To align with our two program aims—breadth and depth of training—interns may choose from eight concentration options. Interns spend approximately 50% of their time in their area of concentration.
Applicants are encouraged to apply to only one concentration. Reason(s) for applying to more than one concentration must be clearly outlined in the applicant’s cover letter.
After matching to Duke, interns will rank their preferences for electives based on their interests, training goals, and rotation availability. Please see the Elective Rotations page for more details about electives.
Concentration Options
APPIC Program Code: 141314
This concentration provides an emphasis on full model Dialectical Behavior Therapy (DBT) approximately 40% time or two days per week in our inpatient and/or outpatient clinics.
Interns will be trained over the course of the internship year to conduct individualized assessments and provide evidence-based Cognitive Behavioral Therapy (CBT) and DBT. This includes training in case formulation and intervention in DBT and many other contemporary CBTs (e.g., CPT, PE, UP, BA, CT) as well as in process-based approaches tailored to the individual using interventions such as reappraisal, defusion, mindfulness, exposure, skills training, etc.
Dialectical Behavior Therapy (DBT) Emphasis
The DBT emphasis caseload is a mix of multi-diagnostic patients (e.g., borderline personality disorder) and those with less complicated presentations. The most common diagnoses treated include mood, anxiety, trauma, and personality disorders.
Interns may co-lead a weekly DBT group for patients with borderline personality disorder or other appropriate diagnostic categories struggling with emotion dysregulation. Co-leading a DBT group provides additional training in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills.
Interns attend a weekly two-hour DBT consultation team meeting in addition to one hour of weekly individual DBT supervision.
Overall, the primary goals for interns include:
- Increased understanding of the cognitive, behavioral, biological, and emotional aspects of mood, anxiety, and personality disorders
- Development of skills in cognitive-behavioral assessment and treatment of these disorders
- Successful oral and written communication with other health professionals
CBT/DBT Concentration Didactics
The CBT concentration provides didactics and educational opportunities to interns through several different activities.
The DBT consultation team meeting serves as an educational opportunity through interactions with faculty and post-doctoral level DBT therapists. One hour of each weekly two-hour meeting is devoted to didactic training. During the first quarter of training, interns participate in intensive seminars on issues related to starting the clinical internship, including “DBT: Model, Principles and Strategies.” These include:
- Using diary cards in DBT
- Conducting chain analyses in DBT
- Implementation of DBT
- Telephone consultation for skills generalization in DBT
All CBT/DBT interns have individual supervision that may include reviewing therapy tapes, live supervision (e.g., “bug-in-the-eye”), co-leading groups with supervisors, and assigned readings.
Interns have supervisors who will work with them continuously throughout the year, allowing for more in-depth supervisory relationships and the development of strong case formulation skills across transdiagnostic models of evidence-based care.
Research Opportunities
Adult CBT/DBT interns who have completed their dissertation may participate in collaborative research projects with Duke faculty. Although research is not a requirement of the rotation, interested interns are encouraged early in the year to explore research options with faculty members.
There are many ways interns can get involved with CBT faculty research projects. CBT faculty strongly encourage and are ready to support interns pursuing research activities. Examples include:
- Jeremy Grove, PhD, is conducting research funded by NIH/NIAAA to develop a mobile health-supported behavioral intervention to reduce risk of suicide, hazardous drinking, and other maladaptive post-discharge outcomes for adults hospitalized for suicidality and co-occurring alcohol misuse/alcohol use disorder.
- Zachary Rosenthal, PhD, directs the Center for Misophonia & Emotion Regulation and the Cognitive Behavioral Research & Treatment Program. His currently funded research examines the role of emotional processes in misophonia, borderline personality disorder, and psychopathology more generally.
- Moria Smoski, PhD, conducts NIH-funded studies of emotion regulation and reward processing in depression, including studies of depression in late life. Dr. Smoski is also involved in ongoing studies of mindfulness-based interventions.
Supervisors
- Colleen Cowperthwait, PhD
- Jeremy Grove, PhD
- Stephanie Hargrove, PhD
- Tyson Pankey, PhD
- Zachary Rosenthal, PhD
- Jeffrey Sapyta, PhD
- Moria Smoski, PhD
Elective Rotations
After matching to Duke, interns will rank their preferences for two or three other elective rotations.
APPIC Program Code: 141311
This concentration involves didactic training, patient care and research experiences. Interns are exposed to empirical and theoretical perspectives from a number of disciplines and are expected to use that information while working in both inpatient and outpatient settings. One intern will spend 60% or three full days working in the Cancer Behavioral Management and Support Clinic.
