Population Served:

0-4, 5-12, 13-17

Mandatory Days:

Thursday AM

Appropriate for:

Third Externship

Training Model

CBT

Posted

October 15, 2018

Montefiore Medical Center of the Albert Einstein College of Medicine - Pediatric Behavioral Health Integration Program (BHIP)

Provide description of externship:

        The Pediatric Behavioral Health Integration Program (BHIP) is composed of two distinct components, HealthySteps (HS) and Child and Adolescent Psychology and Psychiatry (CAPP), which provide behavioral health services throughout the pediatric lifespan. HS is a mental health promotion program that provides developmental and behavioral support and guidance to families with children ages 0-5 years, through an attachment- and trauma-informed lens. CAPP targets school-aged and adolescent youth with mild to moderate depression, anxiety, disruptive behaviors, and trauma. BHIP pediatric psychologists coordinate care with primary care providers by offering developmental and behavioral health services and ensuring shared treatment plans and goals within the electronic medical record system. Evidence-informed services include preventive support for families with children under 5, brief assessments, short-term interventions, and referral to longer-term treatment when relevant. BHIP intervention length is typically 4-8 sessions.

        The goal of the BHIP externship is to prepare externs to work in the primary care setting treating children across the pediatric lifespan (infants, toddlers, children, adolescents, and emerging adults). Montefiore serves pediatric patients from ethnic minority, economically challenged, and linguistically diverse families. Externs will receive both clinical training and didactics in working with infant-parent dyads, parent behavior management techniques, and cognitive behavioral therapy for youth with ADHD, anxiety, and depression. A unique aspect of working in primary care is the ability to conduct warm hand-offs, defined as meeting a referred patient on the same day as their medical visit. Externs will be trained to conduct warm hand-offs using motivational interviewing, short problem-focused assessments, and brief intervention. Working in primary care also involves treatment related to health psychology such as needle fear/phobia, sleep difficulties, and pain disorders. Externs will learn to communicate effectively with the primary care team, schools, and other relevant organizations. 

Requirements:

  • Must be available 2 days per week (minimum 16 hours; up to 18 hours). Must be available Thursdays. The second day may depend on supervisor availability.
  • Each extern is typically placed at 2 primary care practices (one per weekday), with assignment to practices dependent upon supervisor availability and extern interest when possible.
  • Must attend didactics throughout externship year on Thursdays. Some travel between sites may be required. 

General information about externship site:
-- Co-Directors of the Program:  Vanessa J. Pressimone, PhD, NCSP & Kathleen Dumpert, PsyD
-- Training Co-Directors, (degree): same as above
-- Program Website: https://www.montefiore.org/bhip
-- Length of externship (in months): 12 months
-- Start & End Dates: 7/1/19 - 6/30/20 (specific dates flexible within these months)
-- How many hours a week are expected of extern?: 16 hours per week (up to 18 hours)
-- Specialty tracks: n/a
-- # of externs to be accepted for 2019-20: We expect to accept 2 externs for the 2019-2020 year.
-- Minimum level of readiness (any prior experiences or level of training required for applicants): advanced graduate students, 4th years or advanced 3rd years in a clinical, counseling, or school psychology doctoral program.
-- Preferences: Significant prior psychotherapy experience with children and adolescents, particularly with evidence-based treatments such as Cognitive-Behavioral Therapy (CBT).
-- Do you provide a stipend? If so how much? No stipend is currently available.


Interviews:
-- When do you expect to begin interviews? (Applications can be submitted no earlier than Jan 22):  Applications will be accepted from January 22-25, 2019. Interview invitations will be sent approximately 2 weeks after this application window. Interviews will be held in the last 2 weeks of February (dates pending).

-- Interview process (provide information about interview process- time frame, how decisions are made) Also, do you conduct individual and/or group interviews; case presentation, other information?: On interview days, each applicant can expect to be present for about 1 hour. During this time, each applicant will complete 2 individual interviews, each interview will be conducted by 2 BHIP psychologists. Applicants are expected to be able to discuss their prior clinical experiences and training goals. They will be asked to discuss 1-2 cases and should anticipate questions requiring them to think actively and creatively about those cases.

