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SJHH ... / Mental Health & Addiction Services/ Mental Health Services/ Psychology Training/ Psychology Residency Program/ Program Overview

Program Overview

Training Philosophy

The Clinical Psychology Residency Program is committed to a scientist-practitioner approach to education and practice. As such, the training of residents emphasizes the delivery of empirically supported assessment and treatment approaches (e.g., Cognitive-Behavioural Therapy).  Many members of the clinical training faculty contribute regularly to the scientific literature, and all faculty members are committed to keeping abreast of the latest research in their respective fields to inform their clinical practice.

The St. Joseph’s Healthcare Hamilton program is committed to preparing residents to become independent practitioners by offering both breadth and depth of experience. The intensive training experience ensures the development of core competencies required by provincial and state licensing boards by providing residents with a range of assessment and intervention opportunities and exposure to different types of clients and services.

The program also supports the concept of psychologists acting in multiple roles. Psychology faculty and residents have integral positions on multidisciplinary teams, and several programs and services are headed by psychology faculty.  Psychologists and psychological associates at St. Joseph’s Healthcare Hamilton are seasoned clinicians, researchers, managers, educators, authors, and advocates for important professional issues. The Residency Program provides opportunities to participate in a wide range of professional activities and to interact closely with colleagues from a variety of other disciplines.

Training Objectives

The primary objective of the residency program is to provide a comprehensive predoctoral internship training experience that assures the development of adequate levels of proficiency across basic areas of clinical psychology, including assessment, therapy, consultation, attention to issues of diversity and individual difference, professional issues, and clinical research. The following goals and objectives must be met to demonstrate a psychology resident is competent in these areas:

Goal 1:  Develop Assessment and Diagnostic Skills

Objectives for Goal 1:  Residents will produce a minimum of four written assessment reports integrating history, interview information, behavioral observations, and psychometric test data. The reports will include accurate DSM-IV TR diagnoses and provide client specific recommendations.

Competencies Expected for Goal 1:  Competencies expected include:  ability to select appropriate assessment methods, demonstrated of accuracy of test administration, ability to conduct interviews independently, effective listening and observational skills, accuracy of scoring results, accuracy in interpretation of results, usefulness of case conceptualization, quality of written report, appropriateness of response to referral question, integration of empirical/critical thinking based on literature, integration of test data with DSM criteria and usefulness of recommendations based on evaluation results.

Goal 2:  Develop Therapy Skills

Objectives for Goal 2:  Residents will be given opportunities to refine their knowledge and skills in empirically validated psychotherapeutic interventions with a variety of presenting problems.

Competencies Expected for Goal 2: Residents will refine their skills in developing therapeutic rapport, in conducting psychotherapy/behavioural change with clients with a variety of presenting complaints, will demonstrate a theoretical understanding of empirically validated clinical approaches, will practice integrating theory into therapy interventions, will actively participate in the process of determining the most appropriate form of treatment for their patient/client, and if necessary in deciding whether a referral to another agency or service is appropriate.  Residents will also learn to set realistic and objective treatment goals, to use background information appropriately, to select appropriate intervention goals, to pace interventions appropriately and to recognize and respond to crises in an appropriate manner. The ability to self-reflect and discuss issues related to transference and counter-transference is also expected.

Goal 3:  Develop Knowledge of Ethics and Professional Issues

Objectives for Goal 3:  Through didactic seminars and discussion in supervision, residents will understand the application of the APA and CPA Codes of Ethics, and Ontario licensure laws.  Residents will also be provided with opportunities to develop their professional identity, gain an understanding of the multiple roles psychologists may play in an interdisciplinary healthcare setting, and will be provided with information about obtaining employment in professional psychology.

Competencies expected for Goal 3: Residents’ conduct is in compliance with APA and CPA Ethical Principles, and in compliance with Ontario laws. Residents reliably consider ethical issues and are able to identify and raise appropriate ethical concerns, anticipate possible ethical concerns, are able to reason through ethical dilemmas and seek supervision appropriately, and arrive at good ethical decisions.  Residents will also be sensitive to issues of confidentiality. Residents will be active and co-operative members of the clinical team(s) they are assigned to, will engage in efforts to broaden their knowledge base (e.g., readings, workshops), and will reliably consider issues around professional development as these relate to their practice (e.g., boundary issues, gaps in knowledge).

