Description of Rotations
For all rotations, the specific responsibilities of each resident will be determined collaboratively with his or her supervisor, in order to meet the requirements of the core competencies and the resident’s personal training goals.
Major rotations typically require a time commitment of 400 or more hours. Minor rotations typically involve a commitment of between 100 and 400 hours.
Anxiety Disorders
Core Faculty: Karen Rowa, Ph.D., C.Psych.
Randi E. McCabe, Ph.D., C.Psych.
Brenda Key, Ph.D., C.Psych.
Irena Milosevic, Ph.D., C.Psych.
Elizabeth Pawluk, Ph.D., C.Psych.
Jenna Boyd, Ph.D., C.Psych.
Adjunct Faculty: Jennifer Hewitt, Ph.D., C.Psych.
Availability: Major or Minor Rotation
Primary Location: Anxiety Treatment and Research Clinic (ATRC), West 5th Campus
The ATRC is an outpatient specialty unit staffed by professionals with a background in psychology, psychiatry, nursing, occupational therapy, or social work. We receive a high volume of referrals and provide services for a range of anxiety and related disorders including panic disorder, agoraphobia, social anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, and generalized anxiety disorder. Opportunities are also available for working with patients with other anxiety related difficulties (e.g., specific phobias, illness anxiety, hoarding disorder). Residents gain experience in clinical assessment using the Diagnostic Assessment Research Tool (DART; McCabe et al., 2017), a semi-structured diagnostic interview developed by the team here at the ATRC. Residents also engage in report writing, liaise with other professionals, and provide individual and group treatments for anxiety and related disorders using primarily cognitive behavioural treatments. Opportunities to conduct mindfulness-based cognitive therapy are also available. Residents are an active part of the multidisciplinary team that meets on a weekly basis for case conferences. During the case conferences, residents will join in discussions about diagnostic and treatment issues. Residents are also invited to become familiar with the relevant research literature, participate in a weekly journal club, and participate in clinical research when possible.
The ATRC aims to be a welcoming and inclusive space for clients of diverse backgrounds. Residents are encouraged to see clients with broad and diverse backgrounds and actively consider how to adapt evidence-based CBT protocols to best meet the needs of a particular client.
In addition to offering clinical services, the ATRC is among the most active anxiety research centres in Canada. Research interests of clinic staff members include the development of short-term, cost effective assessments and treatments for anxiety, and the investigation of cognitive, behavioural, mindfulness, and biological factors in the etiology and treatment of anxiety and related disorders. Some current projects include validating the DART, evaluating mindfulness-based cognitive therapy as a first-line treatment for Obsessive Compulsive Disorder, and developing a Family Accommodation Reduction program for close others of people with OCD. Resident involvement in ongoing research is strongly encouraged and residents are invited to attend a monthly research meeting at the ATRC to develop and discuss ongoing projects. For more information about the ATRC, refer to the website: www.stjoes.ca/anxiety
Behavioural Medicine Consultation Services
This is a general consultation service for those medical/surgical inpatients or outpatients requiring psychological assessment and/or intervention. Our main partners are the Consultation-Liaison Psychiatry Service, Palliative Care, Complex Care, General Internal Medicine, the Intensive Care Unit, and Renal Transplant. Brief psychological interventions target mood, anxiety, somatization, adherence, and adjustment-related concerns for the medically ill. This rotation is based at the Charlton Site.
Behavioural Sleep Medicine (BSM)
The Behavioural Sleep Medicine rotation provides experiences with patients who have been referred by the Firestone Sleep Medicine Clinic who have insomnia with or without comorbid sleep and mental health disorders. Opportunities exists for learning semi-structured assessments for sleep disorders (e.g., Duke) as well as mental health disorders (e.g., Mini). The resident will engage in training in CBT for Insomnia in both individual and group format. An in-depth understanding and analysis of sleep logs (e.g., Consensus Sleep Diary) will also be part of the experience along with participation in sleep medicine rounds.
Borderline Personality Disorders Services
Core Faculty: Kerri Bojman, Psy.D., C.Psych.
Availability: Major Rotation or Minor Rotation
Primary Location: West 5th Site
The Borderline Personality Disorders Services (BPDS) at St. Joseph’s Healthcare provides outpatient treatment for adults who are diagnosed with borderline personality disorder (BPD). BPDS also provides on-going training and consultation to student learners and health care professionals.
