Oxford University Press recently announced the 2022 word of the year—"goblin mode.” Karmel Choi, PhD discusses what this word says about the state of people’s mental health in 2022 and talks about whether “goblin mode” is a good mindset to embrace or a troubling one.
The Behavioral Medicine rotations in the Internship in Clinical Psychology are designed to provide a broad range of clinical experiences.
Current rotations for all BMED interns
Outpatient Psychiatry Department
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 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.
Dialectical Behavior Therapy
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.
Blake 11 – Inpatient Psychiatric Service
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).
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.
Elective Rotations and Additional Training Opportunities
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.
Health Promotion and Resiliency Intervention Research (HPRIR) Program
About Our Program
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 Program Research Aims:
- Conduct behavioral delivery science research that enhances healthcare access and utilization
- Assess mind-body resiliency interventions adapted for patients, providers, and vulnerable or underserved community populations
- Build interventions that bridge oncology and primary care treatment across the cancer care spectrum
- Develop psychosocial and behavioral treatments that are accessible, sustainable, and integrated into healthcare systems
- Promote health equity and health justice
- Increase the use of telehealth research designs and treatment
- Leverage innovative technology-based means of intervention delivery
- Prioritize community outreach intervention research
- Facilitate implementation research in resiliency and behavioral treatments
- Elyse Park, PhD
- Giselle Perez, PhD
- Daniel Hall, PhD
- Christina Luberto, PhD
- Joanna Streck, Ph.D.
- Lara Traeger, Ph.D.
- Lucy Finkelstein-Fox, Ph.D.
- Rachel Millstein, Ph.D.
- Kelly Irwin, MD, MPH
Description: Within the Behavioral Medicine internship track, the HPRIR experience is an opportunity for an intern to specialize and expand their training in health promotion (e.g., cancer screening, tobacco treatment, physical activity) and resiliency (mind-body, integrative medicine) research through additional clinical and clinical research-related electives (see electives below). The core of the experience takes place in the MGH Mongan Institute, where 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 overall Program Training Aims are to (1) train clinicians in resiliency and behavioral intervention research, (2) prioritize training in health equities and disparities research, (3) increase the diversity of clinical researchers trained in resiliency and behavioral intervention research, and (4) promulgate training in evidence-based mixed methods (qualitative and quantitative) research
Patients may be 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. Patients 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.
Goals: The goals of the HPRIR intern experience are to: (1) provide interns with supervised clinical training in evidence-based treatments; (2) develop interns’ abilities to treat patients as part of a multidisciplinary care team; (3) provide an opportunity for interns to formulate and execute treatment plans; and (4) be a part of a multidisciplinary team of clinical researchers whose clinical work informs their research. Interns will see patients with chronic medical conditions and psychosocial stressors, direct individual and group supervision, resiliency training and clinical supervision, and 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.
Clinical research: Interns will have opportunities to see patients referred to the the Behavioral Medicine and Psychiatric Oncology clinics. 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 (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. Opportunities for postdoctoral fellowship trainings will be available and supported.
Didactics and supervision: Clinical work will be supplemented by several supervisions, meetings, and didactics. First, interns will receive weekly individual supervision from a licensed clinical psychologist in HPRIR and weekly group supervision with interns in the Behavioral Medicine and Psychiatric Oncology tracks. Second, 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.
HPRIR Elective Rotations:
- Cancer Survivorship Groups (SMART-3RP): Co-lead this 9-session group-based mind-body program for cancer survivors which integrates relaxation training with cognitive-behavioral therapy and positive psychology principles. Special interest groups will also be available, including mind body groups for adolescent and young adult survivors.
- Smokefree Support Study: MGH Cancer Center service that provides individual tobacco treatment counseling to patients who have been diagnosed and treated with cancer. The SSS treatment protocol integrates cognitive behavioral therapy, mind-body techniques, and motivational interviewing.
- VHL Resiliency: Lead/co-lead a resiliency program for patients diagnosed with von Hippel Linda Disease, a rare genetic disease that predisposes individuals to develop multiple tumors (malignant and benign) throughout their bodies at any point in their life.
