Cognitive Behavioral Therapy Elective

The Cognitive Behavioral Therapy (CBT) Elective provides experiences in a clinical setting according to the scientist-practitioner model and encourages academic careers in psychology.

Interns in this elective receive intensive training designed to provide:

1. Up-to-date knowledge of clinical research methods and outcomes
2. Knowledge of the nature of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) conditions and treatment interventions based on the current empirical literature
3. Experience in formulating and implementing treatments based on functional analyses of maladaptive behaviors in patients with a wide range of severity, comorbidity, and clinical presentations
   

Treatment, Assessment & Evaluation

The CBT Elective provides interns with experience evaluating and treating patients with conditions representing a full spectrum of DSM-5 disorders. To insure that experience with a variety of disorders and relative specialization with several disorders is achieved, interns track the number of patients seen within each diagnostic category. An effort is made to create diversity in each intern's case load. The clinical training requirement for interns is eight patient-contact hours per week. Typically, interns schedule approximately ten patient/hours per week to insure a full eight hours of contact. CBT interns will get exposure to some behavioral medicine cases during the internship year.

CBT interns will also co-lead a dialectical behavior therapy (DBT) group and attend DBT team meetings for six months. (In addition, interns will do a six-month, four-hour/week rotation on the Inpatient Psychiatry Service on Blake 11.)

Participation in a number of diagnostic programs will help ensure that, in addition to providing state-of-the-art CBT interventions, CBT interns become facile with the issues associated with pharmacologic and combined pharmacologic and cognitive-behavioral treatment. Outcome findings for pharmacotherapy, CBT and their combination are addressed in the CBT seminar. During the internship, interns will become aware of the common doses, side-effects, and actions of the agents most commonly applied in the pharmacotherapy of anxiety, mood, and somatoform disorders. In addition, the CBT elective provides specialty training in issues of combined treatment and discontinuation of pharmacotherapy for patients with anxiety and affective disorders. Experience with and awareness of the effectiveness of CBT for different diagnostic categories helps prepare interns for interacting with managed care companies and other mental health professionals.

Consultation

CBT interns provide consultations to medical and psychiatric patients hospitalized at Mass General on an as-needed basis.

Research

Typically, successful applicants to the CBT elective have already demonstrated a commitment to clinical research as evidenced by an emerging history of completed research publications and/or presentations. To make the most of the clinical research training, an incoming intern would have their dissertation either nearly complete or complete before starting the internship. One of the objectives of the CBT elective is to solidify the interns' background and skills necessary for a career in academic research.

As part of our commitment to the Scientist-Practitioner model, clinical research is a regular and protected part of the CBT elective. Faculty from the anxiety (panic disorder, social phobia, PTSD, generalized anxiety disorder (GAD)), obsessive-compulsive disorder (OCD), bipolar, depression, psychotic disorders, digital health, and adult ADD programs offer a wealth of research opportunities to CBT interns, including multiple ongoing investigations of the nature and treatment of anxiety and affective disorders. In addition to these direct experiences, the CBT Seminar provides training in the use of structured clinical interviews and discusses the methods and findings in recent clinical research trials. The structure of these ongoing studies allows for the intern to add existing measures to ongoing projects or to design side studies of their own.

