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. This profile was last updated October 30, 2022.
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.
All rotations are two days per week. Briefly, the Consultation-Liaison (CL), Critical Care Medicine, Psychiatry Consultation-Liaison/ED Service, and Trauma 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 10
End Date: June 30 (flexible)
How many hours a week are expected of extern? 16
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 collaboration with medical teams, providing feedback and recommendations for care with goal to address psychological challenges related to medical illness. Research - Students will provide screeners and interventions for Trauma patients with elevated blood alcohol levels upon admission. Ongoing studies include satisfaction with Behavioral Medicine services and entifying personality attributes that are predictive of trauma symptoms. If students want to initiate health psychology research, we are very supportive of this! 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 and Dr. Alexa Hays
4) Women's Health and NICU: OP clinical experience providing screening and assessment of Women's Health patients within a high risk OB/GYN clinic and providing short-term brief therapy as it relates to loss, infertility, high risk pregnancy, or challenges during/after pregnancy. IP clinical experience working with families who have infants in the NICU. Providing clinical intervention and treatment bedside or via telehealth to families who are coping with premature births and potential medical/developmental challenges of newborns. Follow-up with NICU families in our Bright Beginnings Clinic after discharge from Cooper. There is also opportunity to see OBGYN patients in-house during hospitalization with issues related to pregnancy. Groups - Opportunity to develop support groups for PPD, NICU families, coping with loss, etc. Supervisor: Dr. Kelly Gilrain
5) Inpatient Psychiatry: On this rotation externs spend your time on the inpatient psychiatric unit and/or emergency department performing screening, individual therapy, therapeutic groups, and clinical interventions. This rotation serves those with serious mental illness in both the inpatient psychiatric unit and the emergency department. Trainees engage in program development, group therapy, as well as individual therapy on the IP Psychiatry Unit. All patients are voluntary and there are never more than 12 patients on the unit. While in the Emergency Room, there will be opportunity to engage in brief interventions working with a collaborative medical team, brief individual therapy sessions, creating behavioral treatment plans and representing Behavioral Medicine as a whole within the context of a medical team. 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. There are weekly didactics, individual supervision, and group supervision as well as supervision from Licensed Clinical Psychologists and a Post-Doctoral Fellow. Supervisor: Dr. Anastasia Bullock
6) Addictions Medicine/ Behavioral Medicine: Clinical experience with Addictions Medicine patients who present with psychological and addictions concerns that may be acute or chronic in nature. Addictions patients are typically managing substance use disorders with concomitant psychological, social and environmental challenges. Focus on assessment and brief interventions including Motivational Interviewing, behavior modification, and mindfulness-based approaches are learned during this rotation. Be an integral part of a multi-disciplinary team along with the Addictions Medicine Team that includes MDs, APN's, and SW. This rotation was established two years ago and it has been an extremely successful integration of behavioral medicine intervention in a busy medical hospital with the possibility to see follow-up patients in the inpatient or outpatient settings. Rotation may allow for co-facilitation of group-based therapy for patients with chronic pain and comorbid opioid use disorder depending on schedule. Opportunity to support and teach medical students / residents in behavioral medicine assessment and intervention. Supervisor: Dr. Aly Ely
7) 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. Dr. Caitlin LaGrotte
8)Psychiatry Consultation-Liaison: This is a new rotation created based on an increased need for interdisciplinary care and the strengthening partnership between Psychology and Psychiatry at Cooper. 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. Further, students will have the opportunity to be part of implementing a new model of care between Internal Medicine and Psychiatry, as well as have the opportunity to address moral distress of primary teams when they are caring for challenging patients. 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. Dr. Anastasia Bullock
9) Trauma and Emergency Department (ED): This rotation will begin with six months on the medical trauma psychology service and transition to six months completing consultation and liaison work in the ED. Cooper University Hospital is an adult Level I and pediatric Level II Trauma Center, verified by the American Plege of Surgeons. The trauma psychology service is dedicated to those patients admitted through the trauma surgery service. Many of these patients present with critical injuries following motor-vehicle collisions, gunshot wounds, abuse, falls, etc. This rotation consists of entifying and serving patients that are at-risk for the development or exacerbation of mental health concerns (e.g., acute stress disorder, post-traumatic stress disorder, adjustment, depression, anxiety, and somatic symptom, etc.). Externs work with patients via bedside assessment, consultation, brief targeted psychoeducation, CBT, ACT, and mindfulness interventions. Trainees also interact with the trauma team and participate in table rounds as needed. Moreover, externs coordinate care with trauma residents, nurse practitioners, and social workers among other health professionals. Supervisor: Dr. Brittany Haage
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. The trainee has the opportunity to develop skills with rapid functional assessments for traditional mental health (including SMI), 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. Wil Skelton
10) Ambulatory Health Psychology: This rotation consists of ambulatory psychotherapy, inclusive of individual and group therapy, with patients with co-morbid medical and mental health conditions (mood and anxiety disorders, compliance, lifestyle choices, sequelae of trauma, coping with medical complications, caregiver stress) at two separate ambulatory locations. On Mondays, externs will have an opportunity to see individual therapy patients and conduct group psychotherapy with a particular focus on poly-trauma at the Ambulatory Psychiatry Chambers Avenue building, and on Friday, externs will have an opportunity to see individual therapy patients and conduct group psychotherapy at the 1011 Main Street and the Ripe Center for Women's Health clinics on the Voorhees campus. Our orientation is predominantly Cognitive-Behavioral, and we use a combination of CBT, ACT and DBT-based interventions. Externs will have the opportunity to collaborate on patient care with multidisciplinary teams and learn case management skills. Dr. Dina Goldstein Silverman and Dr. Jennifer Bush
# of externs to be accepted for 2023-24: 5-6 Consultation/Liaison Service; 1-2 CEEC; 2 Integrated Primary Care; 1 Women's Health; 1 Pediatrics; 1-2 IP Psychiatry; 1 Addictions; 1 Critical Care Medicine; 2 Psychiatry Consultation-Liaison/ED Service; 1 Trauma and Emergency Department (ED); Ambulatory Health Psychology;1.
Minimum level of readiness (any prior experiences or level of training required for applicants: Preferences: MA preferred
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 and Cover Letter indicating which 2 rotations are of interest, faculty you are interested in working with, and any previous Health Psychology experience
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.