Psychology Externship

Training & Rotations for External Students

Advanced Training for Pre-Doctoral Psychology Students

Our psychology externship program is geared for advanced pre-doctoral students in clinical/professional psychology. Each year, approximately 10 positions may be offered, dependent upon the availability of opportunities and the match of interests between supervisors and externs. Externs are assigned to one of the core clinical experiences or evaluation rotations. In the Division of Behavioral Health, we serve infants, children and adolescents who are hospital inpatients and outpatients, referred from other ambulatory services of the hospital or from the community.


Training & Rotations for Externs

The Division of Behavioral Health at Nemours/Alfred I. duPont Hospital for Children offers a psychology externship for advanced pre-doctoral students in clinical/professional psychology. Within the Department of Pediatrics, the Division of Behavioral Health includes psychologists and psychiatrists. We have an APA-approved clinical psychology internship. In Psychology, there are currently 16 full and part-time doctoral-level licensed psychologists, seven psychology residents (interns), six postdoctoral fellows and up to 10 extern students. We serve infants, children and adolescents in need of psychological evaluation and treatment.

The patient population includes hospital inpatients and outpatients referred from other ambulatory services of the hospital, or from the community.


Training Overview

Our externship positions typically last 9- to 12-months, depending on the needs of the student and clinic needs. An additional year of externship training may be offered, contingent on faculty approval. There is no stipend available for practicum training. You’ll need to commit at least one eight-hour day per week to practicum training, although many participants elect to commit to two days.

Externs will be assigned to one of the core clinical experiences or evaluation rotations. They will also be welcome to participate in other educational activities available through the hospital — including ethics rounds and grand rounds.

Clinical Experiences

Our externship program provides a rich variety of clinical experiences, in a range of settings, under supervision by our faculty.

 
Behavior Consultation Clinic (BCC)

The Behavior Consultation Clinic (BCC) is designed to provide short-term services for parents and children ages birth to 5 years for a wide range of behavioral and developmental concerns such as parent-child conflict, daycare problems, sleep problems, toileting concerns, and sibling rivalry. Supervision is conducted via a one-way mirror.

Appointments are 45 minutes and therapy focuses on short-term, goal-oriented techniques. There may also be opportunities to participate in resident/medical student teaching. This rotation takes place on Fridays.


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Primary Care

The Primary Care externship focuses on providing brief therapeutic intervention and consultation with professionals, including pediatricians, nurse practitioners, medical residents, nurses and medical students, in a Nemours affiliated primary care office. One full day is spent in clinic, focusing primarily on short-term, goal-oriented interventions.

The experience also includes utilizing brief screening measures (e.g., Wide Range Intelligence Test, Wide Range Achievement Test-4, Comprehensive Test of Phonological Processing) as needed to clarify diagnosis and inform educational interventions.

There may also be opportunities to participate in resident/medical student teaching. The patient population includes a wide variety of diagnoses including behavioral disorders, ADHD, learning disorders, mood disorders, anxiety disorders, elimination disorders, as well as many concerns of early childhood including eating and sleeping difficulties. This rotation takes place on Tuesdays.


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Weight Management Clinic

Year-long externship positions are also available through the Weight Management Clinic. This is a multidisciplinary clinic staffed with physicians, psychologists, nurse practitioners, exercise physiologists and nutritionists. Externs placed with this rotation have the opportunity to work directly with adolescents presenting to our bariatric surgery program, as well as carry outpatient therapy cases.

Clinical work centers around helping children and their families initiate and maintain lifestyle changes, as well as cope with environmental stressors and psychological co-morbidities. Opportunities for pediatric psychology programmatic development and research are also available. This rotation takes place on Wednesdays.


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Psychological Consultation and Therapy for Youth With Cardiac Conditions

This clinic provides psychological consultation and therapy for children and adolescents with congenital heart disease and other heart-related conditions. Common referrals include anxiety or adjustment concerns related to a cardiac diagnosis, adherence to medication and lifestyle change, and attentional/behavioral concerns common among children who had open-heart surgery during infancy.

The extern in this clinic will see four patients one evening per week and will have the opportunity to collaborate with medical professionals in the Nemours Cardiac Center. Opportunities to work with other chronic illness populations within this clinic may also be available. This rotation takes place on Thursdays. This rotation can be a stand alone externship placement or can be combined with another rotation (such as the Diagnostic Evaluation rotation).


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Early Childhood Psychotherapy

As part of the Early Childhood Psychotherapy Rotation, externs provide evidence-based psychotherapy services to young children (aged 2-6) and their families. Common reasons for referral include disruptive behaviors, anxiety, parent-child conflict, attention concerns and emotion regulation difficulties. Treatments provided may include Parent-Child Interaction Therapy (PCIT), exposure-based cognitive behavioral therapy for anxiety, and parent management training using a family-systems approach.

