I. Introduction and Context
The mission of Hartford Hospital and The Institute of Living (IOL), Hartford Hospital's Division of Psychiatry, is to promote, restore, and maintain the health of all people we serve. The Institute of Living, a teaching hospital founded in 1822, is one of the nation’s foremost psychiatric facilities. The Institute contains 110 inpatient beds, as well as a school, adult and child outpatient clinics, and partial hospital and intensive outpatient psychiatric and substance abuse treatment programs. We are a tertiary care hospital and treat some of the more severely mentally ill psychiatric patients in Connecticut. Many of the patients coming to the IOL have been psychiatrically hospitalized many times and have severe and persistent mental illness. The setting includes 35 acres of historic and finely landscaped grounds less than a mile from downtown Hartford, geographically located midway between New York and Boston.
In 1994 The Institute of Living, then functioning as a private psychiatric hospital, was consolidated with Hartford Hospital (a major teaching hospital and long-time neighbor) further enriching this training environment. In 2011 Connecticut Health Systems became the parent corporate structure for Hartford Hospital, which includes the integration of a system of health care consisting of several hospitals, physician practices, a visiting nurses association, laboratories, etc. The Department of Psychology is a section of the Department of Psychiatry. All psychologists are appointed to the medical staff and hold non voting privileges but meet regularly with Psychiatry and have special consultative status via the bylaws of Hartford Hospital and the Department of Psychiatry. No other discipline in mental health has such a consulting status. The Institute of Living retains its name and board and has been ranked over the past few years in US News and World Report as one of the top psychiatric services in the United States. The Psychology section has full financial support from the Department of Psychiatry and Hartford Hospital. Currently we employ approximately 55 psychology staff and trainees at Hartford Hospital.
The first psychologists at The IOL were appointed in 1936 and we have had an APA-accredited Internship since 1957 (one of the oldest and longest accredited program for psychologists in the USA). The Postdoctoral Residency Program was accredited through APA in 2005 as a traditional psychology practice program. It is the mission of Psychology to hire and retain staff and trainees who will provide high quality treatment and assessment services to all patients as needed in the Connecticut Health System, and for the Director of Psychology and Training to be responsible for providing training in Clinical Psychology. All of the training programs are funded by Hartford Hospital. While there is no one academic umbrella for The IOL, many Psychologists hold one or more appointments at neighboring or distal Universities, including UCONN Health Center and UCONN, Yale University, the University of Hartford, Wesleyan, and Case Western University. Some of the staff teach psychology courses at the undergraduate or graduate level throughout the Connecticut area. We also have a number of practicum students from doctoral programs throughout the New England area, volunteers and summer externs.
Residents in Psychology are provided one year of training in a traditional psychology practice model with the goals of achieving advance practice methods in psychology that go beyond the entry level competence of interns. Beginning with the 2015-2016 training year, the positions having a focus in Neuropsychology and Anxiety Disorders will not be subsumed from the traditional accredited program but will continue to be integrated into the overall Residency program for a variety of learning, educational and training experiences.
Residency training takes place in two primary areas of emphasis; Child/Adolescent Clinical Psychology and Adult Clinical Psychology. The settings within which training takes place include The IOL, Hartford Hospital, the Grace Webb School, and Connecticut Children’s Medical Center. The residency applicant must have completed, or be within one month of completing, all requirements for granting of the Doctoral Degree, including the completion of an APA-accredited doctoral internship in either Clinical or Counseling Psychology. Applicants who express an interest in enrolling in our one-year advanced practice training in general psychology as part of our traditional practice program need to have a strong interest in working with the full range of psychological and psychiatric functioning that includes severely and persistently mentally ill populations. The mission of the training program is to provide a diverse group of Residents with learning at a more integrated and complex level of training than that achieved at the end of the internship training year. Six areas of competence as defined by the Commission on Accreditation and The American Psychological Association are identified as the measurable competencies for general training in psychology and they are the benchmarks by means of which we measure each Resident’s training throughout the residency year. Successful completion of the year entails having reached an advanced level of competency in these areas, as measured by consensus using a single tool for all Residents, regardless of area of emphasis. Goals are established for each Resident as they move from an entry level degree of competence in the science and practice of psychology to an advanced level of competence, to prepare the Resident for a fully licensed practice in psychology. Each Resident’s training is carefully supervised and their goals measured by a unitary evaluation tool. Within the two major focus areas, there are the following areas of emphasis; (1) General Adult Psychology including placements in Adult Inpatient and Schizophrenia Rehabilitation; (2) Child and Adolescent Psychology, including placements in Child Inpatient, the Grace Webb School and Pediatric Psychology; (3) Clinical Neuropsychology (not available for 2014-2015 training year); and (4) Anxiety Disorders.
Hartford Hospital and its parent organization have training and education as core operational goals under which our internship and residency programs are included. Whenever possible we encourage joint learning ventures with the Psychiatric Residents. Many of our Psychology staff actively teach in the Psychiatry Residency Training programs and our Residents in Psychology interact with the Psychiatry Residents on a regular basis. A number of funded (internally and externally) research programs in psychology have brought several million dollars over the past 5 years to the research mission of Hartford Hospital.
Hartford Hospital and its parent organization have training and education as core operational goals under which our internship and residency programs
are included. Whenever possible we encourage joint learning ventures with the Psychiatric Residents. Many of our Psychology staff actively teach in the Psychiatry Residency Training programs and our Residents in Psychology interact with the Psychiatry Residents on a regular basis. A number of funded (internally and externally) research programs in psychology have brought several million dollars over the past 5 years to the research mission of Hartford Hospital.
