CHA Psychology Postdoctoral Options for 2024-2025
Option I: Adult Neuropsychology (two years)
Option II: Primary Care-Behavioral Health/Family Medicine
Option III: Child and Adolescent Acute Services
Option IV: Adult Psychodynamic Treatment in the Program for Psychotherapy
Option V: Adult Psychotherapy/Psychological Assessment Services
Option VI: Treatment of Early Psychosis/Adult Psychotherapy
Option VII: Adolescent Risk Assessment and Violence Prevention
Option VIII: Mindfulness and Psychotherapy
I: Adult Neuropsychology Service
This two-year program provides intensive training in clinical neuropsychological assessment at the Neuropsychological and Psychological Assessment Service (NAPA) in the psychiatry department at CHA. Our objective is to provide intensive training in the neuropsychological assessment of a range of adult outpatient populations with primary neurological, medical, psychiatric, and developmental disorders. Outpatient referrals stem from neurology, primary care, and psychiatry divisions, and include evaluations of patients who present with a variety of neurological disorders, such as dementia, movement disorders, head trauma, seizure disorders, vascular disorders, metabolic disorders, and sleep disorders. Psychiatric referrals include mood, anxiety and psychotic disorders, as well as complex trauma, and polysubstance abuse. Patients with neurodevelopmental disorders such as learning, attention-deficit/hyperactivity, and autism spectrum disorders are also evaluated. We conduct brief neuropsychological screens in primary care. There is also a minor rotation of inpatient neuropsychological evaluations (medical-surgical, psychiatric, geriatric units). Fellows sometimes work on an assessment team with psychologic assessors to coordinate patient care and integrate comprehensive assessments. The majority of our patients are from ethnic, racial and culturally diverse backgrounds, and fellows develop strong skills in multicultural neuropsychological assessments and work with medical interpreters as needed.
The neuropsychology training program adheres to guidelines proposed by the Joint Task Force of Division 40 of the APA and the Houston Conference on Specialty Education and Training in Clinical Psychology to meet eligibility requirements for ABPP Board Certification in the specialty of Clinical Neuropsychology. To meet these goals, fellows conduct two outpatient evaluations per week, and one to two cognitive screens per week. They receive two to three hours of supervision weekly. They also have the opportunity to engage in a cognitive remediation rotation. They complete various intensive seminars over the course of two years within the hospital and Harvard Medical. First year seminars include adult neuropsychology, and a clinical case seminar (using a fact-finding method). In their second year, fellows participate in a neurology rotation in which they shadow a neurologist in clinic. They also participate in a brain-cutting seminar, a case seminar, Psychiatry Grand Rounds, and a joint virtual lectures series between Cambridge Health Alliance and the Boston VA neuropsychology programs. The wider Harvard Medical School system provides fellows with other diverse didactics. Opportunities for advanced training in psychological assessment are also available and multidisciplinary interaction with psychiatry, neurology, and geriatrics is typical. The program, consistent with its scientist practitioner approach requires the fellow to participate in at least one research project culminating in a publication in a peer-reviewed journal or presentation at a national scientific conference within the two-year training.
II: Primary Care-Behavioral Health/Family Medicine
The fellow in this one-year track will work in the Primary Care Behavioral Health Integration (PCBHI) Program at the primary care and family medicine clinic in Malden. The fellow will conduct psychiatric intake evaluations, triage to appropriate settings of care, individual and group psychotherapy, multidisciplinary consultation, and warm hand-offs and risk assessment. The fellow will gain experience in assessing and treating patients with a wide range of psychiatric and adjustment issues, as well as promoting behavioral management of chronic medical conditions.
Additional fellowship opportunities include clinical teaching to medical residents and co-leading group medical visits for addictions, chronic pain, weight management, and/or diabetes management. The fellow will attend multidisciplinary medical team meetings at the primary care site, as well as PCBHI team meetings with therapists, psychiatrists, and mental health care partners. The fellow will also attend the Integrated Care and Consult Liaison Seminars, and the Fellows Professional Development Seminar.
III: Child and Adolescent Acute Services
This one-year fellowship consists of rotations on two inpatient CHA inpatient units: The Child Assessment Unit and the Adolescent Assessment Unit, as well as an outpatient rotation in the Autism and Developmental Disabilities evaluation clinic in the Child Outpatient Psychiatry Department. Currently, the child unit (CAU) is a 13-bed locked inpatient unit serving children ages 3-12 and the adolescent unit (AAU) is a 22-bed locked inpatient unit serving adolescents ages 13-19. Both have a patient population that is quite diverse ethnically and diagnostically, and operate within a collaborative interdisciplinary team framework. There is also potentially an option for exposure to the child and adolescent neurodevelopmental units.
While on the inpatient units, fellows serve as the primary clinician for two cases in which they provide individual, family and systems assessment and interventions. Fellows also complete 3-4 psychological assessment batteries during the two inpatient rotations, often including performance (projective), personality, and cognitive testing measures. Supervision emphasizes psychodynamic, attachment, trauma-informed and family systems approaches. Fellows also lead and co-lead therapy groups on each unit, including psychodynamic approaches and utilization of performance tasks to enhance understanding of patient needs in novel group designs.
IV: Adult Psychodynamic Treatment in the Program for Psychotherapy
The Program for Psychotherapy (PFP) fellowship in the Outpatient Psychiatry Department (OPD) of the Cambridge Health Alliance (CHA) is a one-year intensive training program focusing on psychodynamic psychotherapy with attention to both theory and technique as well as both service and training, including consideration of indications for shorter- or longer-term therapy. The fellowship consists of 40 hours per week consisting of 20 patient/clinical hours, 4 hours of individual supervision, 1 hour of group case consultation, 3 hours of seminar time (a PFP reading seminar on theory and technique of psychodynamic psychotherapy, a PFP reading seminar on object relations in psychodynamic theory, and an OPD seminar on short-term psychotherapy), 3 hours of research, 5.5 hours of paperwork/collateral work/seminar preparation, 1 hour of grand rounds, .25 hours per week (once a month) of a precepting meeting, 1 hour per week professional development meeting, and 1 hour a week of an all fellows meeting (which at various times includes administrative issues, in-service training, a discussion with a senior faculty member, and the PFP case conference). Optional seminars and group supervisions are also offered.
