Predoctoral internship Training Program in
Clinical & Community Psychology

Training Sites

Yale-New Haven Psychiatric Hospital

YNHH and YNHPH Program Description
Psychology Internship Training Tracks

• Adult/Dialectical Behavior Therapy Track
• Adolescent & Adult Training Track

Psychological Assessment Training
Individual Psychotherapy Training
Research Elective
Supervision and Seminars

YNHH and YNHPH Program Description

Yale-New Haven Hospital is the major teaching and clinical research facility of the Yale University School of Medicine. It is a 900 bed general hospital that encompasses the Yale-New Haven Psychiatric Hospital (YNHPH) a 74 bed, acute care, psychiatric facility that consists of four main inpatient programs and a range of intensive outpatient/day hospital programs.

Clinical services include:

A General Adult Inpatient Unit treats patients 18 years and older, and a specialized Geriatric Unit focuses on treatment of the elderly. The patients generally present with complex combinations of disorders reflecting psychotic, affective, cognitive, neurological and medical components. Treatment in the short-term setting focuses on rapid comprehensive diagnosis, symptom reduction, and pharmacological treatments. Psychosocial treatments emphasize individual and family crisis intervention.

The Dual Diagnosis Inpatient Unit is designed to evaluate and treat patients with both psychiatric and substance abuse disorders. Detoxification, pharmacotherapy, relapse prevention, social problem-solving, stress management and family education are important components of the program.

The Adolescent Inpatient Unit conducts short term treatment of adolescent and young adult patients with a wide range of diagnoses including affective disorders, psychoses, developmental disorders, conduct disorders, and psychiatric disorders combined with substance abuse. Comprehensive biopsychosocial assessment and treatment, intensive family consultation and crisis intervention are the core treatment modalities. After discharge, some patients continue to be followed in a brief (6 to 8 week) after-school intensive outpatient program, which is designed to help patients make the transition from inpatient treatment to their home and school environments.

The Adult Ambulatory Services (intensive outpatient programs) are geared to adult patients who do not require the level of supervision and support provided by an inpatient program, but who need more intensive intervention than is readily provided in most outpatient settings. Most patients are admitted for treatment of mood disorders, anxiety disorders, chronic suicidal ideation, co-occurring disorders (psychiatric and substance abuse disorders), personality disorders and family/interpersonal conflicts. Patients are admitted to one of four main treatment tracks: 1). General adult track for patients with depression, anxiety and psychiatric problems; 2). Dual diagnosis track for patients with psychiatric and substance abuse disorders; 3). Specialized Dialectical Behavioral Therapy (DBT) track for patients with borderline personality disorder features who struggle with chronic patters of suicidal or other self-destructive behaviors; and 4). DBT for substance abuse (DBT-SUD is provided for patients who struggle with borderline personality disorder features and substance abuse.

Psychology Internship:

The Psychology Internship at the Yale-New Haven Psychiatric Hospital provides an opportunity to work in clinical settings that are using emerging models of mental health care. The internship provides experience reflecting the increasing emphasis on short-term inpatient and intensive outpatient care with triage to outpatient treatment. It provides the opportunity to work with acutely ill adults and adolescents who suffer from a range of disorders including mood disorders, psychotic disorders, personality disorders, and substance abuse disorders in combination with major mental disorders. The settings in which the interns' participate allow for the development of skills in assessment of psychiatric disorders, rapid treatment strategies, multidisciplinary collaboration, and integration of therapeutic interventions including pharmacotherapy.

Applicants for predoctoral training must chose between one of two training tracks. The training programs in each track span inpatient, intensive outpatient, and outpatient service settings and provide training in core competencies of assessment, intervention, consultation, research and cultural diversity. As such, interns will each track receive training in direct patient care, group leadership, effective participation in daily rounds and staff conferences, and therapeutic, administrative, and theoretical issues. Predoctoral interns are trained in multiple therapeutic modalities, including crisis intervention, individual case management, group therapy, family therapy, and in collaborative methods for pharmacologic and psychotherapeutic interventions including Dialectical Behavior Therapy. All predoctoral interns also receive clinical training in psychological assessment, and have the opportunity to conduct long-term psychodynamic individual psychotherapy within Yale's Long Term Care Clinic (LTCC).