II. Application Process
A. Requirements for Application
Ph.D. or Psy.D. in Clinical or Counseling Psychology from an APA-accredited program, with a completed APA-accredited pre-doctoral internship in Clinical Psychology
. The program begins on September 1 of each year and ends on August 31.
B. Application and Interview Deadlines
Applicants for the Neuropsychology emphasis area have a deadline of January 1 and are required to participate in the APPCN match process. All other applications and supporting materials, transcripts, and letters of reference must be submitted by January 1 and use the on-line application process provided through APPIC (APPAS CAS). Interviews with the Director of Psychology and Training, current residents, and members of the training committee will be arranged by invitation after a review of all application materials is completed. Interviews will be arranged between mid-January and mid-February. Inquiries regarding your application can be made by calling (860) 545-7167.
Notification of acceptance will follow guidelines suggested by APPIC for this year’s Residency process.
Applicants must use the application form
found on this website as a supplement to the APPAS.
Residency stipends are $37,400 (paid bi-weekly) and benefits include an employee-chosen health plan, 15 vacation days and five sick days., and 6 paid hospital holidays.
IV. Submitting Applications
Applicants need to access the application by using the following link https://appicpostdoc.liasoncas.com/applicant-ux/#/login.
In addition to the online application, please download and complete the Postdoctoral Application and submit/upload along with the stated supporting documents. --->
V. The Psychology Department
The Psychology Department, within Hartford Hospital’s Department of Psychiatry, has its own leadership, with the Director of Psychology and Training reporting to the Medical Director. Psychology training is subsumed under one budget administered by the Director of Psychology. A full time Administrative Associate is available to the trainees and the Director. The Director of Psychology and Training has clinical, supervisory, and administrative responsibilities, and is also integrated into training programs throughout the hospital but especially with teaching and supervisory training of Residents in the Department of Psychiatry’s Residency training programs. All psychologists hired in the Hartford Healthcare system report to the Director of Psychology for discipline-specific issues, professional education, licensing, continuing education as necessary, and credentialing. Psychologists in the Hartford Health Care system report clinically to the supervisors in their respective areas of emphasis.
The faculty of the Department of Psychology at the IOL consists of 32 FTEs and 5 part time doctoral level psychologists, seven interns, and nine Residents. The department's theoretical perspective is integrative and eclectic with major emphases in psychodynamic psychology (ego psychology, self psychology, object relations and attachment psychology), cognitive behavioral psychology, systems theory (emphasizing group and family theory and practice, and behavioral psychology. We have a strong Group Psychotherapy training emphasis at the IOL. Members of the Psychology Department currently carry treatment responsibilities in the Child and Adolescent Division, Adult inpatient and Outpatient division, the General Psychiatry Service, Hartford Hospital’s Rehabilitation and Stroke, Transplant, Pain, Bariatric, and Epilepsy Services, and in Geriatric Services. Expertise in the areas of group psychotherapy, addictions, neuropsychological assessment, health psychology, psychological assessment, pediatric psychology, substance abuse treatment, head injury, trauma/abuse, anxiety disorders, schizophrenia, brief therapy, pediatric consultation, and psychoanalytic psychology exists within the Psychology Department. Active research include areas of neuropsychological correlates of schizophrenia and affective disorders, attention deficit disorder, traumatic brain injury, group psychotherapy, sexual, gender dysphoria in children and adults,. borderline personality disorders (using DBT), the cognitive-behavioral treatment of anxiety disorders, health psychology and psychological assessment.
VI. The Residency in Clinical Psychology
Prospective candidates for the one-year Residency in Clinical Psychology can apply to be considered for one or more areas of emphasis. Applications are provided online and sent electronically to the e-mail address noted on the website.
As a tertiary hospital The IOL specializes in the evaluation and treatment of acute and chronic psychiatric and behavioral disorders, including acute exacerbations of chronic conditions. Stabilization of psychiatric crises using an integrated blend of brief psychotherapy, crisis stabilization, family consultation, psychopharmacology, case management, and contact with community resources has become the hospital's primary mission and those areas of practice are emphasized in the training of the Residents in psychology. Special emphasis is given to suicide and violence assessment using specific tools (SAFE-T and the Broset) as part of each patient’s hospitalization. Residents are trained in the use of these tools as part of their inpatient work. The hospital has been very successful in establishing an umbrella of care for its patients, integrating the use of inpatient, partial hospital, and intensive and less intensive outpatient services in response to a patient's changing treatment needs. We serve a multi ethnic and multi lingual community and services are available in many languages. There is ongoing cultural competency emphasized in the Hartford Hospital mission and specifically in the Residency programs where it is suggested that every supervisory and clinical contact involve a recognition of how a patient’s gender, sexuality, ethnicity, religion and social status affect the course and etiology of a patient’s illness.
The Residency training program is structured such that the Resident assumes primary clinical responsibilities within the hospital’s integrated healthcare delivery system. Indeed, Residents assume responsibilities similar to those of a staff Psychologist working within the same work site. However, the Residents are closely supervised on their work with the mission of helping them to achieve independence in their clinical practice by the end of the training year. To this end the weekly Residency Professional Seminar focuses of professional growth and development and attends to the need for Residents to become supervisors. Residents are introduced to the methods of supervisory practice and are all involved in supervising either Interns in Clinical Psychology or externs. There are also opportunities for peer supervision. Our teaching faculty believes that the Residents need to be responsive to the changing context of health delivery systems throughout the country, and are provided all the administrative tools in the Hospital, including detailed updates on administrative goals and changes throughout the year and monthly updates on the hospital’s financial issues. Opportunities to gain expertise in administrative psychology/psychiatry are provided in individual supervision, and seminars, including the Residency weekly seminar.
