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Department of Psychiatry

Houston, Texas

The Alkek Building at Baylor College of Medicine
Psychiatry
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Core Training Experiences

Outpatient Psychotherapy

Interns provide approximately four hours of psychotherapy per week to outpatient clients through the Baylor Psychiatry Clinic or the Student Counseling Service. This core training experience is intended to offer breadth of training and supervision, providing a balance to the more specialized training obtained at the primary sites. Interns are expected to develop competence in formulating a useful case conceptualization that draws on theoretical and research knowledge and to formulate appropriate therapeutic treatment goals in collaboration with their patients. Because the Baylor Psychiatry Clinic and Student Counseling Service draw from different populations and are structured differently, interns are encouraged to carry an even distribution of cases from these two sources to maximize breadth of training. Occasional opportunities for assessment may arise in either context. Interns have the opportunity to request referrals commensurate with specific training goals and consult with supervisors to assure that they treat a variety of problems and patients.

For breadth of training, intern supervisors for these outpatient cases are typically different from supervisors at their primary training track. Supervisors are selected by interns in consultation with the Training Director and primary track supervisors at the beginning of the internship year, with more available supervisor options than interns. Supervisors include psychologists primarily affiliated with Baylor College of Medicine and providers in the community who have clinical faculty appointments. Supervisor theoretical orientations represent a variety of approaches (e.g., cognitive-behavioral, integrative). The orientation of the supervisor, the interest of the intern and the needs of the patient typically combine to determine the therapeutic approach used in a given case. Over the internship year, interns tend to develop a therapeutic approach that fits their particular background and is further developed through supervision.

Baylor Psychiatry Clinic

The Baylor Psychiatry Clinic of the Menninger Department of Psychiatry and Behavioral Sciences is an outpatient community mental health clinic providing comprehensive assessment and treatment of psychiatric, psychological, and relationship difficulties and offering training experiences for psychiatry residents and psychology interns. A broad spectrum of clinical problems appropriate for outpatient treatment come to the attention of psychology interns in this service, with mood disorders, anxiety disorders, personality disorders, and interpersonal problems being common. The clinic offers experiences in long-term individual psychotherapy as well as short-term intervention. Interns with interest in additional child, adolescent, or family therapy experience may receive referrals from the Child and Adolescent Psychopharmacology Clinic.

Student Counseling Service

Baylor College of Medicine’s Student Counseling Service offers psychotherapy and medication management services to Baylor medical, graduate, and allied health students. Students are offered 12 psychotherapy sessions at no cost to them per academic year. Common presenting problems include depression, anxiety, interpersonal problems, academic difficulties, and adjustment issues. Interns may have the opportunity to gain couple therapy experience.

Secondary Rotations

The main goals of secondary rotation experiences are to provide breadth of training through exposure to content/setting/supervision outside of one's primary track and to foster interns' competence in research. Research secondary rotation offerings vary from year to year but capture a wide array of research areas with many more offerings than interns. At orientation, interns are provided with a list of available research secondary rotations for the training year and are encouraged to contact faculty to find a good "fit" for their secondary rotation based on interest and experience.

Secondary rotation assignments are made by mutual agreement between interns and supervisors (in consultation and with approval of the training director), who then create a learning plan that specifies the nature of the intern's involvement in the research project. To provide an example of the range of topics, recent interns have chosen projects addressing suicidality in eating disorders, mental health barriers to weight management, relationships between children’s media use and eating/activity, evaluation of novel approaches for treatment-resistant depression, evaluation of a school-based intervention for pediatric obesity, anxiety disorder treatment for veterans, cognitive functioning in children with autism, assessment of sleep and suicidal behaviors, Spanish translation of a mental status assessment tool, PTSD intervention for veterans , and evaluation of social-cognitive risk factors of psychopathology in adolescents. The internship expects that each research secondary rotation includes collaboration on a scholarly product (e.g., poster presentation or manuscript for submission), with many interns earning first-author publications from the experience.

In addition to the research-focused secondary rotations, our program also offers a more clinically focused secondary rotation in the Baylor Psychiatry Clinic/Student Counseling Service (SCS). The "Psychotherapy Services Liaison" serves a minor administrative role, assisting with client assignments and monitoring the flow of clientele, as well as a primary clinical role, providing psychotherapy to 2-3 additional outpatients per week and receiving additional supervision for those patients. Interns who may need or desire more therapy experience, perhaps due to being engaged in substantial research on their primary rotation (e.g., Geriatric Mental Health Care and Research track), sometimes consider the Psychotherapy Services Liaison position.

Didactic Experiences

All interns (regardless of track) participate in core didactic experiences that include a full range of topics on assessment, treatment, consultation, diversity and ethics/professional behavior. Interns often attend specialized seminars/conferences as part of their primary tracks as well. The following conferences are regularly scheduled and attended by all interns regardless of training track.

  • Topic Seminar Series: Conducted by departmental faculty, invited faculty and other professionals in the Houston community, this series of seminars covers a broad range of topics areas chosen to offer additional clinical preparation and exposure or because of ancillary interest. Seminars include such topics as psychopharmacology, intervention with specific populations or using specific treatment approaches, supervision and consultation, assessment, forensic issues, professional development, ethical issues, and cultural diversity. This seminar series addresses relevant research as well as clinical application. It is structured such that more introductory topics or topics likely to be encountered during the internship year are scheduled earlier in the year, with topics becoming more specialized as the year progresses. Topic selection is informed by feedback from previous interns.

  • Group Training Director Meeting: Each month interns meet as a group with the Training Director. This time is open to discuss matters that interns feel are important to their training. It is used to clarify administrative procedures, discuss the training program and any issues relevant to training and augment the didactic and research experiences. Matters of professional and career development are also discussed.

  • Peer Supervision Case Conference: This monthly conference consists primarily of case presentations, with discussions of empirically supported interventions, management of challenging clinical issues, and comparative approaches to treatment. Literature relevant to case material may be incorporated in the discussion. Karen Lawson, Ph.D., facilitates this conference.

  • Diversity Case Conference: This monthly conference focuses on case discussions with relevant issues of diversity and individual differences. Mariella Self, Ph.D., and Gina Evans-Hudnall, Ph.D. co-facilitate this conference.

  • Research Conference: This monthly conference provides interns an opportunity to demonstrate the integration of science and practice by presenting and discussing their ongoing or completed research. Interns may use this time for presenting their dissertation research, research secondary rotation research, or to prepare for job interviews or upcoming conference presentations.

  • Grand Rounds: September through May, a weekly grand rounds sponsored by the Menninger Department of Psychiatry and Behavioral Sciences features both research and clinical presentations by Baylor faculty and invited local and national lecturers. A wide variety of topics are offered, varying from year to year.
  • Individual Training Director Meeting: Each intern is scheduled to meet individually with the training director four times per year. These meetings focus on discussion of the intern’s progress, training goals, and feedback about the program; dissertation progress; career goals and post-internship plans; and any other matters of personal importance to the intern.

  • Council of Houston Area Training Sites (CHATS): Seven times per year (Fridays 2:30-4:00 p.m.) the six currently APA-accredited internship programs in the Houston area rotate hosting a didactic presentation focused on issues of professional development or practice, with interns from each of the APA-accredited internship programs (i.e., 30-40 interns) attending.