The rotation in the Cancer Behavioral Symptom Management and Support Clinic is based on a scientist-practitioner model of training and is comprised of clinical and research activities that address the psychological, social, behavioral and symptom management needs of cancer patients.
The intern will gain experience in the role of a psychologist on a medical team and learn how to collaborate within and contribute to a multidisciplinary team.
Clinical activities are conducted as part of the Duke Cancer Patient Support Program and the Duke Adult Blood and Marrow Transplant Program.
The Duke Cancer Patient Support Program provides psychological services to cancer patients and their families in the outpatient clinics of the Duke Cancer Institute, a National Cancer Institute-designated comprehensive cancer center.
The Duke Adult Blood and Marrow Transplant Program, which is closely associated with the Duke Cancer Institute, is internationally recognized for its novel approaches to treating leukemia, lymphoma and myeloma through bone marrow and stem cell transplantation. The Duke Cancer Institute and the Duke Blood and Marrow Transplant Program treat patients from a range of ages, ethnic and racial backgrounds and socioeconomic statuses, and from rural and urban settings in North Carolina and the larger region.
Experiences on this rotation aim to increase the intern’s knowledge and skills for treating psychological, social, behavioral and symptom management issues that occur during the cancer experience. The intern in this rotation work works closely with the multidisciplinary Cancer Patient Support and Bone Marrow Transplant teams, including:
- Psychologists
- Psychiatrists
- Marriage and family therapists
- Social workers
- Physicians
- Nurse practitioners
- Pharmacists
- Nutritionists
- Physical therapists
- Patient financial advisors
- Patient and nurse navigators
Assessments
The intern is trained to conduct and interpret psychological assessments and health behavior evaluations for patients, their families and caregivers. Assessment techniques include behavioral observation, standardized psychological measures, semi-structured interviews and diagnostic interviews. The intern will also perform regular follow-up assessments of post-treatment quality of life for patients undergoing bone marrow transplant.
Through training and clinical experiences, the intern will become skilled at assessing the psychological, relationship and behavioral health issues that impact individuals and families affected by cancer.
Psychological Services
The intern will provide psychological services for patients, their families and caregivers. Clinical experiences include outpatient CBT-based psychotherapy, manualized behavioral interventions for symptom management and health behavior interventions. Psychological services are provided in individual, couples and group settings through face-to-face meetings, phone and web-based technologies.
The intern will also gain competence in developing treatment plans and choosing appropriate, evidence-based interventions for the range of issues and problems that arise for patients and their families when faced with a serious, life-threatening illness.
Supervision
The intern will participate in weekly individual supervision sessions for psychological assessment and psychotherapy cases. The intern will participate in monthly group team meetings with other psychologists (e.g., faculty, post-doctoral fellows) working with the Cancer Patient Support Program. This meeting will provide group supervision on therapy cases and can be a forum for clinical research training.
Each week the intern will also participate in a multidisciplinary team meeting that includes members of our collaborating care teams (e.g., Cancer Patient Support Team, Blood and Marrow Transplant Team). Through regular participation in multidisciplinary team meetings, the intern gains a sophisticated conceptualization of patients.
Educational Seminars & Research
During the rotation, the intern will attend educational seminars on psychopharmacology and psycho-oncology. A developmental approach is used. Initially the intern is given educational materials about cancer and the stem cell and bone marrow transplant process, and they work closely with a psychologist or other team member to develop an understanding of the treatment process and the clinic environment. Later, the intern is assigned their own patients and groups.
Finally, the intern will have the opportunity to participate in ongoing research activities. They are exposed to issues of research design, quality control and data analysis inherent in the testing of standardized treatment protocols and program evaluation.
Supervisors
Elective Rotations
After matching to Duke, interns will rank their preferences for one or two other elective rotations.
APPIC Program Code: 141316
In this concentration, interns will be able to rank their preferences to create an individualized internship experience. Rotations available for this track include:
- ADHD Program
- Dialectical Behavior Therapy (DBT)
- Duke Center for Adolescent & Young Adult Substance Use Treatment (CAST)
- Duke Fertility Center
- Neurosurgery Collaborative Peer Coaching Program
- Pain Psychology
- Palliative Care Clinic
- Perinatal Mental Health
- Transplant/Medical Psychology Program
APPIC Program Code: 141312
The Duke Center for Eating Disorders (DCED) treats conditions in which a trusting and responsive relationship to oneself and particularly to one’s body is disrupted.