A. Training Philosophy
The Institute of Living/Hartford Hospital (IOL) Postdoctoral Residency in Clinical Psychology adheres to a science-informed practice model of training. We view this model as being compatible with a diverse array of career paths, focusing on practice areas in psychology. Almost all of our graduates choose clinical areas of practice and research as their career choice, while also teaching at a local college or university and supervising students. The unifying theme in this Residency is the practical integration of scholarship and psychological science into practice. Toward this end, the residency emphasizes the use of critical thinking skills and the thoughtful and systematic evaluation of clinical work using a variety of best practices informed by current trends in the science of psychology as they evolve over time.
B. Orientation Period
During the first week of the Residency each trainee meets with faculty members and various key administrative and clinical personnel in the healthcare system.
The purpose of these meetings is to meet with key personnel and to integrate into the flow of the department and the healthcare system.
The prevalence of drug use in today's society has received widespread recognition. In response to recent nationwide trends among both corporate businesses and hospital communities, the Institute has recognized the need to establish clear drug use policies for its employees. In light of this concern, the hospital has instituted a confidential drug testing procedure for all new employees that began on January 1, 1990. The hospital's Employee Assistance Program has requested that all departments notify prospective applicants of this procedure. Testing via urinalysis will occur prior to the Residency start date with employment contingent upon the results.
C. Training Requirements and Goals
The Residency prepares the Trainee to become skilled at utilizing new research and applied findings and integrating them into practice. Supervision and seminars will have the Residents reading, discussing and evaluating practice relevant research and applied articles, develop treatment plans informed by best practices, and discussing the therapeutic, ethical and legal aspects of current findings. All Residents will be required to conduct a scholarly research project that involves program development or evaluation or an evaluation of treatment efficacy. Residents will present their research projects during our annual “Psychology Day” at the end of the training year, during which the Department’s service contributions to the hospital’s core mission and the training program is recognized at a hospital-wide celebration. The overall education and training goal of the Residency program is to train professional psychologists for primary practitioner roles in clinical services, particularly in the public sector, though some of the Residents may choose to focus on teaching and research and more scholarly pursuits. This expected outcome flows from the primary goals of the program:
- The acquisition of advanced competencies in the foundational competencies of professional psychology in general and,
- To prepare Residents for Independent Practice through the acquisition of best practice models of assessment and intervention that are pertinent to the areas of emphasis chosen by the Resident and,
- To provide a supportive mentoring environment, foster further professional development and role consolidation necessary for autonomous functioning as licensed psychologists.
Advanced competencies are identified as involving the following core areas of competency that have been identified by APA for Residency training programs including the following:
(1) Assessment, diagnosis and interventions;
(2) Consultation, program evaluation and supervision;
(3) Strategies of Scholarly inquiry;
(4) Organizational management and administrative issues;
(5) Professional conduct ethics and law; and
(6) Issues of cultural and individual diversity
Each of the areas of emphasis uses these competencies as the template for evaluating and assessing a Resident’s growth and development over the year of Residency Training. All Residents are exposed to supervisory experiences and receive supervision, in individual and group formats. Supervisory training is combined for all areas of emphasis in three weekly meetings for all the Residents and staff as well as other trainees (the Psychology Rounds, the Resident’s professional seminar and the weekly advanced case presentation seminar). All meetings are held weekly for one hour and allow the Resident to present clinical and scholarly material to their peers and to Consulting Psychology and Psychiatry staff.. Three professional staff are present at the weekly Residents’ Professional Seminar to mentor and guide the Residents in their goals to acquire the skills and material necessary to meet an advanced level of competency in primary areas of clinical work by the end of the year. These staff also guide Residents through their project proposals and the carrying out of their project for the year. All of the teaching and clinical staff attend Psychology Rounds on a weekly basis and provide teaching and consultation to the Residents and other trainees. Initially all Residents are assessed for having met the core competencies appropriate to the internship level (entry level of competence). Goals for the year are identified for each Resident in terms of what they should expect to accomplish to achieve advanced levels of competencies over the training year. Reading lists and educational materials specific to each area of emphasis provide additional scholarly introductions to the application of general skills in that area. Consultation skills are learned through working with interdisciplinary staff, presenting clinical and scholarly material at case conferences, seminars and professional education seminars. The Residents are looked upon by other staff as educators and they have the opportunity to supervise and consult to non psychology staff. Residents are expected to present scholarly material as part of their case conferences, citing relevant scholarly and research issues related to empirically informed and guided treatment, best practice models and up to date information on practice standards.
All Residents receive monthly reports from the Director of Psychology related to management issues at the hospital. These issues may be discussed formally and informally in supervision and in Psychology Rounds. The Director of Psychology and Training is trained in group methods (and certified by AGPA as Group Therapist) and systems theory, and provides Residents with models to understand and explain the impact that hospital and non hospital systems have on their professional development and care of patients. All Residents are expected to demonstrate significant growth in their professional development and maturity as well as advanced knowledge of ethical, legal, diversity and cultural issues present throughout their work as Psychologists. They are expected to acquire a body of advanced knowledge regarding the practice standards pertinent to general psychology and to their areas of emphasis. We stress a model of lifelong learning, the formation of peer support groups for post Residency learning and support the Residents’ acquisition of new models of learning based on best practice models, empirically informed treatment models and the development of research protocols for studying one’s methods and practices when necessary. The diversity curriculum for Residents provides a library of resources, mentoring and focused learning experiences in which cultural and diversity issues are stressed. It is expected that these issues are to be discussed in every supervisory experience.