The goals of this rotation are twofold: 1) to learn how to assess, conceptualize, and treat the complex, multi-diagnostic problems that individuals with BPD experience, and 2) to develop a strong understanding and skillful application of DBT. Residents can learn how to conduct assessments to diagnose BPD and common co-occurring disorders such as PTSD, eating disorders, substance use, and mood disorders. Training emphasizes effective risk assessment and management of suicidal and non-suicidal self-injurious behaviours. Residents are expected to co-facilitate a DBT skills group, carry an individual caseload, provide telephone coaching during office hours, and participate in weekly team consultation meetings. Residents who are interested in completing a minor rotation at BPDS would be expected to co-facilitate a DBT Skills group and encouraged to attend team consultation. There may be opportunities for residents to co-facilitate other groups offered through BPDS (e.g., Cognitive Processing Therapy for PTSD), depending on supervisor ability and applicant experience. There may also be opportunities for residents to provide additional training and consultation, depending on current opportunities and applicant experience.
The Borderline Personality Disorder Services also is pursuing a number of research initiatives looking at factors influencing response to treatment, as well as program development and evaluation. Residents are expected to familiarize themselves with the research literature relevant to BPD and DBT, and are encouraged to participate in ongoing research projects.
Chronic Pain Clinic
The Chronic Pain Clinic provides integrated services for adults suffering from various chronic pain conditions, including musculoskeletal pain, neuropathic pain, chronic headaches, postsurgical chronic pain, and complex regional pain syndrome. The clinic is staffed by an interdisciplinary team, including pain physicians, a nurse, a psychologist, a kinesiologist, a social worker, and a dietitian. The clinic places a strong emphasis on the biopsychosocial model for the understanding and management of chronic pain and focuses on working with patients to improve functioning and quality of life. Training opportunities for residents include conducting initial consultations as part of the interdisciplinary assessment to assess patient’s emotional functioning and appropriateness for the self-management for chronic pain group, co-facilitating the self-management for chronic pain group, providing short-term individual cognitive-behavioural interventions to address issues around difficulties coping and adjusting to living with chronic pain, and co-facilitating the orientation sessions for new patients. Opportunities for research may also be available through this rotation.
Concurrent Disorders Outpatient Program (CDOP) and the Young Adult Substance Use Program (YA-SUP)
Core Faculty: Victoria Stead Ph.D., C.Psych. (Supervised Practice)
Availability: Major or Minor Rotation
Primary Location: West 5th Campus, 100 West 5th St.
The CDOP is an outpatient specialty clinic that provides assessment and treatment services for individuals struggling with substance use and other co-occurring psychiatric disorders (e.g., depression, anxiety, post-traumatic stress disorder; referred to as a concurrent disorder). Within the CDOP, resides a specialty clinic targeting the needs of young adults (YA-SUP; ages 17-25 years) with concurrent disorders. Opportunities can be made available for both programs depending on experience and availability. Supervision will be provided by a psychologist in supervised practice. The programs takes a client-centred and harm reduction approach to assessment and treatment of these clients. Residents have the opportunity to complete psychological consultation assessments on a variety of complex clinical presentations, often in collaboration with other team members (e.g., psychiatrists and nurse practitioners). These psychological consultations usually include diagnostic clarification (via psychodiagnostic and cognitive screening measures), specialized case conceptualizations (for primary treating clinicians), and treatment recommendations. From these consultations, residents are then expected to provide specialized feedback to clients regarding the results of their assessments (including communication of diagnoses). Treatment is integrative and often involves many therapy modalities, including motivational interviewing, cognitive behavioural therapy, dialectical behaviour therapy (informed approaches and skills groups), mindfulness, and acceptance and commitment therapy. Measurement-based care is embedded within YA-SUP from onset to discharge with the aim of this to help guide collaborative treatment planning and empower clients in the autonomy of their care.
The CDOP and YA-SUP are staffed by a multidisciplinary team consisting of professionals with a background in psychology, psychiatry, social work, nursing, and community mental health. These programs rely heavily on community partnerships, and there are opportunities for residents to collaborate with different community agencies. Residents are an active part of the multidisciplinary team that meets on a weekly basis for case conferences. During the case conferences, residents are expected to discuss diagnostic issues and treatment recommendations. Residents are also expected to become familiar with the relevant research literature in the areas of substance use and concurrent disorders and youth mental health.