In addition to treating individuals with eating disorders such as anorexia nervosa, bulimia nervosa, Avoidant/Restrictive Food Intake Disorder (ARFID), and binge eating disorder, our focus includes the treatment of other psychosomatic disorders such as pediatric pain and medical conditions (e.g., children and adolescents with musculoskeletal disorders).
An overriding value in our work is helping individuals to feel seen and understood as their authentic selves. To that end, we work closely with families so that all identities and perspectives can be supported by the individuals closest to them. We have a weekly didactic seminar and weekly team meeting with psychiatrists and specialists in family medicine, social work, adolescent medicine, and psychology to discuss challenging cases and coordinate care.
We treat individuals from the ages of three and up so interns can self-select the developmental stages they are comfortable working with or use this as an opportunity to try their skills with a new age group.
New research and developments in the center include an NIMH clinical trial for five- to nine-year-olds with ARFID; a parent group for parents of transgender or gender diverse teens; an online middle school group for ARFID; and the study of DukeLine, an anonymous mental health text support line for college students. Work with DukeLine also provides trainees with the opportunity to supervise undergraduate mental health coaches.
Supervisors
Elective Rotations
After matching to Duke, interns will rank their preferences for two or three other elective rotations.
APPIC Program Code: 141327
The child autism concentration intern, the only intern with a placement in the Duke Center for Autism & Brain Development, should have some background or special interest in autism.
The Duke Center for Autism & Brain Development provides a wide range of clinical services for children, adolescents and young adults with Autism Spectrum Disorders (ASD). The center’s multidisciplinary team is comprised of licensed psychologists, board-certified child psychiatrists, licensed clinical social workers, behavior analysts and a pediatrician.
Center faculty and staff strive to provide patient-centered, coordinated team-based care and collaborate closely with experts from a wide range of medical subspecialties, including:
- Pediatric neurologists
- Pediatric primary care physicians
- Speech-language pathologists
- Medical geneticists
- Gastroenterologists
- Developmental pediatricians
These interdisciplinary collaborations foster a comprehensive model of care that is designed to address the complex medical and behavioral health needs of individuals and families who seek services through the center.
Clinical Experiences & Didactics
The autism rotation offers numerous clinical experiences, including evidence-based evaluation and treatment of ASD and other neurodevelopmental disorders. In the evaluation component of the rotation, interns gain first-hand experiences administering, scoring and interpreting diagnostic and assessment tools, preparing psychological reports and collaborating with the clinical team.
In the intervention component, interns may be involved in the provision of individual, family and group therapy services. Opportunities to participate in infant-toddler diagnostic evaluations are available. In addition, interns are introduced to early behavioral intervention, based on the Early Start Denver Model (ESDM). The ESDM is a comprehensive behavioral early intervention approach for children with autism aged 12 to 48 months that has been validated in a randomized clinical trial.
Finally, interns participate in case consultations and are encouraged to pursue opportunities to take part in school-based consultations, community presentations and other training experiences. Supervision is provided in individual and group formats. Interns also gain supervisory experience by providing peer supervision to graduate student trainees.
In addition to the clinical training experiences, the rotation involves active participation in a weekly didactic seminar. The didactic series provides exposure to ongoing clinical research that is focused on innovative evaluation and treatment approaches.
Supervisors
Elective Rotations
After matching to Duke, interns will rank their preferences for two or three other elective rotations.
APPIC Program Code: 141325
The child trauma concentration intern, the only intern with a placement in the Center for Child and Family Health (CCFH), should have some background or special interest in trauma.
CCFH is a collaborative endeavor of Duke University, University of North Carolina-Chapel Hill, North Carolina Central University and Child and Parent Support Services. CCFH is a community-based, multi-disciplinary setting that specializes in the assessment and treatment of children and families who have experienced trauma.
Social services, schools, law enforcement or the court have referred many of the families who receive services at CCFH. CCFH serves an ethnically diverse clientele, and the majority of the children and families served are low-income or Medicaid-eligible clients.
Services offered at CCFH include:
- Early intervention and prevention services
- Assessment of traumatic sequelae
- Trauma-focused treatment
- Forensic evaluations
- Family and legal support
The rotation at CCFH involves working primarily with evidence-based treatments with a culturally diverse clientele of traumatized youth and their families. Interns have opportunities to learn several trauma informed interventions (e.g., Trauma-Focused Cognitive Behavioral Therapy and Parent-Child Interaction Therapy). Interns also utilize a range of treatment modalities, including:
- Individual therapy with children and adolescents
- Family therapy
- Parent education
- Intensive in-home treatment
- Community-based interventions
- Group interventions with children, adolescents and parents
The intern serves as a liaison with multiple community agencies, including schools, social services and the court system, for each assigned case and also participates in initial evaluations and limited psychological assessments.
