Elective Rotations

After matching to Duke, interns will rank their preferences for two or three other elective rotations to diversify their clinical experiences based on their interests.

The table below provides an overview of which elective rotations can be selected for each track/concentration. See below the table for detailed descriptions of each elective rotation.

ELECTIVE ROTATION CBT HEALTH CHILD
ADHD Program X X X
Duke Center for Adolescent & Young Adult Substance Use Treatment (CAST)     X
Duke Center for Eating Disorders X   X
Duke Consultation & Brief Psychotherapy Clinic X    
Duke Fertility Center   X  
Family Studies Program X   X
Health Risk Behavior Management Program   X  
Inpatient Consultation X    
Neurosurgery Collaborative Peer Coaching Project X X X
Outpatient CBT/Behavioral Activation/Mindfulness Interventions X    
Pain Psychology X X  
Palliative Care Clinic   X  
Perinatal Mental Health X X X
Psychosocial Treatment Clinic     X
Transplant/Medical Psychology Program X X  

Elective Rotation Details

Applies to: CBT, Health, Child 

The ADHD Program at the Duke University Medical Center is one of the nation's leading programs for research and clinical services for ADHD and related behavior problems. The program is staffed by five licensed psychologists and one board-certified child psychiatrist. 

The ADHD Program participates actively in three primary activities: 

  • Adult and child clinical services
  • Federally-funded (e.g., NIMH) research grants
  • Industry-funded clinical trials

Interns have the opportunity to participate in evidence-based treatment and evaluation services for children, adolescents and adults through our outpatient clinic. ADHD is the primary presenting concern for assessment and treatment cases, but comorbidity is common and thus interns experience a diverse variety of clinical presentations. 

Treatment services in which interns may participate include:

  • Parent behavior management group
  • Adult ADHD cognitive behavioral therapy and mindfulness-based intervention groups
  • Academic skills training group for middle and high school students 
  • Individual treatment cases (typically focused on parent behavior management training, academic support skills for adolescents, coping skills for children and cognitive behavioral therapy for adults).

Our assessment procedures conform to the practice parameters outlined by the American Academics of Pediatrics and Child and Adolescent Psychiatry and include the use of rating scales from multiple informants, interviews and brief cognitive testing, as indicated. These assessments also include formulation of treatment plans and written reports.

Program faculty provide presentations to schools and the community upon request, and we encourage intern participation in these activities. In addition, interns may be involved with consultation and teaching activities with other Duke specialists.
  
Interns are exposed to a number of clinical research activities within the Duke ADHD Program through didactic presentations and engagement with individual faculty members. Opportunities exist for interns to be involved in preparation of papers based upon our extensive databases and nationally recognized research activities. 

Learn more about our current ADHD research.

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Applies to: Child

The team at the Duke Center for Adolescent & Young Adult Substance Use Treatment (CAST) works with families to create customized plans that help young people overcome alcohol and other drug problems. Our treatment options include outpatient and intensive outpatient treatment programs. Interns will participate in all intensive outpatient activities including team meetings, individual and group interventions.

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Applies to: CBT, Child

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 eating disorders such as anorexia nervosa, bulimia nervosa, Avoidant/Restrictive Food Intake Disorder (ARFID), and binge eating disorder, our focus includes other psychosomatic disorders such as pediatric pain. This focus also includes helping individuals to feel seen and understood as their authentic selves. Thus, a focus of our work is working with families of individuals who identity with diverse identities to help promote acceptance and understanding.


We have a weekly didactic seminar and weekly team meeting with psychiatrists, 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 integrating DukeLine into the internship experience for supervision opportunities (DukeLine is an anonymous peer support text line of trained undergrads supporting other undergrads).

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Applies to: CBT

The Duke Consultation & Brief Psychotherapy Clinic (C&BP) provides empirically-based services to individuals primarily affiliated with the Duke community (current employees/faculty/students) across the adult lifespan. The clinical focus of the C&BP clinic is to increase access to brief, efficacious psychotherapy by offering a combination of targeted functional assessment and brief integrative psychotherapy.  
 
This rotation includes extensive training in integrative case formulation, which intends to identify behavioral, interpersonal, and cultural factors that contribute to the ongoing maintenance of problematic issues. This rotation will also emphasize intentional assessment of strengths and individual differences that impact the client’s personal growth and engagement in mental health services.
 