Externs see patients for one half-day per week and will receive live supervision via one-way mirror. This rotation takes place on Monday afternoons and can be a stand-alone externship placement or can be combined with another rotation (such as the Diagnostic Evaluation rotation).


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First State School Externship

This position offers the opportunity to provide therapy (individual, family and group), consultation (classroom teachers, nursing staff), and brief assessment services in a school-based setting for children with a variety of chronic illness conditions.

The First State School at Wilmington Hospital (Christiana Care Health System) is one of the first and only hospital-based schools in the United States dedicated to providing integrated specialized medical and therapeutic care (e.g., nursing as well as psychological, psychiatric, occupational, physical and speech therapies) with traditional classroom schooling.

Physicians may refer kindergarten age to high school age patients to the First State School because of medical necessity. Typical diagnoses of children attending the First State School include diabetes, sickle cell anemia, hemophilia, HIV, kidney and liver disease, asthma, cancer and gastrointestinal disorders. Therapy work is predominantly targeted towards medical adherence, adjustment to illness, coping with stressors and enhancing school academic and social functioning.

There will be opportunities for the extern to consult with the child’s medical team (hospital and school-based), classroom teachers and educational diagnostician (e.g., behavior plans; accommodation plans) and consulting psychiatrist. The extern will be on-site a minimum of 1 day per week (Wednesdays), with the opportunity for up to 2 days per week.


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Stress, Illness and Pain Skills (SIPS) Group

The Stress, Illness and Pain Skills (SIPS) Group is a weekly, 75-minute education and skills-based group serving youths ages 13 and up with chronic illness-related pain. This rotation involves assisting the psychologist with conducting consultations for patients referred to the group, as well as co-facilitating the group with the psychology fellow. Extern responsibilities include assisting with parent and adolescent interview, co-facilitating adolescent group, administering and scoring assessment tools and writing notes. This rotation takes place on Monday afternoons and can be combined with another rotation (such as the Diagnostic Evaluation rotation).


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Soiling, Toileting and Retraining Treatment (START) Group

The Soiling, Toileting and Retraining Treatment (START) Groups is a group treatment program designed to address the needs of families with children with chronic constipation and encopresis ages 5-8. This program uses evidence-based interventions that include teaching specific behavioral skills along with review of medical and nutritional factors related to encopresis. The group offers an engaging platform for goal setting and discussion in a family-based group setting with caregiver and child components. The extern will assist the psychologist with conducting consultations for patients referred to the group and will co-facilitate the child group with the psychology resident. This rotation takes place on Tuedays and can be combined with another rotation (such as the Diagnostic Evaluation rotation).


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Diagnostic Evaluations

Diagnostic Evaluations may include assessment of intellectual functioning, academic achievement, attentional and executive functioning, and personality and behavioral variables that contribute to school, family, social and developmental difficulties.

 
Neurodevelopmental Evaluations

Assessment of neurodevelopmental functioning to assist in understanding the relationship between brain physiology and behavior may also be offered. Participation is expected in testing and interviewing procedures as well as in providing feedback to families and other involved parties like outside professionals and schools.

Case conceptualization, dissemination of findings and report writing will all be addressed. This rotation typically takes place on Wednesdays or Thursdays.


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Neuropsychological Evaluations

This rotation involves completion of neuropsychological testing with children and adolescents presenting with neurocognitive or neurobehavioral difficulties associated with medical, neurodevelopmental or genetic disorders. Test batteries typically include measures of intellectual functioning, attention, memory, language, executive functioning and psychosocial functioning. Externs would assist with test administration and scoring, report-writing and provision feedback to families.

1-on-1 weekly supervision would cover test administration issues,
case conceptualization with regards to neuroanatomy and development, and discussion of differential diagnoses. This rotation requires 2 days per week.


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Concussion Clinic

This rotation involves participation in the Concussion Clinic, a multidisciplinary outpatient clinic for assessment/evaluation of the cognitive disruption from concussion, in addition to appreciating the broader psychological dimensions. Population age is from 2-18, with a mix of etiologies including sports, falls, motor vehicle accidents, bike accidents and the like. Computerized neurocognitive testing is used primarily for the middle school population and older, with paper and pecil batteries and questionnaires for younger patients. The testing provides a monitoring tool in recovery process and contributes to managing return to activity, most notably school, in conjunction with physician/medical team members. Externs are involved in testing, prodiving feedback to families, and devising return plans under supervision. This externship takes place on Wednesday and Thursday.


