Clinical Psychology Training Consortium
Psychology Internship
Behavioral Medicine track
Justin Nash, Ph.D., Track Coordinator

The primary purpose of the Health Psychology/ Behavioral Medicine Track is to enable interns to understand the relationship between behavior and health and to learn to deliver interventions that promote health, prevent disease, and manage chronic illness. In addition, interns learn the biopsychosocial model of illness and, through their work with a variety of patient populations, become familiar with psychosocial factors influencing adjustment and adaptation to chronic medical conditions. Interns also develop specific skills for behavioral consultation and intervention in general medical settings and acquire an understanding of how a psychologist can be utilized in that setting.

For clinical and research interests for the faculty listed below please click here.

The Health Psychology/ Behavioral Medicine Track is comprised of the following rotations:

Behavioral Medicine - Rhode Island Hospital
Faculty Supervisors: Donn Posner, Julie Boergers

The Behavioral Medicine Rotation at Rhode Island Hospital has three components: (1) The adult outpatient sleep and anxiety disorders program and (2) The pediatric sleep disorders program.

Both the adult and pediatric sleep programs are connected with The Sleep Disorders Center of Lifespan Hospitals, which is an interdisciplinary service, designed to diagnose and treat primary and secondary sleep disorders. The staff of the Sleep Disorders Center includes psychologists, pulmonologists, pediatricians, and sleep technicians. A number of sleep-related presenting problems in adults and children are evaluated, including psychophysiological insomnia, idiopathic insomnia, behavioral insomnias of childhood, parasomnias, circadian rhythm sleep disorder, sleep apnea, periodic limb movement disorder, and insomnia's secondary to medical and psychiatric illness. Primary problems related to sleep disorders often include anxiety, stress, depression, substance abuse, headaches and chronic pain.

The adult anxiety program involves the diagnosis and treatment of a wide variety of anxiety disorders with an emphasis on anxiety as it relates to medical illness such as irritable bowel syndrome, heart disease, seizure disorders and withdrawal from benzodiazepines. Other cases may include more standard anxiety disorders such as panic disorder, generalized anxiety disorder, social phobia, obsessive-compulsive disorders, and posttraumatic stress disorder. The Center is staffed by both psychologists and psychiatrists and training is provided to post-doctoral fellows as well. Treatment modalities include pharmacological interventions, individual, and family modalities.

Behavioral Medicine in Primary Care - Department of Veterans Affairs Medical Center

Supervisors: Nelly Freydin, Psy.D., Pamela Steadman-Wood, Ph.D.
This rotation is located within the Primary Care Medical Service. The Primary Care service currently serves 28,000 veterans yearly, 95 % male with a an active women's health speciality clinic, and is staffed by 19 physicians. This internship rotation is designed to introduce the trainee to behavioral health consultation within the primary care setting. Interns serve as a member of a multidisciplinary treatment team comprised of primary care providers, psychiatrists, social workers, clinical pharmacists, and nursing staff. The intern will spend 4 days per week in Primary Care with Dr. Freydin as the primary supervisor and 1 day per week in Home-Based Primary Care (HBPC) with Dr. Steadman-Wood as the primary supervisor.

During the 4 days per week in Primary Care, the intern will develop a working knowledge of the function and role of a behavioral health consultant within the medical system, distinguishing the differences between the specialty/traditional mental health and the behavioral consultant model, as well as the biopsychosocial aspects of stress, illness and coping as it relates to physical functioning. From a cognitive-behavioral orientation, the intern will also develop disease-specific knowledge to assess the interplay between physical and mental health, evaluate mental and cognitive status, and deliver brief evidence-based interventions for a variety of presenting problems. The intern will learn how to provide the referring primary care physician with succinct same-day feedback. Common clinical and sub-clinical presentations of the following disorders may present in primary care:
depression and other mood disorders, anxiety including PTSD, substance abuse, dementia, adjustment disorders, chronic pain syndromes and their adverse emotional sequelae, and post-concussion syndrome. Furthermore, the intern will learn how to utilize psychoeducation within the context of group medical visits in the smoking cessation, obesity management and other medical speciality clinics. Overall, the interns will become more familiar and comfortable interacting with primary care physicians and learn how to add value and communicate within a medical culture.