-- What application materials are required (i.e., CV, transcript, how many reference letters, case summary, test report, other?: Interested applicants should submit the following materials via the portal: cover letter, CV, clinical writing sample (e.g., case summary), and 2 letters of recommendation.


Intervention and Assessment:
-- Intervention training experiences offered. Estimate average number of individual patients that students will carry; estimate number of groups and other types of interventions. Offer description:

Over the course of the year:

  • Externs will complete 1 warm hand-off and treat 4-5 pediatric patients per week who present with ADHD, anxiety, depression, early childhood problems (e.g., tantrums, sleep, feeding).
  • Externs will receive comprehensive training and supervision in:
    • Motivational Interviewing in primary care with children and families who range in readiness for change
    • ADHD evaluation and treatment
    • Parent Management Training for pediatric disruptive behaviors
    • Working with pediatricians, health educators, and social workers to develop multidisciplinary care plans

-- Assessment training experiences commonly offered. Describe:

Assessment experiences will involve 45-60 minute intakes involving clinical interview of parent and child, as well use of screening scales such as the Vanderbilt, SCARED, GAD-7, CES-DC, and PHQ-9M. Externs will be exposed to universal screenings (e.g., PSC-17, M-CHAT-R, ASQ-3, and ASQ:SE), which are administered by other pediatric primary care staff. This externship does not offer neuropsychological or psychoeductional evaluation opportunities. However, as part of their care of therapy patients, externs may be able to review evaluation reports that were completed elsewhere.

-- Expected number of full assessment batteries completed during externship (defined as administration of a battery of standardized tests): n/a
-- Estimate # of integrated assessment reports per year: n/a
-- If offering Rorschach, which scoring systems used: n/a

Supervision:
-- Estimate hours/week of individual supervision: 2 hours/week
-- Estimated hours/week of group supervision: 1-2 hours/month of group supervision dedicated to BHIP externs.

-- Estimated hour/week of didactics: 1-3 hours per didactic, 1-3 didactics per month

-- Estimated co-therapy hours with supervisors: The teaching process will progress from externs shadowing their supervisors, to supervisors observing externs (live supervision, in the treatment room), and culminating in externs managing independent case loads. During shadowing periods, learning will be supported through co-therapy as appropriate for externs' individual learning needs.

-- Context of didactics (seminars, Grand Rounds): typically 1-2 didactics per month are seminars/lectures created specifically for externs. Externs also participate in monthly, BHIP team meetings that often include a lecture geared for licensed staff, as well as participate in a 1-hour seminar every 2-3 months for licensed staff to support motivational interviewing skills.
-- Estimated informal open door "curbside" supervision: Supervisors are available while externs are on-site for informal "curbside" supervision, as needed.

-- Describe direct supervision. Specify if observation occurs during intervention, assessment, consultation (audio, video, live in person (in treatment room, one-way mirror, live video stream): Amount of direct supervision gradually lessens across externship year.  Direct supervision is done live in person, in the room for intakes, intervention, and warm hand-offs.  Externs may also consult remotely with other BHIP psychologists and psychiatrists.


Support: 

-- If you have only one extern, would you be to have the extern participate in a peer support consortium with other sites- live or "SKYPE"?:  n/a
-- Is the agency readily accessible through public transportation?  Yes. All sites are accessible by subway or bus, depending on location. However, access to a personal vehicle may be more convenient for some practice locations. Applicants may note concerns during interviews or if offer extended.

-- Wheelchair accessible: yes

-- Are home visits required as part of the trainee's duties?  No.

-- Is a transportation stipend provided? No stipend is currently available.

Company Name:

Montefiore Medical Center of the Albert Einstein College of Medicine - Pediatric Behavioral Health Integration Program (BHIP)

Location:

Bronx, New York

Population Served:

0-4

Mandatory Days:

Thursday AM

Appropriate for:

Third Externship

Training Model

CBT

Posted

October 15, 2018

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