Despite the success of evidence-based psychotherapy for mood disorders and the advent of FDA-cleared transcranial magnetic stimulation (TMS) and ketamine, a significant fraction of patients does not recover and is considered “treatment-resistant.” Helping this segment requires state-of-the art care driven by innovative research for the individualization and augmentation of today’s treatments. The UNC Department of Psychiatry brings together a unique set of clinicians and interdisciplinary researchers to move the needle for the treatment of mood disorders. This track offers comprehensive clinical and research training by an interdisciplinary team of clinicians and researchers specialized in mood disorders. The premise is that the dynamic interplay between evidence-based psychotherapy, affective neuroscience, and interventional psychiatry offers the opportunity to answer clinically relevant questions that will ultimately lead to the development of novel, personalized interventions at the interface of psychology, psychiatry, and neuroscience.
This track combines clinical work in a broad spectrum of services (inpatient/outpatient/ER) with a substantial involvement in affective neuroscience research. The clinical training will provide a deep understanding of the different clinical settings, patient populations, and evidence-based treatment modalities. Particular emphasis is on serving a diverse patient population with focus on cultural sensitivity and humility. Unique feature of this track is the heavy involvement in cutting-edge clinical trials and mechanism-of-action studies of novel interventions derived from affective neuroscience such as the investigation of sex hormones on brain function and clinical trials of non-invasive brain stimulation for the treatment of major depressive disorder.
Interns will perform evidence-based diagnostic assessments, provide brief evidence-based behavior therapy, learn clinical trials methodology, receive training in medication and brain stimulation studies, and perform smaller independent research projects. This track is ideal for a candidate who is passionate about research in mood disorders and the intersection between clinical psychology and neuroscience.
The Carolina Center for Neurostimulation in the UNC Department of Psychiatry, directed by Dr. Flavio Frohlich, is a premier interdisciplinary research group that studies the mechanism of action and clinical efficacy of non-invasive brain stimulation such as transcranial magnetic stimulation (TMS) and transcranial alternating current stimulation (tACS). The Center focuses on the rational design of individualized treatments that will ultimately combine psychotherapy, brain stimulation, and pharmacology. There are several ongoing clinical trials in mood disorders for which interns perform clinical assessments (e.g., SCID, MINI, HAMD). The center houses and closely collaborates with the interventional psychiatry service that offers TMS and esketamine for treatment-resistant depression.
Supervisor: Crystal Schiller, PhD
Interns will receive training in behavioral activation (BA) to provide manualized BA therapy on an outpatient basis to pregnant and postpartum women with depression and anxiety, and to healthcare workers through the Taking Care of our Own program. Interns will be trained in the manualized approach and receive weekly supervision as they deliver the intervention to adult patients.
Supervisors: Crystal Schiller, PhD; Marly Hill, PhD
The Acceptance and Commitment Therapy (ACT) clinic consists of a weekly ACT didactic seminar and outpatient clinical care. Interns will conduct clinical assessments with new patient, interpret results, and write an evaluative report. For patients appropriate for ACT treatment, interns will engage in at least 6 weekly sessions with patients, followed by ongoing ACT intervention, as needed.
Supervisor: Mary Hill, PhD
Additional Track Opportunities
Interns will learn to conduct evidence-based diagnostic and depression assessments in a weekly didactic and case consultation seminar led by Dr. Schiller. Dr. Schiller takes a developmental training model in which interns receive didactic instruction, observe clinical assessments and code interviews, practice conducting assessments with fellow trainees, then advance to conducting assessments alongside other trained clinicians before conducting assessments independently under the supervision of Dr. Schiller.
Didactics will also aim to enhance trainee knowledge of oppression and marginalization issues as they relate to our patients and our clinical practice. Interns will be instructed in the use of the ADDRESSING Model to understand cultural influences as a multidimensional combination of age, developmental and acquired disabilities, religion, ethnicity, socioeconomic status, sexual orientation, indigenous heritage, national origin, and gender. Interns will receive training to apply the ADDRESSING Model to clinical assessment using the DSM-5 Cultural Formulation Interview. Interns will be training to use the DSM-5 Cultural Formulation Interview to support case conceptualization and clinical interventions.
Interns will receive training in both evidence-based clinical assessment and treatment for mood and anxiety disorders. They will also receive training in clinical trials research and affective neuroscience.
Interns will be required to conduct an independent research project during their internship year. Beyond contributing to ongoing research projects and examining existing data, interns may also perform independent small-scale research projects of clinical interventions. One area of particular interest is the development and scientific investigation of integrated brief treatments that combine evidence-based, client-centered brief interventions with non-invasive brain stimulation. The Carolina Center for Neurostimulation periodically offers training in non-invasive brain stimulation and human neurophysiology (multi-day, hands-on course). Individual research training is offered tailored to individual needs, projects, and career plans.
Interns will have opportunities to supervise post-bac clinical interviewers and graduate-level clinical psychology practicum students, and to provide education and training to medical students and psychiatry residents. Interns will be trained and supervised by core faculty to identify the training goals of the supervisees and design a training experience tailored to supervisees’ needs and goals.