Adult clinical/behavioral medicine track

Interns on this track enhance their psychotherapy and behavioral medicine skills while experiencing psychologists' various roles within a medical setting. They collaborate with psychiatric, medical primary care, and medical specialty teams in both outpatient and inpatient settings. Major experiences include: adult outpatient, co-leading a transdiagnostic acceptance and commitment therapy group, multidisciplinary cancer clinic, weight management/bariatric surgery, and chronic pain.

Clinical experiences

General & behavioral medicine outpatient therapy
Interns conduct assessment and time-limited, evidence-based therapy with adults referred for a broad range of psychological and medical concerns. Common general psychiatry referrals include mood and anxiety disorders, post-traumatic stress disorder, obsessive-compulsive disorder, adjustment reactions, and grief. Common behavioral medicine referrals include obesity, insomnia, chronic pain, treatment adherence, adjustment to chronic illness, and end of life issues. Interns will learn and practice cognitive-behavioral therapy, acceptance and commitment therapy, motivational interviewing, cognitive-behavioral therapy for insomnia in a flexible manner that it tailored to each individual patients and takes into account individual and cultural differences. Interns become adept in accurate diagnosis of specific mental health conditions, evidence based practice in its truest form, case conceptualization from different behaviorally-based theoretical orientations, focusing treatment goals, and collaborating with referring providers and other members of patients’ care teams.

Interns will also have the opportunity to co-lead a transdiagnostic acceptance and commitment therapy group. This group begins with an informational session for newly referred patients, where psychoeducation on the ACT model is provided and patients are screened for contraindications to group (e.g., severe PTSD, high suicide risk). Interns learn about ACT through this flexible, eight-session protocol that covers the six core processes of ACT and associated behavioral exercises and metaphors.

Chronic pain
With the chronic pain and opioid dependence epidemics reaching crisis levels over the last several years, our involvement in chronic pain management has expanded significantly. We serve as important members of Geisinger’s Interventional Pain Clinic, where we assist in evaluating and preparing patients for spinal cord stimulator trials, conduct psychoeducational and behaviorally based therapy groups, and provide brief individual therapy. We work closely with the multidisciplinary pain program, which also includes physical therapists, nurse practitioners, physicians, a licensed clinical social worker with specialization in substance abuse, and an art therapist. In addition, we conduct evaluations for patients preparing for spine surgery as part of Geisinger’s Destination Spine program, through which individuals requiring back surgery who work for contracted corporations travel to Geisinger for their care. We are also an integral part of Geisinger’s initiative to accurately diagnose and treat fibromyalgia and therefore we receive many referrals for individual and group therapy for patients struggling with chronic pain and the psychosocial correlates of this condition, including depression and insomnia. Interns learn the biopsychosocial model of chronic pain, as well as cognitive-behavioral and acceptance and commitment therapy skills critical to patients’ recovery from chronic pain.

Interns learn the biopsychosocial model of chronic pain and use evidence-based strategies to enhance quality of life, increase physical activity, and prevent further disability in this unique patient population.

Multidisciplinary bariatric surgery program
Psychologists are viewed as vital members of the multidisciplinary bariatric surgery team, which is also comprised of surgeons, gastroenterologists, registered dieticians, mid-level providers, and administrative staff. Geisinger is an MBSAQIP-accredited Center of Excellence in bariatric surgery and maintains high standards for patient outcomes, and psychologists are involved in every step of this rigorous program from educating patients considering surgery, conducting pre-surgical psychosocial evaluations, providing behavioral health coaching for patients having difficulty making the required lifestyle changes, and providing individual and group therapy for pre- and post-operative patients, as well as individuals in the conservative weight loss program. All interns will conduct pre-surgical evaluations and follow-up with bariatric patients throughout the training year, and those interns with greater interest in this specialty will also co-lead groups and receive weight management and disordered eating therapy cases.

Multidisciplinary cancer clinics
Psychologists are integrated in several multidisciplinary cancer clinics, which include surgeons, medical oncologists, radiation oncologists, and nurses navigators. Interns will spend six months providing brief consultations in weekly multidisciplinary breast cancer or gastrointestinal (esophageal, gastric, pancreatic, rectal/colon) cancer clinic. Interns will have the opportunity to conduct brief, targeted assessments of newly diagnosed patients and follow some patients through the treatment process. Interns will also attend tumor board conferences and present clinical information at multidisciplinary team meetings directly following clinic. Interns will become knowledgeable about the salient medical and psychosocial issues for patients with a cancer diagnosis and how to work effectively in integrated care settings.

Sample rotation schedule
Click to view sample rotation schedule. (PDF)

Postdoctoral fellowship opportunities
One-year postdoctoral fellowship opportunities in adult psychology and behavioral medicine are consistently available each year, and many of our interns remain for a second year to complete this advanced, specialized training. Postdocs are prepared for independent practice and their first professional position in a healthcare setting. They have earned a “junior colleague” status, which means they represent our program as members of multidisciplinary teams, take the lead on clinical research and quality improvement projects, and receive training in the administrative and operational intricacies of integrated care. In addition, postdocs learn to supervise our pre-doctoral interns, teach medical students and psychiatry residents, and offer presentations and trainings to medical professionals. Adult/behavioral medicine interns who are interested in staying for fellowship are encouraged to apply and complete interviews in the fall for early consideration.

"Our program prepares interns to provide evidence based care tailored to each individual patient they encounter in a medical setting and to function as a valued member of interdisciplinary teams throughout the healthcare system."