The table below provides an overview of which elective rotations can be selected for each concentration area. See below the table for detailed descriptions of each elective rotation.
| ELECTIVE ROTATION | CBT/DBT | HEALTH | CHILD | ED |
|---|---|---|---|---|
| Acceptance & Commitment Therapy Clinic | X | X | X | |
| ADHD Program | X | X | X | X |
| Dialectical Behavior Therapy (DBT) | X | X | ||
| Duke Center for Adolescent & Young Adult Substance Use Treatment (CAST) | X | X | X | X |
| Duke Consultation & Brief Psychotherapy Clinic | X | X | X | |
| Duke Fertility Center | X | |||
| Eating Disorders | X | X | ||
| Family Studies Program | X | X | ||
| Gender PRIDE Clinic | X | X | X | |
| Inpatient Psychology (Behavioral Health) at Duke Regional Hospital (learn more) | X | X | X | X |
| Inpatient Psychology (General Medicine) at Duke University Hospital | X | X | X | |
| Neurosurgery Collaborative Peer Coaching Project | X | X | X | X |
| Outpatient CBT/Behavioral Activation/Mindfulness Interventions | X | X | ||
| Outpatient Pediatric Neuropsychology Clinic | X | X | ||
| Pain Psychology | X | X | ||
| Perinatal Mental Health | X | |||
| Psychosocial Treatment Clinic | X | X | ||
| Transplant/Medical Psychology Program | X |
Elective Rotation Details
The ACT at Duke Clinic offers in-depth training on Acceptance and Commitment Therapy (ACT). Interns are trained to a high level of competency in functional assessment / case formulation, and engagement of the six core ACT processes (acceptance, defusion, self-as-context, present moment awareness, values and committed action). Interns refine skills in the application of ACT to an array of presenting problems, including anxiety and mood disorders, eating disorders and psychological issues in the context of chronic illness (e.g., type 1 diabetes) or other medical issues (e.g., infertility, cancer). Most patients seen in the ACT at Duke Clinic are adults, although there may be opportunities to treat adolescents.
Interns complete an ACT core competency assessment and participate in collaborative goal setting to achieve individual training goals. Interns are assigned to an individual supervisor and supervision is facilitated by live observation and audio tape review. Interns also attend a weekly didactic and group supervision with psychiatry residents, clinical psychology graduate students, and postdoctoral fellows, which includes didactic learning methods, and experiential exercises and skills demonstration and practice.
ACT at Duke Clinic faculty are leading ACT-based research. Faculty are highly supportive of Interns involvement in ongoing studies, which includes ACT clinical trials, digital and mobile health delivery and process of change research. Interns may also have the opportunity to be trained in clinical trial protocols or fidelity review, which deepens understanding of the model.
Supervisors:
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.
Supervisors:
Interns attend a weekly two-hour DBT consultation team meeting and may provide individual therapy and/or co-lead a weekly DBT group for patients struggling with emotion dysregulation. Co-leading a DBT group provides additional training in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills.
Please note that the DBT elective is different from the Adult CBT/DBT concentration, which provides a more extensive DBT training experience.
Supervisors:
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.
Supervisors:
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.
Supervisors:
This rotation in the Department of Obstetrics and Gynecology provides an integrated Psychological Services Program in the Duke Fertility Center through the Department of Psychiatry & Behavioral Sciences. The Psychological Services Program serves individuals and couples with diverse gender identities and sexual orientations who are working to build their families.
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
- ACT and CBT theory and interventions
- Administration and interpretation of the Personality Assessment Inventory (PAI)
- Providing psychosocial consultation in complex medical decision-making
- Crisis management intervention (e.g., ultrasound reveals no fetal heartbeat; panic attack prior to egg retrieval procedure, etc.)
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 (especially panic disorder, specific phobia, and general anxiety disorder)
- Adjustment disorders
- PTSD/trauma exposure
- Eating disorders (among both obese and underweight patients)
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)
Supervisors:
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.
Please note that the Eating Disorders elective is different from the Eating Disorder Concentration, which provides a more extensive training experience.
