University of North Carolina – Chapel Hill, North Carolina Central University, and Child and Parent Support Services. CCFH is a community-based, multi-disciplinary setting which specializes in the assessment and treatment of children and families who have experienced trauma.  Many of the families who receive services at CCFH have been referred by social services, schools, law enforcement, or the court.  Although CCFH serves an ethnically diverse clientele, the majority of the children and families served are low income or Medicaid eligible clients.  Services offered at CCFH include early intervention and prevention services, assessment of traumatic sequelae, trauma-focused treatment, forensic evaluations, and family and legal support. 

The rotation at CCFH involves working primarily with evidence based treatments with a culturally diverse clientele of traumatized youth and their families. Interns will have an opportunity to learn several trauma informed interventions (e.g., Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Parent-Child Interaction Therapy (PCIT)). Interns will also utilize a range of treatment modalities including: individual therapy with children and adolescents, family therapy, parent education, intensive in-home treatment, community- based interventions, as well as group interventions with children, adolescents, and parents.  The intern liaisons with multiple community agencies including schools, social services, and the court system for each assigned case.  The intern also participates in initial evaluations and limited psychological assessments.

Interns on this rotation participate in a year-long didactic series on trauma and trauma-informed interventions and services. Live and video-based supervision is available. Supervision is generally conducted through a combination of individual and treatment specific group discussions as well as multi-disciplinary team presentations. 

On average, one to two interns are selected to participate on this rotation for approximately 50% of their time for the entire year. For more information about CCFH visit our website at www.cffhnc.org 

Supervisor(s):  Ernestine Briggs-King, Ph.D., and George (Tripp) Ake, Ph.D.

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D. ADHD Clinic

The ADHD Clinic at the Duke University Medical Center is one of the nation's leading programs for research and clinical services pertaining to ADHD and related behavior problems.  The program is staffed by five licensed psychologists, one board-certified child psychiatrist, and a number of study coordinators and research assistants.  In the last three years we have also provided support for 1-2 post-docs per year.  The ADHD Clinic participates actively in three primary activities: 1) Federally-funded (e.g., NIMH) research grants; 2) Industry-funded (e.g., pharmaceutical companies) clinical trials; 3) Clinic services to the community.  These activities encompass patients from preschool age to adulthood.   

The ADHD Clinic offers a clinical rotation for the clinical psychology internship program.  Interns will be involved in evidence-based evaluation and treatment for children, adolescents and adults, primarily through our outpatient fee for service clinic.  Our assessment procedures conform to the practice parameters outlined by the American Academics of Pediatrics and Child and Adolescent Psychiatry and include the use of rating scales from multiple informants, interviews, and brief cognitive testing as indicated.  These assessments also include formulation of treatment plans and comprehensive written reports. Interns also spend time in our LD clinic, conducting psycho-educational testing for learning disorders. Other clinical services in which interns participate include a parent-training group, child coping skills group, an adult ADHD coping skills group, organizational skills summer programs for middle and high school students, and individual treatment cases (typically focused on parent training or academic support skills).  We also provide presentations to schools and the community upon request, and encourage intern participation in these activities.   

There are a number of clinical research activities within the Duke ADHD Program to which interns are exposed through regular didactic presentations.  These include two NIMH-funded, multi-site treatment outcome studies in the follow up phase: the Multimodal Treatment Study of ADHD Children (MTA) and the Preschool ADHD Treatment Study (PATS). With Dr. Wells, we are also participating in a current trial of organizational skills treatment for ADHD children.  We maintain a large database for our clinic including several environmental variables.  With regard to individual faculty projects, Dr, Kollins has several grants evaluating the relationship between ADHD and smoking. Dr. Hardy has NIH funded work evaluating computerized attention training for cancer survivors and Drs. Hardy and FitzGerald have funding to examine facial recognition and emotion regulation skills in an ADHD sample.  In addition, faculty of the ADHD Clinic are continually active in the development of new research opportunities, including those in the area of teacher training.  Opportunities exist for interns to be involved in preparation of papers based upon our extensive databases and nationally recognized research activities.