Learners will gain experience in how to quickly establish and maintain therapeutic alliance, clarify SMART goals, and provide brief empirically-based psychotherapy approaches (i.e., up to 10 sessions). Learners will achieve improved skills in client motivation enhancement, routine outcome monitoring, and use of modular care pathways that best target the patient’s specific proximal needs. Due to the brief format, learners will also have the frequent experience of taking ownership of the full treatment-arc that includes assessment, implementing targeted brief care, case management, and empowering patients to continue their individual work after leaving the C&BP clinic.  

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Applies to: Health

This clinic in the Department of Obstetrics and Gynecology provides a Psychological Services Program through the Department of Psychiatry & Behavioral Sciences. The Psychological Services Program serves individuals and couples with diverse ethnic and racial backgrounds, gender identities and sexual orientations who are working to achieve parenthood.

Interns in this rotation learn about the psychological aspects of reproductive medicine and provide psychological services on-site alongside healthcare providers. Interns gain assessment experience conducting structured diagnostic interviews and psychological testing with egg donor and gestational carrier candidates. They also provide consultation and counseling to future parents who need an egg donor, sperm donor or gestational carrier to build their family. 

Interns receive training in:

  • Conducting individual, couples and group therapy with patients facing fertility treatment, recurrent pregnancy loss, perinatal mood disorders, fertility preservation or embryo disposition concerns after conclusion of fertility treatment
  • Crisis management interventions (e.g., ultrasound reveals no fetal heartbeat; panic attack prior to egg retrieval procedure, etc.)
  • CBT and ACT theory and interventions
  • Use and interpretation of the Personality Assessment Inventory (PAI)
  • Providing psychosocial consultation in complex medical decision-making  

Interns attend and/or present in a weekly Third Party Reproductive team meeting (comprised of Reproductive Endocrinology physicians, fellows and nurses) and thus gain experience in contributing as a health psychologist within a multidisciplinary medical team.

Interns receive weekly, individualized supervision delivered in a combination of individual and small group formats. Interns also have the opportunity to gain experience in providing supervision to the Duke clinical psychology graduate students completing a year-long clinical rotation in our program. Interns are supported in their learning about the psychological aspects of reproductive medicine through a combination of weekly educational seminars and weekly supervision of recorded therapy sessions.

Diagnoses commonly seen include:

  • Mood disorders
  • Anxiety disorders (particularly panic disorder, specific phobia & GAD)
  • Adjustment disorders
  • Personality disorders
  • Eating disorders (among both obese and underweight patients)
  • Patients with a trauma history

Issues commonly addressed include:

  • Grief and loss
  • Marital conflict
  • Existential concerns ("Why do bad things happen to good people?"; "Am I being punished?")
  • Stress and coping
  • Parenting concerns
  • Alternate family-building strategies (e.g., donor egg/sperm, adoption)

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Applies to: CBT, Child

The Family Studies Program & Clinic is composed of a multi-disciplinary faculty, psychologists, psychiatrists and social workers who have expertise in family therapy, as well as a multi-disciplinary trainee group (psychology interns and psychiatry residents). The program provides interns with supervised training in family assessment and family therapy, parenting therapy and couples therapy using a live, behind-the-one-way-mirror supervision model.

Supervisors and other team members observe all therapy sessions, and supervisors provide immediate "bug in the eye" feedback using linked computer monitors between the observation room and the therapy room. 

In addition to live and observed couples therapy, parenting therapy and general family therapy, interns also attend a weekly didactic seminar in general and specialty topics in the fields of family functioning and family and couples intervention. Patients for the Families Studies Program & Clinic are referred from the adult and child psychiatry programs and from specialty services within the Medical Center. 

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Applies to: Health

A rotation in the Health Risk Behavior Management Program is an opportunity to develop important skills for assessing and treating individuals with a substance use disorder (SUD) or who have difficulty living in accordance with recommendations for overall healthy living. Services are provided in an outpatient clinic serving adults across the lifespan, and some young adult referrals are co-managed with the Duke Center for Adolescent and Young Adult Substance Use Treatment (CAST) program. Common problems addressed on this rotation include:

  • Alcohol, cannabis and tobacco use disorders
  • Patients stable on opiate replacement therapy (e.g., Suboxone)
  • Chronic pain with long-term prescription opiate use
  • Difficulty with effective management of chronic conditions

Many individuals treated in the program have comorbid mental health conditions including depression, PTSD and anxiety. 
 
Experiences on this rotation aim to increase interns’ knowledge and skills for understanding and treating individuals from a transdiagnostic, functional behavioral perspective. Interns are trained to use a range of assessment tools (e.g., standardized psychological assessments, semi-structured interviews and urine tox screens) to assist in diagnosis and establishing a coherent treatment plan that accounts for an understanding of health concerns, substance use disorder (SUD) and mental health issues. 
 
