Major and Minor Rotations

A.F. Williams Family Medicine Center is a primary training site for Family Medicine residents as well as clinical pharmacy students, nurse practitioner students, physician assistant students, psychology graduate students, and medical students. Our multidisciplinary team also includes care managers, a social worker, and tele-psychiatry consultants. This provides numerous opportunities for psychology interns to work collaboratively on a multidisciplinary team.

The overarching goal of the primary care psychology major rotation is to train psychologists to provide a full range of clinical primary care psychology services as key members of multi-disciplinary healthcare teams, develop an array of interprofessional competencies, and become leaders in this growing area of healthcare. Specific goals include developing core competencies of primary care psychology such as providing consultations to patients and providers, participating in multidisciplinary care teams, providing brief individual therapy services, becoming skilled with warm hand offs and co-consultations, providing diagnostic clarification and brief assessment, providing in-patient consultation, providing group interventions, and assisting with population-based care initiatives. We provide many opportunities for interns to become familiar with the varied roles that psychologists can have in medical education.

Interns will engage in the provision of primary care psychology services in collaboration with attending psychologists, family physicians, psychiatrists, care managers, psychiatric nurse practitioners, physician assistants, RN’s, MAs, social workers, medical students, residents, graduate psychology students, and pharmacy students. These services may include:

1. Consultation regarding behavioral health questions and presenting problems 
2. Consulting with physicians about patient care, mental health and health behavior change
3. Provision of team based care
4. Teaching and supporting patient self-management skills
5. Facilitation of health-related support groups
6. Individual patient assessment and intervention
7. Health promotion/disease prevention interventions
8. Psychological screening and assessments
9. Opportunities to supervise psychology practicum students and engage in supervision of supervision

Interns will contribute to the education and training of medical students and medical residents via:

1. Collaborative care/clinical teaching
2. Small group teaching
3. Coaching physicians in techniques of health behavior change
4. Medical precepting (supervision of psychosocial aspects of medical care)
5. Hospital rounds
   

Interns may potentially participate in ongoing research and/or program development in community based medicine with options including:

1. Serving on grant writing teams
2. Participation in clinical home visits
3. Participation in practice based research working groups
4. Focal study of a selected underserved population

Interns will master a primary care psychology curriculum through:

1. Direct patient care in the primary care setting
2. Selected readings
3. Attending lecture and seminar series
4. Participation in medical school education activities, including Family Medicine, Rural Health and Psychiatry Grand Rounds
5. Participation in daily supervision

Interns will work collaboratively with family medicine residents and attending providers within a consultation-liaison structure to best care for patients during in-patient hospitalizations. In particular, services such as mental health screening, brief mental health interventions, health behavior change interventions, family meetings, and discharge plans are engaged effectively in this team format. Interns will observe these interactions, act independently, and receive supervision during this learning experience. In patient experience can be up to two 1/2 days per week (Tuesday and Thursday afternoons).

The rotation supervisors are well versed in evidence-based approaches to interventions in primary care, medical specialty, and traditional mental health settings. Trainees can expect to gain exposure to and expertise in behavioral activation, cognitive behavioral therapy, dialectical behavior therapy, mindfulness-based cognitive therapy, acceptance and commitment therapy, and health behavior change assessment and intervention.

Our patient population includes insured and underinsured patients from a large variety of ethnic and socio-economic backgrounds. It also includes refugees from Africa, Iraq, Iran, Russia and South East Asia, medical students, residents, and medical school faculty.

The interns will receive a minimum of 3 hours of supervision per week, inclusive of individual supervision, group and precepting. Some of this supervision is individual and some will be completed as part of a precepting model where you will have the opportunity to work with supervisors with patients individually and learn from how they work and then discuss approaches to best serve those patients before and after encounters.

Within this model, clinical psychology interns serve as behavioral health providers (BHPs) who function as consultants to primary care providers (PCPs) and patients by providing brief consultations with interdisciplinary team members, shared medical appointments with PCPs, patient warm handoffs, psychological assessment and screening, and targeted episodes of psychotherapy. There will also be opportunities to engage in other clinic activities such as implementing quality improvement and research initiatives and running behavioral health groups, depending on clinic needs. Interns will have the opportunity to supervise psychology practicum students and participate in supervision of supervision curriculum to support enhancing their supervision skills. 

The overarching goal of the primary care psychology major rotation is to train psychologists to provide a full range of clinical primary care psychology services as key members of interdisciplinary healthcare teams.