As a group of psychologists we meet at the beginning of each training year to discuss with the training faculty the objectives and goals for training for all the Residents in psychology. In order to ensure consistent education across areas of emphasis we use a single tool to measure adherence to the training and we get feedback every six months from Residents and staff regarding the achievement of the core objectives and goals in each of the training areas of emphasis.. All Residents are evaluated at the end of the year on the same set of core competencies regardless of their chosen area of emphasis. Supervisory staff meet together on a monthly basis to provide feedback about training goals and objectives for each Resident and to provide feedback about whether the individual is appropriately achieving their goals for their Residency, and whether or not a Resident is satisfying the criteria for graduating and sitting for licensure as independent practitioners.
In order to graduate, all Residents regardless of area of emphasis are required to demonstrate Core Competencies in the following areas:
(1) Assessment, diagnosis and interventions;
(2) Consultation, program evaluation and supervision;
(3) Strategies of Scholarly inquiry;
(4) Organizational management and administrative issues;
(5) Professional conduct ethics and law; and
(6) Issues of cultural and individual diversity.
Core Competency 1: Assessment, Diagnosis and Interventions
Residents will become proficient in providing consultation to members of their treatment teams, other allied health providers requesting psychological services, and to peers, consulting with other professionals regarding the utility and necessity for psychological assessment, and in determining the tools and methods appropriate to that task. Residents will demonstrate advanced proficiency in the use of relevant assessment tools so as to diagnose, identify patient strengths and to assist in carrying out appropriate interventions for their patients in diagnosis, assessment and any relevant interventions related to treatment and discharge planning.
Core Competency 2: Consultation, Program Evaluation and Supervision
Residents will become proficient in consultations within areas of emphasis. They will become competent in evaluating their programs, learning about how to utilize patient satisfaction measures and how to evaluate their interventions. This may involve learning how to evaluate specific tools to measure patient outcome and the administration, scoring, interpretation and reporting of the results of patient feedback onto treatment objectives. This may also relate to learning appropriate assessment and consultation methods to achieve treatment goals and/or tools that assist in diagnosis, identification of patient strengths and in treatment planning. This includes the provision of feedback to patients and to treatment team members. Residents will supervise interns or externs and learn and acquire supervisory training and skills at an advanced level of competency, beyond that learned during Internship training.
Core Competency 3: Learn Strategies of Scholarly Inquiry
Residents will utilize the scholarly literature to inform their interventions with patients. Residents and supervisors will be required to bring to the supervisory experience relevant scholarly literature related to specific assessment, treatment and therapy goals and how they may influence treatment and planning decisions. Residents will learn how to read relevant scientific literature on empirically supported treatment, empirically informed methods of treatment and outcome treatment studies that inform us as to the best practice models, what interventions to avoid lest we harm a patient, and how to chose appropriate interventions and strategies based on the best available information and science in the field. In addition, they will be expected to engage in critical thinking to determine how to integrate the best scholarly research and best practice models of care to guide our decision making in choosing appropriate methods of treatment and tests to use for our evaluations. Residents will exhibit advanced levels of competency in these areas, beyond what was learned during Internship.
Core Competency 4: Organizational Management and Administrative Issues
Residents will demonstrate an advanced level of competency in understanding issues of organizational management in hospital care, and how specific administrative issues protect patient safety and provide a “do no harm” context for patient care regardless of where one practices along the spectrum of patient care. Residents will learn the effectiveness of team building in working with an interdisciplinary staff and develop a proficiency in asking relevant questions regarding how the hospital context and administrative conflict can affect the care of patients in positive and negative ways. Residents will achieve an advanced level proficiency in understanding and working successfully in the areas of organizational management and administrative issues. The Director of Psychology provides all of the staff, including the Residents, with monthly updates on all aspects of administrative issues at Hartford Hospital. There are regularly generated hospital wide e-mails from hospital administration discussing these issues and they come up at the weekly Psychology Rounds and the Professional Seminar for Residents. Residents discuss these issues in multiple formats and are given an opportunity to provide input into H3W (How Hartford Hospital Works) and how the Hospital can work better to meet patients’ needs. All administrative management meetings involve a high level of transparency and the administration insists that all members of the HH community (n=7000) are aware of changes in the financial and clinical planning process at HH. By the end of the training year Residents should have an advanced level of competency in this area and know how these issues impact patient care and how to utilize these issues for the benefit of the patient- therapist alliance.
Core Competency 5: Professional Conduct, Ethics and Law
All treatment is affected by the professional role of the psychologist with the patient and by relevant ethical and legal issues that guide professional practice. Every clinical supervisory encounter involves issues of boundaries, boundary maintenance, inevitable boundary crossings and the avoidance of boundary violations. These issues are presented to the entire staff at the beginning of each year in the context of professional presentations at Psychology Rounds and the Professional Seminar. Issues of liability, risk, ethical and legal problems are presented to the Residents throughout their training year. In the Professional Seminar the APA Trust book on Liability is utilized and test questions shared with the Residents. By the end of the training year the Resident will be expected to raise these issues and to know how to resolve professional and ethical dilemmas, how to seek out professional consultation and how to engage the patient in the process of discussing these issues as they arise in the evaluation, consultation and treatment of patients. By the end of the training year the Residents are expected to have an advanced level of understanding of ethical, professional and local legal issues guiding treatment decision making.