- Sickle Cell disease: Assist with leading a mind body program integrated into the care of patients diagnosed with sickle cell disease.
- Collaborative Care and Community Engagement Program: Participate in a collaborative care model focused on serious mental illness and cancer including engagement of patients with cancer and preexisting serious mental illness in hospital, outpatient, and community settings to gain expertise in cognitive behavioral therapy for psychosis, motivational interviewing, person-centered care, and collaborating with social work, psychiatry, and navigation.
HPRIR Study Interventionist
- The Smoke Free Support Study 2.0 (SSS2): Deliver a virtual evidence-based tobacco treatment newly diagnosed cancer patients who smoke and receive care at community oncology settings. Trial findings will establish the effectiveness and cost of utilizing a virtual strategy to deliver evidence-based tobacco treatment in community oncology settings and provide detailed initial data on implementation processes that will inform subsequent testing of multi-level implementation strategies for broad national dissemination into community cancer care settings.
- The Smokefree Support Service: Deliver evidence-based tobacco treatment (based on SSS2) to patients who are currently receiving treatment or who have been treated at the MGH Cancer Center locations. This tobacco treatment is delivered virtually and in conjunction with oncology and primary care treatment teams.
- Pulmonary Nodule Clinic Smoking Cessation Service: Deliver evidence-based tobacco treatment (based on SSS2) to patients who are undergoing screening at the MGH Pulmonary Nodule Clinic. This tobacco treatment is delivered virtually and in conjunction with thoracic, primary care, and radiology treatment teams.
- Integrating Tobacco Treatment into Lung Screening at PHS/SCREEN ASSIST: Deliver evidence-based tobacco cessation counseling to smokers receiving a lung cancer screening test. The goal of the study is to identify the most effective combination of (1) tobacco cessation counseling (4 vs. 8 sessions); (2) nicotine replacement (2 vs. 8 weeks); and referral to a community-based resource to address social stresses that make quitting difficult (referral vs. no referral).
- Caregiver R21: Deliver an evidence-based mind-body resiliency group intervention (SMART-3RP) to caregiver (partner/family member/friend) and cancer survivor dyads via a telehealth platform. The study will assess whether the intervention effects on caregiver and survivor resiliency are interdependent and identify characteristics associated with intervention effectiveness, as well as explore the intervention effects on caregivers’ and survivors’ health care utilization.
- Promoting Resilience and Mental Health Among Health Professional Workforce (HRSA): Deliver evidence-based informed programs that promote resilience, wellness, and mental health among the health center workforce serving in rural and medically underserved areas of Massachusetts. The goals of the study are to identify and implement evidence-informed interventions that promote wellness and resilience among the health center workforce with various modalities (i.e., in-person, virtual, and independent sessions), and to enhance organizational cultures at these health centers to move towards a sustainable model for enhancing employee mental health and wellness.
- Prevalence and Patterns of Vaping Nicotine and Cannabis by Patients with Opioid Use Disorder and Tobacco Use in Substance Use Disorder Peer Recovery: Assist with mixed-methods cross-sectional survey studies to examine vaping and cigarette smoking behaviors and attitudes among adults with OUD in buprenorphine treatment as well as among SUD peer recovery coaches.
- Assessing the Effect of Virtual Navigation to Improve Health Insurance Literacy and Decrease Financial Burden: A CSS Randomized Trial / HINT II: Deliver the Health Insurance Navigation Tools psychoeducational program to colorectal cancer survivors (HINT C Study) or to childhood cancer survivors (HINT II Study). The program involves 5 virtually-delivered sessions that teach health insurance literacy, patient advocacy, and current legislation related to health care access (i.e., Affordable Care Act) in an attempt to increase health insurance literacy and decrease financial burden for patients.
- Transitions Study: Deliver a 5-session coping skills intervention to assist patients with lung cancer in transitioning from curative treatment to survivorship. The intervention integrates problem-focused and emotion-focused coping strategies.
- Pathways Study: Deliver a psychosocial intervention to support patients with rectal cancer who are initiating an intensive course of treatment. The intervention combines medical information with strategies for maintaining quality of life.
