How Childhood Adversity Could Shape Mental Health and Resilience in Adulthood
Could early-life childhood adversity such as trauma, socio-economic hardship, or parental illness have an impact mental health and resilience later in life?
This elective is a part of the Internship in Clinical Psychology. This predoctoral internship is open to matriculated doctoral students enrolled in clinical or counseling psychology programs.
The Behavioral Medicine rotations in the Internship in Clinical Psychology are designed to provide a broad range of clinical experiences.
Core rotations are completed by all BMED interns.
The Outpatient Psychiatry Department (OPD) rotation is a year-long rotation. Behavioral Medicine (BMED) interns provide evidence-based cognitive-behavioral treatments to individual therapy outpatients. You will have the opportunity to treat a wide range of psychological disorders (e.g., mood disorders, anxiety disorders and adjustment disorders) in patients with and without medical comorbidities. Common medical populations served include patients with cancer or post-cancer treatment, neurological problems (such as epilepsy or multiple sclerosis), HIV and endocrine disorders, including type-2 diabetes. Interns carry a caseload of approximately 8-10 patients, and they receive high-quality supervision weekly from multiple supervisors (two hours of individual clinical supervision and one hour of small group supervision). You will also have the opportunity to work as part of multidisciplinary team, communicating with patients’ primary care providers, psychiatrists and medical specialists to provide comprehensive, high-quality patient care. Patients can self-refer to the OPD or be referred by their medical providers
Each intern will participate in the Dialectical Behavior Therapy (DBT) rotation for six months of the internship. This rotation includes co-leading a weekly 90-minute DBT skills group through the outpatient psychiatry department at Mass General for patients with borderline personality disorder and other psychiatric comorbidities. During the rotation, you 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 clinicians and trainees.
As part of the generalist training component of the internship, BMED interns will complete a six-month rotation for one half day per week on Blake 11, home of the Inpatient Psychiatric Service. You will learn to provide brief psychological interventions for patients hospitalized on the unit for acute psychiatric concerns and will be exposed to a full spectrum of psychiatric diagnoses, including anxiety disorders, major depressive disorders/suicidality, substance use disorders and psychotic disorders. Interns observe and participate in patient rounds and actively collaborate with a multidisciplinary team of psychiatrists, residents, nurses, social workers, occupational therapists, case managers and other unit staff. You will receive individual supervision for cases and attend a weekly group seminar to discuss clinical issues relevant to inpatient psychiatric care. Interns also have opportunities to co-lead groups based on individual interest or to observe electroconvulsive therapy (ECT) sessions and evaluations within the Acute Psychiatry Service (APS).
Interns are given an opportunity to select 1-3 elective rotations (depending on goals and timing of elective rotations) to complement their training goals for internship year.
In order to better serve patients, behavioral medicine has psychologists embedded in several hospital clinics and centers, including the Digestive Healthcare Center at Mass General. 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.
Mind-body resiliency groups for individuals with medical illnesses Interns can spend 3-6 months on this rotation, which includes observing and then co-leading a 2 hour/week 9-session group-based mind-body program for patients which integrates relaxation training with cognitive-behavioral therapy and positive psychology principles. Groups are available for cancer survivors; special interest groups for cancer survivors will also be available, including mind body groups for adolescent and young adult survivors, groups for Spanish speakers, etc. The intern can also train in working with patients diagnosed with Von Hippel-Lindau Disease, a rare genetic disease that predisposes individuals to develop multiple tumors (malignant and benign) throughout their bodies or patient with Sickle Cell disease.
Using extremely effective and well-validated Cognitive Behavioral Therapy for Insomnia (CBT-I) protocols, interns will have the opportunity to work with patients struggling with insomnia and other co-morbid sleep and psychiatric disorders using a brief CBT-I intervention to help improve sleep. Interns will complete a well-regarded training that they can utilize to help with the common disorder of insomnia going forward in other settings as well, and will have access to referrals from neurology colleagues at the MGH Sleep Medicine Department. CBT-I-specific supervision and ongoing training in behavioral sleep disorder treatment is provided.
MGH Cancer Center Smokefree Support Service: Interns can spend one half-day a week for 6 months at the MGH CC Smokefree Support Service. Interns will be trained to deliver outpatient evidence-based individual and group interventions (integrating cognitive behavioral therapy, mind-body techniques, and motivational interviewing) for people with cancer who smoke/vape. All treatment is delivered via telehealth.
Interns can spend one half-day per week at the Collaborative Care and Engagement Program for six months of the internship year. Interns can be involved in evidence-based individual and group therapy for treating SUD and dual diagnoses. Interns can train in either the West End Clinic An outpatient facility for those with substance use disorders and co-occurring mental health disorders. Interns can provide individual psychotherapy or co-lead a DBT group), the ARMS clinic (An outpatient clinic for those with SUDs and co-occurring mental health disorders focused on youth and young adults. Opportunities for individual and group psychotherapy.), or the HOPE clinic (An outpatient clinic that provides care for pregnant women with substance use disorder and their infants from conception through early childhood).