At the completion of this rotation, trainees will be able to:

1. Rapidly conduct assessments of a patient’s presenting problems to identify short- and long-term goals that align with patients’ values and PCP’s referral requests.
2. Provide appropriate levels of care to all patients ranging from one-time consultations to targeted episodes of psychotherapy/behavioral health interventions to coordinating outpatient mental health care.
3. Provide targeted therapy services inclusive of trauma-informed care and Whole Person Pain initiatives
4. Conduct psychological testing and diagnostic clarification
5. Provide in-patient consultation
6. Function as key members of interdisciplinary teams inclusive of physicians, physician assistants, psychologists, care managers, pharmacists, social work, and tele-psychiatry consultants. 
7. Be familiar with the varied roles that psychologists can have in medical teams and participate with team members in a myriad of ways to improve care for patients and populations.
8. Strengthen clinical supervision skills. Interns are matched with practicum / extern students when available whom they meet with regularly to provide case consultation for primary care behavioral health patients 
   

Behavioral Health Clinic: Interns will see a mix of new and follow-up patients each week. Both in person and telehealth services are provided. After an initial training/observation period, interns will be responsible for conducting the initial consultation, developing an appropriate treatment plan in collaboration with the patient, and coordinating care inside and outside of the clinic. Differential diagnoses and treatment recommendations will be determined together with the supervisor (who will be present during the clinic).

Inpatient Experience: Interns will have opportunities to devote time at the University Hospital at the Anschutz Medical Campus where they will work collaboratively with family medicine residents and attending providers to offer the best care for patients during in-patient hospitalizations. In particular, services such as mental health screening, brief mental health interventions, health behavior change interventions, family meetings, and discharge plans are engaged effectively in this team format. Interns will observe these interactions, act independently, and receive supervision during this learning experience from DFM licensed psychologists.

Professional Meetings/Development: Interns will have the opportunity to attend meetings focused on interdisciplinary primary care, including a weekly telepsychiatry huddle and primary care specific didactics. Interns will also have $2,000 in professional development funds to use toward attending professional conferences throughout their training year. 

Evidence based approaches to treatment are used with an emphasis on Cognitive Behavior Therapy, Behavioral Activation, Motivational Interviewing, Dialectical Behavioral Therapy, and Acceptance and Commitment Therapy. Initial consultations emphasize a case conceptualization that highlights the relationships between a patient’s life context, experience, and symptoms/behavior. Subsequent visits include evidence-based interventions based on collaborative decision-making between patients, trainees, and the clinical supervisor.

 

Our clinics serve patients from diverse cultural backgrounds across the lifespan. Patients most commonly present with depression, anxiety, trauma, adjustment disorder, parenting difficulties, substance use, insomnia, weight loss, and management of chronic pain and other chronic diseases. A large proportion of patients at both sites are affiliated with the University of Colorado Boulder as students, staff, and faculty.

Interns receive regular supervision as stipulated by APA guidelines and the internship program. This includes both formal one-on-one supervision as well as live supervision via the precepting model. The precepting model is a framework for live clinical supervision in which experienced attending psychologists guide and teach interns through a structured framework of patient care and feedback. The attending psychologist provides live supervision during a portion of the intern’s appointment with each patient and is thereby able to provide effective, timely, and focused instruction enhancing the intern’s critical thinking, clinical skills, and overall learning experience.

Working in HPSA designated service areas as a part of their training with the Boulder and Louisville Integrated Behavioral Health and Primary Care major rotation makes interns at these sites eligible for HRSA sponsored Loan Repayment Programs. Students working in HPSA sites also receive priority funding when applying for the National Health Service Corps Loan Repayment Programs. Please see above linked sites for further details.  

Professional disciplines represented at JFK include developmental pediatrics, child psychiatry, clinical psychology, social work, speech and language pathology, occupational therapy, and special education. JFK Partners is affiliated with Developmental Pediatrics at Children’s Hospital Colorado and all clinical work is completed within Developmental Pediatrics.

JFK Partners is also actively involved with community agencies to address the needs of persons with IDD. Faculty at JFK Partners hold appointments in the Departments of Psychiatry and Pediatrics.

The JFK Partners Autism and Developmental Disabilities Clinic, a component of Developmental Pediatrics/JFK Partners, provides a variety of interdisciplinary clinical services to persons of all ages. The Clinic provides a full range of clinical services, including disciplinary and interdisciplinary evaluations, consultation, therapies, and clinical research activities.

JFK Partners is a university based interdisciplinary training program with a commitment to the following goals for psychology trainees:

1. Teach trainees about the needs and strengths of persons with IDD  and their families.
2. Teach trainees a variety of specialized clinical skills for supporting persons with IDD , including psychological assessment, psychotherapy and consultation.
3. Teach trainees to work in an integrated fashion with members of an interdisciplinary clinical team.
4. Foster development of leadership skills and scholarly activities related to the field of IDD.
5. Introduce trainees to values involving inclusion, family and individually centered care, health equity, advocacy, and self-determination for persons with IDD.