In addition to offering clinical services, the CDOP includes an integrated program of research and evaluation led by faculty members from the Department of Psychiatry and Behavioral Neurosciences at McMaster University and the Peter Boris Centre for Addictions Research. Research interests of the clinical and research staff include conducting innovative empirical research that bridges the gap between science and practice to ultimately identify preventative measures and overall improve evidence-based care. Research collaboration across SJHH clinics is also welcomed. Resident involvement in ongoing research is strongly encouraged.
Early Intervention in Young Adult Mental Health
Core Faculty: Taylor Hatchard, Ph.D., C.Psych.
Caitlin Davey, Ph.D., C.Psych.
Adjunct Faculty: Peter Bieling, Ph.D., C.Psych.
Availability: Major or Minor Rotation
Primary Location: Youth Wellness Centre, 38 James Street South
The Youth Wellness Centre (YWC) focuses on early intervention for youth ages 17-25 years experiencing either emerging or complex and ongoing mental health difficulties, with the goal of rapid access to services, including assessment, treatment, and recovery. The YWC is a youth-based clinic located in the community in downtown Hamilton that is linked both to primary care and community referral sources, as well as to specialized mental health services within St. Joseph’s Healthcare. Our services are intended to ease and expedite access to services and resources, improve continuity and coordination of care, and advocate as well as support youth and their families. Importantly, the YWC is intended to remove barriers to accessing care, and consequently, provides care to many youth from marginalized and underserviced communities, with specific services for transgender and gender diverse (TGD), and racialized youth, and is developing culturally safe services for Indigenous young people. The YWC was created and designed with youth advisory input, including our physical space, services offered, staffing, and engagement with clients. Our program strives to create a space of equity, diversity and inclusion, which we are actively working toward in a variety of ways, including but not limited to regular discussions to support racialized youth, consultation with our youth advisory council, and developing specific services for underserviced communities as described above.
In terms of clinical presentations, residents gain exposure to a wide range of presenting concerns, including mood (e.g., MDD, PDD) and anxiety disorders (e.g., SAD), posttraumatic stress disorder, and emotion dysregulation, as well as a range of symptom severity (e.g., from mild to more severe presentations). As noted above, residents will also gain exposure to a youth from diverse backgrounds (e.g., BIPOC, 2SLGBTQIA+ youth). Residents gain experience in clinical assessment using structured interviewing techniques, report writing, consultation with other treating professionals, and individual and group treatments for youth with an array of mental health concerns using evidence-based treatments. Residents are an active part of the multidisciplinary team that meets on a weekly basis for case conferences. During the case conferences, residents are expected to discuss diagnostic issues and treatment recommendations. Residents are also expected to become familiar with the relevant research literature in the area of early intervention for youth mental health.
In addition to offering clinical services, the YWC includes an integrated program of research and evaluation led by faculty members from the Department of Psychiatry and Behavioral Neurosciences at McMaster University. Research interests of clinic staff members include uncovering the neural correlates of minority stress in sexual and gender minority individuals, improving evidence-based practices for youth, as well as treatments for specific populations such as the TGD and Indigenous communities in Canada. Resident involvement in ongoing research is strongly encouraged.
Eating Disorders
Core Faculty: Michele Laliberté, Ph.D.,C.Psych.
Availability: Major or Minor Rotation
Primary Location: Eating Disorders Clinic, West 5th Campus
The Eating Disorders Clinic (EDC) at St. Joseph’s Healthcare is a specialty outpatient clinic providing multi-disciplinary assessment and treatment to clients with eating disorders. The EDC offers transdiagnostic CBT group treatment for individuals with Anorexia, Bulimia and Other Specified Feeding and Eating Disorders and provides specialized CBT group treatment for individuals with Binge Eating Disorder. Additionally, the EDC also provides individualized Cognitive Behaviour Therapy – Enhanced (CBT-E) to some of the youngest transition-aged youth, aged 16-18. Extended treatment is offered to clients returning from higher levels of care (i.e., day hospital, residential or inpatient treatment) and to clients from the EDC who require longer to recover (for example, because of weight restoration). The EDC also offers group- and CBT-based body image treatment. The majority of assessment and treatment is currently being provided virtually.
