The BMED Service is very involved in training the next generation of Behavioral Medicine researchers, and provides a one-year training elective in Behavioral Medicine through the APA-approved pre-Doctoral internship in clinical psychology at the MGH/Harvard Medical School. General information and application materials (click on "How To Apply") for the pre-Doctoral internship in clinical psychology, as well as the one-year training elective in Behavioral Medicine, are available here.

Additional information about clinical opportunities within our internship program are available here .

If you would like to learn more about current Behavioral Medicine research projects, please visit the research activities section of our Web site.

Additional Training

The BMED service provides additional training in clinical methods and research by offering Post-Doctoral Fellowships. Since 2004, BMED has trained 12 Post-Doctoral Fellows. Seven of these Fellows have been promoted to Instructors at the MGH /Harvard Medical School, two have assumed tenure track Assistant Professor positions at academic Psychology Departments, and 3 are currently Post-Doctoral Fellows.

Clinical research Post-Doctoral Fellowships are also typically available; these Fellowships depend on the status of various internal or external funding mechanisms. Typically, we know about the availability of Post-Doctoral positions for July or September after the end of January of that year.

In collaboration with the Division of Global Psychiatry at MGH, Behavioral Medicine has a postdoctoral training opportunity in the NIMH-funded T32 fellowship, the Global Psychiatric Clinical Research Training Program. This fellowship is a protected time, clinical research fellowship devoted to providing training to fellows interested in clinical research careers in global mental health. Mentored by Dr. Conall O’Cleirigh, there may be postdoctoral training opportunities available in Cape Town, South Africa focusing on evaluating a nurse-delivered cognitive behavioral therapy (CBT) intervention for HIV medication adherence and depression, or in India focusing on HIV prevention among men who have sex with men (MSM). More details about the fellowship can be found here and here. For more information about what might be available in the upcoming year, please email Dr. Christina Psaros.

Current rotations

Outpatient Psychiatry Department (OPD): The Outpatient Psychiatry Department (OPD) rotation is a year-long rotation in which interns provide evidence-based cognitive-behavioral treatments to individual therapy outpatients. Behavioral Medicine (BMED) interns have the opportunity to treat a wide range of psychological disorders (e.g., mood disorders, anxiety disorders, adjustment disorders) in patients both with and without medical comorbidities. Common medical populations served include individuals with various types of cancer (and those with survivorship status), neurological problems (e.g., epilepsy, multiple sclerosis), HIV, and endocrine disorders (e.g., type 2 diabetes). Interns carry a caseload of approximately 8-10 OPD patients, and they receive high-quality supervision weekly from multiple supervisors (two hours of individual clinical supervision and one hour of small group supervision). BMED interns also have the opportunity to work as part of multidisciplinary team, communicating with patients’ primary care providers, psychiatrists, and/or medical specialists to provide comprehensive and high-quality patient care. Patients can self-refer to the OPD or be referred by their medical providers.

Neuroscience Intensive Care Unit: The neuroscience ICU rotation combines clinical training with research. Each of the 2 interns will rotate in the Neuro-ICU 1 day/week for several months. The interns will participate in multidisciplinary staff meetings, will co-lead a 30 minute skills group for caregivers, and will provided assessments and brief interventions to patients and families within the ICU. All interns will receive hands on training though shadowing an experienced clinical psychologist within the Neuro- ICU, as well as supervision of clinical cases. Research opportunities include participation in an ongoing prospective study of patients and caregivers aimed at identifying predictors of depression and post traumatic stress at 3 and 6 months post ICU admission, manuscript preparation, assistance in the design of semi-structured interviews, conducting focus groups with patients and caregiver, intervention development and help with grant preparation and intervention delivery.

Weight Center: Each BMED intern spends one half-day per week at the MGH Weight Center for 6 months of his or her internship year. The MGH Weight Center is a multidisciplinary subspecialty obesity medicine clinic treating patients with obesity or other conditions related to weight. Each Weight Center patient is assessed by a team that includes a physician, dietitian, and psychologist, who together formulate a comprehensive, individualized treatment plan. Weight Center treatments for obesity include behavioral weight management intervention, pharmacological treatments, and weight loss surgery; for many Weight Center patients, the team psychologist plays an active role in treating eating disorder symptoms and/or providing behavioral problem-solving, motivational interviewing, and/or sleep hygiene interventions. Under the supervision of Weight Center psychologists, the BMED intern will conduct psychosocial evaluations of new Weight Center patients, formulate treatment recommendations, and carry a caseload of 1-3 short-term therapy cases at any given time during the rotation. Therapy cases typically involve treating emotional eating and binge eating disorders, supporting healthy lifestyle changes, and reducing distress related to body image through the application of motivational interviewing, problem-solving, and CBT principles and techniques. Interns also work closely with the other members of their patients’ Weight Center team to provide coordinated care. Interns receive one hour of formal supervision weekly, with informal supervision contact as needed. There is also a strong didactic component to this rotation, with assigned readings of scientific articles related to a wide range of obesity and obesity treatment topics, and weekly discussions of these articles during supervision.