Key faculty involved in research & clinical training

• Amanda W. Baker, PhD – Anxiety, mood and traumatic stress disorders
• Kate Bentley, PhD – Prediction and prevention of suicidal and nonsuicidal self-injurious thoughts and behaviors; transdiagnostic CBT
• Jennifer A. Burbridge, PhD – CBT for adult depression, anxiety disorders, ADHD, comorbid medical conditions, women's reproductive health/fertility
• Taylor A. Burke, PhD – Suicidal and nonsuicidal self-injury prediction and prevention in youth and young adults using novel methodologies and computational approaches (e.g., intensive active and passive monitoring, computer vision, acoustic and visual behavior analysis)
• Corinne Cather, PhD – CBT for psychosis
• Anne Chosak, PhD – OCD and OC spectrum disorders (BDD, trichotillomania, etc,) and anxiety disorders in adults
• Antonia Chronopoulos, PhD – CBT for adult depression and anxiety (panic disorder, social phobia, specific phobia, generalized anxiety) 
• Jonah N. Cohen, PhD – Anxiety, mood, traumatic stress; treatment integration 
• Kamryn T. Eddy, PhD – CBT and family-based treatment (FBT) for eating disorders
• Jeanne Fama, PhD – Etiology and treatment of OCD spectrum and anxiety disorders in children, adolescents and adults
• Lauren B. Fisher, PhD – Depression, suicide risk, CBT for depression in patients with traumatic brain injury
• Jennifer L. Greenberg, PsyD – Body image and OC spectrum disorders across the lifespan
• Aude Henin, PhD – The treatment of childhood anxiety disorders and bipolar disorder. Longitudinal studies of risk factors for anxiety and mood disorders
• Rachel Ishikawa, PhD – CBT for adult depression, anxiety and traumatic stress disorders
• Douglas Katz, PhD – Treatment of bipolar and trauma and stress-related disorders.  Research on psychosocial interventions for bipolar disorder
• John Kelly, PhD – Addiction treatment and recovery, translation and implementation of evidence-based practices
• Nancy Keuthen, PhD – Clinical treatment of OCD and OC spectrum disorders (e.g. trichotillomania, BDD, etc.) Research on trichotillomania and other body-focused repetitive disorders (e.g. skin picking)
• Richard Liu, PhD – Depression, suicide, and NSSI in childhood, adolescence, and emerging adulthood
• Luana Marques, PhD – CBT for anxiety 
• Christina Massey, PhD – CBT for adult depression, anxiety disorders, ADHD, somatic symptoms 
• Jamie Micco, PhD – CBT for anxiety disorders in children and adolescents
• Maren B. Nyer, PhD – CBT/DBT; mind-body interventions for depression in adults, including mindfulness-based therapy and yoga
• Paola Pedrelli, PhD – CBT for mood disorders in young adults and adults, brief motivational interventions for alcohol use disorders mild and moderate alone and co-occurring with mood disorders, CBT for GAD
• Jennifer Ragan, PhD – CBT for OCD and obsessive-compulsive spectrum disorders
• Jessica Rasmussen, PhD – CBT for OC spectrum disorders (hoarding, OCD, body dysmorphic disorder, etc.) and CBT for anxiety disorders
• Diana M. Ronell, PhD – Fear of flying, panic symptoms and medical anxiety

• Randi M. Schuster, PhD – Etiology and treatment of adolescent substance use disorders; substance use and neuropsychiatric comorbidities; translation and implementation of evidence-based prevention and intervention programs in school-based settings

• Susan Sprich, PhD – ADHD, anxiety disorders and trichotillomania in children, adolescents and adults, DBT
• Louisa Sylvia, PhD – CBT for mood disorders in adults, especially bipolar disorder; mind-body and lifestyle interventions for depression
• Jennifer Thomas, PhD – CBT for eating disorders
• Aisha Usmani, PhD – OCD and OC spectrum disorders, including body focused repetitive behaviors, tic disorders, anxiety disorders, CBT including acceptance-based skills
• Rachel Vanderkruik, PhD – Women's mental health
• Hilary Weingarden, PhD – CBT for OCD and related disorders; research focus on shame as a risk factor in body dysmorphic disorder, and smartphone-based assessment and interventions for BDD
• Sabine Wilhelm, PhD – OCD and OC spectrum disorders, including information processing, treatment development and treatment outcome research, digital health interventions

Didactics

In addition to the internship core didactics, the following seminars are required:

• CBT seminar (weekly)
• Behavioral Medicine seminar (weekly)
• Group supervision and case conferences

Supervision

• 2+ hours of individual supervision
• 2 hours of group supervision
• Supervision provided in both group and individual formats is designed to offer a variety of perspectives on the care of patients. In all cases, supervision is designed to combine perspectives based on empirical research and enhanced with clinical experience.

Awards

The Mass General/Harvard Medical School Predoctoral Internship in Clinical Psychology received the "Outstanding Training Program" Award in 2011 by the Association for Behavioral and Cognitive Therapies (ABCT).   

Postdoctoral Training Opportunities

In the past few years, we have had interns stay on for postdoctoral training in a number of different programs including the Center for OCD and Related Disorders, the Depression and Clinical Research Program, the Center for Anxiety and Traumatic Stress Disorders, the Psychotic Disorders Program, the Dauten Family Center for Bipolar Treatment Innovation and others. Interns tend to stay on with the programs in which they have worked during the internship year. More than half of CBT interns stay on at Mass General for postdoctoral training, although there is no guarantee of postdoctoral positions

Related Links

• Center for Anxiety and Traumatic Stress Disorders
• Cognitive Behavioral Therapy Program
• Center for OCD and Related Disorders
• Tic Disorders Clinic and Research Unit
• Dauten Family Center for Bipolar Treatment Innovation
• Eating Disorders Program
• SUD Program
• The Center for Digital Mental Health