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The Behavioral Medicine track is designed to offer interns a comprehensive experience in the assessment and treatment of patients with various medical conditions and disease states. The Behavioral Medicine intern will primarily spend time in Primary Care, Transplant, and Pain Management clinics in addition to minor electives that address a variety of patient presentations (e.g., eating disorders, bariatric surgery etc.). Collectively, this track offers interns the opportunity to work on multidisciplinary teams in a large academic medical center and gain experience working with individuals from diverse backgrounds who are pursuing evidence-based treatment for a variety of acute onset and chronic health conditions. Interns will have the opportunity to gain extensive knowledge about the intersection of medical morbidity and psychological intervention, consultation in an academic medical center, and evidence-based interventions that improve psychological functioning and quality of life.

 

Given the diversity of the patients served across clinics, the Behavioral Medicine intern will have the opportunity to discuss the importance of cultural sensitivity and cultural humility. Supervisors are committed to providing a supportive learning environment that focuses on diversity, equity, and inclusion. Readings will be provided and discussion will be encouraged to increase interns’ knowledge of oppression, marginalization, and racial disparities as they relate to our patients and their care.

 

Clinical Rotations and Patients:

 

  • Primary Care (Linda Myerholtz, PhD)

This rotation will engage psychology interns to a variety of models of integrated care including co-located care, and interprofessional team-based models such as Primary Care Behavioral Health (PCBH) and Collaborative Care (CoCM). The training sites offer a stepped care approach to integrated behavioral health care to address diverse patient needs. The training sites also offer MAT for substance use concerns and psychology interns will have the opportunity to collaborate with DATA-waived MAT prescribers and patients in integrated care treatment approaches.

 

Training will build a solid foundation in understanding the interplay of physical illness and emotional wellbeing, knowledge of common chronic health care conditions, and knowledge of medical culture. A key element of this will be a focus on using tele-behavioral health modalities in effective ways to reduce barriers to access to care.

 

Interns will learn rapid psychological assessment strategies. This will include the integration of screening tools frequently used in primary care settings. Interns will learn skills in brief psychotherapy, single session work, motivational interviewing, health behavior change counseling as well as longer term individual therapy. Additional clinical skills in assessment, intervention (CBT, dialectical behavioral therapy, acceptance and commitment therapy), clinical consultation, as well as teaching will be included.

 

  • UNC Heart and Lung Transplant & Left Ventricular Assist Device programs

(Eileen J. Burker, Ph.D., CRC)

 

Interns will have the opportunity to perform inpatient and outpatient psychological evaluations of adult candidates being considered for lung, heart, or heart/lung transplantation and LVAD surgery.  Interns will consult with the physicians, nurses, physical therapists, and the social workers on the heart and lung transplant teams and VAD teams.  Interns can attend the multidisciplinary lung transplant and heart transplant/LVAD team meetings to present their impressions and recommendations.  Interns will provide individual or couples therapy before and after transplantation and/or LVAD surgery.  Interns will consult with patients waiting in the hospital for transplant and then provide supportive therapy as they wait for and then recover from transplant. Interns can participate in a structured group for lung transplant patients and/or co-lead an unstructured group for lung or heart transplant patients.  Interns can shadow other professionals on the team (e.g., palliative care, cardiothoracic surgeon, pulmonologist) to gain an in-depth understanding of the transplant process. Interns will have the opportunity to supervise graduate students in mental health counseling who are completing practicum and internship with the transplant and LVAD programs.

 

  • Pain Management (Amy Goetzinger, PhD, Seema Patidar, PhD, and Skye Margolies, PhD)

Our outpatient pain management center is a multidisciplinary clinic serving patients from the entire state of North Carolina. Interns are supervised by a clinical health psychologist/pain psychologist. Interns typically interact with attending physicians, pain fellows, residents, nurses, and clinic staff. Interns learn how to work well in a demanding multidisciplinary health clinic and have opportunities to attend all training seminars and didactics offered to our medical fellows and residents (including grand rounds, pain didactics, neurology didactics, and journal club). Interns can elect to shadow physicians at times during patient visits and procedures for further training opportunities.

 

Interns conduct semi-structured diagnostic interviews, administer psychological tests, co-lead/lead group therapy, provide individual therapy, participate in crisis management as needed, and perform case management. Interns learn how to assess psychosocial risk for medical interventions (spinal cord stimulator), chronic opioid management suitability assessment, and develop comprehensive recommendations for short- and long-term treatment plans. Opportunities for substance abuse assessments and treatment, particularly for opioid use disorder, are available. Interns learn pain coping skills training protocols using CBT, ACT, and mindfulness. Patients in our clinic present with comorbid mental health conditions including PTSD, panic disorder, anxiety/GAD, OCD, mood disorders, sleep disorders, somatization features, and personality disorders, offering opportunities to develop skills and competencies in both clinical psychology and health psychology. Clinical consultation is done with attending physicians, pain psychiatrists, medical fellows, nurse practitioners and clinical pharmacists.

 

Recommended Minor Rotations:

  • Center of Excellence for Eating Disorders (including Bariatric Surgery)
  • Integrated Liver Disease
  • Abdominal Transplant

 

Professional Development:

We actively support the professional development of our interns.  Interns are encouraged to co-author peer reviewed journal articles and submit research to peer reviewed national conferences (e.g., SBM, APS, APA). In addition, interns who want to pursue a career in academic medicine may have the opportunity to give lectures in the Department and/or supervise master’s-level trainees.

 

Research Opportunities:

Interns are welcome to join our ongoing research or initiate new research projects in any of the areas/clinics listed above. There are ample opportunities to engage in research in Primary Care, Transplant, Eating Disorders, and/or others.

 

Track Coordinator:

Eileen J. Burker, Ph.D., CRC

 

Clinical Supervisors:

Eileen J. Burker, Ph.D., CRC

Linda Myerholtz, PhD

Amy Goetzinger, PhD

Seema Patidar, PhD

Skye Margolies, PhD)