Acute Psychiatry Service Rotation (APS): As part of the generalist training component of the internship, behavioral medicine interns will complete a six-month rotation for one half day per week in the Acute Psychiatry Service (APS) of the Massachusetts General Hospital Emergency Department. Psychology interns will learn to work in a fast-paced environment, perform a time-sensitive and comprehensive psychiatric evaluation, conduct a complete risk assessment, work with an interdisciplinary team of doctors, nurses, psychiatry residents, and attending psychiatrists, and compose concise clinical documentation. Specifically, interns will conduct a full psychiatric evaluation focused on risk assessment, planning, and disposition for children, adults, and geriatric patients who present to the ER with emergent concerns around mental health (e.g., suicidality, homicidality, psychosis, substance abuse, intoxication). Interns will present each case to the attending psychiatrist, giving a clear outline of the psychiatric and medical history, impressions of the possible psychiatric diagnoses and differential diagnoses, and a preliminary assessment and plan. The attending psychiatrist will interview the patient him or herself, and the intern is encouraged to observe during this process if time permits. The intern will work with the attending psychiatrist to finalize the assessment and disposition plan, and will then work with support staff to implement the plan, which may include discharge, referral to partial hospitalization program, or inpatient psychiatric admission. As part of this rotation, interns will also attend a weekly APS seminar, which will provide an opportunity for clinical supervision, as well as education and training around working in the APS environment.

Dialectical Behavior Therapy (DBT) Rotation: Each intern will participate in the Dialectical Behavior Therapy (DBT) rotation for 6 months of the internship. This rotation includes co-leading a weekly 90-minute DBT skills group through the outpatient psychiatry department at MGH for patients with borderline personality disorder and other psychiatric comorbidities. During the rotation, the intern will co-lead the DBT group with an expert in DBT and have the opportunity to participate in a weekly DBT team meeting with other expert DBT clinicians and trainees in the DBT service. During the team meeting, there are opportunities to receive feedback about cases and group progress and learn about other ongoing DBT groups at MGH. There may also be opportunities to lead program evaluation of DBT services depending on intern interests and initiative.

Possible rotations:

Gastroenterology Service: In order to better serve patients, behavioral medicine has psychologists embedded in several hospital clinics and centers, including the Massachusetts General Hospital Digestive Healthcare Center. The majority of behavioral medicine patients seen through the Digestive Healthcare Center are diagnosed with inflammatory bowel disorders (Crohn's Disease and Ulcerative Colitis) or functional gastrointestinal disorders such as Irritable Bowel Syndrome, Gastroparesis, and Cyclical Vomiting Syndrome. Typical referrals include (1) patients having difficulty adjusting to a recently diagnosed chronic GI condition, (2) patients facing challenges around adherence to medication, diet, or lifestyle changes, and (3) patients for whom stress and anxiety management strategies could improve their medical conditions either directly (by reducing episodes) or indirectly (by improving coping). Directly addressing these challenges often yields noticeable benefit after just a few sessions. Opportunities may be available for interns interested in working with this population.

The Fenway Institute Rotation, Fenway Health: Dr. O’Cleirigh directs the Behavioral Science Team at the Fenway Institute with a primary focus on intervention development to support HIV prevention and treatment and LGBT health disparities. The rotation at the Fenway Institute is available to Behavioral Medicine Clinical Psychology Interns who have an interest in HIV research and/or in LGBT health. The rotation is typically arranged for the intern to spend one full day a week at the Fenway Institute with the potential to increase their time during the second semester of the internship year. The opportunities for interns on the Behavioral Science Team at the Fenway Institute multiple and varied and are typically linked to current research projects in progress or in development. These projects are generally conducted by researchers who have their primary appointment at Harvard Medical School and in the Behavioral Medicine Program at Massachusetts General Hospital. The Directors of the Fenway Institute are Drs. Kenneth Mayer and Judy Bradford who work closely with the Behavioral Sciences Team.

Current behavioral research projects at the Fenway Institute include the following:

Project THRIVE. Project THRIVE (PI O’Cleirigh) is a National Institute of Mental Health funded R01 randomized controlled trial to evaluate the efficacy of an integrated treatment platform combining Cognitive Process Therapy with sexual risk reduction counseling to reduce PTSD symptom severity and sexual risk for HIV among gay/bisexual and other men who have sex with men who have histories of childhood sexual abuse.

Project RISE. Project RISE (PI Boroughs) is a treatment development project funded by Harvard University Center for AIDS Research. This is a mixed methods study designed to specify and provide an initial test of an intervention to address bullying-related distress and substance use among emerging adult gay/bisexual and other men who are either HIV-positive or at risk of becoming HIV infected. This study utilizes the Unified Protocol and will incorporate technology based platform.

Project PRIME. Project PRIME (PIs O’Cleirigh/Taylor) is a National Institute of Drug Abuse funded study examining the interrelationships between chronic pain and opiate dependence on engagement in HIV care and HIV treatment adherence among older (50+) HIV-positive gay/bisexual and other men who have sex with men. This is a mixed method study utilizing qualitative semi structured interviews, quantitative survey, toxicology screening, physical examination, and medical chart review.

Project BUILD. Project BUILD (PI Blashill) is a National Institutes of Mental Health funded study to develop a cognitive behavioral intervention to address the dual challenges of body image disturbance/dissatisfaction and appropriate engaged in HIV care among HIV-positive gay/bisexual men.

The opportunities for interns on these projects include participating in treatment and treatment development studies as protocol therapists. This involves learning and implementing novel manualized cognitive behavioral treatments and receiving weekly clinical supervision. The intern also participates in weekly research team meetings and other trainings. The intern will also be expected to participate in preparing manuscripts for publication and preparing conference submissions from study data sets. Opportunities to make co-author and first author contributions are available on most of these projects. The Behavioral Science Team is constantly developing new projects and the opportunity to contribute to new and ongoing grant submissions is expected and forms part of the supervised research mentorship that is provided through the rotation at the Fenway Institute.

Interns who elect this rotation enjoy the experience of working in the more relaxed atmosphere of an LGBT Health Center (the largest Health Center meeting the needs of the LGBT Community in the country). This rotation also provides opportunities to become involved in biomedical research projects, ongoing epidemiological studies, and policy and education initiatives all of which form part of the Fenway Institute’s portfolio.

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