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Empirically Supported Evaluation and Treatment of Disruptive Behavior Disorders

When participating in Empirically Supported Evaluation and Treatment of Disruptive Behavior Disorders, externs have two primary responsibilities. Students participate in weekly psychological evaluations of children presenting with behavioral, attentional, and/or learning concerns, and are responsible for administering and scoring tests and writing comprehensive evaluation reports.

Tests used include widely used measures of cognitive ability, memory functioning, academic ability, phonological processing and attention ability, as well as standardized behavior checklists. Additionally, students will also assist in concurrent child and parent Conduct Clinic groups. Duties include gathering baseline data, participating as a co-therapist for child or parent groups, and assessing outcome data.

The clinic is scheduled such that evaluations are conducted in the morning (Wednesdays), scoring and writing occur in the early afternoon, and groups are conducted at the end of the day (Wednesday and Thursday 5-7 p.m.). Individual and group supervision is provided.


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Early Childhood Diagnostic Evaluations

This opportunity provides a range of experiences with families with young children, generally 2 years through 6 years of age. Developmental, behavioral, emotional and social concerns are addressed diagnostically using a wide variety of assessment measures. Responsibilities include: caregivier interview, administration of standardized assessment measures, report writing and providing feedback to caregivers. This rotation takes place on Mondays.


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Early Childhood / Primary Grade Diagnostic Evaluations

An externship is also available conducting Early Childhood and Primary Grade Diagnostic Evaluations with children ages birth through third grade. Developmental and behavioral concerns are assessed with the Bayley III, WPPSI-III, WISC-IV, DAS-II, Stanford Binet-5 and a variety of adaptive behavior and social-emotional measures.

Duties include participation in parent interview and child play, administration of standardized assessment measures, report writing and providing feedback to parents. This rotation takes place on Tuesdays.


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Autism-focused, Differential-diagnostic Evaluations

This evaluation experience considers the complex diagnostic questions that arise when evaluating for an Autism Spectrum Disorder. Children aged 4 to 18 present with the question of an Autism Spectrum Disorder, but other diagnostic considerations such as mood disorders, behavior disorders, language disorders, cognitive disorders and psychotic disorders are explored as well.

The trainee will gain exposure to the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), projective measures (including the Rorschach Inkblot test), and standardized measures of cognitive, academic, emotional, behavioral and social functioning.

Duties will include conducting parent and child interviews, administration of assessment measures, report-writing and parent feedback. A strong emphasis will be placed on conceptualization considering differential diagnostic questions and a family systems approach. This rotation takes place on Mondays.


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Child and Adolescent Personality Evaluations

The Personality Evaluation rotation serves children ages 6 to 18 years. In addition to measures of intelligence, achievement, memory, learning and attention, this evaluation incorporates standardized and projective measures of child and adolescent personality. Examples of such measures include:

  • Millon Pre-Adolescent Clinical Inventory (MPACI) 
  • Millon Adolescent Clinical Inventory (MACI) 
  • Minnesota Multiphasic Personality Inventory-Adolescents (MMPI-A) 
  • Children’s Apperception Test (CAT) 
  • Thematic Apperception Test (TAT) 
  • Rorschach Inkblot Test 

Externs will learn the administration, scoring and interpretation of instruments, and develop the skill sets necessary to write integrative reports with a large focus on understanding the patient within attachment, family systems and personality conceptualization frameworks. This rotation typically takes place on Mondays.


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The Nemours/Alfred I. duPont Hospital for Children is adding a five-story expansion to enhance our quality of care for our patients and families.

About Our Hospital in Delaware

The duPont Hospital for Children is a multi-specialty, tertiary care teaching institution located on a 300-acre estate in the scenic Brandywine Valley in Wilmington, Del.

As a program participant, you’ll have access to advanced computer systems for patient care activities, electronic mail, word processing, internet access and library research functions. Among the hospital’s amenities for all staff are:

  • free parking
  • park-like setting
  • gym/fitness center
  • on-site child care center for children of staff
  • massage therapy

Learn More About duPont Hospital for Children »


What's Coming in 2014

We’re building a healthier future for kids by expanding our hospital. Opening in 2014, our enhanced hospital will be like no other in the region — designed by and for families.

Learn About Our Expansion »

Contact Us

Meghan Lines, PhD

Director of Externship Training, Division of Behavioral Health
Nemours/ Alfred I. duPont Hospital for Children
P.O. Box 269
Wilmington, DE 19899
(302) 651-4500
meghan.lines@nemours.org

Email is the preferred method of contact.

Apply for Our Externship

Deadline: February 3, 2014

Get details about requirements and submitting your application.


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Resources

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