Advanced Training for Predoctoral Psychology Students
The Division of Behavioral Health at Nemours/Alfred I. duPont Hospital for Children offers a psychology externship for advanced predoctoral students (3rd year students and above) in clinical, school, and counseling psychology. Positions are offered, dependent upon the availability of opportunities and the match of interests between supervisors and applicants. In the Division of Behavioral Health, we serve infants, children and adolescents who are hospital inpatients and outpatients, referred from ambulatory services of the hospital, and the community.
Training & Rotations for Externs
Within the Department of Pediatrics, the Division of Behavioral Health includes psychologists, licensed clinical workers and psychiatrists. We have an APA-accredited Doctoral Internship in Health Service Psychology, and we also offer training through our Postdoctoral Fellowship program. In Psychology, there are over 50 doctoral-level licensed psychologists, psychology residents (interns), postdoctoral fellows and externs. We serve infants, children and adolescents in need of psychological evaluation and treatment.
Our externship positions typically last 9 to 12 months, depending on the needs of the student and clinic. There is no stipend available for externship training. Externship rotations are organized by type of training experience (i.e., intervention, integrated primary care, evaluation rotations). Additional training experiences, such as involvement in group therapy, are available to supplement any training experience so long as the training experiences do not conflict with one another. There is one position per rotation unless otherwise indicated. Externship rotations are one day per week unless otherwise indicated. Students seeking a two-day placement can apply for multiple rotations. In addition to clinical experiences, externs are welcome and encouraged to participate in other educational activities available through our externship program and the hospital, including professional development lectures, didactic seminars and grand rounds.
In March 2020, externs transitioned to a remote training model. Externs across training rotations provided telehealth services with their supervisors as possible. In June 2020, our training program transitioned slowly and carefully to a hybrid model of training where some rotations continue to provide telehealth services, with limited in-person service delivery for certain patients and rotations. In person work is guided by numerous precautions according to the CDC: rigorous sanitization protocols; strict social distancing and masking at all times on clinic/hospital grounds; strict adherence to hand hygiene (facilitated by ample hand sanitizer stations); and strict screening protocols of all patients/families and employees that includes temperature checks upon clinic/hospital entry. Externs are supplied with Personal Protective Equipment, including medical-grade surgical masks and face shields. Supervision meetings are conducted remotely, via FaceTime, Vidyo, Google Duo or another video-based technology. Live supervision/real time direct observation has continued, uninterrupted, through a feature of our telehealth platform. All didactic seminars are held via distance technology. We are proud of the way that our program has been able to maintain high-quality training during this challenging time
Our externship program provides a rich variety of clinical intervention and evaluation experiences, in a range of settings, under supervision by our faculty. Rotations are organized by type of training experience (i.e., intervention, integrated primary care, evaluation rotations), and some rotations include a combination of intervention and evaluation opportunities. Specific days of the week in which rotations are offered is noted where applicable. If a rotation has flexibility for another day of the week, that will be noted in the description.
The Autism Behavior Consultation Clinic (ABC) is designed to provide brief, targeted behavioral services for children with Autism Spectrum Disorder (ASD) or other developmental disorders and their caregivers. Intervention focuses on empirically-based approaches to behavior management and addresses a wide range of behavioral and developmental concerns, including aggression, tantrums, compliance, self-help skills and toileting concerns. Appointments are 60 minutes and therapy focuses on evidence-based, short-term, goal-oriented techniques. This experience often involves coordination with schools and/or other multidisciplinary team members as appropriate.
Externs see patients on Wednesday afternoons and receive both individual and live supervision via one-way mirror. Third year students and above are encouraged to apply. Externs are able to combine this with another rotation for a 2-day placement. Preferred start date is July 2021.
Supervisor: Emily Bernabe, PhD
The Behavior Consultation Clinic (BCC) is designed to provide evidence-based intervention services for children ages birth to 5 years and their parents. Patients present with a wide range of behavioral and developmental concerns that occur in early childhood, including disruptive behavior, separation anxiety, specific phobias, selective mutism, emotion regulation difficulties, sleep problems, toileting concerns, and selective eating. Externs have the opportunity to implement empirically-supported interventions for these concerns in a fast-paced, real-world clinic setting. Clinic runs on Friday mornings from 8 a.m. to 12:30 p.m., with up to six 45-minute visits. Live supervision is provided via a one-way mirror and additional individual supervision is available on an as-needed basis. Friday afternoon is typically used for supervision, telephone coordination with medical and child care providers, and documentation. There are also opportunities to participate in medical resident teaching during clinic.