- Mindfulness-Based Cognitive Therapy Delivered via Group Videoconferencing for Acute Coronary Syndrome Patients with Depressive Symptoms: Deliver an 8-week MBCT or health enhancement program focused on targeting depression and promoting cardiac health behaviors to patients after acute coronary syndrome (e.g., myocardial infraction or unstable angina, “a heart attack”).
- Bridge: Person-Centered Collaborative Care for Serious Mental Illness and Cancer: Join an interdisciplinary team delivering person-centered care including conducting individualized psychosocial assessments of barriers to cancer care, strengths, and illness understanding and delivery of brief evidence-based therapies to support coping with cancer and serious mental illness for patients and caregivers. The program also incorporates an interdisciplinary psycho-oncology tumor board to extend the reach of psycho-oncology expertise to community settings and adaptation in partnership with Latino communities.
For MORE INFORMATION About HPRIR Clinical Research Collaborations:
- MGH Cardiac Psychiatry Research Program
- The Benson-Henry Institute for Mind Body Medicine
- MGH DCR Qualitative Mixed Methods Research Unit
- MGH Tobacco Research & Treatment Center (TRTC)
- MGH Cancer Center Equity Program
- Training in Oncology Population Sciences (TOPS) T32 Postdoctoral Training Program
- Harvard Medical School Research Fellowship in Integrative Medicine
- MGH K12 fellowship in Addiction Medicine
- American Cancer Society Postdoctoral Fellowship
- MGH Psychiatry Global Training
Description: Within the Behavioral Medicine internship track, the Psycho-Oncology experience is an opportunity for an intern to specialize and expand their training in psychosocial oncology through additional clinical and clinical research-related electives (see electives below). 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. 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. Patients may be individuals, couples, or families and may range in age from 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. Patients may be seen remotely, in the clinic, or during an infusion appointment in a private room (outpatient visits are currently virtual until further notice). 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. Psychotherapeutic treatments are evidence-based including cognitive behavioral therapy, dialectical behavioral therapy, mindfulness, and acceptance and commitment therapy.
Goals: The goals of the Psycho-Oncology experience are to: (1) provide interns with supervised training in psychotherapy with patients and family caregivers during treatment for cancer and cancer survivors; (2) enhance foundations in evidence-based interventions for psychosocial well-being and behavior change in the context of oncology; (3) provide an opportunity for interns to formulate cases and participate in report writing; and (4) enhance general competency in collaborating with a multidisciplinary care team to provide optimal clinical care. These goals are accomplished through direct supervised experiences with diverse patients at various stages along the continuum of cancer care, the opportunity to collaborate with multidisciplinary teams within the cancer center, and didactic experiences specific to oncology, psychology, and behavioral medicine.
Clinical research: Interns will also be members of the Cancer Outcomes Research & Education Program (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 (see elective experiences below). 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. 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).
Didactics and supervision: Clinical work will be supplemented by several supervisions, meetings, and didactics. First, interns will receive weekly individual supervision from a licensed clinical psychologist in the Center for Psychiatric Oncology & Behavioral Sciences. Second, 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.
Potential Faculty Mentors in the Psycho-Oncology Experience:
- Joseph Greer, PhD
- Jamie Jacobs, PhD
- Lara Traeger, PhD
- Elyse Park, PhD, MPH
- Giselle Perez, PhD
- Daniel Hall, PhD
- Ashley Nelson, PhD
- Amy Clara, PsyD
- Kelly Irwin, MD
*Interns may also be co-mentored by our CORE collaborators in the Department of Medicine ( (e.g., oncology clinicians, palliative care clinicians, nurse researchers)
Psycho-Oncology Specific Elective Rotations:
- Cancer Survivorship Groups (SMART-3RP): Co-lead this 9-session group-based mind-body program for cancer survivors which integrates relaxation training with cognitive-behavioral therapy and positive psychology principles.
- CORE Study Interventionist: Train and become a study therapist on NIH- and foundation-funded trials of supportive care interventions for patients with cancer and their family caregivers. Examples of ongoing studies:
- The Transitions Program: An RCT of a 5-session CBT- and acceptance-based intervention to improve quality of life in adults who recently completed treatment for cancers with high risk of recurrence, funded by the American Lung Association.
