Stress Clinical Services and Research / Yale Stress Center

Overview

The Yale Stress Center internship involves placement in a comprehensive outpatient treatment program and participation in a clinical research project.

The Stress Center Clinical Services and Research placement aims to provide fellows with a comprehensive experience in evaluating and treating stress related disorders, using a range of therapeutic approaches and a solid biopsychosocial framework, as well as a closely mentored experience in developing and testing hypotheses related to stress, health, and/or addictive behaviors. Fellows are exposed to intensive training in stress reduction techniques, such as meditation, biofeedback, breathing exercises, and gentle yoga, in addition to training and exposure to cognitive, behavioral, dialectical and acceptance based therapies.

Placement Options

This track consists of a single twelve-month placement within the Stress Center Clinical and Research settings.

Number of Interns

One doctoral fellow is selected into the Stress Center Clinical and Research Program each year.

The Setting

Using an interdisciplinary approach to interventions, Yale Stress Center clinical services address chronic stress and stress related maladaptive behaviors that adversely affect health outcomes. Our bio-psychosocial approach integrates behavioral and physical healthcare while emphasizing early intervention.

A full spectrum of services is offered by a multi-disciplinary team at a range of intensity levels. Services aim to expand awareness of the effects of stress on the mind, body, and behavior, and teach skills targeting the effects of stress and maladaptive behaviors.

The primary populations served at the Stress Center include: Individuals at risk for or experiencing stress related chronic medical conditions and diseases, such as hypertension, heart disease, obesity and metabolic syndrome, Type II diabetes, fibromyalgia, and some types of cancers; individuals with stress related substance addictions, such as alcohol, cocaine, and nicotine, as well as behavioral addictions; and individuals with mood disorders, anxiety disorders, personality disorders and adjustment disorders.

The Internship

This internship track follows the scientist-practitioner model, training fellows for careers with competence in both scientific research and clinical practice. Fellows will work closely with a team of psychologists, dietitians, MBSR instructors, psychiatrists, nurses, and others with training in health psychology, exercise physiology, endocrinology and mind/body approaches. An individualized plan of clinical and research training will be developed for each fellow, based on strengths and interests of the fellow and consistent with training program requirements. Individual and group supervision on clinical care and research will be provided.

Core clinical activities constitute up to 80% of the internship. Fellows will be trained to conduct biopsychosocial stress screenings, diagnostic interviews, and evaluations using a range of interview skills and clinical tools. Each intern will serve as the primary clinician for 12-16 patients within the Stress Center's clinical services and clinical trials. Fellows will be trained to co-lead Mindfulness Based Stress Reduction classes with experienced instructors. The fellows also will provide individual and group therapy, using the following stress reduction and mind/body approaches: stress and emotion regulation skills coaching; Mindfulness Based Cognitive Therapy; biofeedback (heart rate variability, respiration, and muscle tension); breath and relaxation training; integrative therapies for stress related addictive behaviors and other stress related conditions; and health, nutrition and exercise training for weight loss and health optimization.

The three major areas in which fellows can expect to receive specialized training include Mindfulness Based Stress Reduction, Stress Related Addictive Behaviors, and Stress and Health.

Mindfulness Based Stress Reduction Program:

This program aims to assist clients in developing healthy lifestyle habits and decreasing stress through mindfulness, breath training, and gentle yoga. Within this track, fellows will learn to lead MBSR classes, workshops, and individual sessions. Although clients in these programs do not necessarily meet full criteria for medical or psychiatric diagnoses, individuals may present with a wide range of medical conditions, addictions, and mental health symptoms (excluding suicidality). The MBSR program is located at 2 Church Street South, New Haven, CT.

Stress Related Addictive Behaviors Program:

This program provides training opportunities in individual and group therapy for clients and research participants with stress related substance and behavioral addictions, using an integrative approach. Outpatient clients are seen at 2 Church Street South, New Haven CT. Research participants may be seen either on an inpatient clinical research unit or outpatient at the Substance Abuse Center at 34 Park Street, New Haven, CT or at 2 Church Street South.

Stress and Health Program:

This program provides training in evaluating individuals for risk of stress related medical conditions, such as heart disease, hypertension, diabetes, obesity and other metabolic disorders and providing preventive treatment interventions, including exercise training, stress relaxation response training, biofeedback, breath training, and individual therapy. Therapy focuses on education on the link between stress and health, the development of an individualized healthy lifestyle program, and coaching on initiation and maintenance of behavior change. This program is located at 2 Church Street South.

Evidence-Based Practices

The following evidence-based practices (EBPs) are used in this placement setting. Fellows generally have exposure to most of these EBPs though do not necessarily receive training or supervised experience in all of them. The EBPs include:

  • Comprehensive Stress and Diagnostic Evaluations
  • Psychodiagnostic evaluations for adolescents and adults
  • Cognitive behavioral therapy for anxiety, depression, pain, insomnia, and addictions
  • Exposure based therapies for anxiety and stress
  • Mindfulness based stress reduction
  • Mindfulness based cognitive therapy
  • 12 step programs for relapse prevention
  • Motivational interviewing
  • Biofeedback
  • Dialectical Behavioral Therapy
  • Wechsler Adult Intelligence Scale-IV
  • Millon Clinical Multiaxial Inventory-III
  • Structured Clinical Interview for DSM (SCID)

Core Research Activities

The Center conducts cutting edge, interdisciplinary research to examine the mechanisms underlying human response to stress, the role of self-control, and how compulsion drives addictive behavior. Fellows will work with their research supervisors to develop a research project related to the themes of stress, addictions, health outcomes and behaviors, including testing hypotheses, data analyses, and manuscript development.

Faculty

Keri Tuit, Psy.D., Primary Supervisor
Rajita Sinha, Ph.D., Primary Research Supervisor
Hedy Kober, Ph.D., Secondary Research Supervisor
Xoli Redmond, Psy.D., Secondary Clinical Supervisor
Nancy Legow, Ph.D., External Clinical Supervisor
John Cline, Ph.D., External Clinical Supervisor
Amit Oren, Ph.D., External Clinical Supervisor

Supervision

Fellows will work closely Dr. Rajita Sinha, the primary research supervisor, and Dr. Keri Tuit, primary clinical supervisor. This will include weekly individual supervision session and direct collaboration with supervisors on research projects and clinical activities. In addition, fellows will be matched with two additional clinical supervisors for weekly clinical supervision. Secondary research supervisors may be assigned based on the individualized research project.

Applicant Qualifications

Applicants for this placement should have an interest and experience in mind/body interventions. Applicants with first hand meditation experience are strongly encouraged to apply. Applicants selected for this placement must be able to successfully pass background checks conducted by Yale University.

For Further Information

Contact Dr. Keri Tuit, Psy.D., Clinical Director: keri.tuit@yale.edu.