Each BMED intern spends one half-day per week at the Mass General Weight Center for six months of the internship year. The 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 or providing behavioral problem-solving, motivational interviewing and sleep hygiene interventions. Under the supervision of Weight Center psychologists, you will conducts psychosocial evaluations of new Weight Center patients, formulate treatment recommendations and carry a caseload of one to three short-term therapy cases at any given time during the rotation, which typically involve treating emotional eating and binge eating disorders, supporting healthy lifestyle changes and reducing distress related to body image. Interns work closely with the other team members to provide coordinated care and 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.
Interns will have the opportunity for research mentorship and collaboration with our faculty. Interns may have opportunities to engage in the delivery of research protocols, data collection and analysis, and attendance at various research-oriented meetings. Interns will be assigned a primary research mentor, but may also have opportunities to collaborate with additional faculty. Our research experiences occur within the following tracks: (1) HIV care and prevention in BMED at MGH (both domestic and international), (2) sexual and gender minority health with The Fenway Institute, (3) mind-body medicine (with the Health Promotion and Resiliency Intervention Research Program; HPRIR program), and (4) psycho-oncology with the Cancer Outcomes Research & Education Program (CORE) and the Center for Psychiatric Oncology and Behavioral Sciences. Each of these experiences are described below.
The HIV Care and Prevention research experience is an opportunity for an intern to specialize and expand their clinical research training related to preventing HIV acquisition and optimizing the wellbeing of individuals living with HIV (e.g., uptake and persistence of biomedical HIV prevention, treatment of mental health conditions, adherence to HIV treatment, aging well with HIV, etc.). Interns will have the opportunity to collaborate with multidisciplinary clinicians, clinical researchers, and health policy experts. Interns will gain experience with a variety of stakeholders, including providers, healthcare systems, and community populations and advocates.
HIV care and prevention research takes place both domestically and internationally. Interns will have the opportunity to participate in research conducted locally at MGH, with the Fenway Institute at Fenway Health in Boston, and with colleagues and collaborators at other institutions in Boston (e.g., Boston University and Boston Medical Center). There are also a number of NIH-funded trials at the R01, R34, and K23 levels that take place globally. Please see examples of our active and recently completed research.
Our research program works with individuals, caregivers, or clinicians and may range in age from young adults to older adults, and sexual and gender minorities, as well as cisgender women. Individuals may be seen remotely in the hospital, during outpatient visits. Evidence-based treatments include positive psychology, cognitive behavioral therapy, relaxation skills, mindfulness, problem-solving and emotion-focused coping skills, and risk and stage-based motivational interviewing.
Interns will have opportunities to participate as interventionists on several NIH-, foundation-, and internally funded randomized clinical trials, at the pilot, efficacy and effectiveness stages of research as well as national datasets and observational studies. With mentorship from faculty (see faculty below), interns may be involved with data analyses, manuscript writing, scientific presentations, and grant preparation, collaborating on a variety of developing, ongoing or completed studies. There will be opportunities to participate in departmental and hospital-wide seminars and lectures on health equity, implementation science, substance use, oncology as it relates to HIV, mixed methods research, and grant writing.
Interns will participate in bi-weekly research in progress meetings and will have an opportunity to participate in a weekly meeting of researchers engaged in global health work attended by psychologists, physicians, nurses, health service researchers and psychiatrists.
Our faculty mentors:
The Health Promotion and Resiliency Intervention Research (HPRIR) Program is a joint initiative between the MGH Department of Medicine Mongan Institute and the Department of Psychiatry to harness the strengths of interdisciplinary behavioral health services to enhance health, wellness, and resiliency.
Our faculty mentors:
Affiliated faculty mentors:
Within the Behavioral Medicine Internship track, the HPRIR research experience is an opportunity for an intern to specialize and expand their research training in health promotion (e.g., cancer screening, tobacco treatment, physical activity) and resiliency (mind-body, integrative medicine) clinical research-related electives (see electives below). Interns will have the opportunity to collaborate with multidisciplinary clinicians, clinical researchers, and health policy experts. Interns will gain experience with a variety of populations of individuals with chronic illnesses, caregivers, providers, healthcare systems and community populations.
Our research program works with individuals, caregivers, or clinicians and may range in age from young adults to older adults. Medical diagnosis include cancer, cardiac disease, substance use disorders, and stress-related medical disorders. Individuals may be seen remotely in the hospital, during outpatient visits. Interns will gain experience with a variety of mental health disorders and challenges related to having a medical illness or sustaining ongoing chronic stress. Evidence-based treatments include positive psychology, cognitive behavioral therapy, relaxation skills, mindfulness, problem-solving and emotion-focused coping skills, and risk and stage-based motivational interviewing.
Interns will have opportunities to participate as interventionists on several NIH-, foundation-, and internally funded randomized clinical trials, at the pilot, efficacy and effectiveness stages of research as well as national datasets and observational studies. With mentorship from HPRIR faculty, interns may be involved with data analyses, manuscript writing, scientific presentations, and grant preparation, collaborating on a variety of developing, ongoing or completed studies. There will be opportunities to participate in departmental and hospital-wide seminars and lectures on health equity, implementation science, primary care, substance use, tobacco use, oncology, mixed methods research, palliative care, nursing, grant writing, and health policy.