- Coping with Caregiving Study: An RCT comparing two evidence-based therapies (i.e., CBT and Emotion Regulation Therapy) delivered over 8 sessions for family caregivers of patients of varying cancer types and stages, funded by an R01 from the NCI.
- Neuro-CARE: A 6-session, individual, CBT-based telehealth intervention to reduce clinically significant anxiety in family and friend caregivers of patients with malignant gliomas, funded by the American Society of Clinical Oncology’s Conquer Cancer Foundation.
- PROWESS: A 6-session CBT-based intervention to increase physical activity and symptom management for patients with metastatic prostate cancer taking androgen deprivation therapy, funded by the MGH Trefler Health Equity Organization.
- YACD: A dyadic telehealth intervention for young adult patients with varying cancer types and stages and their partner caregivers, funded by the American Cancer Society and foundation donation.
- Horizons: An RCT of a group-based coping skills intervention to improve quality of life in adults with chronic graft-versus-host disease following hematopoietic stem cell transplantation, funded by the Leukemia & Lymphoma Society.
- Pathways: A psychoeducational intervention to improve coping self-efficacy in adults with cancer who are receiving total neoadjuvant therapy, funded by private donation.
For more information about the Center for Psychiatric Oncology and Behavioral Sciences, visit:
For more information about the Cancer Outcomes Research & Education (CORE) Program, visit:
For more information about CORE’s Caregiving Research Program, visit:
Potential Postdoctoral Opportunities:
Training in Oncology Population Sciences (TOPS) T32 Postdoctoral Training Program
American Cancer Society Postdoctoral Fellowship
Adolescent and Young Adult (AYA)
BMED interns may have the opportunity to participate in an Adolescent and Young Adult (AYAs; aged 18-39) clinical rotation for six months of the internship. This rotation includes participating in a series of seminars, involving speakers within and outside of MGH/HMS, centered on exploring the biological, social and emotional concerns that make this population unique in their experiences when diagnosed with a chronic medical condition that interferes with important age-specific milestones. This rotation may include some overlap with the Cancer Center Survivorship Program, wherein the intern may help co-facilitate a weekly 90-minute resiliency group for adolescents and young adults who are transitioning off cancer treatment and/or are diagnosed with other chronic medical conditions. Interns interested in expanding their 6-month rotation may also have the opportunity to become involved in ongoing AYA clinical research trials. This includes participating as a study interventionist or group facilitator, participating in biweekly clinical research supervision team meetings as well as biweekly research meetings with other faculty and trainees working with AYA populations. This rotation will provide interns with the opportunity to receive specialized training in working with AYA populations confronted with the demands of managing a chronic medical illness.
Cancer Center Survivorship Program
BMED interns may have the opportunity to participate in a Cancer Center Survivorship Mind-Body Resiliency Program rotation for six months of the internship. This rotation includes co-facilitating a weekly 90-minute resiliency group with Mass General Cancer Center patients who are transitioning off cancer treatment. Resiliency groups are currently being held at Mass General sites in Boston, Waltham and Danvers through the Cancer Center Survivorship Program. During this 6-month rotation, you will formally train in the delivery of the Stress Management and Resiliency Training (SMART) Program, a mind-body program based on principles of relaxation response elicitation, CBT and positive psychology developed through a collaboration between BMED and the Benson-Henry Institute for Mind Body Medicine. Training involves participating in an 8-session resiliency program as a participant and partaking in a 2-day implementation training. You will co-facilitate the resiliency group with BMED faculty Elyse Park, PhD, Lara Traeger, PhD and Giselle Perez, PhD, as well as participate in weekly team supervision meetings.
Interns interested in expanding their 6-month rotation may also have the opportunity to become involved in one of several funded mind-body clinical research trials. This includes learning and implementing the manualized resiliency treatment as a group facilitator and participating in biweekly clinical research supervision team meetings as well as biweekly research meetings with faculty and trainees affiliated with the Cancer Center Survivorship Program. This rotation will provide interns with the opportunity to learn more about ongoing cancer survivorship research projects, contribute to new and ongoing cancer survivorship grant applications and participate in preparing first author and co-author manuscripts for publication and conference submissions.