Residents will learn to evaluate the severity of eating disorders, including both psychiatric and medical risk that help determine the appropriate level of care for the individual client. In addition to the various eating disorder presentations, residents will gain exposure to a wide range of other psychiatric concerns, and issues of emotion dysregulation or over-control that must be considered in planning treatment. Residents will also gain exposure to clients from diverse backgrounds (e.g., BIPOC, 2SLGBTQIA+ youth), and learn to work sensitively with diversity related to body weight. Residents work within a multidisciplinary team including psychologists, a psychometrist, psychiatrist, social worker, nurse practitioner, and dieticians, and are expected to contribute to weekly team discussions. Residents gain experience in the screening and assessment of eating disorders, clinical report writing, individual and group therapy for eating disorders. Working with other disciplines on the team, residents will also be encouraged to develop a good understanding of both nutrition and medical risks associated with assessment and recovery from an eating disorder.
Fully integrated into the clinical services provided at the EDC are both program evaluation and research initiatives. The EDC has collaborated on a number of projects with the Peter Boris Centre for Addiction Research and the McMaster Children’s Hospital eating disorders program. Research conducted within the clinic has been strongly focused on understanding factors that impact treatment outcomes. Residents are expected to familiarize themselves with the relevant research literature in eating disorders and obesity, and are encouraged to participate in ongoing research projects.
Forensic Psychology
Core Faculty:
- Mini Mamak, Ed.D., C.Psych.
- Heather Moulden, Ph.D., C.Psych.
- Peter Sheridan, Ph.D., C.Psych.
- Bruno Losier, Ph.D., C.Psych.
Adjunct Faculty:
- Gary Chaimowitz, M.D., FRCPC
Primary Location:
- West 5th Campus
APPIC Program Code for the Forensic Stream: 184613
Options for residency training in forensic psychology include a Forensic Psychology Stream for those candidates who intend to pursue professional licensure as a Forensic/Correctional Psychologist. Residents with a strong interest in forensic psychology but who do not intend to declare competence in forensic psychology have the option of completing a secondary minor rotation with the forensic program. Applicants interested in being considered within the Forensic Psychology Stream should state this intention in their cover letter.
The Forensic Psychiatry Program offers comprehensive assessment and treatment services to justice involved individuals with major mental disorders. The program includes one assessment unit, four rehabilitation units, an active outpatient service, as well three specialty clinics (Sexual Behaviours Clinic, Aggression Clinic, and the Brief Assessment Unit). Residents will have an opportunity to contribute to court ordered assessments of criminal responsibility, fitness to stand trial, and presentence risk evaluations. Residents will also have the opportunity to conduct risk assessments for the Ontario Review Board and be involved in individual or group-based treatment including but not limited to Forensic DBT, CBT for psychosis, motivational enhancement, anger management, and substance abuse.
All residents in the forensic psychology rotation can expect to be involved in the assessment of a broad range of psychopathology including Schizophrenia, Bipolar Disorder, Antisocial Personality Disorder, and various other personality disorders and conditions. Residents may also have the opportunity to witness expert testimony, attend review board hearings, and attend correctional settings.
All residents will build proficiency in the assessment of psychopathology, personality, mood, cognitive functioning, risk, and behaviour. Residents will integrate information about the patient’s psychological and psychiatric status to arrive at opinions related to diagnosis, criminal responsibility, fitness to stand trial, risk of recidivism, and be able to speak to individualized risk management and rehabilitation strategies. Residents will hone their report writing and communication skills.
Residents in the Forensic Psychology Stream will spend a minimum of 50% of the training year, up to a maximum of 80% of the training year, with the Forensic Psychiatry Program. Stream Residents will be required to conduct a minimum of 5 court ordered assessments and 5 risk assessments. In addition, stream residents will be required to participate in at least one assessment in each of the specialty clinics. Stream residents will be required to co-facilitate at least one treatment group and take on one individual treatment client. Stream residents will also have the opportunity to attend Forensic Psychiatry didactic seminars. Stream residents are encouraged to become involved in ongoing clinical research endeavours.
Special Qualifications
For those residents who wish to apply to the Forensic Stream, previous relevant coursework/training in forensic assessment and theory is required, as is experience with a broad range of standard psychological and risk related measures.
