A Day in the Life of a Clinical Psychology Trainee
A Day in the Life of an Extern - Child Track
My name is Gabriella John and I am a Psychology Extern at Columbia University Irving Medical Center in the Pediatric Oncology, Hematology & Stem Cell Transplantation Track. The externship program provides intensive training in working with children, adolescents, and young adults with medical illness and providing evidence-based interventions to an ethnically and economically diverse pediatric population.
Due to the COVID-19 pandemic, I am currently fulfilling my responsibilities as an extern remotely under the supervision of Dr. Dara Steinberg. A typical “work from home” day includes psychodiagnostic intakes and short-term therapy sessions for patients with a various concerns including adjustment to new diagnoses and treatment, depression and anxiety, and adherence to medical treatment. I have the opportunity to work with a range of team members through providing consultations and rounds. I attend virtual extern lectures on topics that address cultural and economic diversity, psychopharmacology, case conceptualization, manual based treatment approaches, and ethical issues. I participate in weekly supervision with my clinical supervisor where I conceptualize cases, navigate challenges and develop my professional goals. Following supervision, I work on several projects including collaborating with other healthcare professionals to disseminate psychoeducational materials to increase awareness of psychological services and common mental health concerns through seminar trainings and a book chapter. Thus, I spend time reading relevant pediatrics psychology and pediatric consultation literature.
As an extern at Columbia University Irving Medical Center, I am proud to work with patients from economically disadvantaged and marginalized groups in order to bridge the gap between accessibility and inequity and deliver culturally appropriate interventions. Moreover, I value the interdisciplinary team-based approach to treatment and the welcoming and supportive training environment.
A Day in the Life of an Extern - Adult Track
My name is Jacqueline Patmore and I am a psychology extern at the Columbia Center for Eating Disorders at NYSPI/CUIMC. Training at NYSPI/CUIMC offers a unique opportunity to learn about the integration of evidence-based practices and thoughtful, patient-centered care. Each day is full of exciting training experiences provided by people who are genuinely invested in my professional growth. I have access to didactic seminars on a wide range of topics, and attend institutional grand rounds, eating disorders case conferences, research meetings, and specialty trainings on a regular basis.
In terms of clinical work, the Columbia Center for Eating Disorders keeps me busy! I work with patients across inpatient and outpatient settings, providing both group and individual therapy. On a given day, it is likely that I will be doing teletherapy with either a patient with binge eating disorder who is receiving Cognitive Behavioral Therapy (CBT) or a family with whom I practice Family Based Treatment for anorexia nervosa. I feel supported in planning my sessions and delivering various treatment components, but also know that I have flexibility and freedom to develop my own style. Each week, I co-lead at least two group therapy sessions. Currently, these include a CBT and meal support groups. Over the course of the training year, I will rotate through other groups including an Acceptance and Commitment Therapy group and an Interpersonal Psychotherapy group for teens. My typical day also sometimes includes observations of evaluations and psychotherapy sessions conducted by seasoned clinicians who are experts in the field of eating disorders. We debrief on the sessions afterwards. This exposes me to different modalities and styles of treatment. The patient population seen includes adolescents and adults from a range of ethnic and socioeconomic backgrounds, sometimes with co-occurring psychiatric problems (such as symptoms of anxiety or depression).
Every day there is at least one supervisory meeting within the eating disorders program. NYSPI also provides all externs with a peer supervision experience, allowing us a space to get to know each other better and talk about clinical work in a casual, collegial setting. My supervisors are motivating and helpful, encouraging me to ask questions, explore my own countertransference, and consider my clients in a culturally sensitive and comprehensive manner.
My schedule is highly customized to my clinical interests, research goals and desire to gain exposure to certain patient populations. The team at the Columbia Center for Eating Disorders has extended opportunities to be involved with research projects (such as evaluating a program that provides peer mentorship to patients with eating disorders), academic and lay-public publications, and advocacy experiences. I am encouraged to provide various treatments and assessments in Spanish.
Above all, what I have come to value most about this externship is getting to be a part of a team of passionate, innovative, and caring individuals. The researchers and clinicians at NYSPI are leaders in their field, producing groundbreaking research and practicing with the highest level of skill. Yet, they remain extraordinarily humble and focused on providing personalized care with consideration for the individual’s unique needs at the heart of each evidence-based intervention.
