Adult clinical and health psychology track

Brief outpatient therapy clinic

As an intern, you’ll spend one to two days a week throughout the training year providing evidence-based assessment and intervention in Geisinger’s Outpatient Psychiatry Clinic. Referrals are selected to ensure a varied and somewhat tailored training experience. Supervisors learn about your clinical interests and training needs at the start of each six-month rotation to inform the selection and scheduling of cases. We aim for you to gain experience in providing evidence-based treatment for mood and anxiety disorders, suicidality, posttraumatic stress disorder, obsessive-compulsive disorder, insomnia and grief/end-of-life issues. We also distribute a wide variety of clinical health psychology referrals across your schedule, with your interests in mind. These include referrals for chronic pain conditions, chronic illness and related issues, weight management and disordered eating, and functional neurologic disorders.

Presurgical evaluations

Presurgical evaluation is a critical skill for clinical health psychologists, so you will be trained in bariatric surgery and/or spine surgery evaluations throughout the year. Given the volume of surgery cases for these specialties and the yearlong nature of the experience, adult clinical and health psychology interns graduate with significantly greater knowledge and experience with presurgical evaluations than most. As a result, you’ll have an edge when applying for clinical health postdoctoral fellowships and early career positions in healthcare.

As an intern, you’ll have a choice of presurgical evaluation training experiences, with the option to participate in both.

Bariatric surgery evaluations

Geisinger is a Center of Excellence in bariatric surgery and performs up to 500 surgeries per year across Geisinger’s service area throughout central and northeastern Pennsylvania. Clinical health psychologists are integral members of the multidisciplinary team, which also includes surgeons, physicians, advanced practitioners, nurses, dieticians and an exercise physiologist. This cohesive team meets monthly to ensure coordinated care for patients and to review and update guidelines for the comprehensive program offered to all patients.

Psychologists participate in patient education and behavioral coaching for patients preparing for life after surgery. They also offer therapy for pre- and post-surgical patients. The presurgical psychological evaluation typically occurs after patients have gone through a four-month education process. During this time, you’ll work with the patient to make required health behavior changes to meet a pre-surgery weight goal.

If you have an interest in weight management and bariatric surgery, you may have the opportunity to lead and co-lead educational and cognitive-behavioral therapy groups for bariatric surgery candidates and post-surgical patients. You’ll also attend monthly multidisciplinary meetings and collaborate with the Geisinger Obesity Research Institute on a clinical research project — and potentially presenting at a national conference and/or publication.

Spine surgery and spinal cord stimulator evaluations

Geisinger is also a Center of Excellence for spine surgery and is widely recognized for ProvenCare Lumbar Spine, an innovative program that standardizes high-quality care and focuses on patient outcomes. Clinical health psychologists work closely with neurosurgery and pain medicine to identify patients who are most likely to benefit from spine surgery and spinal cord stimulator implants. They also coordinate interdisciplinary care with primary care providers, psychiatrists, physical therapists and other medical specialties.

All patients being considered for neuromodulation therapy (e.g., spinal cord stimulator) or for certain spinal procedures are referred for the presurgical psychological evaluation. This is an important opportunity for clinical health psychologists to provide patients education on the biopsychosocial model of pain and discuss behavioral pain management strategies that may be incorporated into their multidisciplinary treatment plan.

Like all aspects of behavioral pain services, data are collected. If you have a research interest in chronic pain and spine surgery, you’ll have an opportunity to create a clinical research project that could lead to a presentation at a national conference and/or publication.

Integrated primary care

As an intern, you will have the chance to spend at least six months, one to two days per week, in one of several Geisinger primary care clinics. Here you’ll provide brief behavioral intervention for a wide range of referrals, taking warm handoffs from primary care providers and collaborating with multidisciplinary teams. Given our aging and increasing chronically ill population, you will receive a number of health psychology referrals and have the opportunity to focus on health behavior change with patients.

If you have a special interest in integrated primary care and/or population health, you can participate in ongoing innovative clinical research and quality initiatives designed to enhance care and access to behavioral services to all patients in our region.

Oncology

Interns in the central region have the opportunity to do at least a six-month, half-day-per-week rotation in one of several multidisciplinary cancer clinics. These clinics begin with a multidisciplinary tumor board to review patients being seen in the clinic and are attended by psychologists, surgeons, pathologists, radiologists, nurses, radiation oncologists, medical oncologists and medical residents/students. Following the meeting, each patient consults with several relevant members of the team and is screened for mental health concerns that could impact treatment decisions or response to treatment.