Goal 4:  Develop Knowledge of Issues related to Diversity and Individual Differences

Objectives for Goal 4: Through didactic seminars, assigned readings and discussion in supervision, residents will learn to recognize and address therapist/client diversity, and will learn to recognize the importance of individual differences and the avoidance of stereotyping.  Residents will also be assigned patients/clients representing diverse populations in order to put theory into practice.

Competencies expected for Goal 4: Residents will be aware of and demonstrate sensitivity to issues of diversity (including cultural, language, gender, ethnicity, sexual preference, age, religion, physical and emotional disability).  Residents will reliably consider issues of diversity or individual difference, will demonstrate self-awareness to their limits of competency in this area, and will seek appropriate consultation and/or supervision and additional resources (e.g., readings) to inform their practice.

Goal 5: Develop Knowledge of and Skills in Consultation

Objectives for Goal 5: Residents will understand the role of a psychology consultant in an interdisciplinary healthcare setting. Through formal didactic seminars on interprofessional care, provision of consultation-based activities in the context of all clinical case assignments, and participation in case consultation during interdisciplinary team meetings, residents will enhance their knowledge of the basic principles and skills for providing professional consultation.

Competencies expected for Goal 5:  Residents will demonstrate an ability to establish a consulting relationship with another healthcare professional through both written and verbal mechanisms, will skillfully select appropriate means and/or psychometric measures to answer consultation questions, will be able to skillfully manage the communication requirements (written and verbal) of particular consultation contexts, will skillfully provide feedback and compose recommendations to the referring agent in ways that are clear and easily understood , and will be able to evaluate consultation outcomes.

Goal 6: Develop Skills in Providing Feedback

Objectives for Goal 6: Residents will be given opportunities to develop their skills in providing feedback to referring clinicians, patients/clients and their family members.

Competencies expected for Goal 6: Residents will develop their ability to effectively communicate clinically relevant information (e.g., case conceptualization, recommendations) to referring clinicians and/or patients/clients and their family members. Residents will learn to adapt and modify feedback in a manner that is appropriate for their target audience and will demonstrate an increasingly appropriate amount of independence corresponding to their developmental level.

Goal 7:  Develop Skills in Supervision and Integration of Supervisory Feedback

Objectives for Goal 7:  Through a didactic seminar, assigned readings, and participation in and discussion during clinical supervision, residents will develop an understanding of basic models and methods of supervision.  When possible, residents will be given the opportunity to provide supervision to practicum students and receive supervision on their supervision.

Competencies expected for Goal 7:  Residents will appropriately seek supervision/consultation, inform patients of their training status and supervisor's name, appropriately respond to supervisors feedback/suggestions, demonstrate increasingly appropriate amount of independence corresponding to their developmental level, will integrate supervisor feedback into clinical care, provide appropriate and constructive feedback to their supervisor, be aware of and effectively deal with ethical and diversity issues in supervision, and effectively address and process resistance and boundary issues in supervision. Residents will demonstrate an ability to respond to and integrate supervisor feedback in their professional and skills development across rotations.

Goal 8:  Develop Skills in Clinical Research

Objectives for Goal 8:  Residents will gain familiarity with the various ways in which professional psychologists integrate clinical research into their careers and will participate in research activities during the course of the year.  Half a day per week is dedicated to resident research time, and residents may choose to work on their dissertations, prepare manuscripts for publication, or participate in new research with residency faculty.  Clinical research skills will also be taught through didactic seminars and grand rounds presentations, assigned readings, through the role modeling provided by residency faculty, and through discussions with supervisors.