Evidence-based approaches to care employed in the clinic include cognitive-behavioral, Relapse Prevention, and mindfulness- and acceptance-based approaches such as Acceptance and Commitment Therapy (ACT). Interns also develop and implement skills for collaborative management of suicidality when it arises in the context of SUD or other health risk behaviors. An abstinence-based approach to SUD care is provided for patients seeking this goal (most commonly in response to alcohol, cannabis or tobacco use), but interns also become familiar with and practice implementing the principles of harm reduction as a means to reduce overall health risk and improve overall wellbeing. 
 
Interns provide individual counseling services, co-facilitate groups (e.g., relapse prevention for alcohol use disorder), conduct co-therapy as appropriate, and have opportunities to work with partners, parents and other family members to bolster an individuals’ progress toward healthier living.
 
Interns participate in weekly individual supervision, and early on in the rotation supervision meetings incorporate didactic material to assist interns in learning the foundational skills for seeing patients independently. Interns on this rotation also have the opportunity to participate in ongoing activities to improve the quality of care offered through formal and informal quality improvement projects and to participate in ongoing efforts to expand services. 
 
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Applies to: CBT

Interns receive specialized training in the application of contemporary principle-driven CBTs in the inpatient setting, where the intern will serve as the psychology consultant to a multi-disciplinary team on the new Duke Psychiatry Inpatient Unit at Duke Regional Hospital.

The intern will learn how to provide collaborative care through working with the unit’s psychiatry teams to formulate goals for one-session psychotherapeutic intervention and/or assessment and direct delivery of brief, targeted interventions with inpatients. Consultation requests and patient clinical presentations vary widely, allowing for extensive development of case conceptualization skills and responsive, flexible use of contemporary CBT interventions, with heavy emphasis on DBT skills and strategies. There is potential to lead DBT groups on the inpatient unit as well.

For interns interested in gaining exposure to clinician education, there will be opportunities to provide informal training in contemporary CBT strategies to medical students, residents and nursing staff at DRH inpatient unit.

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Applies to: CBT, Health, Child

The program pairs psychology interns/psychiatry residents with neurosurgery residents in the spirit of providing 1:1 support in the form of processing the experiences of intensive professional training and potentially acquiring new skills for managing new roles and responsibilities.

Interns have the opportunity to shadow neurosurgery residents including into surgeries, rounds, and other venues to truly understand the life of a neurosurgery resident. Development of short didactic presentations on specific themes identified by residents as areas where they would like to grow along with facilitation of small group discussions related to those presentations also will be part of the rotation. 

This rotation may include other opportunities and efforts from our COVID Response Team, developed in March 2020.  

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Applies to: CBT

Interns will learn contemporary cognitive behavioral therapies focused on emotion regulation and reward processes in major depressive and other mood disorders. Interns will participate in team meetings and supervision to learn how to translate knowledge from cognitive neuroscience research including functional neuro-imaging to better understand and improve psychosocial interventions, including cognitive behavioral and mindfulness interventions.

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Applies to: CBT, Health

The rotation in Pain Psychology is located at the Duke Spine Center which encompasses an interdisciplinary out-patient clinic focusing on the treatment of back and spine disorders. This training opportunity is heavily focused on the psychological assessment and treatment of medical and surgical patients who are being considered for chronic opioid management, implantation of medical devices for pain management (e.g., SCS, TDDS), and cognitive-behavioral psychotherapy with an emphasis on behavioral pain management. Patients at the Spine Center reflect a diverse racial and ethnic heritage, age ranges, socio-economic backgrounds, sexual orientations and gender identities. 

Interns on the Pain Psychology rotation will receive didactics and training in the psychology of chronic pain, performing semi-structured diagnostic clinical interviews in this setting, and communicating behavioral treatment plans to both patients and their referring interdisciplinary teams. Common diagnostic categories represented in this patient population include mood disorders, anxiety, PTSD, adjustment disorders, somatic symptom disorders, substance abuse, personality disorders, traumatic brain injury, mild cognitive impairment and psychosis.

Interns also receive training on:

  • Cognitive-behavioral psychotherapy for chronic pain
  • The application of mindfulness meditation for patients with chronic pain
  • Crisis management
  • Interdisciplinary case consultation
  • Psychometric assessments (If on-site services are active)

Interns receive individualized supervision adjusted to their developmental level based on familiarity with chronic pain populations and diagnostic evaluations. A comprehensive training manual aids in providing interns an evidence-based approach to the clinical assessment and interventions on the rotation. 