Health Psychology/Behavioural Medicine
Core Faculty:
- Sheryl Green, Ph.D., C.Psych.
- Joseph Pellizzari, Ph.D., C.Psych.
- Tyler Tulloch, Ph.D. C.Psych (Supervised Practice)
Primary Location:
- Charlton, King and West 5th Campuses
Opportunities for training in health psychology / behavioural medicine occur within several contexts and settings. Patient presentations are typically complex from both medical and psychiatric perspectives. The aim is to develop competency in psychological consultation and brief interventions. One can accomplish this within inpatient medical/surgical settings and outpatient clinics. Training experiences within both general behavioural medicine and sub-specialty clinics are negotiated in advance based on the completion of a major or minor rotation, resident preferences and supervisory availability.
Following is a list of training opportunities available for a resident to consider. If a major rotation in health psychology is considered, resident preferences would be considered along with the following core components; 1) training experiences in a minimum of three clinics/services throughout the year, 2) training with an inpatient population, 3) training in an outpatient clinic, 4) development of consultation skills, 5) individual short-term treatment, and 6) group treatment. A minor rotation in health psychology would be based on resident preferences and supervisor availability and involve 1) development of consultation skills, 2) training with inpatient or outpatient populations, and 3) individual and/or group treatment.
Ontario Structured Psychotherapy West Region
Core Faculty: Matilda Nowakowski, Ph.D., C.Psych.
Peter Bieling, Ph.D., C.Psych.
Caitlin Davey, Ph.D., C.Psych.
Brenda Key, Ph.D., C.Psych.
Colleen Merrifield, Ph.D., C.Psych.
Availability: Major or Minor Rotation
Primary Location: Ontario Structured Psychotherapy West Region, 1 King Street West
The Ontario Structured Psychotherapy (OSP) Program is an innovative, stepped care program that offers publicly funded, measurement-based CBT for depression, anxiety, and anxiety-related problems to adults (18+) across the province of Ontario with a focus on priority populations that often experience barriers to accessing mental health services (e.g., those who are Indigenous, people of colour, 2SLGBTQIA, Francophone). While the program provides evidence-based CBT protocols, individual case formulation and cultural adaptation are emphasized and measurement-based care is incorporated to monitor treatment progress and inform treatment planning. In addition to the provision of care, a key and unique feature of the program is CBT clinician training, including regular individual and group clinical consultation from clinical consultants (i.e., experts in CBT). St. Joseph’s Healthcare Hamilton (SJHH) and St. Joseph’s Healthcare London (SJHC London) are jointly working to oversee the provision of OSP in the West Region of the province (OSP West).
Psychology residents completing a rotation in OSP West gain exposure to a range of presenting concerns of mild to moderate severity, including depression, anxiety (panic disorder, agoraphobia, social anxiety, illness anxiety, specific phobia, GAD), and anxiety-related concerns (PTSD and OCD). As noted above, residents will gain exposure to adult clients from diverse backgrounds. Residents receive training in both brief, semi-structured intake assessments as well as structured diagnostic assessments for more complex clinical presentations and gain experience working within a stepped-care model. Residents gain experience in evidence-based group and individual CBT protocols for depression, anxiety, and anxiety-related concerns (including ERP for OCD and CPT for PTSD) delivered virtually and in-person. Residents also develop their clinical consultation skills through participation in co-clinical consultation of CBT therapists.
Residents are an active part of the multidisciplinary team that meets on a weekly basis for assessment and treatment case conferences. During the case conferences, residents are expected to discuss diagnostic issues, treatment recommendations, and treatment challenges. OSP West integrates program evaluation and quality improvement projects and residents have the opportunity to be actively involved in ongoing projects within the program.
Women's Health Concerns Clinic (WHCC)
The Women's Health Concerns Clinic (WHCC) is a unique outpatient clinic that provides assessment, consultation and treatment for women who are experiencing mood and anxiety problems associated with reproductive life cycle events, including menstrual cycle changes, pregnancy and postpartum periods and menopause. The WHCC also conducts clinical and biological research in these areas. Within the clinic, the team consists of psychologists, psychiatrists, gynecologists, nurses, social workers, mental health counselors, research and laboratory staff, and trainees.
