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 Child Clinical Psychology Elective is designed to provide strong generalist training with opportunities for interns to begin to develop specialization within a variety of programs through Mass General for Children.
Child track interns gain experience in diagnostic assessment, developmental neuropsychological and psychoeducational evaluation, integrative and cognitive-behavioral individual therapy, family therapy and brief consultation to schools and medical providers. Interns can choose to focus equally on therapy and assessment or to focus more in one of these areas in preparation for more specialized post-doctoral training. Within the therapy concentration, there are several elective opportunities to focus on special populations.
Across all clinical experiences, there is an emphasis on training interns to provide evidence-based services to diverse populations of children and families in an academic medical center. Child interns follow the scientist-practitioner model of the MGH internship with opportunities to collaborate on, or continue their own, clinical research. They participate in didactics with interns from other tracks as well as attend seminars specific to pediatric and family work.
Interns in the Child Clinical Psychology Elective spend approximately half of their direct clinic services time in the Child Psychiatry Outpatient Clinic. This patient population is economically and culturally diverse and includes children and families with multiple psychological, social, and medical problems. Typical referral problems include anxiety disorders, depression/mood disorders, ADHD and parenting difficulties. Interns obtain closely supervised experiences in individual child therapy, cognitive behavioral therapy, parent guidance interventions and family therapy. There is frequent collaboration with child psychiatry fellows for treatment and case management. On average, interns see approximately eight to ten patients (individuals or families) per week.
Additionally, interns have the option of gaining experience with special populations by choosing to complete up to two elective rotations over the course of the year including:
- Pediatric behavioral medicine: seeing children that are referred by various pediatric medical services, including gastroenterology and endocrinology through the outpatient clinic with supervision by a pediatric psychologist.
- Dialectical behavior therapy: co-leading a weekly DBT group for patients ages 12 to 18 years, attending weekly consultation group, 30-minutes weekly supervision with group leader and the option to see one group member in individual therapy.
- ARMS Program: providing individual therapy and/ or co-leading parent groups for families of patients ages 14 to 22 with substance abuse related problems, attending clinic rounds, 1 hour of group supervision weekly.
- Transgender Health Program: providing individual and/or family therapy to pediatric patients seen through the MGH Transgender Health Program with 1 hour of group supervision weekly.
- Early Intervention with Young Anxious Children: evaluating and treating children ages 2-6 years who have shy or fearful temperament or anxiety disorders using family-based CBT, with 1 hour of supervision weekly.
Child interns also do a six-month, four-hour per week rotation providing service for adult psychiatric inpatients (MGH Blake 11). This is a shared clinical experience with interns from other tracks. The emphasis for child interns is on seeing emerging adults (ages 18 to 22) admitted to the unit and on a developmental approach to assessment, diagnosis and treatment planning. While on Blake rotation, interns attend a once weekly seminar specific to inpatient assessment and treatment.
Developmental Neuropsychological and Psychoeducational Assessment
Interns provide developmental neuropsychological, psychological and psychoeducational evaluations through the Learning and Emotional Assessment Program (LEAP). Interns become familiar with basic approaches to evaluating neuropsychological functioning of children and adolescents. Emphasis is placed upon the assessment of learning problems and developmental disabilities, but the interns also gain expertise in assessing psychological functioning using projective and other evaluative measures, as many of the referrals present with a mixture of learning, behavioral and emotional difficulties. On average, interns perform two to three test batteries per month.
Interns wishing to prepare for application to postdoctoral fellowship in pediatric neuropsychology have the option of devoting more of their clinical time to assessment at LEAP and carrying fewer outpatient therapy cases.
Child interns integrate research literature into their ongoing clinical and assessment practices. In addition, there is a strong history of child interns participating in ongoing research projects within the department of psychiatry and within specialty areas of medicine (e.g., neurology, endocrinology, behavioral medicine). Child interns have a minimum of 4 hours per week dedicated research time throughout the year to focus on activities such as completing or publishing their dissertation, collaborating on mentor led research projects, and/ or preparing grant applications for postdoctoral fellowship. Interns have 1-hour weekly research supervision with an experienced clinical researcher.
In addition to the internship core didactics, the following seminars are required for child interns:
- Family therapy seminar: 1 hour per week
- Child cognitive behavioral seminar: 1 hour per week
- Child psychology seminar: 1 hour per week
- LEAP Clinical Rounds: 1 hour per week
- Individual psychotherapy supervision: 2 hours per week (1 hour of cognitive behavioral therapy supervision, 1 hour of integrative psychotherapy supervision)
- Family therapy supervision: 1 hour per week
- Assessment and testing supervision: 1-2 hours per week
- Research supervision: 1 hour per week
In addition to the many opportunities for informal mentorship at MGH,
- Child interns are paired with a non-evaluative mentor for informal support throughout the year. Non-evaluative mentors are post-doctoral fellows or early career psychologists, often who have previously completed the child internship elective at MGH themselves.
- Child interns also meet 1 hour weekly, 3 of 4 weeks per month, with one or both child internship track co-directors for formal mentorship of the internship experience and planning for post-doctoral fellowship.
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