The Yale-New Haven Psychiatric Hospital offers training in a variety of practice settings based in two main tracks. These include the Adult/Dialectical Behavior Therapy Track, and the Adolescent & Adult Training Track.  

Option 1: The Adult/Dialectical Behavior Therapy Track (APPIC #118311):

Two predoctoral interns are selected into the Adult/Dialectical Behavior Therapy Track. The track consists of an eight month primary rotation within the adult ambulatory services with special emphasis in Dialectical Behavior Therapy training, and a four month secondary rotation within the hospital's general adult inpatient unit.

Increasingly, moderately to severely ill patients, who would have been treated with extended stays in inpatient services, are now managed in less restrictive ambulatory service settings such as a partial hospital or intensive outpatient programs. Accordingly, the focus of the Adult Training Track within the YNHPH is on continuity of care from inpatient treatment to intensive outpatient treatment, and the acquisition of advanced clinical skills in Dialectical Behavior Therapy for acutely ill patients.

Core clinical responsibilities:

In the Adult Ambulatory Services, the intern serves as a primary clinician for 8-10 patients within the program's DBT and DBT-SUD tracks. The DBT and DBT-SUD tracks provide full-model DBT treatment modified for a group-based day hospital setting. DBT/DBT-SUD therapy groups include skills training, diary card review, behavioral analysis, and skills coaching. In addition, the interns and other DBT clinicians provide telephone skills coaching and meet weekly for a DBT consultation group. Interns may also have the opportunity to conduct brief individual therapy using the DBT model based on fellow’s interest and clinical availability.

Interns also receive additional training leading cognitive-behavioral psychotherapy and topic-focused groups, conducting admission assessments, and participating in daily treatment planning and review meetings. As the primary clinician, the intern meets with the patient, receives information about the patient from other clinicians and program staff, coordinates program treatments with those provided by the patient's outpatient therapist, and plans for the patient's discharge from the program. The intern learns to coordinate knowledge of psychopathology, psychotherapy, and pharmacotherapy with management of environmental stressors.

In the general adult inpatient site, the intern is the primary clinician for 3 patients, and takes part in daily rounds and treatment planning meetings. As the primary clinician, the intern coordinates acute inpatient treatment. This is accomplished by assessing and meeting regularly with the patient, organizing information about the patient from other clinicians and unit staff, assisting in the family-based interventions, and planning for the patient's discharge in consultation with the patient's outpatient therapist. This is done in a collaborative, multi-disciplinary setting.

During the entire training year, interns will receive clinical training in psychological assessment, and will have the opportunity to conduct long-term individual psychotherapy within Yale's Long Term Care Clinic (LTCC).

Option 2: The Adolescent & Adult Training Track (APPIC #118312):

Two predoctoral interns are selected into the Adolescent & Adult Training Track. The track consists of an eight month primary rotation within YNHPH’s Adolescent Inpatient and Outpatient Services, and a four month secondary rotation within the hospital's Adult Ambulatory Services. This training track provides interns with the opportunity to receive a unique intensive inpatient and outpatient clinical training experience with adolescents and families, while also enabling interns to gain additional specialized experience with acutely ill adults in an intensive group-oriented program.

Core clinical responsibilities:

The Adolescent placement is an eight-month rotation within YNHPH's short-term adolescent inpatient unit and step-down intensive outpatient program. This rotation provides interns with the opportunity to learn about a wide range of psychopathology in adolescents characterized by fairly diverse socioeconomic and ethnic backgrounds. The most frequently encountered problems involve mood disorders, psychosis, PTSD, disruptive behavior disorders (such as oppositional defiant disorder, conduct disorder, and ADHD), and substance use disorders.

Predoctoral interns function as primary clinicians within a multidisciplinary team to an assigned caseload of adolescent inpatient and intensive outpatient program patients. Thus, predoctoral interns have the opportunity to provide services for both acutely disturbed patients in need of inpatient crisis stabilization as well as for those requiring a step-down intensive outpatient level of care. Interns within this track work closely with families and local school systems and also have the opportunity to learn about the community context of adolescent psychopathology and how to perform multiple roles with this population. Clinical activities include primary clinician for approximately four adolescent patients, family therapy, group therapy (intensive group psychotherapy as well as a modified Dialectical Behavior Therapy skills group), crisis intervention, and collaboration with community clinicians, schools and agencies.