Trainees are also invited to participate in the Pain Lecture Series to learn more about the multi-disciplinary treatment of chronic pain with surgeons, anesthesiologists, physical therapists, pain psychologists, and rehabilitation specialists, as well as to participate as an intern co-facilitator with the monthly Clinical Health Psychology Symposium.

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Applies to: Health

In this rotation, interns receive training in empirically-based cognitive-behavioral, mindfulness and couple-based strategies for psychological distress and symptom management among patients with serious medical illness and their family caregivers. They also receive training in the role of mental health providers in palliative medicine.
 
The rotation includes one half-day per week in the outpatient palliative care clinic under the supervision of Dr. Jason Webb, where interns are members of a multi-disciplinary team. They have the opportunity to conduct brief psychological assessments of patients and caregivers and provide brief, focused interventions for distress and symptom management.
 
Another half-day per week is in the outpatient psychiatry clinic under the supervision of Dr. Laura Porter, where interns provide longer-term psychotherapy to patients and caregivers focused on helping them manage the symptoms and psychological challenges associated with serious illness.
 
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Applies to: CBT, Health, Child

The Perinatal Mental Health Clinic is a specialized clinic that uniquely addresses the mental health needs of women in the perinatal period, provides consultation to primary care providers, seeks to address health inequities in perinatal care, and offers specialized training in perinatal mental health. Our multidisciplinary team includes psychiatrists, psychologists, a perinatal social worker, and trainees in psychiatry and psychology. 

This training experience offers opportunities to provide assessment and treatment services to women with diverse presenting concerns, with a particular focus on perinatal mood disorders, in addition to OCD, bipolar disorder, trauma and ADHD. Other treatment foci may include adjustment to perinatal loss, infertility, and birth trauma.

Trainees will receive instruction in the delivery of empirically supported interventions, including Cognitive Behavioral Therapy and Interpersonal Psychotherapy. Trainees also may assist with care coordination and consultation to other members of the care team. Finally, as a part of a multidisciplinary team, students will gain experience working on a collaborative care team for perinatal patients.  

Students will receive weekly individual supervision, group supervision as well as direct/live supervision. In addition, students will be expected to attend a weekly didactic seminar on perinatal medication management and mental health treatment. 

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Applies to: Child

The Psychosocial Treatment Clinic (PTC) at the Duke Child and Family Study Center serves children, adolescents and families utilizing evidence-based practice. This rotation includes training in empirically supported treatments for children and adolescents primarily with anxiety and mood disorders, yet many patients have significant comorbidity. The rotation includes a weekly didactic seminar or case conference and all participants will receive live supervision and participate in the observation of their peers. Example didactics include:

  • CBT case formulation
  • Contextual functional analysis
  • CBT for childhood anxiety
  • CBT E/RP for OCD
  • CBT for adolescent depression
  • Assessment and treatment of school refusal

Psychology Interns work closely with Child Psychiatry Fellows through this rotation at the Duke Child & Family Study Center. Seminars, case conferences and multidisciplinary treatment teams consist of psychology interns, clinical and school psychology practicum students, and child psychiatry fellows. Individual supervision is provided for all psychology interns and case conferences are utilized to provide maximize exposure to a diversity of ages, presenting problems and treatment approaches. 

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Applies to: CBT, Health

This rotation offers psychological services to solid organ transplant recipients as well as to patients being considered for solid organ transplantation at Duke, including patients with chronic heart failure, end-stage pulmonary disease, chronic liver disease, and renal failure.  

We offer a full range of psychological services for organ transplant patients, including pre- and post-transplant psychological evaluations, inpatient and outpatient psychotherapy, peri-operative neurobehavioral screening assessments for delirium and psychosocial functioning, and psychoeducational/support groups for lung transplant candidates. Evaluations with transplant candidates assess:

  • Patient adherence
  • Substance use
  • Cognitive functioning
  • Psychological functioning/coping
  • Transplant-related motivation/knowledge
  • Social support

The intern also can play a prominent role in the assessment of living kidney donors, and can participate in weekly interdisciplinary team meetings for the lung, heart, liver and renal transplant programs. Services are provided both in- and outpatient and at times, urgent evaluations are requested (e.g., Tylenol overdose). Donor evaluations assess:

  • Readiness/motivation to donate
  • Psychological functioning/coping
  • Social support
  • Cognitive functioning
  • Ability to adhere to post-surgical recommendations
  • Substance use

If interested, there are opportunities to participate in educational lectures provided to transplant coordinators and staff and to participate in M&Ms and quality improvement projects. 
 
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