V: Adult Psychotherapy/Psychological Assessment Services
This one-year fellowship combines a half-time advanced psychological assessment experience with a half-time psychotherapy experience in the Program for Psychotherapy (please see Option IV above for a description of that program).
In the outpatient placement, fellows provide psychotherapy of adult outpatients for which they receive intensive supervision, as well as the opportunity to participate in seminars in psychotherapeutic technique offered through the Program for Psychotherapy. At the psychological assessment service (NAPA), fellows receive supervision and training in projective and objective assessment techniques within a Therapeutic Assessment model of care and participation in a psychological assessment seminar. Fellows in this rotation have the option of attending a variety of neuropsychological testing seminar offerings. There is also limited opportunity to gain experience in neuropsychological assessment. Assessment frequently requires multi-disciplinary delivery of care and coordination with neuropsychologists of neuropsychological assessments.
Assessment patients for this fellowship include adults with a wide range of psychiatric conditions, including mood and anxiety disorders, severe and persistent psychotic disorders, complex trauma, and polysubstance abuse. Patients with medical, neurologic, and neurodevelopmental disorders such as learning disabilities, attention-deficit disorder, and autism spectrum disorders are also evaluated for co-morbid psychiatric conditions.
VI: Treatment of Early Psychosis/Adult Psychotherapy
TThis one-year fellowship combines a half-time adult psychotherapy experience in the Program for Psychotherapy with a half-time placement in the Recovery in Shared Experiences (RISE) clinic, a multidisciplinary team providing comprehensive, recovery-oriented services to adolescents and adults experiencing a first episode of psychosis and their families. This placement will include experiences in comprehensive intake and diagnostic assessment, evidence-based individual therapy (individualized resiliency training), family therapy and group treatment. An option to participate in ongoing research is also available.
Fellows will also work in the Program for Psychotherapy (please see Option IV above for a description of that service). In this outpatient placement, fellows provide psychotherapy of adult outpatients for which they receive intensive supervision, and also have the opportunity to participate in seminars in psychodynamic therapeutic techniques.
VII: Adolescent Risk Assessment and Violence Prevention
This one-year fellowship consists of specialized training in juvenile risk assessment as well as violence prevention treatment for adolescents and young adults. The fellow selected for this position will provide consultation to the Cambridge Police Department through the Safety Net Collaborative. Safety Net is a partnership between the Cambridge Health Alliance and Cambridge Police designed to integrate mental health services into juvenile policing and has been recognized by the International Association of Chiefs of Police as a promising approach to the prevention of juvenile delinquency.
The fellow will also conduct safety assessments for the Cambridge Public Schools. There are also part-time rotations through the year in the Juvenile Court Clinic in either Lowell or Cambridge. The fellow will provide individual and family therapy through the Child/Adolescent Outpatient clinic at the Cambridge Health Alliance and will conduct at least one group utilizing a violence prevention curriculum developed to address retaliatory violence in youth. There is also an opportunity for research through the ongoing program evaluation of the Safety Net Collaborative. Seminars are available through the Court Clinic, and the fellow will also attend the Professional Development Seminar.
VIII: Mindfulness and Psychotherapy
The Advanced Clinical Mindfulness Fellowship is a one-year fellowship that includes expert clinical training and protected research time focused on the delivery and evaluation of evidence-based mindfulness interventions for mental healthcare. The fellow will work full-time in the Mindful Mental Health Service (MMHS) within the Center for Mindfulness and Compassion (CMC) at Cambridge Health Alliance. CMC is a national leader in research on and implementation of evidence-based approaches to integrating mindfulness and compassion practices into primary and mental health care. The MMHS is an innovative clinical service that offers evidence-based mindfulness interventions as a billable service for hospital patients with emotional and behavioral health needs.
Under expert supervision, fellows will learn to co-lead structured mindfulness-based clinical groups following empirically supported protocols, including Mindfulness-Based Cognitive Therapy and Mindfulness Training in Primary Care. Fellows may assist with other mindfulness groups for specific patient needs, such as Introduction to Mindfulness groups for patients with trauma symptoms, and Alumni groups for patients who completed previous groups and need support to maintain mindfulness skills for mental health.
Fellows will also carry a caseload of approximately 8 individual therapy patients. Individual visits may include supportive and problem-solving sessions for patients in current mindfulness groups, as well as short-term individual therapy following evidence-based MBCT or MTPC individualized protocols. There will be the option to carry some individual cases longer-term throughout the year. Fellows will also conduct two integrative psychiatric intake evaluations/week for MMHS and participate in the MMHS weekly team meeting, which is an interdisciplinary team meeting for clinical supervision and administration. Fellows will have the option to conduct screening assessment and brief interventions as part of the CHAMindWell community mental wellness program. Fellows will participate weekly in a didactic and experiential meditation and psychotherapy certificate course and meet with international experts for mentoring.
This fellowship also includes 20% protected research time. CMC is a national leader in mindfulness-based intervention research, with multiple studies funded by the NIH and other institutes. Fellows will be expected to develop an independent research project throughout the year through opportunities that exist within ongoing research studies at CMC, and/or through the Center’s Quality Improvement Program. Fellows will be encouraged to apply for internal HMS and NCCIH-sponsored research fellowships.