A Day in the Life of an Intern - Child Track
I am a Psychology Intern (Child/Adolescent Track) at NewYork-Presbyterian/Columbia University Irving Medical Center (NYP/CUIMC). I am fortunate to be a trainee at Columbia Medical Center, where I have access to resources and opportunities that enrich my education and professional development every day.
The Internship training program at NYP/CUIMC includes mentorship, didactic training and practical experience that draw from a wide array of perspectives and philosophies. The majority of my work involves direct clinical care for child and adolescent patients. These patients have diverse clinical presentations, which the training program ensures by stratifying my caseload between two twelve-month specialty training rotations. I am personally involved in the Child Anxiety and Depression Clinic (CADC) with the Trauma elective and Disruptive Behavior Disorders training rotations, though there are numerous other rotations interns can select from when they begin the program, including School-Based Mental Health, Dialectical Behavior Therapy, and others.
In the CADC training rotation, I work with children and adolescents who experience challenges with mood and anxiety, as well as with reactions to extremely distressing events in their lives. I help these patients learn skills to reach their goals through evidence-based practices, including traditional Cognitive Behavioral Therapy, as well as “third-wave” acceptance-based approaches. In the Disruptive Behavior Disorders training rotation, I work with children and adolescents who experience challenges with attention control, behavioral problems, and anger. Within this training rotation, I am learning new therapeutic techniques, such as Parent-Child Interaction Therapy, and Parent Management Training. I receive extensive training through individual and group supervision for each of these rotations.
A unique aspect of the Internship training program is that I also work with adult patients each week through the adult outpatient clinical services, and through the adult diagnostic evaluation program. These experiences have helped advance my training across the life span, and through the psychodynamic supervision I receive for my adult work, I have learned techniques that allow me to take a more integrative approach to adult therapy.
In addition to my direct clinical work, I attend several weekly didactic training seminars that cover content ranging from psychopharmacology, to professional ethics, to psychodynamic approaches to therapy. One benefit of these seminars is that they are often led by individuals trained in fields other than Clinical Psychology, including Psychiatry, Social Work, and the law. This integration of perspectives from such a diverse set of professional backgrounds in this training program has provided insights into the ways that other professionals conceptualize and help manage psychological distress.
My internship training year at NewYork-Presbyterian/Columbia University Irving Medical Center has been conducted primarily through remote technology. I conduct my patient visits, meet with supervisors, and attend training seminars through remote video conferencing. Though I was uncertain about what this this shift to remote work would mean for my training year, I have been impressed by how well-run the remote training program has been, and how close my cohort of co-interns have become.
My role an intern has been a pivotal experience that has led to considerable growth for me as a professional. I am fortunate to have training that balances breadth across topics and disciplines with depth within key areas of specialization. Perhaps more than anything, I feel fortunate to work alongside co-interns, supervisors, and training directors who consistently make NewYork-Presbyterian/Columbia University Irving Medical Center feel welcoming and supportive.
A Day in the Life of an Intern - Adult Track
My name is Kate Foley, and I am an intern at New York Presbyterian/Columbia University Irving Medical Center on the Adult Track. I am currently rotating through the LGBTQIA+ adult outpatient care program, and I also am a member of the clinic’s comprehensive Dialectical Behavior Therapy treatment team. As an intern at NYP/CUIMC, I carry a psychologically and culturally diverse caseload of eleven adult patients who I treat using a variety of different modalities, work that is supported by a total of nine clinical supervisors. Each of my supervisors is an expert in their discipline, which means that every week, I’m fortunate to receive focused instruction in cognitive behavioral, relational psychodynamic, LGBTQIA+ affirmative, Jungian psychoanalytic, psychodynamic for couples, traditional behavioral, and dialectical behavioral approaches to psychotherapeutic intervention. It is often said that internship year provides each trainee with an opportunity to begin to find their “own clinical voice,” and one of the unique aspects of the training program at NYP/CUIMC is that it intentionally empowers interns to experiment with an array of different theoretical orientations to help us determine for ourselves which framework fits best.