Rising 4th year students and above are encouraged to apply, externs are able to combine this with another rotation for a 2-day placement. Preferred start date is June 2021.
The Behavioral Developmental Access Clinic (BDAC) is designed to provide externs with experience with a broad range of complex early childhood concerns including medical, behavioral, social, emotional, attentional and developmental challenges in children under the age of 5. Externs will be able to participate in consultation, follow-up/short term therapy, feedback and brief assessment screening visits while learning how to conceptualize complex diagnostic presentations and identify appropriate interventions.
Externs see patients on Wednesday and obtain 3-5 clinic hours per week. Third year students and above are encouraged to apply. Externs are able to combine this with another rotation for a 2-day placement. Preferred start date is July 2021.
Supervisor: Colleen Butcher, PhD
The Clinical Child and Adolescent Therapy rotation provides intervention services for children and adolescents with depression, anxiety and other mood disorders. Patients are typically 8 to 21 years. Externs will gain experience conducting semi-structured diagnostic interviews, administering rating scales, and consulting with schools and outside providers to assist with diagnostic clarity and treatment planning. Externs will then gain extensive experience providing therapy to children, adolescents and families using evidence-based cognitive-behavioral therapy, interpersonal therapy, dialectical behavior therapy and behavioral techniques.
Clinic will run on Thursday afternoons from 1 p.m. to 5 p.m. with up to four, 45-60 minute visits per day. Live supervision is provided via one-way mirror with an additional hour allotted for supervision on Thursday prior to starting clinic. The extern will also have the opportunity to receive supervision from Psychology Fellows who are also working in clinic.
Fourth year students and above are encouraged to apply, externs are able to combine this with another rotation for a 2-day placement. Preferred start date is June or July 2021.
Supervisor: Chrissy Cammarata, PhD
This position offers the opportunity to provide therapy (individual, family and group) and consultation (classroom teachers, nursing staff) 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, 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, 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.
Externs will see patients and work with the interdisciplinary team on Wednesday. Externs will be on-site a minimum of 1 day per week. 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. Fourth year students and above are encouraged to apply, externs are able to combine this with another rotation for a 2-day placement. Preferred start date is July or August 2021.
Supervisor: Steven K. Reader, PhD
This externship provides opportunities to complete initial diagnostic evaluations, therapeutic intervention, and consultation services with children and adolescents referred from the Division of Gastroenterology. Presenting conditions include adjustment to organic gastrointestinal diagnoses (i.e., Inflammatory Bowel Disease, Celiac Disease, motility disorders, etc.) and functional gastrointestinal disorders (i.e., functional abdominal pain, Irritable Bowel Syndrome, encopresis, etc.). Externs will gain experience using behavioral, cognitive-behavioral, and acceptance-based strategies within this pediatric population. Potential opportunities to work and/or collaborate with other disciplines in multidisciplinary clinics are available.
Date of rotation is flexible. Placements are available at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., (Monday, Tuesday, last Wednesday of the month) and/or the Nemours duPont Pediatrics, Specialty Care Center, in Deptford, N.J., (Wednesday, Thursday). Third year students and above are encouraged to apply, externs are able to combine this with another rotation for a 2-day placement. Preferred start date is July or August 2021.
Supervisor: Kira Branch, PsyD
The Interdisciplinary Feeding Clinic in the Swank Autism Center provides consultation, evaluation, and treatment for children who present with feeding disorders in the context of previously diagnosed Autism Spectrum Disorder (ASD) or other developmental concerns.. The feeding team includes a pediatric psychologist, speech language pathologist, registered dietician, and pediatric gastroenterologist. Externs in this clinic will have the opportunity to participate in the interdisciplinary feeding consultation clinic, as well as provide evidence-based behavioral interventions for children with chronic feeding difficulties. With supervision, externs will participate in outpatient behavioral feeding therapy sessions, which include a combination of direct service and parent training to address feeding concerns. There will also be opportunities for co-treatment with other providers and consultation with other members of the patient’s care team (e.g., developmental medicine, gastroenterology, etc.). Additionally, ther will be opportunities to complete both evaluations and follow up via telehealth.