Core Competency 6: Issues of Cultural and Individual Diversity
All direct care involves integrating the unique perspective of the patient and the intersubjective process of the therapeutic dyad into the treatment plan. This style of inquiry involves the recognition of the important of issues of how culture and diversity affect patient symptoms and treatment. Not only is this a core competency of APA but there is an evolving body of literature on how all of medicine and psychology involves real gender differences in every organ system that must be appreciated (cf. M. Legato Ed., Principles of Gender Specific Medicine. Elsevier, academic Press, 2nd edition, 2010). It is expected that every clinical encounter, including supervision, must make reference to how the unique issues of gender, culture, spirituality, and ethnicity affect the treatment process. We emphasize to Residents how a patient’s metaphors of their illness interact with our metaphors of illness, and how those metaphors need to be incorporated into the treatment plan.
D. Overview of the Residency
Areas of Emphasis
A prospective Resident may apply to one or more areas of emphasis to be considered for the general training in advanced levels of competencies in psychology. Currently there are 9 positions that are funded. An area of emphasis is defined as a placement setting in either child or adult psychology which serves as the primary site of training for the Resident the training year. The areas of emphasis are described below. Residents placed in the areas of Neuropsychology and the Anxiety Disorders Center have a two year training structure and while they continue to be under the direction of the Director of Psychology and Training and participate in the seminars with all residents, are not currently part of the accredited Postdoctoral Training Program.
General Clinical Psychology Area of Emphasis - Child/Adolescent:
School-based Psychological Assessment and Psychotherapy
The Resident assigned to the Grace Webb School, our on-site therapeutic school that provides elementary, middle, and high school programming, will have the opportunity to carry child and adolescent patients in the Grace Webb School and outpatients admitted to several of our outpatient clinics. The Resident will have the opportunity to provide individual, group, and family psychotherapies to the Grace Webb students as well as conducting cognitive and personality testing to children and adolescents. The Grace Webb School and the outpatient clinics serve the regional and local community, which is very ethnically, racially, and socioeconomically diverse including both urban and suburban populations. The Grace Webb School, while providing academic programming to its students, also provides individual and group psychotherapies to the students. Grace Webb students are enrolled for the full academic year and as a result, the Residents have the opportunity to provide longer-term therapy.
In the Grace Webb school the Resident will be expected to complete 3 comprehensive assessments each month. Testing referrals will include psychodiagnostic evaluations as well as triennial evaluations mandated by the school system. Residents will work closely with Psychiatrists, other Psychologists, teachers, and social workers within the service. There is also the possibility of the Resident becoming involved in elective training opportunities providing outpatient psychotherapy to patients at Connecticut Children’s Medical Center.
Training will focus on the preparation for advanced practice competence in provision of brief inpatient treatment with children and adolescents presenting with a wide range of acute and severe psychopathology, from a treatment model integrating empirically supported interventions and a contemporary psychoanalytic object relations perspective.
Residents will develop advanced skills and experience in rapid psychodiagnostic and risk assessment, psychodynamic case formulation, integrating object relations assessment with DSM-IV diagnosis. In addition, Residents will develop advanced competency in treatment planning and intensive case management, drawing upon comprehensive case formulation to generate psychodynamically and behaviorally-informed treatment recommendations and interventions. This will include working familiarity with a repertoire of interventions, including focal individual psychotherapy, group therapy, psychopharmacology, family therapy, milieu therapy, and behavioral/ cognitive-behavioral/DBT techniques.
Residents are responsible for a caseload of three inpatients, split between the child and adolescent units. The amount of direct service will vary considerably based upon individual patient needs but on average, each patient will require a minimum of 30 minutes daily of direct contact individually and often involve multiple family meetings during the week. Residents will also receive training in process-oriented group psychotherapy with adolescents and social-skills group therapy with children.
Training focused in pediatric psychology provides a particular emphasis on consultation/liaison at Connecticut Children’s Medical Center (CCMC), an acute-care children’s hospital. The Resident works closely with experienced pediatric psychologists and two child & adolescent psychiatrists with focused area of training practice in consultation/liaison. Advanced training is provided in the understanding of major pediatric illnesses and the comorbidity of psychiatric problems in the medical population. The Resident participates in all clinical assessments and the management of recommendations for hospitalized patients. The Resident is encouraged and supported to take a leadership role with other trainees, including psychology interns, general psychiatry residents, and medical students. The Resident participates in establishing and revising treatment plans. Skills in the role of consultant and managing systems needs are emphasized. In addition, the resident will assume the responsibility of providing individual and/or family psychotherapy to a select number of outpatients referred from the various medical departments at CCMC.
General Clinical Psychology Area of Emphasis - Adult:
The focus of training is on the delivery of brief, intensive treatment with severely emotionally disturbed patients admitted to our general adult inpatient psychiatric unit. Residents should have psychiatric inpatient experience and sufficient clinical competence to quickly assume an independent level of functioning. Residents should also be comfortable with psychodynamic theories of individual psychopathology and group psychotherapy, have experience using cognitive-behavioral techniques, and have experience in family therapy. Competence in psychological testing and a working knowledge of behavioral psychopharmacology and the biological components of psychiatric symptoms is desired.
The resident will be assigned to one of the general adult inpatient services that admit patients 18 and older for treatment of acute symptoms. This training site will prepare residents to work within a managed-care environment and strengthen their diagnostic, assessment, and brief therapy skills. Each resident will serve as a primary therapist for three patients and provide conjunctive family/marital therapy when indicated. The unit is milieu-based and provides short-term therapies for severely disturbed patients in need of hospitalization, many of whom have gone through unsuccessful outpatient and short-term inpatient treatments.
Broad spectrums of patients, including those who are acutely psychotic, personality-disordered, addicted, conduct-disordered, and affectively-disordered, are seen on the units. Residents gain experience not only as primary therapists and case managers, but also as psychologists functioning as members of a multidisciplinary team and learning methods of milieu therapy. Each Resident will, along with a predoctoral intern, assume responsibility for conducting the unit's intensive psychotherapy group program. Along with the unit psychologist, the Resident will also provide consultation to the other treatment teams.