Objectives:

1. The psychology intern will learn to administer (or gain mastery with) a variety of cognitive, academic and adaptive assessments for individuals with IDD, including ASD (ages 15 months – 21 years).  
2. The psychology intern will learn to administer (or gain mastery with) gold standard autism assessment measures with individuals aged 15 months–21 years.   
3. The psychology intern will apply the basic tenets of evidence-based interventions to:
   1. Design teaching and educational strategies for persons with IDD to develop new skills
   2. Focus on strengths of the individual and how to best capitalize on these abilities as a means of forging positive social connection and supporting school and community participation
4. The psychology intern will learn to assess the complex co-occurring psychiatric needs of individuals with ASD/IDD, as well as deliver evidence-based interventions (individual, group, and family).
5. The intern will receive training on Facing Your Fears – a CBT group therapy program for managing anxiety in children with ASD, The psychology intern will co-facilitate  a Facing Your Fears group for autistic youth without intellectual disability (ages 8-14) and a research group of Facing You Fears adapted for autistic teens with intellectual disabilities (ages 12-18). The psychology intern will work on an interdisciplinary team with members from other disciplines, including occupational therapy and speech/language pathology, and child psychiatry to evaluate and treat persons with IDD, and to provide comprehensive oral and written feedback to family members. The psychology intern will support residents from the Departments of Family Medicine and Psychiatry to gain knowledge around Autism evaluations while rotating through the interdisciplinary team in addition to collaborating with the resident on interview skills for the assessment of mental health conditions
6. The psychology intern will complete a scholarly project in collaboration with a supervisor on a topic related to ASD/IDD.

Facing Your Fears (CBT group intervention for treating anxiety in youth with ASD): The intern will co-facilitate at least one Facing Your Fears group.​​

Monthly Developmental Pediatrics Research Didactic seminar focused on conducting research related to IDD. This group also generates ideas for new research projects and presents findings from ongoing projects.

Monthly discussion/meetings within the wider Developmental Pediatrics clinic in which recent research projects/contributions to the literature are discussed.

Core LEND curriculum focusing on the assessment and treatment of ASD/IDD. This coursework is required for some trainees, but not for psychology interns. Some specialty topics and presentations may be of particular interest to interns (e.g. Sensory and Motor Interventions; Complementary, Alternative and Integrative Medicine; Sleep Disorders in Children with Special Needs, etc.) and are available for interns to join.

Monthly ADOS reliability meetings within the Developmental Pediatrics community.

There are a variety of seminars, courses, and lectures provided by the UCEDD as a whole and available to any of the trainees. While some courses are required for interns (e.g., Key Concepts, Leadership Dialogues) as part of the LEND training program, other course are optional (see optional activities tab).

We use a mix of theoretical approaches, including cognitive-behavioral, developmental, and family systems theoretical orientations. Additionally, a major philosophy of JFK Partners is to promote culturally responsive, family focused interventions in inclusive settings. Each intern also becomes familiar with positive behavioral approaches for growth and change.

• Interdisciplinary and disciplinary diagnostic services
• Positive behavioral methods for skill building and behavior management
• Cognitive/behavioral therapy (individual and group-based)

The people referred to JFK Partners are of all ages, from infancy to adulthood, with a diagnosis (or a question of a diagnosis) of a developmental disability. There is a focus on diagnosis and treatment of people with autism spectrum disorder. JFK Partners serves people with IDD throughout the Rocky Mountain region, both urban and rural settings, with a variety of racial/ethnic backgrounds and with varying access to social and economic resources.

The intern receives supervision for all clinical activities, including psychological assessment and psychotherapy  Two. psychology faculty members are on site at JFK Partners (Drs. Judy Reaven and Audrey Blakeley-Smith) and three psychology faculty members are on site within Developmental Pediatrics (Drs. Lisa Hayutin, Lindsey DeVries, and Caitlin Middleton).

Assessment supervision is shared by several primary faculty supervisors (Drs. Judy Reaven and Audrey Blakeley-Smith). The intern will be supervised for 6 months by each of these supervisors. Supervision for assessments averages 1 ½ - 2 hours per evaluation, not including live supervision during the assessment itself. Supervision covers preparation for the assessment, review and interpretation of data, and written and oral reporting in addition to live support in co-administration of certain assessments.

Psychotherapy supervision is generally provided by one supervisor for the entire year, 1 hour per week. Live supervision is an important components of the supervision and faculty may observe telehealth sessions lives as well.  Each intern may participate in a psychotherapy group supervision (e.g., Facing Your Fears). Finally, interns are also able to help support the supervision of psychology externs on the team.