In addition to diverse and intensive supervision, internship at NYP/CUIMC offers opportunities to gain targeted experience in neuropsychological assessment and intake evaluation. All adult track interns participate in a month-long intensive training course at the very beginning of internship year in order to prepare us to administer neuropsychological assessment batteries to clients referred from both inpatient and outpatient settings. Over the course of the year, each intern is assigned approximately four individual testing cases, which are presented and discussed during weekly supervision with professional neuropsychologists. Additionally, all interns participate in a six-month evaluation rotation, during which we conduct comprehensive intake interviews in partnership with psychiatric medical providers, reflecting the split-care treatment approach of the adult outpatient clinic. Working closely with psychiatrists not only provides training in psychopharmacology, but facilitates the development of a holistic understanding of each new patient by contextualizing complex psychiatric presentations through the lens of often equally complex medical histories.
The unique characteristics and opportunities of NYP/CUIMC’s internship program aside, the defining feature of this training year has, of course, been the fact that it has occurred entirely via telehealth. In the span of a few weeks last March, COVID-19 necessitated something of a revolution in the field of psychology. Internship training programs were no exception, and I’ll admit I initially questioned whether or not it would be possible to have the kind of experience on internship I had been imagining over the course of my graduate training. However, after nearly six months as an intern at NYP/CUIMC, I can honestly say that I wake up every day excited to get to work — which, incidentally, is exactly what I was hoping for internship before COVID-19 changed everything. I believe this speaks to the strength and integrity of the program, the dedication of clinic staff, and the flexibility and openness of the training directors to reimagine and then implement a rigorous and exciting curriculum for all trainees under their care. I’m grateful to feel both encouraged to operate with greater autonomy, and consistently supported every step of the way by a group of thoughtful and caring individuals — including my co-interns and other fellow trainees — and I’m looking forward to seeing what the rest of the year brings.
A Day in the Life of a Postdoctoral Fellow - Child and Adolescent Psychology
Michelle Fenesy, PhD
My name is Michelle Fenesy, PhD. I am a Clinical Psychology Postdoctoral Fellow in the Washington Heights Youth Anxiety Center at Columbia University/New York Presbyterian Hospital. I completed my graduate training at the University of California, Los Angeles and my pre-doctoral internship at Weill Cornell/New York Presbyterian Hospital.
As a postdoctoral fellow in Child and Adolescent Psychiatry, my typical day incorporates varied activities across two clinical settings. Three days per week I am housed within the Washington Heights Youth Anxiety Center. There, I deliver individual cognitive behavioral therapy and other evidence-based treatments to individuals ages 16-28 years old with anxiety and co-occurring disorders. The Washington Heights Youth Anxiety Center specializes in providing developmentally and culturally tailored care designed to support patients from the Washington Heights community gain independence as they navigate the transition to adulthood. At this clinic my days include individual supervision, individual therapy sessions, and co-leading therapy groups. I also provide collateral sessions for family members and consult with other providers as well as schools to help effectively support my patients. Once a week I attend grand rounds, featuring renowned scientists, sharing their studies focused on clinical science, developmental psychopathology, and the delivery of culturally relevant treatment. Outside of the Youth Anxiety Center, I work two days a week at one of New York Presbyterian Hospital’s School-based Health Centers, located at a high school in Inwood neighborhood. This setting enables medical providers to easily connect high school students to behavioral health care as indicated. Beyond providing individual therapy to students, my role in the School-based Health Center has an emphasis on outreach and prevention. Another psychologist and I lead webinars for large groups of high school students focused on topics to improve their well-being and functioning (e.g., time management skills for remote learning, coping with stress, improving communication and connection during a pandemic). The webinars enable us to reach a broad audience and reduce barriers to accessing care for students who may be interested in receiving treatment. Importantly, I have learned how to frame my knowledge of psychological principles for a general audience through the creation of these webinars, which has resulted in improvements in my communication skills overall. The variety of training experiences across both sites enhances my learning and supports me in becoming a more flexible clinician.
The supervision at the Youth Anxiety Center and School-based Health Center is highly impressive. My supervisors consistently support me in making progress towards my training goals and encourage me to develop my own professional identity. Further, the fellowship is committed to the provision of culturally relevant and responsive care to the primarily Latinx community we serve. Through seminars and supervision as well as interactions with my patients, I have learned about the local community and been able to reflect on my own privilege. This training has enhanced my cultural humility and I expect that I will continue to grow in this regard throughout the year.