Treatment of Psychotic Disorders and Schizophrenia
The postdoctoral training pairs experience in a specialized intensive outpatient setting with providing intensive brief inpatient therapies. This area of emphasis prepares the trainee for advanced practice competence in the areas of treatment, evaluation and rehabilitation of adults with schizophrenia spectrum disorders. Pairing this intensive outpatient experience with the inpatient treatment program, including the provision of psychodynamically informed supportive individual, group, and family psychotherapies, enables Residents to develop advanced practice skills working with severe mental illness in patients at various levels of need and acuity in a variety of treatment settings. The postdoctoral training in the Schizophrenia Rehabilitation Program provides individual, group and family therapy, case management, cognitive remediation and psychoeducational services to intensive outpatient program participants. The Resident also has opportunities to work with patients participating in ongoing applied research projects.
The Schizophrenia Rehabilitation Program (SRP) is both an intensive treatment program and a research program. SRP is designed to conduct and incorporate the latest research on treatment and rehabilitation of schizophrenia to develop a best practice model for assessment and intervention. Areas of research incorporated into the program include vocational interventions and outcomes, cognitive interventions and outcomes, psychopharmacological interventions for positive, negative and cognitive symptoms, and behavioral interventions. Residents treat participants in ongoing research studies and participate in the implementation of innovative treatment programming for individuals with schizophrenia spectrum disorders.
Clinical Neuropsychology Area of Emphasis:
Clinical training in Neuropsychology involves training both at the IOL inpatient units and Hartford Hospital medical services involving integrated experiences both within psychiatric and general medical settings. In keeping with the goals of the broader training program, the Clinical Neuropsychology area of emphasis will develop professionals with the advanced competency training necessary to accurately diagnose, effectively assess, and offer effective interventions to a broad age range of individuals with various neuro-cognitive and neurobehavioral impairments including those with major psychiatric disorders. This area of emphasis will also prepare the Residents to work effectively with interdisciplinary staff in the evaluation and treatment of patients with complex neuropsychiatric disorders and/or head injury or systemic CNS problems. Professional development in educating/supervising is also a component of training. Involvement in clinical research and psychotherapeutic interventions also ensures the breadth and depth of advanced professional competence. Residents work with a multidisciplinary staff typical of bed services and are exposed to the complexities of caring for head injured and neuropsychiatric patients by nurses, social workers, interns and residents and attending staff. Each of the services has conferences and rounds that pertain to the site specific rotation, e.g. Trauma clinic, head Injury, Stroke Clinic, Memory Disorders Clinic, Geriatric Service, Alzheimer’s Service, Cognitive Rehabilitation Service , Schizophrenia Clinic, etc. Residents conduct evaluations (brief and complex) and also engage in the psychotherapeutic treatment of patients and their families during the recovery process of CNS injuries or illness.
This area of training prepares residents for advanced practice competence in the delivery of cognitive-behavioral therapy (CBT) and preparation for practice in adult and pediatric anxiety disorders, with a focus on the following diagnostic groups: Obsessive-compulsive disorder and obsessive-compulsive spectrum disorders, Panic disorder, Agoraphobia, Generalized anxiety disorder, Social anxiety disorder, and Posttraumatic stress disorder. In addition, residents receive advanced training in structured diagnostic interviewing and cognitive-behavioral case conceptualization. Residents will receive some training in research analysis and the application of scientific findings to clinical practice and will develop familiarity with the administration of a research project. Methods of treatment involve behavioral and cognitive behavioral therapies in individual and group treatment. Residents will have the opportunity to work both with adults and children presenting with Anxiety and hoarding behaviors. The program is research based and also uses manualized training models.
Residents attend a variety of seminars, offered by both Psychology and the Psychiatry Residency Training Program. The following seminars will be available this year and each resident will determine with his primary supervisor which seminars should be attended:
- Residency Professional Seminar, weekly (Required)
- Child Psychology Residency Seminar (Required)for Child areas
- Clinical Inference & Professional Ethics
- Modern Readings in Personality and Psychotherapy
- Introduction to Neuropsychology (Required) - 4 weeks
- Weekly Grand Rounds (Required)
- Psychology Rounds, weekly (Required)
- Group and Family Therapy
- Clinical Case Conference (Required)
- Neuroscience Seminar
- Neuropsychology Seminar (required in that area of emphasis)
Residents are required to attend the weekly Psychology Rounds where both administrative and educational issues are addressed. Besides involving the Residents in the full workings of the department and providing an inside view of the hospital-based practice of clinical psychology, a wide range of educational topics is discussed. In accordance with APA guidelines, each Resident will be expected to present to the faculty case material involving research findings, dissertation topics, specialized treatment and diagnostic issues, a psychotherapy case or psychodiagnostic evaluation during the year. During the training year some sessions of the Psychology Rounds are devoted to specialized topics in boundary crossing and violations, liability, , cultural diversity and supervision. Outside speakers are also invited to present on topics not covered in the Psychology Rounds but important for clinical care and best practices.
VII. Evaluation of Trainees and the Training Program
The tool for measuring a Resident’s achievement of the core competencies is assessed by satisfactory scores achieved on the Core Competency Scales used by supervisors in assessing their Residents. All of the Residents’ supervisors fill out the evaluation form every six months. Training in utilizing that instrument is provided on a yearly basis so that uniformity in a Residents ratings are consistently done across areas of emphasis and are a valid indicator of a person’s achievement of those goals. Moreover, these issues are discussed on a monthly basis in the supervisory meetings set up by the Director of Training.