Patients with positive scores on evidence-based screening tools or with other potential concerns based on chart review and team discussion will meet for a consultation with the psychologist or psychology intern, at which time psychoeducation, treatment recommendations and resources are provided to the patient and family as needed. Patients living locally and seeking a follow-up may be offered services in the brief outpatient therapy clinic or, if available, with our psychosocial oncology providers at the Henry Cancer Center in Wilkes-Barre, Pa.

If you have a strong interest in psychosocial oncology, you may request primary clinical placement in our Northeast Region, where you’ll have more opportunity to provide ongoing clinical care to people diagnosed with cancer and their caregivers under the supervision of Ashley Perez, PsyD. Interns in the northeast will work two days a week for a six-month rotation at the cancer center where they will see individual patients for brief, evidence-based intervention, participate in tumor boards, conduct bone marrow transplant evaluations and be available for warm handoffs from medical providers. Within this rotation, there is frequent opportunity for intern engagement with program development and quality improvement projects.

As part of the adult clinical and health psychology track, you will spend two mornings per week for six months working as a member of one of the following integrated specialty care clinics. Both experiences will primarily be based in outpatient clinics providing brief consultations and behavioral interventions; however, you will have an opportunity to provide some inpatient consultations as well. 

Adult cystic fibrosis clinic

Funded by a three-year mental health coordinator grant through the Cystic Fibrosis Foundation, clinical health psychology provides mood and anxiety screening, assessment and brief intervention to adults attending quarterly outpatient clinic appointments. Our department also offers bedside consultations for patients hospitalized for “tune-ups” and disease exacerbations. As an intern, you’ll be a critical member of this multidisciplinary team, which includes meeting with pulmonologists, a nurse coordinator, a respiratory therapist, a dietitian and a social worker.

Functional neurologic condition/psychogenic non-epileptic seizure clinic

All interns will likely get exposure to functional neurologic conditions during the year. If you’re interested in gaining a deeper understanding of the biopsychosocial factors contributing to neurological conditions and evidence-based, cognitive-behavioral therapy (CBT) intervention for their treatment, you can dedicate a half-day per week for six months to working with these referrals from Geisinger neurology’s accredited Level IV Epilepsy Center.

Transdiagnostic acceptance and commitment therapy group

If you’d like a deeper understanding of acceptance and commitment therapy (ACT) and its implementation in a group therapy format, you’ll have the opportunity to co-lead this weekly group for people who have anxiety, depression and other concerns.

During orientation and monthly didactics, adult track interns attend a series of trainings in clinical skills. These may include the following:

• Motivational interviewing (attended with child and neuropsychology tracks)
• Suicide risk assessment and intervention
• Cognitive behavioral therapy for insomnia (CBTi)
• Cognitive behavioral therapy for chronic pain
• Cognitive behavioral therapy for psychogenic non-epileptic seizures
• Exposure-based therapies for post-traumatic stress disorder (PTSD)
• Collaborative assessment and management of suicidality (CAMS)

In addition, you will attend eight hours of didactic seminars per month on a variety of clinical topics. Each seminar focuses primarily on adult populations and professional development topics. Topics include but are not limited to the following:

• Cultural awareness
• Ethical and legal practice series
• Psychopharmacology series
• CV preparation, postdoc/job applications, interviews and salary negotiation
• LGBTQ affirmative assessment and therapy
• Acceptance-based therapy approaches
• Healthcare reform
• Neurocognitive screening
• Adult attention-deficit/hyperactivity disorder (ADHD) assessment and CBT for ADHD
• Integrated primary care
• The aging brain
• Substance abuse/addiction

Adult clinical and health psychology interns also attend a weekly Biopsychosocial Case Conference designed to discuss challenging clinical cases from a biopsychosocial approach.

In accordance with American Psychological Association (APA) accreditation requirements, you’ll have four hours of supervision per week. Adult clinical and health track interns receive at least two hours of individual supervision per week and are assigned a primary supervisor. This advisor will serve as a program development/research preceptor as well. Individual supervision is also provided in specific rotations. In addition, the Biopsychosocial Case Conference counts as one hour of weekly group supervision.

The remainder of the supervision is provided in a separate group supervision format. The agenda of the group supervision will be determined by the cohort and led at times by the track coordinator or training director, to discuss general issues related to the internship.

As an adult clinical and health psychology intern, you’re provided four hours of dedicated time per week to participate in an ongoing quality improvement or program development project. You and your supervisor will determine if you’re ready to take on a project once you’ve demonstrated proficiency with clinical and administrative responsibilities.