Residents within this rotation will have exposure to various clinical scenarios in women's health and will be able to provide psychological assessments/consultations and brief cognitive behavioural treatments for difficulties that are gender-related. Residents will also participate in ongoing CBT group interventions (e.g., CBT for perinatal anxiety, CBT for menopausal symptoms), in clinical/research team meetings, and in supervision to junior students. Opportunities to be involved in ongoing clinical research projects are present.
Respiratory Rehabilitation
This patient population consists primarily of those suffering from Chronic Obstructive Pulmonary Disease (COPD). Training opportunities include:
- Outpatient psychological consultation with patients attending the Firestone Institute of Respiratory Health (FIRH). The "Firestone" is the regional respiratory service for the City of Hamilton and the Hamilton Niagara Haldimand Brant Local Health Integrated Network (LHIN). Psychological services are delivered within the clinic, on-site, in a collaborative care model;
- Psychological consultation with patients attending the Respiratory Rehabilitation Day Program (RRDP). This involves both individual and group-based modalities and working in an interprofessional model of care that includes respirologists, an occupational therapist, a physiotherapist, a social worker, and a respiratory therapist.
Reasons for psychological consultation include anxiety and mood-related concerns, adherence issues, adjustment difficulties, and smoking cessation. This rotation is located at the Charlton Site.
Mood Disorders
Core Faculty:
- Brenda Key, Ph.D., C.Psych.
- Margaret McKinnon, Ph.D., C.Psych.
- David Grant, Ph.D., C.Psych.
- Caitlin Davey, Ph.D., C.Psych.
Adjunct Faculty:
- Gary Hasey, M.D., FRCPC
Primary Location:
- Mood Disorders Service, West 5th Campus
The Mood Disorders Service employs a multidisciplinary team of psychologists, psychiatrists, nurses, social workers, vocational rehabilitation therapists, recreational therapists and occupational therapists who assess and treat individuals with either unipolar depression or bipolar disorder. Residents gain experience with diagnostic interviewing for mood disorders (both inpatient and outpatient), psychodiagnostic testing (including personality assessment), and individual and group therapy. The primary treatment orientation on this rotation is cognitive behavioural, based on empirically validated protocols for the full spectrum of depression, bipolar disorder, and co-morbid mood-anxiety conditions. Residents may also have the opportunity to be involved in delivering other forms of group therapy (e.g. mindfulness based cognitive therapy, behavioural activation, running therapy, brief emotion regulations skills).
In addition to the clinical service, the mood disorders program incorporates a large, well-funded and internationally renowned research facility that investigates the causes and treatment of mood disorders. The current projects are always changing and residents have the opportunity to collaborate with on-going research.
Multi-Care Kidney Clinic (MCKC) and Home Dialysis Program
The Multi-Care Kidney Clinic provides interdisciplinary care to outpatients with chronic kidney disease (CKD) up until that point when they either start dialysis, receive a living donor kidney transplant, or initiate palliative care. Many CKD patients have comorbid physical and mental health conditions such as diabetes, heart disease, fatigue, insomnia, and depression. CKD patients must adjust to numerous changes to their health and treatment plans as the disease progresses, and face many difficult decisions along the way, including whether or not to start dialysis, and which type to choose.
Residents in this rotation may work with patients before and/or after they initiate dialysis, and may support patients through this difficult transition period. Training opportunities may include: 1) psychological consultation to assess decisional conflict and provide decision-making support to pre-dialysis patients in the process of treatment-related decision-making; 2) brief individual cognitive-behavioural intervention with pre-dialysis patients to decrease barriers to decision-making and/or home dialysis uptake; and 3) brief individual cognitive-behavioural intervention with home dialysis patients (either peritoneal dialysis or hemodialysis) to help manage comorbid mental health problems, including depression, anxiety, insomnia, interpersonal conflict, and adjustment- and adherence-related concerns. Residents may also have the opportunity to accompany the psychologist on home visits to observe therapy provided in the home setting, depending on COVID-19 restrictions. This rotation is based primarily at the King Campus, but may also involve some work at Charlton.
Neuropsychology
Core Faculty:
- Jelena King, Ph.D., C.Psych.
- Christina Gojmerac, Ph.D., C.Psych.
- Heather McNeely, Ph.D., C.Psych.
- Emily MacKillop, Ph.D., C.Psych. ABPP-CN
- Elena Ballantyne, Psy.D., C.Psych.
