APPIC #118323
Overview
The Behavioral Medicine Service is a psychological consultation and intervention program integrated within specialized outpatient medical services of Yale-New Haven Hospital (YNHH) and the Smilow Cancer Hospital. Interns work within multidisciplinary teams of medical providers (consisting of physicians, surgeons, nurses, and social workers) and gain valuable experience in the provision of behavioral health consultation, psychological assessment, and behavioral health intervention to a broad range of medically ill patients. Emphasis is placed on understanding the psychosocial factors influencing adjustment and adaptation to chronic medical conditions, and on developing skills for behavioral consultation and intervention in an academic medical setting.
Placement Options
This track consists of a single, full-time, twelve month placement within YNHH’s Behavioral Medicine Service.
Number of Interns
Two predoctoral interns will be selected into the Behavioral Medicine track for the 2013-2014 academic year.
The Setting
The Behavioral Medicine Service is a part of the Psychiatric Services of Yale-New Haven Hospital. Developed in 2008, the Behavioral Medicine Service has become a valued and integrated component of the Yale-New Haven Transplantation Center and the Smilow Cancer Hospital.
The Yale-New Haven Transplantation Center (YNHTC) provides expert, comprehensive and compassionate care for adult and pediatric patients throughout the world who are candidates for organ transplantation. The YNHTC specializes in liver, kidney, pancreas and heart transplantation; and is the region's leader in the evaluation and treatment of advanced liver disease.
The Smilow Cancer Hospital is the only NCI-designated Comprehensive Cancer Center in Southern New England. It is a new state-of-the art facility that offers a full range of patient support services to address the physical, emotional, and spiritual needs of patients. Smilow Cancer Hospital is a new facility designed to be warm and welcoming for patients and their families. Special features, including a roof-top healing garden, a reflection room, open spaces, and thoughtful artwork, help create a calming, peaceful environment.
The majority of the predoctoral intern’s clinical training occurs within the outpatient care clinics of these two programs, however, interns also have the opportunity to perform consultations and provide counseling to hospitalized patients as well.
The Internship
The goal of the Behavioral Medicine Service is to provide support and assistance to medical care providers and their patients so that the patient’s emotional and mental health needs can be addressed within the context of their overall medical care. The service operates under the premise that integrated behavioral medicine has the potential to benefit both patient and physician by improving access to behavioral health care for medically compromised individuals, improving adherence to medical treatments, targeting lifestyle and psychosocial issues effecting wellness, addressing issues of pain management, stress tolerance, addictions, coping, and by helping to prevent the development of more serious mental health disorders through early recognition and intervention.
Interns divide their time training between the Yale-New Haven Transplant Center’s Liver Transplant program and the outpatient care clinics at Smilow Cancer Hospital. Within each of the medical specialties, Behavioral Medicine interns consult with medical providers and patients and psychotherapy to medically ill patients using a combination of supportive, cognitive-behavioral, and mindfulness-based therapeutic approaches. Interns also attend and participate in a number of weekly multidisciplinary meetings and case conferences such as the Liver Transplant Recipient Review Committee, Melanoma Tumor Board, and the Palliative Care Interdisciplinary Team Meeting.
Within the Liver Transplant program, interns receive specialized training in the evaluation of living donors, and participate in the program’s Donor Advocacy Team. Interns also provide individual behavioral weight loss, drug and alcohol relapse prevention, and stress management and relaxation training to pre and post-liver transplant recipients. As members of the program’s Recipient Review Committee and Donor Advocacy Team, interns gain valuable firsthand experience in issues related to organ allocation, patient selection, transplant ethics, and the psychological and neurocognitive functioning of patients with acute liver failure and end stage liver disease.
Within the Smilow Cancer Hospital, interns provide care and consultation to referred patients from the breast, gynecology, lung, melanoma, neuro, and medical-oncology services. Interns also spend one-half day per week within the head and neck cancer clinic and receive specialized training in brief Motivational Interviewing to identified high-risk patients for smoking cessation and alcohol reduction. Interns also participate in a monthly Menopause, Intimacy and Sexuality clinic within the gynecology-oncology service. Within this clinic, interns work closely with a faculty gynecologist and gynecology-oncology surgeon and perform brief individual behavioral health consultations with women who have a history of cancer and whose primary concern relates to sexuality, sexual functioning, body image, or menopause. In certain cases, interns may also follow some of these patients for brief individual or couples behavior therapy to address targeted areas of concern. Interns also have the chance to attend and participate in weekly Melanoma Tumor Boards and Palliative Care Interdisciplinary Team Meetings.
Predoctoral interns within the Behavioral Medicine Service also have the opportunity to conduct brief neuropsychological assessments within the Psychiatric Consult-Liaison and Cardiac Surgery Services of YNHH. Most diagnostic assessments involve 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 within the Behavioral Medicine Service also receive weekly supervised individual psychotherapy training within the Department of Psychiatry’s Long Term Care Clinic.
Scholarly Activity
One-half day per week of protected research time is provided to allow interns the opportunity to 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.
Faculty
Jessica Barber, Ph.D., Clinical Supervisor
Dwain Fehon, Psy.D., Primary Advisor
Stacey Salant, Ph.D., Clinical Supervisor
Benjamin Toll, Ph.D., Clinical Supervisor
Seminars and Specialized Training
In addition to the core didactic seminars within the Department of Psychiatry, and general hospital-based seminars, Behavioral Medicine interns also have the opportunity to attend an elective Clinical Health Psychology training seminar sponsored by the Connecticut VA Health System. Numerous additional didactic health and medicine related case conferences, seminars, and grand rounds are offered through the Yale-New Haven Transplantation Center and Yale Cancer Center. Participation in these optional activities is at the discretion of the intern and their primary advisor as their schedule permits.
Behavioral Medicine interns are also invited to attend the YNHH Dialectical Behavior Therapy Summer Seminar (July and August). This seminar covers theory, formulation and major strategies of Dialectical Behavior Therapy (DBT) as it is applied to treating severe borderline personality disorder in outpatient and day hospital settings. Attendees actively engage the material through discussions of cases and video examples, skills practice, self-monitoring and problem solving exercises, and role play.
For Further Information
For more information about this placement site, please e-mail dwain.fehon@yale.edu.
