Women’s Health

Based in the Department of Psychiatry & Behavioral Sciences, the Perinatal Mental Health Clinic is a specialized clinic that uniquely addresses the mental health needs of women in the perinatal period. Clinicians provide consultation to primary care providers, seek to address health inequities in perinatal care, and offer 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, Acceptance and Commitment 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. 

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

Supervisors

• Breanna Dede, PhD
• Ashley Johnson, PhD

This rotation at the Duke Fertility Center provides training in an integrated Psychological Services Program through the Department of Psychiatry & Behavioral Sciences and the Department of Obstetrics and Gynecology (Ob/Gyn). The Psychological Services Program serves individuals and couples, including those with diverse gender identities and sexual orientations, who are working to build their families through fertility treatment.

Interns in this rotation learn about the psychological aspects of reproductive medicine and provide psychological services on-site alongside an interdisciplinary healthcare team. Interns may provide individual, couples, and group therapy to patients experiencing infertility and pregnancy loss. 

They gain assessment experience with gamete donors and gestational carrier candidates by conducting structured diagnostic interviews and psychological testing. Interns also provide consultation and counseling to future parents who need an egg, sperm, or embryo donor or gestational carrier to build their family. 

Interns receive training in:

• Psychotherapy to patients facing fertility treatment, recurrent pregnancy loss, perinatal mood disorders, fertility preservation or embryo disposition concerns after conclusion of fertility treatment
• Evidence-based theory and interventions emphasizing ACT, CBT and trauma treatments
• 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.)
• Administering and interpreting the Personality Assessment Inventory (PAI)

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)
• ADHD

Therapeutic issues commonly addressed include:

• Grief and loss
• Relationship conflict / Couples therapy
• 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)

Interns attend and/or present in a weekly Third-Party Reproductive team meeting (comprised of reproductive endocrinology physicians, advanced practice providers, reproductive endocrinology and infertility fellows, Ob/Gyn residents, and nurses) and gain experience in contributing as a health psychologist within a multidisciplinary medical team.

Interns receive weekly, individualized supervision, partner with and observe supervisors in delivering care in complex case, and complete a year-long weekly didactic seminar on special topics in reproductive psychology. 

Supervisors

• Julia Woodward, PhD
• Stephanie Schuette, PhD

The Duke Cancer Institute (DCI) Women’s Sexual and Reproductive Health Rotation offers clinical psychology interns the opportunity to gain specialized training in the unique challenges faced by women following a cancer diagnosis and treatment. This rotation is part of the DCI Supportive Care and Survivorship Center’s Women’s Sexual Health and Oncofertility programs and emphasizes the integration of psychological services into multidisciplinary cancer care.

Interns work closely with an interdisciplinary team that includes psychologists, marital and family therapists, pelvic health physical therapists, oncologists, gynecologists, nurse practitioners, patient navigators, and other specialists in sexual and reproductive health.

Together, this team addresses a broad spectrum of concerns experienced by women after cancer, including changes in sexual function (e.g., desire, arousal, orgasm, resolution), impacts on sexual well-being, sexual pain, concerns related to iatrogenic menopause, fertility preservation and decision-making, and treatment-related impacts (e.g., vaginal changes after pelvic radiation, sexual changes related to endocrine therapy).

Interns develop competencies in both assessment and psychotherapy within this rotation. They provide individual therapy and couples therapy addressing sexual and reproductive health concerns, with integrated sex therapy training throughout the experience. In collaboration with the oncofertility team, interns also provide decision support and psychological care related to fertility preservation, fertility treatment after cancer, pregnancy during or after treatment, and fertility loss. Interns will receive weekly individual supervision along with group supervision, interdisciplinary case consultation meetings, and didactics.

The rotation emphasizes evidence-based and theory-driven interventions, including Acceptance and Commitment Therapy (ACT), Cognitive-Behavioral Therapy (CBT), trauma-focused approaches, and sensate focus interventions. Through these modalities, interns gain experience supporting women and couples navigating the complex intersections of sexuality, fertility, cancer survivorship, and overall personal and relational well-being.

This rotation is ideally suited for trainees with interests in women’s health, health psychology, psycho-oncology, sexual and reproductive health, sex therapy, and integrated care. Interns completing this experience will develop advanced skills in providing sensitive, evidence-based, and collaborative care to women and their partners during and after cancer treatment.

Supervisors

• Rebecca Shelby, PhD
• Juliann Stalls, PhD