Adjunct Faculty:
- Abbie Coy, Ph.D., Psychometrist
- Catherine Dool, M.A, Psychometrist
- Margaret McKinnon, Ph.D., C.Psych.
Primary Location:
- Clinical Neuropsychology Service (CNS), West 5th Campus
APPIC Program Code for the Neuropsychology Stream: 184612
The Clinical Neuropsychology Service (CNS) is a centralized consultation service that provides comprehensive assessment of psychological and neurocognitive functioning in a wide range of adult inpatients and outpatients including those with neurological (e.g., stroke, neurodegenerative disease), medical (e.g., respiratory, nephrology, rheumatology, cardiac) developmental (e.g., autistic spectrum, learning), psychiatric (e.g., psychotic, mood/anxiety), and substance abuse disorders. Supervisors in the CNS are actively engaged in both individual and team-based research and the service emphasizes evidence-based practices. Clinical training in the CNS encompasses practicum through to post-doctoral opportunities, and residents may have the opportunity to provide supervision to practicum students and/or undergraduate research students. Resident training is organized sequentially into an outpatient rotation and an inpatient rotation. Residents typically participate in 2 outpatient assessments per week in addition to co-leading an outpatient cognitive remediation group. During the inpatient rotation, residents are immersed in the role of psychologist as consultant in a medical/ psychiatric setting and conduct a variable number of consultations and brief inpatient assessments each week based on clinical demand and case complexity.
Assessment: Neuropsychological services are provided to virtually all SJHH medical and psychiatric programs. These include brief inpatient assessment, comprehensive outpatient assessment, cognitive monitoring of patients receiving Electroconvulsive Therapy (ECT), intellectual developmental disability assessment, and dementia assessment. All residents in neuropsychology will build proficiency in assessing intellectual and academic skills, problem-solving and executive functioning abilities, attention and memory, visual and perceptual construction skills, language abilities, motor functions, mood, personality and behaviour. Residents will integrate information about the patient’s neuropsychological and psychiatric status to arrive at a diagnosis and recommendations for rehabilitation strategies, will sharpen skills in report writing and the communication of assessment results and recommendations to referring agents, patients, and their families. Residents may also have the opportunity to be involved in functional behavioural assessments and behavioural intervention planning within the inpatient rotation.
For those residents with a specific interest in working with an older adult population, there is an opportunity to acquire experience in assessing older adults with and without concurrent mental illness through both outpatient and inpatient rotations. These specialized assessments allow residents to provide input related to differential diagnosis, prognosis, discharge planning, and treatment recommendations.
Faculty in the CNS also provide inpatient psychiatric diagnostic assessment services. Residents will gain experience using a variety of assessment techniques including structured and semi-structured clinical interviews (e.g., DART, MINI) and various self-report personality inventories (e.g., PAI, NEO-PI-R).
Intervention: Opportunities for formal training in evidence-based cognitive interventions include several manualized programs which are aimed at various patient populations. Interventions currently being delivered in the CNS include: Memory Boost, which focuses on memory in adult general psychiatric patients; Memory and Aging (Wiegand, Troyer, Gojmerac, & Murphy (2013), Aging and Mental Health, 17(7), 806-815), which is aimed at healthy, community-dwelling older adults interested in learning about normal age-related memory changes and strategies to improve memory; Learning the ROPES for Mild Cognitive Impairment (Troyer, Murphy, Anderson, Moscovitch, & Craik (2008), Neuropsychological Rehabilitation, 18(1), 65-88) which is aimed specifically at cognitively impaired older adults with or without concurrent mental health disorders. The ROPES program is run by a multi-disciplinary team and includes a family member support component. There is also a MINDful ACTion Group, a modified mindfulness intervention for adults with a psychiatric diagnosis and subjective cognitive impairment, and a Menopause and the Brain group, a cognitive remediation group that addresses changes related to the menopausal transition. For all interventions, there is an opportunity for residents to be involved in formal program evaluation. Stream residents will co-facilitate three rounds of one cognitive remediation group. Specific group opportunities will depend on resident’s prior experience and availability of programming.