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 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:
- Algorithm Study: (PI O’Cleirigh) A multi-site study to (1) compare the efficacy of Algorithm Treatment, which includes the generation of a pharmacotherapy prescription recommendation sent to the patient’s medical provider through the electronic medical record, to Enhanced Treatment as Usual for smoking cessation among PLWH smokers engaged in HIV clinical care; (2) characterize provider-, staff-, patient-, and clinic-level facilitators and barriers to integration of Algorithm Treatment; and (3) examine the cost effectiveness for the intervention relative to primary smoking outcomes.
- QUIT Study: (PI O’Cleirigh) A multi-site study to (1) test the efficacy of the cognitive-behavioral-based QUIT intervention plus Nicotine Replacement Therapy in HIV-infected smokers, using a 3-arm RCT; (2) examine the degree to which smoking abstinence is mediated by reductions in symptoms of anxiety and depression; and (3) estimate the cost-effectiveness of the QUIT intervention for smoking cessation among smokers living with HIV with clinically significant symptoms of anxiety/depression.
- National HIV Behavioral Surveillance: (PI O’Cleirigh) A CDC-funded study run in 3 annual, rotating cycles, each of which aims to surveille a population at increased risk for HIV. The cycles include: (1) gay, bisexual, and other men who have sex with men (MSM) [2017,2020]; (2) persons who inject drugs (IDU) [2018, 2021]; and (3) heterosexuals at increased risk for HIV infection (HET) [2019, 2022].
- Project MATTER: (PI Batchelder) A National Institute of Drug Abuse funded randomized controlled pilot study to test the feasibility and acceptability of a text-enhanced cognitive behavioral intervention to address stigma and shame as barriers to HIV self-care among men who have sex with men with active substance use disorders.
- iSTRIVE: (PI Batchelder) A National Institute of Drug Abuse funded randomized controlled pilot study to test the feasibility and acceptability of an incentivized directly observed therapy intervention paired with a psycho-behavioral intervention to address stigma and shame as barriers to HIV self-care among people who inject drugs and are virally detectable.
- PrEPsteps: (PI Chai) A study funded by the National Institutes of Health to build and test a smartphone-based PrEP adherence system that responds to adherence data collected through a novel digital pill, with a focus on improving PrEP adherence among who have sex with men (MSM) who use stimulants. Consists of focus group discussions to understand how HIV-negative MSM with stimulant use would use a new smartphone intervention, PrEPsteps, that gives people tools to improve their adherence to PrEP (Aim 1), and a 90-day trial in which MSM would use the digital pill as a tool to help with PrEP adherence (Aim 2).
- DigiPrEP: (PI Chai) A Gilead Sciences-funded study to test the use of a digital enabled PrEP (DigiPrEP) to measure PrEP adherence in men who have sex with men (MSM) who use substances other than alcohol. Consists of individual qualitative interviews to understand how MSM would use and respond to digital pills that measure real-time medication ingestion (Aim 1) and a 90-day feasibility and acceptability trial in which MSM would use the digital pill as a tool to help with PrEP adherence (Aim 2).
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.
Aging and HIV
Interns may have the opportunity to co-lead a weekly Aging with HIV group at Mass General. The group is didactic in nature, leveraging existing evidence-based intervention content developed for people living with HIV (e.g., LifeSteps, adjusted cognitive processing therapy content, mindful self-compassion, motivational interviewing and substance use management). Opportunities to participate in research related to aging and HIV may also be available.
Interns will participate in weekly team supervision meetings. This rotation will provide you with the opportunity to learn more about ongoing projects related to women’s health, both for women living with HIV and women who are not living with HIV, contribute to new and ongoing grant applications, and participate in preparing first author and co-author manuscripts for publication and conference submissions. Clinical and clinical research opportunities (e.g., serving as a protocol therapist), may also be available.
Community-Based Mental Health and Substance Use Initiatives
Interns will have the opportunity to be involved in community-based collaborative initiatives to identify, refine, and implement evidence-based intervention strategies to expand the capacity of community-based organizations to address unmet mental health, substance use, and HIV treatment and prevention needs through several research and implementation projects.
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