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Addiction Medicine Track Description 2022-2023

Track Overview: The Addiction Medicine Track is designed to offer interns comprehensive training and experience in the assessment and treatment of substance use disorders (SUD) in a tertiary psychiatric care setting. Interns will work as part of a multidisciplinary treatment team that includes psychiatrists, social workers, medical fellows, and peer support specialists, along with a supervising clinical psychologist. The primary treatment modalities emphasized in this track include cognitive-behavioral therapy (CBT)/skills training, motivational enhancement therapy (MET), and behavioral support for medication management. Interns will gain exposure to pharmacological approaches to SUD treatment by virtue of working with patients receiving pharmacotherapy (e.g., naltrexone, buprenorphine) and with team physicians to coordinate patient care. Clinical activities are based primarily at the UNC Substance Use and Treatment and Recovery (STAR) clinic (outpatient services), with additional activities in the UNC Medical Center (inpatient Addiction Medicine services). Consistent with a scientist-practitioner model, involvement in addiction treatment research is also a component of this rotation. Typically, research training and experiences will be acquired by completing a minor rotation in Addiction Clinical Trials. Efforts are made to ensure that interns acquire opportunities with patients from a diverse range of cultural and socioeconomic backgrounds, including populations diverse with respect to race/ethnicity, religion, socioeconomic status, disabilities, sexual orientation, and sexual identify. Interns will also acquire experience with diverse populations by engaging in telehealth services with patients from rural/under-resourced areas of North Carolina.

 

APPIC Program Code:

 

Clinical Rotations and Patients:

 

  • Substance Treatment and Recovery (STAR) Clinic (Christian Hendershot, PhD)

 

Interns’ clinical work will be based primarily in the Substance Treatment and Recovery (STAR) clinic, an outpatient service within the UNC Addiction Medicine Program located at the Weaver Dairy Road site. The primary clinical populations served include patients with alcohol use disorder, opioid use disorder, and stimulant use disorder; interns will also gain exposure to other diagnostic populations. Patients typically present with a range of addiction severity and acuity, and often present with co-occurring psychiatric conditions (e.g., mood disorders). All interns will gain experience in SUD assessment and treatment planning using evidence-based frameworks (e.g., American Society of Addiction Medicine placement criteria). Interns will also gain intervention experience by providing one-on-one behavioral interventions in outpatient settings.

 

This rotation will also emphasize training in telehealth service delivery, including providing assessment and treatment to UNC Health patients in outlying/rural regions of North Carolina. Additional opportunities that may be available in this track include group cognitive-behavioral treatment for alcohol use disorder (in person and virtual) and conducting assessment and brief interventions with patients in the inpatient Addiction Medicine services. Opportunities for attending clinical didactic rounds for focused skill development (e.g., motivational interviewing) will also be available.

 

  • Addiction Clinical Trials (Minor Rotation) (Christian Hendershot, PhD)

 

Consistent with the aim of providing training in a scientist-practitioner framework, interns will typically complete a minor rotation that involves clinical assessment and/or treatment in the context of clinical trials of pharmacological or behavioral treatments. In addition to these roles, the research rotation will provide a context for training in clinical research methodology, opportunities to interact with other addiction scientists in research and didactic settings, and ideally, opportunities for data analysis and publications. The research rotation is based jointly in the Department of Psychiatry and the Bowles Center for Alcohol Studies, a world-class addiction neuroscience institute that hosts a P60 Comprehensive Alcohol Research Center grant and a T32 postdoctoral training grant in alcohol research (both funded by the National Institutes on Alcohol Abuse and Alcoholism). Clinical addiction research is also supported by the North Carolina Translational and Clinical Sciences (NC TraCS) Institute, an NIH-funded center dedicated to promoting translational science at UNC and affiliated institutes. Additional opportunities for training in clinical and translational research methodology are often available by virtue of the collaboration with NC TraCS. Overall, the joint emphasis on clinical services and clinical research is intended to provide interns with translational training that spans addiction treatment and addiction science. This focus is well suited for interns who intend to pursue clinical research careers.

 

Recommended Minor Rotations:

 

  • Research Rotation (Bowles Center for Alcohol Studies)
  • Integrated Liver Disease Program
  • Chronic Pain
  • Center for Excellence in Eating Disorders
  • Bariatric Surgery

All Elective Rotations <Link>

 

Didactics:

A half-day training workshop in Motivational Interviewing (MI) is typically offered to all STAR clinicians in the first week of July. This workshop emphasizes orientation to MI, foundational skills, and interactive training exercises. In addition, during the internship year interns may elect to participate in a weekly clinical didactic seminar that includes a focus on advanced MI intervention skills, along with occasional opportunities for coding/feedback related to MI proficiency. Interns will also have opportunities to attend guest lectures and didactic sessions focused on current topics in addiction medicine, which are offered occasionally throughout the year. Additionally, the minor research rotation will allow the opportunity to attend scientifically oriented lectures and didactic seminars offered in association with BCAS.

 

Professional Development:

Training and professional development goals are an explicit focus of training and supervision activities in the Addiction Medicine track. The intern’s professional development goals (including clinical, research, and teaching goals) will be identified at the outset of the year and reviewed at regular intervals.

 

Research Opportunities:

As noted above, there are opportunities for training in clinical and translational science projects by virtue of the Addiction Clinical Trials minor rotation. Interns completing this rotation will have regular opportunities to interact with addiction scientists and collaborators associated with affiliated Centers (e.g., Bowles Center for Alcohol Studies). Interns will also have opportunities for mentored experiences in manuscript preparation, and (if desired) training grant preparation (e.g., F32) as part of the research rotation.

 

Supervision Training and Opportunities:

Whenever possible, interns will have opportunities to supervise graduate-level clinical psychology practicum students, and/or to provide education and training to medical students and psychiatry residents. These opportunities may vary from year to year depending on the number of additional trainees in the clinical service. Interns may also have the opportunity to supervise/mentor junior team members on research projects (e.g., data analysis and manuscript preparation).

 

Track Coordinator:

Christian Hendershot, PhD

 

Clinical Supervisors:

Christian Hendershot, PhD