The Core Competencies are assessed by the Core Competency Scale that utilizes the following:
- The Resident must receive supervisory ratings of 4 (High Intermediate)on a 5-point scale (entry level) at mid-year, and a minimum rating of 4 at year’s end (functions mostly independently/meets advanced proficiency level) in order to graduate. At midpoint any Resident whose level of achievement of the Core Competencies are deficient (less than 85% of the competencies rated as “4”, High Intermediate”expected the entry level degree of competency) will be given a warning and a remediation program to follow in order to satisfy graduation requirements. At year’s end, Residents require to have 85% of their ratings be a “5” (Advanced).
- The Resident must receive satisfactory hospital QA reports indicating that they have met all of the hospital requirements for competency in care and meeting all of their clinical responsibilities over the year, meeting Hartford Hospital H3W goals of ICES (an acronym for achieving the goals of Integrity, Caring, Excellence and Safety in their patient care). As part of their responsibilities Residents must demonstrate timeliness of process notes, charting in the medical record and follow through on any responsibilities that are part of their areas of emphasis.
VIII. Who Should Apply
Applications are accepted from doctoral Psychologists from APA-accredited programs in Clinical or Counseling Psychology who have completed an APA-accredited internship. Residency applicants should have an interest and background in psychological evaluation and psychotherapy, and interest in advancing competencies in providing hospital-based services to patients experiencing both acute psychiatric difficulties and chronic mental health issues. Applicants need to have completed their doctoral degree or have a letter from their program attesting to the planned completion of degree requirements within the first month of the residency.
IX. Residency Selection Procedure
Eligibility of Applicants:
- Completion of an APA-accredited Ph.D. or Psy.D. program in clinical, or counseling psychology.
- Doctoral degree conferred from an APA – accredited graduate school training program in psychology prior to the start of training Must be in good academic standing in their academic departments;
- Have interests, aptitudes, and prior clinical experiences that are appropriate for the residencies goals and objectives;
- Cover letter describing the applicant’s interest in clinical psychology and completion of our application, and a statement of the applicant’s short and long-term career goals.
- Curriculum vitae
- Three letters of recommendation
- Sample copy of a psychological/neuropsychological assessment report
- Sample copy of a psychotherapy case conceptualization and treatment summary
- All graduate school transcripts (copies issued to student are acceptable)
- All materials must be received by January 1
An applicant’s completed application will be reviewed by at least two members of the psychology staff who are participating in the residency selection.
During the initial review an applicant may be excluded from further consideration for the following reasons:
- Applicant did not complete an APA-accredited doctoral psychology program
- Applicant has not completed an APA-accredited internship
- Applicant has no experience providing comprehensive psychological testing using intellectual, objective, and/or projective measures.
- Applicant has neither completed a graduate course in initial interviewing or DSM-IV nor had supervised experience in conducting an initial intake interview and providing individual psychotherapy.
Live interviews are required for selected applicants. For applicants who are scheduled for interviews, each applicant will be interviewed by the Training Director, a current resident, and at least two other supervisory staff. Each interviewer submits their ratings to the Training Director after the interview, and this feedback is used to help construct the final ranking list for the match.
Application materials are due by January 1
Questions can be directed to James DeGiovanni, PhD. Director of Psychology and Training at firstname.lastname@example.org
All application materials will be thoroughly reviewed, with particular focus on the goodness of fit between the applicants’ training experiences and the tasks in the area of emphasis to which they are applying .To facilitate this process, members of residency selection committee will complete an Applicant Evaluation Form on which they will rate applicants based on a number of criteria, including the quality of their letters of recommendation, academic qualifications, clinical qualifications, match between their experience and focused area to which they are applying, and ability and willingness to work as part of a multidisciplinary team. As part of this form, members of the training committee are asked if they would recommend granting an interview to the applicant.
Following an in-depth review of all applicants’ materials, applicants will be required to travel for an in-person interview. If unable to attend an in-person interview, applicants may schedule a telephone or Skype interview. Applicants will be notified if they have received an interview no later February 15th.
Applicants invited for an interview will meet with the training director and primary supervisors supervisor(s) in their area of emphasis as well as a current resident. They will also be provided with information about the hospital system, be given a tour of the facility and have ample time to ask questions. Interviews are held in between mid-January and mid-February.
The residency program at the Institute of living is following the match policies initiated by the Association for Postdoctoral and Psychology Internship Centers (APPIC).
After acceptance of an offer for postdoctoral training the applicant must complete the Hartford Hospital new employee application process prior to starting in September, which includes completing a written application, TB test, physical examination and a drug screen. Applicants who will be training at CCMC and in child and adolescent areas will also need to have a criminal background check by the local police department a lease interested in an early dinner once Eric is not free but also five early
Statement of Nondiscrimination
The Institute of Living/Hartford Hospital is an equal opportunity employer. We welcome applicants from various racial, ethnic, sexual orientation, religious and cultural backgrounds as well as those with physical disabilities.
Resident’s will work 12 consecutive months, 40 hours a week, Monday through Friday. A total of 1960 hours will be spent in direct service, indirect service, didactic training and supervision. Out of the 1,960 total hours, residents are required to provide a minimum of 40% on direct service.
Residents are provided a stipend of $37,400, receiving payments bi-weekly over the course of their 12 month placement. They will receive a hospital orientation and training as a member of the staff.