The preferred day for this rotation is Tuesday. Extern will obtain 4-5 hours per week. Live supervision will be provided via one-way mirror. Third year students and above are encouraged to apply. Externs are able to combine this with another rotation for a 2-day placement. Preferred start day is August 2021.
Supervisor: Allyson Davis, PhD
Parent-Child Interaction Therapy (PCIT) is an empirically-supported dyadic treatment that is considered the "gold standard" for moderate to severe disruptive behavior problems in young children. Externs on this rotation learn how to provide PCIT to young children (2-6 years old) with disruptive behaviors and/or emotional concerns and their caregivers. Training in the implementation of PCIT with fidelity is provided in accordance with PCIT International standards for certification, and it is sometimes possible for externs to become certified in PCIT upon completion of the rotation. On occasion, PCIT modifications and/or other evidence-based treatments may also be offered in conjunction with standard PCIT, as children may also present with anxiety, emotion regulation difficulties, attention concerns, and toileting/sleep concerns.
The externship day begins at 11 a.m. on Mondays with group supervision, followed by clinic Monday afternoons from 1-5 p.m. Live supervision via one-way mirror is provided throughout clinic, and individual supervision can also be provided as needed. This experience often involves coordination with schools and/or other multidisciplinary team members as appropriate. Dates for this rotation will be Monday afternoon. Externs can obtain up to 4 hours per week of intervention experience. Advanced 4th and 5th year students are encouraged to apply, this experience can be combined with another to create a 2-day placement. Preferred start date is June 2021.
This externship provides specialty training in providing trauma-based consultation and evidence-based, trauma-informed intervention. The extern will receive training and supervision in Body Safety, which is an abbreviated form of trauma-focused cognitive behavioral therapy (TF-CBT) for youth and families with unsubstantiated/unfounded allegations of abuse, ongoing contact with alleged initiator, or mild symptoms of posttraumatic stress. The extern will also have the option to work with children under the age of 12 exhibiting problematic sexual behaviors, if interested.
This rotation can occur on Tuesday, Wednesday, or Thursday. A typical caseload may include 2-3 trauma consultations a month, as well as 2-3 weekly Body Safety cases for 3-4 clinical hours a week. Participating in group supervision with fellows and residents, as well as additional trauma-related training opportunities, may be available on Thursdays. Some case management (e.g., contacting case workers, obtaining releases) will be required. Interest in working with this population, students with experience or exposure to trauma-informed work, and third year students and above are encouraged to apply. Preferred start date is August 2021.
Supervisor: Allison Dovi, PhD
Integrated Primary Care Consultation and Treatment
This externship focuses on conducting diagnostic assessments, implementing brief therapeutic interventions, and providing consultation services with professionals at Nemours duPont Pediatrics primary care offices at Foulk Road and Middletown. One full day is spent with clinic patients, focused primarily on short-term, goal-oriented interventions. As of October 2020, externs are treating patients through telehealth, transition to in-person services will occur as space and safety guidelines permit. The patient populations are sociodemographically diverse and includes a wide variety of ages and presenting conditions including behavioral disorders, ADHD, mood disorders, anxiety disorders, elimination disorders, developmental delays, learning disabilities as well as eating and sleeping difficulties. Externs will gain experience utilizing brief screening measures (e.g., Wide Range Achievement Test-5, Comprehensive Test of Phonological Processing-2) as needed to clarify diagnoses and inform therapeutic and educational interventions when in person care is provided. Externs may also have the opportunity to shadow medical providers, assist with Quality Improvement projects, and present psychology lectures to office staff.
Locations and days in which specific rotations are available are listed below. Fourth year students and above are encouraged to apply. Rotations can be combined with others to create a 2-day placement. Four hours of intervention experience can be expected per week with additional opportunities for shadowing and consultation. Preferred start date is July or August 2021.
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 will assist with test selection and planning, test administration, scoring and report-writing, as well as observing feedback sessions with families. Individual supervision will occur weekly and cover test administration issues, case conceptualization with regards to neuroanatomy and development, and discussion of differential diagnoses. An expectation to participate in didactic experience is also part of this rotation.
This rotation requires two days per week and one day must be Thursday; there is some flexibility with the second day for Dr. Bosenbark. Dr. Freeman's rotation will be Tuesday. The clinical case material, supervision and didactics that comprise this experience are designed to provide a broad introduction to pediatric neuropsychology and to prepare the extern for further training in the area of neuropsychology. Fourth year students and above are encouraged to apply. Preferred date start is July or August 2021.