Although this is a clinical fellowship, I have been able to initiate a scholarly project given my interest in research. The opportunity to conduct a research project that aligns with my prior work has been an excellent addition to my experience and connected me to additional clinicians and researchers from multiple Youth Anxiety Center sites. The willingness of the training team to help me complete a research project demonstrates their aim of creating an individualized training experience for postdoctoral fellows.
Melissa Manrique, PsyD
My name is Melissa Manrique, and I am a Clinical Child Psychology Postdoctoral Fellow at NewYork-Presbyterian/Columbia University Irving Medical Center (NYP/CUIMC). I primarily work at the outpatient clinic at NewYork-Presbyterian Morgan Stanley Children’s Hospital (CHONY), where I am continuing my training in providing evidence-based treatment to economically, ethnically, and racially diverse children and adolescents, as well as their families. I was drawn to the program’s broad training opportunities within a setting that ensures its services are culturally sensitive and integrated with scientific research.
As a postdoctoral fellow, I take on multiple roles on a weekly basis, providing telehealth services to children and adolescents, as well as their families at the CHONY clinic and School-Based Mental Health Program (SBMHP). At the CHONY clinic, I am involved with the Child Anxiety and Depression Clinic (CADC), specifically with the Tics, Tourette’s and Related Disorders rotation providing evidence-based treatment. I also provide weekly outpatient Dialectical Behavior Therapy (DBT) within the Acute Care rotation to adolescents and their parents through individual and multi-family skills group treatment. In addition to my work at CHONY, I work two days a week at the SBMHP for one of the local elementary schools. The SBMHP offers training opportunities providing a combination of direct, preventive, and outreach services. This program uniquely addresses disparities in health care, allowing me to treat children and their caregivers within their own school system.
In my experience as a fellow, the program is highly dedicated to promoting my professional growth through mentorship, seminars, multidisciplinary team meetings, and a host of rich training experiences. I am highly impressed with the exceptional quality and quantity of weekly individual and group supervision that I receive from several psychologists with varying clinical expertise. I also have the opportunity to attend a professional development seminar series with a variety of panelists and weekly grand rounds led by medical experts. Another appealing aspect of my fellowship experience is a weekly Spanish seminar, where I have the opportunity to further develop my cultural competence and professional identity as a bi-cultural and bilingual-Spanish clinician. As I advance in my clinical training this year, I look forward to deepening my clinical knowledge and enhancing my delivery of evidence-based treatment to diverse patient populations in a welcoming and supportive academic hospital setting.
A Day in the Life of a Postdoctoral Fellow - Adult Psychology
Jenna Hennessy, PhD
My name is Dr. Jenna Hennessy and I am a Clinical Psychology Post-Doctoral Fellow in Midtown NYC within Columbia University Irving Medical Center’s Department of Psychiatry. The fellowship offers me the unique opportunity to continue honing my clinical skills treating individuals with anxiety and mood disorders, while providing the opportunity to develop a broader understanding of personality pathology and integrative treatment approaches.
Throughout my search for a post-doctoral position, I was primarily interested in sites that would foster independent practice while providing the support and structure of a larger healthcare system. The fellowship at Columbia has met and exceeded these criteria by offering a multitude of rich training experiences. The bulk of my clinical work includes treating adults with a range of presenting concerns including anxiety, depression, trauma, interpersonal and relational distress, and difficulties regulating emotions and behaviors. I provide weekly individual outpatient psychotherapy using a variety of evidence-based approaches including Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT). As a post-doctoral fellow, I receive several hours of individual and peer supervision per week to assist in the conceptualization and treatment of these individual cases. I also have the opportunity to supervise externship trainees on individual cases using a DBT framework.
In terms of other forms of treatment, I co-lead several groups including a DBT skills group for LGBT individuals, a stress management group, and a trauma-focused skills group for patients within the Columbia Day Program. I enjoy the opportunity to work in collaboration with other staff within Columbia Psychiatry and found that this fellowship emphasizes the multi-disciplinary treatment approach foundational to comprehensive patient care. For example, I attend several team meetings per week with staff from the Columbia Day Program, Smithers Clinic, and Women’s Program focused on case consultation and specific skills development. The training experience is rounded out with a variety of weekly didactics and opportunities to connect with other post-doctoral fellows for a professional development series.
What I value most about this fellowship is the scaffolding put in place to ease the transition from trainee to practicing clinical psychologist. This placement has been ideal in helping foster independent clinical decision making while providing the structure and support of a team-based, academic healthcare setting.