Supervisor(s): Scott Kollins, Ph.D., Desiree Murray, Ph.D., David Fitzgerald, Ph.D., and Kristi Hardy, Ph.D., and Lisa Ahern, PhD

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E. Psychosocial Treatment Clinic

The Psychosocial Treatment Clinic at the Duke Child and Family Study Center serves children, adolescents, and families utilizing evidence-based practice.  This rotation includes training in empirically supported treatments for children and adolescents primarily with anxiety and mood disorders.  The rotation includes a weekly didactic seminar or case conference and all participants will experience live supervision and participate in the observation of their peers.  Example didactics include: Functional Analysis, CBT for childhood anxiety, CBT E/RP for OCD, CBT for Adolescent Depression, Habit Reversal Training for Tourette Syndrome and Tic Disorders, and Addressing Comorbidity.    

The Psychosocial Treatment Clinic works in conjunction with the Psychopharmacology Clinic at the Duke Child and Family Study Center.  Seminars, case conferences and multidisciplinary treatment teams consist of psychology interns, clinical psychology graduate students, psychiatry residents and child psychiatry fellows.  Individual supervision is guaranteed for all psychology interns and case conferences are utilized to provide maximize exposure to a diversity of presenting problems and treatment approaches.  

Supervisor(s): Chris Mauro, Ph.D., David Goldston, Ph.D., and Rebecca Dingfelder, PhD

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I.1 – FOCI WITHIN THE CHILD CLINICAL CONCENTRATION

            (I.1.a) Child Trauma Focus.  One intern is accepted into the Child Trauma focus.  This intern spends 50% in the CCFH-NC rotation (described above in C.) all year.  The other 50% time is divided among 3-4 of the other rotations.  

            (I.1.b) ADHD Focus.  One intern is accepted into the ADHD focus.  This intern will spend approximately 30-40% time in the ADHD rotation (described above in D.) all year.  The remainder of the time will be divided among the Family Studies, CBDH, and PTC rotations (described in A, B, and E above). 

            (I.1.c) Community Psychology Focus.  One intern is accepted into the Community Psychology focus.  This intern will spend 30-40% time in the CDBH rotation all year (described in rotation B).  The remainder of time will be divided among the Family Studies, ADHD, and PTC rotations (described in rotations A, D, and E).   

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II. Pediatric Psychology

Primary interns in this concentration generally spend 70% time here for the year and the remaining time on at least two of the rotations under the Child Clinical concentration. 

The Pediatric Psychology Service is composed of medical psychology faculty, interns, clinical psychology graduate students, psychodiagnostic technicians, and support staff.  The Service provides assessment, consultation and treatment services to infants, children, adolescents, and families under the care of the Pediatric specialty divisions.  The primary foci of assessment referrals are the cognitive, emotional and psychosocial functioning of children with medical, neurological, and developmental problems.  Many referrals involve children with such chronic medical illnesses as cancer, seizures, and sickle cell anemia.  

Pediatric psychology faculty and interns also participate on other multidisciplinary teams including 1) Pediatric Neuro-Oncology, 2) Pediatric Hematology-Oncology, 3) Pediatric Bone Marrow Transplant, 4) Pediatric Neonatology (Special Infant Care Clinic) and 5) Pediatric Pain Clinic.  The role of Pediatric Psychology is to assess neuropsychological and behavioral changes secondary to disease processes, treatment regimen, as well as to assess the child and parent coping and adjustment. 

Current research by pediatric psychology faculty focuses on coping with chronic childhood illness and on the cognitive and behavioral changes associated with disease processes and treatment.  Interns have the opportunity to participate in these projects. 

Supervisor(s):  Melanie J. Bonner. Ph.D. (Pediatric Psychology Clinic, Pediatric Neuro-Oncology), Kathryn Gustafson (Special Infant Care Clinic (SICC)), Kristina K. Hardy (Bone Marrow Transplant Program) and Kelly Anthony (Pain Clinic)

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