Interns will participate in the weekly HPRIR meetings in clinical research and resiliency research. Attended by both psychologists, physicians, nurses, health service researchers and psychiatrists, this meeting offers and discuss clinical research and clinical questions.
Please view our active or recently completed research studies.
Within the Behavioral Medicine Internship track, the Psycho-Oncology research experience is an opportunity for an intern to specialize and expand their research training in psychosocial oncology. The core of the experience takes place in the MGH Center for Psychiatric Oncology & Behavioral Sciences, an outpatient setting within the MGH Cancer Center and the Department of Psychiatry, and the Cancer Outcomes Research & Education Program (CORE). CORE is an interdisciplinary group that conducts innovative research and educational programs to improve the experience and outcomes of patients and caregivers across the continuum of cancer care. Interns will enhance their skills in evidence-based interventions for psychosocial well-being and behavior change in the context of oncology and enhance general competency in collaborating with a multidisciplinary care team to engage in effective clinical research.
Through evidence-based research in supportive oncology care, interns will gain experience with a variety of patient populations receiving oncology treatment, nearing end of life, or coping with long-term or late onset issues in cancer survivorship. Our research program works with individuals, couples, and/or families, including young adults to older adults. Types of cancer include breast cancer, lung cancer, hematologic malignancies, gastrointestinal cancer, prostate cancer, genitourinary cancer, melanoma, multiple myeloma, brain tumors, and other malignancies. Interns will gain experience with a variety of disorders and challenges related to cancer including depressive disorders, anxiety disorders, adjustment disorders, post-traumatic stress disorder, substance abuse, mild cancer treatment-related cognitive impairments, symptom management, adherence to treatment, existential concerns, and survivorship issues.
Interns will also be members of CORE, with opportunities to serve as a study therapist on several NIH-, foundation-, and internally funded randomized clinical trials in supportive oncology care for patients. Interns will also have the opportunity to serve as a study therapist on funded randomized clinical trials for family caregivers of patients with cancer through CORE’s Caregiving Research Program. With mentorship from Psycho-Oncology faculty (see faculty below), interns may be involved with data analyses, manuscript writing, scientific presentations, and grant preparation, collaborating on a variety of ongoing or completed studies. *Interns may also be co-mentored by our CORE collaborators in the Department of Medicine (e.g., oncology clinicians, palliative care clinicians, nurse researchers).
Following the internship, opportunities exist to transition to a postdoctoral fellowship through the T32 TOPS fellowship, a grant-funded postdoctoral fellowship through the American Cancer Society, or another grant-funded postdoctoral position (see postdoctoral opportunities below).
Interns will participate in the twice-monthly faculty meeting for the Center for Psychiatric Oncology & Behavioral Sciences. Attended by both psychologists and psychiatrists, this meeting offers an opportunity to stay up to date on clinic and department policies as well as discuss clinical cases. Second, interns will attend a monthly group supervision with faculty from the Dana-Farber/Harvard Cancer Center, a collaboration between psychologists at the Dana-Farber Cancer Center and the MGH Cancer Center. Third, interns will attend a weekly meeting of the multidisciplinary CORE Program, including a monthly journal club. The weekly CORE meeting offers the opportunity to discuss innovative research and clinical care with faculty specializing in oncology, psychiatry, palliative care, social work, and nursing. Several workshops are offered throughout the year that interns may choose to take advantage of to enhance their clinical and research skills. Finally, interns may choose to attend cancer center grand rounds, psychiatry grand rounds, palliative care grand rounds, and other disease-specific grand rounds.
Please view our active or recently completed research studies.
Potential faculty mentors in the psycho-oncology experience:
Affiliated faculty mentors:
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 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.
Please see our active and recently completed research.
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.
Find information on psychiatry residencies, fellowships and other continuing medical education opportunities.
U.S. News & World Report rates Mass General Psychiatry the top in the nation.
Could early-life childhood adversity such as trauma, socio-economic hardship, or parental illness have an impact mental health and resilience later in life?
In this large-scale comparative effectiveness trial, researchers demonstrated the equivalence of delivering early palliative care via video versus in-person visits on quality of life in patients with advanced lung cancer.
The Mass General Addiction Recovery Management Service (ARMS) addresses gaming, gambling and problematic digital technology use in young adults.
In a double-blind, randomized, cross-over study of adults who use cannabis regularly, researchers from Massachusetts General Hospital assessed participants’ brain activity under the influence of THC (the main psychoactive component in cannabis) versus placebo.
Advanced meditation and related experiences offer new possibilities for improving mental health and well-being.
Study finds that altered states of consciousness associated with yoga, meditation, mindfulness, and other practices are common, and mostly positive or even transformative, but that for some people, they can be linked to suffering.
This elective is a part of the Internship in Clinical Psychology. This predoctoral internship is open to matriculated doctoral students enrolled in clinical or counseling psychology programs.