Competencies expected for Goal 8:  Following the scientist-practitioner model, residents will demonstrate ongoing commitment to expanding their scientific knowledge base and will organize time effectively in order to incorporate clinical research into their learning goals.  Residents will demonstrate high levels of awareness of relevant clinical research and integrate their scientific knowledge base into their clinical practice.  Residents will also display the ability to critically evaluate research identifying strengths and limitations of the relevant literature.  Moreover, residents will demonstrate the ability to communicate clinical research findings effectively in a style appropriate for a variety of different audiences (e.g., to professional colleagues, clients, and their care givers).

Structure of the Program

The Residency Program runs from September 1 through August 31.

The program requires 2,000 hours of supervised practice to be completed over 12 months. Residents work 40 hours per week, with specific hours to be determined by each rotation. Some rotations may require residents to work one evening (e.g., until 8:00 p.m.) per week. Residents spend more than 50% of their time in direct contact with patients; an example of a typical work week is as follows:

• 8 to 10 hours individual therapy

• 2 to 4 hours group therapy (e.g., 1 or 2 groups)

• 6 hours assessment (e.g., 2 to 3 comprehensive assessments) - more if neuropsychology rotation

• 4 hours individual supervision

• 2 to 3 hours multidisciplinary team meetings

• 3 to 5 hours didactic training (weekly seminars, rounds, case conferences)

• 10 to 12 hours preparation, reading, report writing, research

• Individualized Rotation Plans: The residency incorporates a combination of concurrent and sequential rotations, varying in length from four to twelve months. Major rotations may comprise over 50% of the residency year. Sometime before the beginning of the residency, a rotation schedule for the entire year is developed collaboratively between the Training Director, relevant supervisors, and each resident. In other words, rotations are developed flexibly to meet the training goals of each individual resident while at the same time meeting requirements for core competencies.

To ensure adequate coverage of the core competencies, it is recommended that residents complete rotations that offer a range of experiences. Two sample resident schedules are provided below. Descriptions of particular rotations are provided later in this brochure.

Resident 1 (General Stream)

Anxiety: September through April (8 months, full time)
Eating Disorders: September through April (8 months, part time)
Health Psychology/Behavioural Medicine: March to August (4 months, full time)

Resident 2 (Neuropsychology Stream)

Neuropsychology: September through August (12 months, 3 days per week)
Mood Disorders: September through August (12 months, 1 day per week)

Workspace

Each resident will be provided with a central office in the Department of Psychology at the West 5th campus, complete with a telephone, voicemail, and computer with on-line access to high speed e-mail, the internet, and various hospital and library resources.  Although the majority of mental health services are now provided at the West 5th campus, for certain rotations (e.g., Health) residents may spend some time at the Charlton site.  When this occurs, office space will be available at each site on the days relevant to the respective rotations.  In addition, some residents will complete a minor portion of their work at off-site programs (e.g., Day Treatment Hospital, King Street Campus).

Didactic Experiences: Seminar Series

In keeping with the scientist practitioner model of training espoused by St. Joseph’s Healthcare, the residency program incorporates a didactic seminar series to supplement and inform the residents’ clinical rotations.  Seminars are held on a weekly basis for 2 hours and are facilitated by faculty from a number of disciplines.  Scheduled seminar topics are based on current theoretical and empirical approaches to understanding, assessing, and treating psychological disorders, as well as topics related to ethics and professional development.  Residents are required to present a clinical case as part of these seminar series.

Topics for the current seminar series are available at: http://www.stjoes.ca/psychology

Hospital Rounds and McMaster Grand Rounds

McMaster University Grand Rounds

Residents are expected to attend Grand Rounds for the Department of Psychiatry and Behavioural Neurosciences, McMaster University (held in the auditorium at the West 5th campus) at 9:00 AM each Wednesday during the academic year. 

Residents are encouraged to attend Mental Health and Addiction Program Rounds offered through at St. Joseph’s Healthcare. 

Residents are required to present at either Grand Rounds or Mental Health rounds.  Presentations may discuss research on a particular topic (such as the dissertation), or may integrate a case presentation with theoretical and/or empirical literature.