Supervisors
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.
Supervisors:
- Donna Eash, PhD
- Miriam Ehrensaft, PhD
- Lisa Honeycutt, LMFT, PhD
- Christian Mauro, PhD
- Jeffrey Sapyta, PhD
- Leigh Spivey-Rita, PhD
- Noga Zerubavel, PhD
NOTE: CBT/DBT interns would be required to have prior training in working with children and adolescents to see patients under the age of 18 in the Gender PRIDE Clinic
The Gender PRIDE—Psychological Resilience, Identity Development, and Exploration—Clinic provides evidence-based, gender-affirming mental health care for transgender and gender diverse children, adolescents, emerging adults (up to age 25), and their families. We support the healthy psychosocial development of transgender and gender diverse youth and emerging adults by providing:
- Thorough gender-informed, trauma-informed intake assessments, to provide diagnostic clarity and develop an evidence-based treatment plan,
- Individual, group, and family-based intervention services to support identity exploration and expression, treat psychological distress, and promote resilience. Group therapy offerings may include skills-based groups for parents of gender diverse youth under 18 and a group for gender diverse transition-age adults (ages 18-25), and
- Interdisciplinary care coordination with social workers, psychiatrists, pediatricians, primary care physicians, endocrinologists, speech and language pathologists, physical therapists, occupational therapists, and surgeons.
Psychology interns rotating with the Gender PRIDE Clinic will receive training in providing gender-affirming care consistent with the WPATH Standards of Care, version 8. Additionally, interns will utilize a range of evidence-based interventions (e.g., CBT, DBT, transdiagnostic treatment approaches) to address comorbid mental health concerns, such as depression or anxiety symptoms associated with gender minority stress.
Interns receive weekly individual supervision and live supervision of sessions as needed. Interns also participate in the Gender PRIDE Clinic’s weekly multidisciplinary case consultation team meeting. This multidisciplinary team includes psychology, psychiatry, and social work teams from both pediatric and adult gender medicine clinics across the health system. Monthly didactic seminars will be offered in the context of our weekly multidisciplinary team meetings.
Supervisors:
The Psychology Consultation Service at Duke Regional Hospital’s psychiatric inpatient unit provides brief evidence-based treatment for adults hospitalized for an acute mental health crisis. Interns on this rotation serve as the psychology consultant to various multidisciplinary treatment teams on the unit. As the psychology consultant, interns operate independently of the treatment teams, utilized by request to address specific needs of the patient/or the team itself.
The most common consultation request made by teams is for the psychology consultant to provide patients a brief, single-session intervention targeting a specific problem (typically the very problem that contributed to their hospitalization in the first place). Interventions are process-based, drawn from contemporary CBTs with heavy emphasis on DBT skills and strategies.
Because of the brief nature of the contact and intervention with patients, interns serving as psychology consultants will learn to rapidly assess for and prioritize treatment targets most relevant to the chief complaint put forth by the patient’s treatment team, and select and flexibly apply CBT (e.g., DBT) strategies accordingly. In addition to brief interventions, treatment teams often utilize the Psychology Consultation Service to receive assistance with differential diagnosis for patients with complex presentations. As a result, interns will hone skills in rapid informal assessment strategies (e.g., behavioral chain analyses) to generate a clinical impression of the patient that will inform the course of the patient’s inpatient treatment.
The intern will be exposed to a wide range of clinical presentations and presenting concerns on the unit, most commonly:
- Suicidal thoughts and behaviors, and non-suicidal self-injury
- Personality pathology
- Traumatic stress
- Psychosis
- Mood and anxiety disorders
- Substance use disorders
- Treatment-interfering behaviors (e.g., medication non-compliance, disruptive behavior).
At the heart of this rotation is the consultation process prior to meeting with patients, whereby the intern meets with the treatment teams to shape consultation requests so that the requests are behaviorally-based, targeted, and linked to an actionable intervention or assessment plan. Treatment teams typically include psychiatrists, social workers, nurses, behavioral technicians, and pharmacists. As a result, interns will emerge from the training experience with a unique skill that is crucial to inpatient psychology: the ability to “translate” the ways other disciplines in the field describe patient behaviors/concerns into the language of clinical psychology.
