PROFESSIONAL TRAINING PHILOSOPHY AND MODEL
The UNC School of Medicine Clinical Psychology Internship has the goal of contributing to the development of well-rounded and competent professional psychologists. Our training philosophy emphasizes broad-based training and experience, within a clinical scientist model of professional development. Our faculty is committed to an individualized, developmental approach to training, an approach that combines structure with flexibility and breadth with depth. The science of psychology forms the foundation for service. During the internship year, interns are exposed to methods of assessment and intervention that are evidence based or supported, and the use of academic and professional resources to inform clinical practice is emphasized.
The Internship is located within a strong public university medical center and has collaborative ties with university- and community-based programs. The diverse population that is served spans the entire age range, all socioeconomic levels, and the many ethnic groups that live in North Carolina. Our programs work with individuals with an enormous variety of mental health, medical, and developmental problems; clinical services are provided in a wide range of inpatient, outpatient, prison, and community contexts. A broad spectrum of theoretical approaches is represented. The Internship’s training model is designed to take advantage of the strengths of our institutions and our faculty to ensure that interns have a rich set of clinical experiences.
Consistent with the mission of the UNC School of Medicine and the Department of Psychiatry, clinical training occurs within the context of providing superior evidence-based or supported service. There is ongoing interprofessional collaboration with the UNC Medical Center’s staff and trainees, including the staff and trainees in medicine and in allied health professions such as social work, nursing, speech and language pathology, and occupational therapy.
Interns enter our program with strong graduate school preparation, with many skills and an identified area of specialization that is reflected in their internship track. Each track has a carefully sequenced and coordinated set of experiences to ensure that the intern will achieve depth of experience in this area of specialization, with competence in assessment, intervention, and consultation. Simultaneously, the framework for the experiential component of the training model is flexible and designed to encourage each intern to explore other areas of interest, taking advantage of some of the program’s many training opportunities to broaden knowledge and skills. A related requirement is that each intern is to obtain significant experience working with individuals with severe mental illness; there are numerous services interns can choose from that will meet this requirement.
Across all services, the faculty is committed to training. Each supervisor tailors training and supervision developmentally, considering the intern’s level of knowledge at the start of the rotation, then modifying the level of support as the intern’s level of professional competence increases. Throughout all services, there is an emphasis on the development of strong general professional skills that are fundamental to the competent practice of professional psychology, such as the ethical practice of psychology and establishing effective relationships with clients. Training methods include observation, demonstration, and audio- and videotaping, with individual and group supervision. Supervisors review with interns the relevant scientific and empirical bases for their clinical area. In addition to closely supervised experiential learning, the Internship offers a didactic seminar, professional development seminar, workshops, and guest lectures, as well as opportunities to participate in didactic opportunities across the School of Medicine.
Structure of the Internship Year: At the start of the year, each intern is assigned a Program Coordinator – a faculty member in the intern’s primary area of interest – who will act as a mentor throughout the internship. If the Program Coordinator-intern relationship does not prove satisfactory, changes can be implemented. During the first week, a four-day orientation program acquaints the new interns with the rich and varied array of training opportunities available. During this week, the intern and Program Coordinator plan the intern’s individualized sequence of training across the year, taking a developmental perspective. They build upon the intern’s existing skills and consider the intern’s goals and interests, the Internship’s framework and various service needs, and the Internship’s training goals. Modifications in this program can be negotiated during the year as new interests emerge or the situation warrants. Interns are also provided with the opportunity to pursue their own research or embark on new research. Scholarship is further supported by having each intern present a scholarly talk, typically on their dissertation research, to an audience of their peers and a faculty committee.
The internship year is made up of two six-month rotations. An intern usually works on multiple services each rotation, both in the area of specialization and in other areas of interest to the intern. Throughout the year, interns have opportunities for scholarship and research. There is approximately one hour of supervision per every 3-4 hours of clinical service (e.g., psychotherapy, diagnostic evaluations, etc.). The Internship faculty carefully tracks each intern’s program and progress to insure the development of strong general professional competencies and, in the area of specialization, strong specific competencies in psychological assessment, therapeutic intervention, and professional consultation.
Modifications due to COVID-19: In 2020, the impact of the pandemic on clinical services and on the internship activities has been significant. In-person psychological services at most of the internship sites were shut down in March 2020. Due to the resources and technical support of the School of Medicine and the Dept. of Psychiatry and following guidance from APA and the Council of Chairs of Training Councils, modifications were made rapidly. Supervisors and interns received training and support for the provision of telepsychology, services for clients and supervision were restructured, and all interns were quickly able to continue their work and successfully complete their internship requirements. At most of our training sites, clinical work was conducted remotely from mid-March through the end of the 2019-2020 internship year in August. Although skills and experiences in telehealth had not been a planned component of the 2019-2020 year; telehealth competencies were achieved. Several sites have continued or resumed in-person services since 2020, with appropriate PPE and protocols.
The 2021-2022 internship year started with planned trainings in telepsychology and with many, but not all, outpatient clinical services being provided remotely. The number of opportunities for providing in-person services has increased and depends, in part, on COVID-19 transmission in the community. Inpatient services continue to be provided in-person. In all instances, when an intern is working in-person, the setting has strict cleaning and safety protocols, and the intern is provided with appropriate PPE. Due to the uncertainties of the course of the pandemic, it is not possible to know the forms that clinical services and supervision will take in 2022-2023. The internship is well prepared for psychological services and internship training to continue in person, remotely, or with a balanced format that uses both. The descriptions of the internship tracks that follow indicate whether, in fall 2021, psychological services are being provided in-person, remotely, or using a combination of in-person and remote technology.
Interviews for 2022-2023 internship positions will be held virtually.