The Adult placement is a four-month rotation based within the hospital's Adult Intensive Outpatient Program. This placement provides interns with an opportunity to treat a wide range of adults exhibiting severe Axis I and Axis II psychopathology within a model of intensive group psychotherapy. Predoctoral Interns receive four months of concentrated supervised group therapy training in traditional process-oriented group psychotherapy and specialized empirically-supported group therapies with an array of adult patients diagnosed with severe psychiatric disorders including substance abuse (See Adult/Dialectical Behavior Therapy track description for more detail).

Training emphasizes multidisciplinary and interagency treatment team planning, intensive group therapeutic interventions involving Motivational Enhancement/Motivational Interviewing, Relapse Prevention, Dialectical Behavior Therapy, interpersonal group psychotherapy, and milieu-based interventions.

During the entire training year, each intern within the Adolescent & Adult Training Track will also have clinical training in psychological assessment, and will have the opportunity to conduct long-term individual psychotherapy within Yale's outpatient Long Term Care Clinic.

Psychological Assessment Training:

Predoctoral Interns have the opportunity to conduct psychological diagnostic testing protocols during the year within each of the two training tracks. Diagnostic assessments at YNHPH include evaluations of newly admitted patients on the inpatient units and patients who have been participating in treatment for longer periods in the ambulatory services programs. Each assessment involves administering and interpreting a variety of instruments, participating in individual testing supervision, consulting with the treatment team about the implications of test results for the patient's treatment, providing feedback to the patient in consultation with the treatment team, and writing a final report. Predoctoral Interns conduct both traditional full battery assessments as well as brief forms of personality assessment and neuropsychological screening.

Individual Psychotherapy Training/Long Term Care Clinic:

In the outpatient Long Term Care Clinic, a psychotherapy training clinic operated by Yale University’s Department of Psychiatry and YNHPH, interns have the opportunity to treat individual outpatients throughout the entire training year. Individual weekly supervision from a psychodynamic perspective is provided to guide the intern in conceptualizing and implementing treatment from an insight-oriented therapeutic modality most appropriate to the assigned cases. Typically, predoctoral interns see one or two individual therapy patients in either once a week or twice-a-week psychotherapy for the full duration of their training year.

Research Elective

An optional year-long research elective is available to predoctoral interns within the YNHPH psychology training program. One-half day per week of protected research time is provided to allow interns the opportunity pursue and conduct clinical research within the Yale School of Medicine. Research training objectives are individually designed and achieved through an apprenticeship model where the intern works closely with a faculty mentor involved in a program of active research. Interns are matched with faculty mentors based on their shared interests and faculty availability. The faculty member serves as supervisor and role model, with the goal of integrating clinical and research skills as well as professional role identity.

Supervision and Seminars:

Predoctoral interns at YNHPH receive individual supervision with full and part-time faculty representing a broad range of interests and expertise. Each intern is assigned a primary supervisor for weekly supervision of assigned cases including individual, group, and family therapy. Primary supervisors are permanent faculty assigned to the same clinical program that the intern is assigned. In addition to formal weekly supervision, a major form of supervision is provided "on-line" via modeling, treatment team meetings, and consultation. Interns are also assigned an individual secondary supervisor who provides additional weekly clinical supervision for the entire training year. Through intensive supervision, interns also address issues in professional development and learn about the complexities of different roles within different treatment settings.

Predoctoral interns at YNHPH also attend, interact, and present material at the weekly Faculty-Interns Training Seminar. Topics within this seminar include psychological assessment; theory and practice; crisis intervention; family assessment and treatment; and advanced group psychotherapy techniques. Additional topics are added each year depending on the interests of interns and faculty. In this seminar group, interns also have the opportunity to present clinical case material as well as findings from independent research projects. Interns may also attend a variety of optional departmental clinical and research forums, and a range of seminars within the Department of Psychiatry, including weekly Departmental Grand Rounds that cover both clinical and research topics.

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