There are additional training opportunities for interns, depending on the intern’s interest and needs of the inpatient unit. For instance, interns can lead DBT skills straining groups on the unit. Interns will also have the opportunity to provide clinician education, including informal supervision and didactic training of learners from other fields, such as psychiatry residents, medical and physician assistant students, nursing, and social work students.
At the outset of the rotation, interns will receive 1:1 didactic training on core CBT (especially DBT) skills and strategies, and observe Dr. Grove conduct consultation meetings and 1:1 sessions with patients on the unit. Once foundational knowledge is acquired, for a short time the intern will take the reins on cases while Dr. Grove observes. This onboarding process typically unfolds over the course of three to four weeks until competence is demonstrated, at which point the intern will begin practicing independently on the unit (though will meet with Dr. Grove for supervision weekly).
Given the heavy emphasis on DBT strategies, prior experience in the direct (i.e., face to face) application of the four modules of DBT skills through practicum or other experiential learning is helpful but certainly not a requirement. Regardless of previous training, Dr. Grove will meet the intern where they are developmentally to provide supervision in skills implementation to build upon foundational training and gain competence in the rapid application of person-centered DBT and other CBT-based skills in an inpatient context. Learn more
Supervisor: Jeremy Grove, PhD
The inpatient psychology service at Duke University Hospital provides psychotherapeutic intervention and/or assessment to patients currently hospitalized for acute medical conditions. Trainees in this rotation will:
- Meet with patients in their hospital room to provide treatment either once or on an ongoing basis depending on the need
- Consult with a wide range of providers and staff
- Offer recommendations and support to the patient’s treatment team. Consultation requests and patient clinical presentations vary widely, allowing for extensive development of case conceptualization skills and responsive, flexible use of evidence based interventions.
Common consult requests include addressing:
- Trauma, including medical trauma or traumatic injuries, such as loss of a limb or injuries caused by a gunshot wound, assault, motor vehicle accident, etc.
- Suicide attempts, where patient is not medically stable for placement at a psychiatric hospital
- Depression and/or anxiety in the context of medical condition, new diagnoses, and/or pre/post-surgery
- Severe eating disorders
- Substance use
- Behavioral change
- Difficulty managing long-term hospitalization
- Difficulty engaging with care and/or treatment team
Trainees will receive training in delivering empirically supported interventions, including Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and Acceptance and Commitment Therapy in acute care settings. Trainees will also have the opportunity to collaborate with a multidisciplinary team, including psychiatrists, psychiatry residents, nurses, social workers, and medical providers across a wide range of specialties (e.g., trauma, surgery, oncology, etc.).
In addition, there are opportunities to learn how to develop comprehensive behavior plans for managing challenging behaviors and enhancing the safety of both providers and nursing staff.
Depending on current clinical presentations of the patients available, trainees can request to focus on particular areas of interest (e.g., trauma, cancer). Of note, although in a medical context, a background in health psychology is not required. However, trainees will be expected to engage in research when necessary to be prepared to meet with patients with a wide range of medical diagnoses.
Trainees will receive direct/live supervision in the beginning of this rotations or long as developmentally needed, as well as weekly individual supervision. Dr. Brownlow is currently on site to provide supervision for this rotation Tuesday mornings, Wednesday afternoons, and all day Thursday.
Supervisor: Briana Brownlow, PhD
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.
Supervisor: McLean Pollock, PhD
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.
Supervisor: Moria Smoski, PhD
Interns assess patients’ neuropsychological and psychological changes secondary to disease processes and/or treatment regimen. The rotation 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
Please note that the Outpatient Pediatric Neuropsychology Clinic elective is different from the Pediatric Psychology concentration, which provides a more extensive pediatric neuropsychology training experience.
Supervisors:
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.
Supervisor: Katherine Applegate, PhD
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.
Supervisor: Ashley Johnson, PhD
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.
Supervisors: