Cooper University Health Care - Behavioral Medicine
Note: We will be accepting all applications through the APA portal going forward. Please submit all applications and materials here.
Description of Externship
As a Behavioral Medicine extern, the trainee spend your time either in the main hospital and/or ambulatory clinics in Camden, depending on your rotation. Regardless of rotation, your primary responsibilities will broadly include performing mental health screenings, individual and group psychotherapy, and other clinical interventions with a variety of medical patients as-needed. Externs are provided with all necessary personal protective equipment (PPE) as well as the opportunity to receive flu shots, vaccines, and boosters. Flu shots are required
All rotations are two days per week. Briefly, the Consultation-Liaison (CL), Critical Care Medicine, Psychiatry Consultation-Liaison/ED Service, and Emergency Department (ED) services exists purely in the main hospital whereas the ambulatory rotations (primary care, pediatrics, women's health) will be mainly outpatient, with the opportunity to follow those under your care into the hospital if and when they are admitted. All are focused on the interaction of the individual's physical and mental health. Full descriptions of each rotation are below. Across all rotations, students will have the chance to conduct therapy as well as brief assessments of cognitive functioning (MOCA, MMSE as well as additional assessment if desired). Clinical Interventions range from brief diagnostic screenings to one-hour interventions. Our orientation is cognitive-behavioral, and we use a combination of CBT, mindfulness and Acceptance-based interventions such as guided imagery, breathing, and progressive-muscle relaxation regularly. There are weekly didactics and group supervision as well as supervision from Licensed Clinical Psychologists and a Post-Doctoral Fellow.
General information about externship site
Director of Behavioral Medicine and Psychological Services: Kelly Gilrain, PhD
Externship site point of contact: Caitlin LaGrotte, PsyD, MEd (lagrotte-caitlin@cooperhealth.edu)
Website: https://www.cooperhealth.edu/allied-health/behavioral-medicine/
Length of externship (in months): 12
Start Date: July 8
End Date: June 30 (flexible)
How many hours a week are expected of extern? 16
Required Day: Monday
We will consider applicants at any training level, though strongly prefer applicants have at least one year of outpatient therapy experience prior to starting.
Rotations
1) Behavioral Medicine Consultation Liaison Service: This rotation consists of inpatient hospital work across all medical departments. Externs work with patients via bedside assessment, consultation, brief CBT, ACT, and mindfulness skills. Patients are referred from across all medical departments and include Trauma, Oncology, Cardiology, Surgery, Pediatrics/PICU, General Medical/Surgical, and Emergency Medicine presenting with a variety of issues (e.g., adjustment to illness/injury, pain management, cognitive dysfunction, end-of-life issues, coping with treatment, marshaling social supports). There is extensive laboration with medical teams, providing feedback and recommendations for care with goal to address psychological challenges related to medical illness. Primary Supervisors: Dr. Kelly Gilrain, Dr. Anastasia Bullock, Dr. Wil Skelton, Dr. Alexa Hays, and Dr. Philip Fizur
2) Cooper Comprehensive Health: Integrated comprehensive health services including Ryan White-Funded primary care, HIV care, and other infectious disease services for those who are HIV+ and newly established dental clinic open to the community. Specialty clinics available include: HepC, women's health, high-risk pregnancy, gender-affirming care, and LGBTQIA+ focus. Dental clinic includes general dentistry and oral surgery. The multidisciplinary medical team includes infectious disease physicians, primary care, addictions medicine and counseling, dentist, oral surgeon, dental hygienist, psychiatry, pharmacy, and medical and non-medical case management. There will be opportunity to see HIV and infectious disease inpatients as well. Research - involvement includes completion of structured clinical interviews (CDQ) for new patients, brief annual assessments of cog function, depression & anxiety, and substance use; evaluation of high-risk patients with multiple medical and social comorbidities, involvement with Behavioral Health Integration Program (BHIP) of NJ and NJ state Trauma Informed Care (TIC) project as well as Behavioral Health Assessment Tool Project (BHAPT). Supervisors: Dr. Cori McMahon and Dr. Michael DeAngelo
3) Integrated Primary Care: OP/IP clinical experience for medically compromised Camden population with co-morbid psychological challenges (depression, anxiety, compliance, poor lifestyle choices, etc). Background in MI is helpful. Externs be able to see the same patients inpatient and outpatient, with the goal of reducing their inpatient admissions due to psychiatric issues and medical non-adherence. Trainees work collaboratively with physicians, social workers, and health coaches. There will be the opportunity to run groups to address diabetes, compliance with medical care and other topics. Groups - Development of variety of support groups for medically compromised patients - med compliance, managing chronic medical issues, DM management, mindfulness, etc. Supervisors: Dr. Philip Fizur
4) Inpatient Psychiatry: On this rotation externs spend their time on the inpatient psychiatric unit performing screening, individual therapy, therapeutic groups, and clinical interventions. Trainees engage in program development, group therapy, as well as individual therapy on the unit. All patients are voluntary and there are never more than 12 patients on the unit. Externs will attend morning rounds with the Psychiatry team, including the attending medical ector, residents, and medical students to discuss cases and treatment goals. Externs will also work closely with nurses to understand current concerns of patients and unit dynamics. Students will have the chance to conduct assessments of cognitive functioning (MOCA, MMSE as well as additional assessment if desired). Clinical Interventions range from brief diagnostic screenings to one-hour interventions. Our orientation is cognitive-behavioral and we use a combination of CBT, mindfulness and Acceptance-based interventions such as guided imagery, breathing, and progressive-muscle relaxation regularly. Externs will document notes in the EMR and provide recommendations to the interdisciplinary team. There are weekly didactics, individual supervision, and group supervision. Supervisor: Dr. Anastasia Bullock
5) Critical Care Medicine: This new rotation will consist of psychological consultation and psychotherapeutic intervention for patients and families within the area of Critical Care Medicine. The focus on this rotation will be completing brief assessment and interventions to adult Medical ICU patients at the bedside as well as supporting family members through the patient's critical illness. If interested, there may also be opportunities to co-lead ICU survivor support groups. Along with mood changes, this rotation will focus on adjustment to illness/hospitalization, pain management, and end -of-life issues. Externs have the opportunity to become part of an integrated team including physicians, nurses, social work, PT/OT, as well as pastoral care. Supervisor: Dr. Caitlin LaGrotte
6)Psychiatry Consultation-Liaison: Externs will work with the Psychiatry team to provide assessment and therapy for patients with psychiatric and risk needs that preclude eligibility for the inpatient psychiatry unit (e.g., psychosocial needs, medical needs, involuntary/crisis status, physical aggression) and they remain in the Emergency Department or the medical floor. In a unique training opportunity, students will be dedicated as a team member in the Medical Psychiatry team and will experience a dynamic workflow of consults and experiences. Common consults often include evaluation of suicidality and self-harm, psychosis, malingering and personality disorders, as well as introduction of evidence-based interventions to improve distress tolerance, emotion regulation, mindfulness and interpersonal effectiveness during acute hospitalization. Externs will have the opportunity to attend daily rounds with the attending psychiatrist on service, residents, and medical students, as well as engage in interdisciplinary coordination with nursing and primary medical teams. Externs will be exposed to psychopharmacology training and true biopsychosocial conceptualizations. Additional experiences will include: learning how to engage in verbal de-escalation to manage behavioral rapid response calls, attend daily multidisciplinary geographic rounds (co-rounding with OB/GYN, Pediatrics, and Emergency Department medical teams), and running family meetings. When developmentally appropriate, externs will have the opportunity to engage in cross-discipline teaching with psychiatry residents and medical students, helping them to learn aspects of psychotherapy by leading or co-leading consults. Clinical interventions range from brief diagnostic screenings to one-hour interventions. Our orientation is cognitive-behavioral and we use a combination of CBT, ACT, and DBT-informed interventions. There are weekly didactics pertaining to psychology in medical settings, individual supervision with a licensed psychologist, and group supervision. Additional opportunities to attend or contribute to grand rounds, as well as research, are possible depending on schedule, bandwidth and availability. Supervisor: Dr. Anastasia Bullock
7) Emergency Department (ED): This specialized training opportunity allows for acclimation to the ED rotation, which serves a diverse population with wide ranging chief complaints from early childhood to older adult. In addition, the trainee will follow patients admitted to the hospital. Also, there will be opportunities to support the general behavioral medicine CL service during periods of numerous consultations. The trainee has the opportunity to develop skills with rapid functional assessments for traditional mental health (including severe mental illness), health psychology populations, and substance use. Interventions across these domains frequently employ psychoeducation, CBT, ACT, and DBT Skills (i.e., distress tolerance). Harm reduction and safety planning are frequently utilized. There are opportunities to engage patients with frequent medical system utilization, which may also include somatic symptoms associated with significant distress and impairment. This rotation strongly encourages inter- and intra- professional collaboration with the recognition that care in the ED quickly transitions to care by Hospital Medicine (i.e., CL Behavioral Medicine, IP) or outpatient leagues (i.e., Early Intervention Program, Cooper Advanced Care Center, Women's, Addictions, Pediatrics). Supervisor: Dr. William Skelton
# of externs to be accepted for 2023-24: 2-4 Consultation/Liaison Service; 1-2 CEEC; 2 Integrated Primary Care; 1-2 IP Psychiatry; 1 Addictions; 1 Critical Care Medicine; 1-2 Psychiatry Consultation-Liaison/ED Service; 1 Emergency Department (ED); Ambulatory Health Psychology;1.
Minimum level of readiness (any prior experiences or level of training required for applicants: Preferences: Behavioral Medicine Consultation Liaison Service, Cooper Comprehensive Health, and Ambulatory Health Psychology: MA preferred. Addictions Medicine/ Behavioral Medicine at least one year of practicum and experience with patients with substance use disorder. Critical Care Medicine: MA required.
Do you provide a stipend? If so how much?: No
Interview process (provide information about interview process- time frame, how decisions are made) Also, do you conduct individual and/or group interviews; case presentation, other information?: We follow the PENDELDOT timeline. All interviews are individual. Case presentations are welcomed but not mandatory.
What application materials are required (i.e., cv, transcript, how many reference letters, case summary, test report, other?: CV, letter of recommendation, and Cover Letter indicating which 2 rotations are of interest, faculty you are interested in working with, and any previous Health Psychology experience.
Recommendation letter: If letter writers do not wish to have their letters sent with your application, they can submit it to the following email address: (lagrotte-caitlin@cooperhealth.edu). Letter writers should include your name in the subject line of the email (e.g., PENDELDOT Letter of Reference for NAME). You are also encouraged to indicate that your letter is coming separately in cover letter).
Intervention and Assessment: Variable as described above in rotation descriptions.
Supervision:
Estimate hours/week of individual supervision: 1
Estimated hours/week of group supervision: 1
Estimated hour/week of didactics: 1
Estimated co-therapy hours with supervisors: Variable by rotation
Context of didactics (seminars, Grand Rounds): Seminars
Estimated informal open door "curbside" supervision: As-needed, on average 1 hour per week
Describe Supervision: Varied by rotation with one hour dedicated outpatient and minimum one hour flexible on inpatient
Specify if observation occurs during intervention, assessment, consultation (audio, video, live in person (in treatment room, one-way mirror, live video stream): Live supervision in patient room / exam rooms. Minimum one hour per semester.