Interns on this rotation participate in a year-long didactic series on trauma and trauma-informed interventions and services. Live and video-based supervision are available. Supervision is generally conducted through a combination of individual and treatment specific group discussions, as well as multi-disciplinary team presentations.
Supervisors
Visit the Center for Child and Family Health website for more information.
Elective Rotations
After matching to Duke, interns will rank their preferences for two or three other elective rotations.
APPIC Program Code: 141324
The child general concentration intern spends two days per week conducting assessments in the Outpatient Pediatric Neuropsychology Clinic. The role of the intern is to assess neuropsychological and psychological changes secondary to disease processes and/or treatment regimen. The clinic is located at the Duke Child and Family Study Center. The focus for the pediatric psychology intern may include evaluation of patients from the following clinics:
- Pediatric Blood and Marrow Transplant Program
- Pediatric Hematology/Oncology
- Pediatric Neuro-Oncology
- Pediatric Neurology and Neurosurgery (Epilepsy Monitoring Unit; Autoimmune Brain Disease Clinic)
- Pediatric Genetics
- Undiagnosed Disease Network Program
Supervisors
Elective Rotations
After matching to Duke, interns will rank their preferences for two or three other elective rotations.
APPIC Program Code: 141320
The pediatric psychology concentration intern must have some background or special interest in pediatric psychology. This intern spends the majority their time engaged in pediatric psychology clinical work through three mechanisms:
- Outpatient Neuropsychology Clinic (2-3 days/week)
- Consultation-Liaison Service (1 day/week)
- Pediatric Chronic Pain & Somatic Symptoms Program (1 day/week)
Outpatient Pediatric Neuropsychology Clinic
The role of the intern is to assess neuropsychological and psychological changes secondary to disease processes and/or treatment regimen. The clinic is located at the Duke Child and Family Study Center. The focus for the pediatric psychology intern may include evaluation of patients from the following clinics:
- Pediatric Blood and Marrow Transplant Program
- Pediatric Hematology/Oncology
- Pediatric Neuro-Oncology
- Pediatric Neurology and Neurosurgery (Epilepsy Monitoring Unit; Autoimmune Brain Disease Clinic)
- Pediatric Genetics
- Undiagnosed Disease Network Program
Consultation-Liaison Service
The pediatric psychology intern also works as part of the Child Psychiatry Consultation-Liaison (CL) service at Duke Children’s Hospital. The CL service is a multidisciplinary team that includes psychologists, child psychiatrists, social work case manager, residents, fellows and medical students. The CL team serves patients throughout the Children’s Hospital with a broad range of conditions.
Consultations are initiated by members of a child’s medical or surgical team. Common reasons that consultation may be requested from psychology include:
- Adjustment to illness
- Coping with acute or chronic pain
- Assessment of emotional or behavioral concerns
- Family coping and support
- Treatment adherence
The intern may participate in initial consults or follow-up care for patients being followed on the service. All of the patients seen by a member of the CL team have been admitted as inpatients to the Children's Hospital.
If continuing mental health services would be helpful after a patient is discharged from a medical floor, they may be referred within Duke or provided with referrals for providers closer to home. Interns may have the option to provide outpatient therapy should the patient’s care remain within Duke.
Pediatric Chronic Pain and Somatic Symptoms Program
The pediatric psychology intern may have the opportunity to work in this multidisciplinary program serving youth with a variety of chronic pain conditions. The treatment team is composed of psychologists, physicians, nurse practitioners, social workers, physical therapists and occupational therapists.
As part of this rotation, the intern provides initial evaluations as well as weekly CBT for chronic pain; participates in weekly case conferences; and serves as a consultant to other members of the treatment team as well as to patients’ schools. This outpatient clinic takes place at The Duke Child and Family Study Center.
Program Staff
Pediatric psychology is composed of medical psychology faculty, post-doctoral fellows, interns, clinical psychology graduate students, psycho-diagnostic technicians and support staff who work in a hierarchical supervision model.
Didactics
Pediatric psychology interns are required to attend Pediatric Grand Rounds on a monthly basis. Depending on specific interests, interns can also attend other didactics including crossover rounds, epilepsy conference, palliative care, transplant academia, etc.
Current research by pediatric psychology faculty focuses on coping with chronic childhood illness and on the cognitive and behavioral changes associated with disease processes and treatment. Interns have the opportunity to participate in these projects.
Supervisors
Elective Rotations
After matching to Duke, interns will rank their preferences for one or possibly two electives.