For recent and forthcoming topics, a schedule of McMaster Grand Rounds is available at:   http://psychiatry.mcmaster.ca/news-events/grand-rounds

Workshops and Research Days

The faculty at St. Joseph’s Healthcare periodically organize workshops open to both staff and students.  Faculty and residents regularly participate in the Psychiatry and Behavioural Neurosciences Research Day, held annually in April. This all-day event highlights current empirical findings, giving residents the opportunity to both learn about the latest research as well as present their own work. There is also an annual Education Half Day organized by the Education Coordinating Committee in the Department of Psychiatry and Behavioural Neurosciences that typically focuses on various aspects of clinician-educator development. Clinical programs including Forensics, Mood Disorders, Schizophrenia, and others annually host full day professional development events, and staff and residents are highly encouraged to attend.

Research Opportunities

Residents are provided with a half-day of protected research time per week.  Residents may spend this time working on their dissertation, preparing papers for publication, or they may choose to get involved in research activities within the training program.  Depending on the resident’s interests and experience, opportunities to participate in clinical research projects or to develop new projects are available on most rotations.  Recent research projects involving residents have included studies of: the effectiveness of community-based CBT group for co-morbid mood, anxiety, and substance use disorders; the influence of catastrophic predictions on the course of panic disorder; cross-validation of a risk-assessment instrument in a forensic population; and the construct validity of the Resident Assessment Inventory (RAI).  Residents are required to present a research poster on any topic, or if they choose, a talk, at the Department Research Day.

Supervision

Residents spend a minimum of four hours each week in direct individual supervision, including discussion of clinical cases and professional development, observing and being observed while providing clinical services, and formal case presentations. Opportunities for group supervision also exist in a number of rotations, and residents are encouraged to participate in peer supervision during regularly scheduled resident meetings.

Evaluation

In addition to the regular and constructive feedback residents receive during supervision, formal evaluations occur twice during each rotation – once at the midpoint, and once at the end.

The midpoint review is intended to provide a formal opportunity to review the progress made on learning goals and plans set out at the beginning of the rotation, and identify areas of strength and weakness that can be further developed throughout the remainder of the rotation. Results of the final rotation evaluations will be amalgamated into a comprehensive resident evaluation that will become a permanent part of the resident’s file.  Summaries of the midpoint and final evaluations are sent to each resident’s university to document his or her progress in the internship course.  Residents are evaluated on the following skill and ability dimensions: relationship with patients, knowledge of psychological theory and clinical research, clinical assessment and testing skills, therapeutic intervention, oral presentation, written reports, professional ethics, team participation, professional development, and utilization of supervision and feedback.

Residents also complete evaluations at the end of each major and minor rotation.  Residents evaluate the amount, quality, and availability of supervision, their supervisor’s clinical and research mentorship, their satisfaction with the amount of patient contact they have, the appropriateness of overall time demands placed on them, research opportunities, the quality of the feedback they receive from their supervisors, the quality of the supervisory relationship, the overall quality of the rotation, and its value to their residency experience.  In addition to the formal evaluation at the end of each rotation, residents are encouraged to approach their supervisors with any concerns that may arise. Finally, residents complete evaluations for each of the didactic seminars.

Residents also receive formal didactic training on care quality and program evaluation.

Accreditation

The Clinical Psychology Residency Program at St. Joseph’s Healthcare is accredited as a predoctoral internship in Professional Psychology by the Canadian Psychological Association (through to the end of the 2015 – 2016 training year).  We will be holding a site visit for re-accreditation with CPA in the spring/summer of 2016. 

The program’s accreditation by the American Psychological Association has ended effective the end of the 2014-2015 training year.  At this time APA discontinued accreditation of all non-US based internship programs.  Applicants in American training programs are encouraged to speak with their Director of Clinical Training regarding the equivalency of CPA accredited internship programs.

The program is also a member of the Association of Psychology Postdoctoral and Internship Centers (APPIC) and the Canadian Council of Professional Psychology Programs (CCPPP).

For more information on our accreditation status:

The Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa ON K1P 5J3
Tel: 1-888-472-0657
Web: www.cpa.ca