Benefits and Liability Insurance
Residents will be offered paid (partially subsidized by the hospital) enrollment within the hospital’s health insurance and/or dental insurance programs and are covered by the organization’s liability insurance during their temporary twelve (12) months of employment (applicable Summary Plan Descriptions for further details regarding service, cost and plan administration can be found on the Hartford Hospital Intranet and orientation packet). Since residents are employed by the hospital for their temporary twelve (12) months of employment, they are covered and must comply with all policies of the hospital, including but not limited to grievances, anti-harassment, and performance expectations residents can access these policies during the hospital’s orientation process and in full through the Hartford hospital website
Paid Time-Off and Holiday Pay
Residents receive three weeks of combined paid time off and sick days as well as six national holidays. Residents request time off from their primary supervisor and if approved then is reviewed by the Director of Psychology and Training. Residents are not permitted to take extended time off during the month of August.
Professional development time will be offered for activities such employment interviews, , professional development conferences and poster presentations at local or national conferences. Residents will receive release time to complete additional educational activities as necessary.
Clerical support is provided in each service by the unit administrative assistant, as well as by the psychology departments administrative assistant. Dictation services are provided for all medical records as needed.
- Evaluations completed by Residents
Residents are asked to evaluate their supervisors twice per year using the Evaluation of Supervision Form. Finally, Residents are asked to complete a written evaluation of the Residency program using the Program Evaluation Form and, after the training year, are asked about their post-Residency employment on the Post-Residency Information Form.
- Evaluations of the Residents
Residents will be evaluated on an ongoing basis throughout the internship year. An initial informal review of the Residents’ strengths and weaknesses occurs after the first two months of the training year. Formal written evaluations will take place every six months. In order for Residents to maintain good standing in the program, they must meet the minimum thresholds for achievement identified for each review on the Resident Evaluation Form. However, there will also be many informal opportunities for feedback as well. These include weekly individual supervision meetings, team staffing meetings, and group Resident supervision meetings with the Director of Training. In addition, staff members and supervisors make themselves available to meet with interns outside of scheduled times if issues arise.
Requirements for Completion of Residency
- Successful completion includes:
- Completion of all paperwork, including reports, consultations, and progress notes.
- Completion of research project as established with primary supervisor
- Presentation of case conceptualization during psychology rounds.
- Attendance at weekly didactic opportunities
- Completion of 1960 hours; 40% of time in direct services
- Satisfactory completion of program training objectives in each of the six core competency areas as indicated by supervisory ratings of at least “4” on all rated areas by year’s end, reflecting the resident is capable of practicing independently.
- Meet criteria of evaluations/minimum thresholds for achievement; 85% of all competency ratings must be a rating of “5” (Advanced Competency)
- Minimum Thresholds for Achievement
In the rare situation when it is recognized that a trainee needs remedial work, a competency assessment form should be filled out immediately, prior to any deadline date for evaluation, and shared with the trainee and the director of training. In order to allow the trainee to gain competency and meet passing criteria for the rotation, these areas must be addressed proactively and a remedial plan needs to be devised and implemented promptly.
Goal for post-doctoral evaluations done prior to 12 months
All competency areas will be rated at a level of competence of High Intermediate (4) indicating Occasional Supervision Needed or Advanced (5) indicating autonomous practice with consultation. Only areas where the post-doc has no prior experience will be rated I. No competency areas will be rated as Remedial or E (New Skill).
Goal for post-doctoral evaluations done at 12 months
At least 85% of competency areas will be rated at level of competence of Advanced (5). No competency areas will be rated as I, R or E. Note: exceptions would be elective rotations that would take a more intensive course of study to achieve this level of competency and the major supervisor, training director and trainee agree that a level of HI is appropriate for that particular rotation (eg., Supervisory skills).
Remediation and Termination
The program’s minimal levels of achievement are linked to the evaluations that directly correspond to the program’s goals and objectives. Residents, supervisors and the Training Director can easily track progress through the year and identify areas where a resident might be in jeopardy of not meeting the program’s minimal levels of achievement. Should a resident not achieve minimum thresholds for achievement at any four-month evaluation, a developmental or remediation plan will be collaboratively developed by the Residents supervisor(s) and the Director of Training. This plan will be presented to the resident and the resident will be given the opportunity to present feedback and suggestions. The resulting remedial plan will serve as a training contract between the resident and the program staff, and adherence to this plan will be closely monitored on a weekly basis. The resident will be required to sign the training plan. She. Due Process Guidelines will also likely be implemented.
A resident failing to comply with the remedial plan due to lack of motivation or gross deficits in skills will be scheduled for a performance review. The resident will be notified of the impending review and concerns to be addressed. This performance review may be requested by the Director of Training, medical director, current rotation supervisors, or the resident. The resident will have the opportunity to respond to concerns.
A written report of the performance review will be presented to the Training Committee, who will determine the need for further action, such as continued monitoring, revision of the remediation plan, and/or probation. The resident will be notified in writing of the Training Committee’s decision and will be required to review and sign the new training plan. Residents wishing to appeal any aspects of this remediation plan will submit a written request to the Director of Training within 14 days of being presented with the new plan.
The resident failing to comply with the remediation plan, failing to improve while on probation, violating ethical and professional codes, or transgressing official policies may be recommended for termination from the residency after a meeting of the Training Committee. In such a case, the Director of Training will provide resident with a written notice of the Training Committee’s decision to recommend to the hospital that the intern be terminated from employment.. The resident will have the opportunity to appeal the decision through the hospital’s Human Resources Department and request consultation with APPIC and/or APA.
Housing is provided by the Resident.
The Psychology Residency is accredited by the Commission on Accreditation of the American Psychological Association.
For information pertaining to APA accreditation, please contact:
American Psychological Association
Office of Program Consultation and Accreditation
750 First Street, NE
Washington, DC 20002-4242
(T) 202-336-5979 (F) 202-336-5978
X. Current Psychology Department Training Staff