Trauma

The Trauma-Focused Training Clinic (THRIVE) clinic provides psychology interns with comprehensive experience in trauma-informed screening, assessment, and intervention across the lifespan. Interns will work with children, adolescents, and/or adults in both outpatient and inpatient settings, serving patients with a wide range of trauma experiences. Through the THRIVE program, interns will learn to collaborate with individuals from diverse backgrounds, honoring each person as the expert on their own experiences, while integrating evidence-based practices.

This rotation emphasizes a justice-oriented approach, with attention to cultural identity, systemic inequities, and contextual factors at each stage of care. Interns will provide trauma-focused treatment, conduct trauma-informed assessments, and participate in the screening and referral process for individuals entering the outpatient clinic.

Interns will receive weekly individual supervision and live session supervision as needed from a licensed psychologist specializing in trauma-focused interventions. They also will participate in a weekly interdisciplinary consultation team, collaborating with psychology faculty and postdoctoral fellows, as well as psychiatrists, social workers, nurse practitioners, and other providers to deliver holistic, team-based care. 

Clinical Training Experience

Trauma-Informed Assessment

Training in Comprehensive Trauma-Informed Assessments (CTIA), which centers partnership with youth and families, collaboration with systems involved (e.g., schools, DSS, etc.), foundation in cultural humility, and utilization of trauma-focused standardized measures as one of many ways to conduct collaborative assessments for diagnostic clarity and strength-based, holistic treatment recommendations.

Direct Clinical Care

Provide trauma-focused interventions for individuals across the lifespan. Interns gain exposure to and experience in multiple approaches, including but not limited to:

• Attachment, Regulation, and Competency (ARC) Framework
• Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
• Cognitive Processing Therapy (CPT)
• Prolonged Exposure (PE)
• Dialectical Behavior Therapy (DBT)-informed interventions

Supervisors

• Stephanie Hargrove, PhD 
• Kelly Sullivan, PhD 
• Mia Tankersley, PhD 
• Angela M. Tunno, PhD, MS 

In this service at Duke University Hospital, the intern will provide psychotherapeutic intervention and/or assessment to patients currently hospitalized for acute medical conditions often experiencing traumatic stress. 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 patients are 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 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 at the beginning of this rotation or long as developmentally needed, as well as weekly individual supervision.

Supervisor: Briana Brownlow, PhD

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

• Miriam Ehrensaft, PhD
• Lisa Honeycutt, LMFT, PhD
• Christian Mauro, PhD
• Jeffrey Sapyta, PhD
• Leigh Spivey-Rita, PhD
• Noga Zerubavel, PhD