During the 1 day per week in HBPC, the intern will learn how to provide services within an integrated care setting that provides home care to veterans with complex chronic disease not managed effectively by routine clinic-based care. The majority of veterans in this program are elderly and at risk for recurrent hospitalization, emergency care or nursing home placement. The intern will learn how psychologists function as part of an interdisciplinary team with a focus on the needs of an aging population. Consultation questions are diverse and include managing chronic illness (e.g., congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, diabetes mellitus, neurological disorders, end-stage liver disease), enhancing medical
regimen compliance, reducing care-giver burden, managing behavioral disturbances in dementia and evaluating decision making capacity. The intern will be involved in all phases of assessment, treatment and care coordination. In this rotation, the intern is offered a distinctive training experience in primary care, including experience to diverse patient population, exposure to the unique needs of an aging population, provision of in-home integrated primary care and mental health services, from both individual and family modalities.

Behavioral Medicine - Department of Veterans Affairs Medical Center
Faculty Supervisors: Alan Sirota, MaryAnn Paxson

This rotation is located within the Mental Health and Behavioral Sciences Service. The intern functions in a number of specialized programs: the Consultation-Liaison Service, the Smoking Cessation Clinic and the Sexual Problems Clinic. As a member of the C&L Team, the intern responds to requests for consultation from inpatient medical, surgical, and intensive-care units. Consultation requests are diverse and include such issues as adjustment reactions to illness, hospitalization, and surgery, acute and chronic brain syndromes, physical symptoms of unknown etiology, evaluating patients’ decision making capacity, suicide attempts, need for transfer to Inpatient Psychiatry, etc. The intern is involved in all phases of assessment, case formulation, and communicating recommendations to the medical teams. Follow-ups and brief interventions are often part of the consultation process. In the Sexual Problems Clinic, the intern learns about multidisciplinary approaches to the medical and psychological assessment and treatment of impotence and other sexual problems. Couples and/or group therapy are often a part of the program. The Smoking Cessation Clinic treats patients with pulmonary and/or cardiac disease using a group approach. In addition, the intern may also assume other outpatient roles such as assisting in evaluating patients who are being considered for organ transplants and following one or two long term therapy patients with Behavioral Medicine issues.

Behavioral Medicine Clinic: Rotation A - The Miriam Hospital
Faculty Supervisors: Ronald Thebarge, Peter Brawer, Sandra Jacobson, Karen Oliver

Behavioral Medicine Clinic: Rotation B - The Miriam Hospital
Faculty Supervisors: Judy Depue, Charlotte Collins, Sandra Jacobson, Justin Nash, Karen Oliver

Centers for Behavioral and Preventive Medicine

Clinical-research focused experiences, unlike the 4-month rotations described above, are 12 month long experiences providing concentrated clinical-research training in a speciality area. During the 1st 8 months of training, time is spent as follows: 50% obesity and diabetes management, 20% hospital consultation-liaison service, 10% cardiac rehab, 10% general outpatient behavioral medicine and 10% didactics. In the last 4 months of training, time is spent as follows: 60% obesity and diabetes management, 40% out-of-track clinical experience.

The overall goal of the rotation is to provide interns with an understanding of the relationship between behavior and physical health using an obese population, a general behavioral medicine population, and a general in-patient medical population. The settings are Weight Loss and Diabetes Research Center, Behavioral Medicine Clinic, and the inpatient units in The Miriam Hospital for consulation-liaison services. The outpatient services are designed to assist those individuals at risk either for developing chronic illness or for those whose existing medical conditions, including cardiovascular disorders, are complicated by psychosocial/biobehavioral factors. The intern functions as a member of the Behavioral Medicine Clinic and conducts comprehensive psychological evaluations and treatment for a variety of problems that can include chronic pain, headache, cardiovascular disorders, stress/anxiety management, nicotine dependence, diabetes, somatoform disorders, and treatment nonadherence. Interns learn about the hypothesized bio-behavioral mechanisms mediating the relationship between behavioral patterns and health status as well as the psychosocial factors influencing adjustment and adaptation to illness. The interns will also serve as a member of the inpatient multidisciplinary consultation-liaison team providing bedside assessment and treatment of acute medical-surgical patients. Consultation questions are diverse, ranging from various lifestyle disorders and pain syndromes to neurological and psychiatric disorders. Interns will also conduct biobehavioral evaluations and treatment in individual and group settings for patients enrolled in clinical trials for weight loss and diabetes management.