Additional Training Opportunities: Residents in the Neuropsychology Stream will spend a minimum of 50%, up to a maximum of 80%, of the training year, engaged in neuropsychology services. Stream residents will be required to attend the CNS triage meetings, Neuropsychology Seminar Series which includes several seminars that are combined with Geriatric Psychiatry Fellowship didactics and Behavioural Neurology didactics, and a minimum of five relevant Neurology/Neurosurgery rounds at the Hamilton General Hospital (via webcast or in person). These additional learning activities are also be available to residents completing a major or minor rotation, but would not be mandatory. All residents will present one clinical case during the neuropsychology seminar series.
Special Qualifications
Options for residency training in clinical neuropsychology include both a Neuropsychology Stream for those candidates who intend to pursue professional licensure as a clinical neuropsychologist, as well as breadth opportunities for general stream residents to complete a major or minor rotation in neuropsychology. Applicants interested in being considered within the Neuropsychology Stream should state this intention in their cover letter. Training provided within the context of the Neuropsychology Stream meets Division 40 Guidelines for Neuropsychology Training. For those residents who wish to apply to the Neuropsychology Stream, previous relevant coursework in Neuropsychological Assessment and Theory is required, as is experience with a broad array of standard neuropsychological tests. Previous coursework in Neuroanatomy is an asset.
Schizophrenia and Severe Mental Illness
Core Faculty:
- Elmar Gardizi, Ph.D., C.Psych.
- Jelena King, Ph.D., C.Psych.
- Heather McNeely, Ph.D., C.Psych.
Primary Locations:
- West 5th Campus
The Schizophrenia and Severe Mental Illness rotation is located within the Schizophrenia and Community Integration Service (SCIS), based at the West 5th Campus. The SCIS is the largest program within the Mental Health and Addictions Services and includes three 24-bed specialized inpatient units and a variety of outpatient services, including the Cleghorn Early Intervention Clinic and the Schizophrenia Outpatient Clinic (SOC) in addition to a transitional discharge / bridging program, four Assertive Community Treatment (ACT) Teams, a Community Treatment Order (CTO) program, centralized rehabilitation services and services devoted to supporting individuals with co-occurring psychiatric illness and intellectual developmental disability. Residents have the opportunity to train in both inpatient and outpatient services, and may focus on developing their skills in intervention and treatment and/or in psychodiagnostic/personality assessment, neuropsychological assessment, and cognitive remediation. Clinical services emphasize evidence-based interventions adherent with the Health Quality Ontario Treatment Standards for Adults with Schizophrenia.
Inpatient Services: The inpatient service offers specialized assessment and intervention to 250 adult inpatients per year who have an established or suspected diagnosis of schizophrenia or other psychotic disorder. The inpatient service is located on three units, Orchard 2, Waterfall 2, Harbour North 2. While working with an interdisciplinary clinical team, residents are an active part of the treatment team, attending weekly team meetings and offering diagnostic consultations and psychological treatment following a Cognitive Behaviour Therapy for Psychosis (CBT-p) approach. Residents are also offered the opportunity to co-lead patient education and support groups. Residents interested in inpatient assessment are supervised in the administration, scoring and interpretation of psychological assessment tools including, most commonly, the Diagnostic Assessment and Research Tool (DART), the Positive and Negative Syndrome Scale (PANSS), the Brief Psychiatric Rating Scale (BPRS) as well as the PAI, NEO-PI-R and the SPQ. Residents integrate information from various sources to arrive at a diagnosis, write assessment reports, and provide feedback to the interdisciplinary teams. Interested residents would also have the opportunity to be involved in cognitive screening and/or depending on their level of background training, comprehensive neuropsychological assessment.
Outpatient Services: Residents outpatient activities occur predominantly within either the Cleghorn Early Intervention Clinic, or the Schizophrenia Outpatient Clinic, both based at the West 5th Campus. Minor or consultation experiences may be available to other outpatient programs within the SCIS on a case by case basis (e.g., consultation to ACTT).
The Cleghorn Early Intervention Clinic provides care to approximately 200 people experiencing early stages of psychosis. Clients may range in age from 16 to 35 years. The interdisciplinary team aims to help clients and their family/friends to identify their concerns and goals, and to develop plans that work on recovering from psychosis. They provide rapid and specialized assessment, treatment and rehabilitation for people experiencing a first episode of psychosis, based on the principles of recovery, and in partnership with clients and their family, while maintaining a leadership position in the field of early intervention. Services include: diagnosis, assessment, neuropsychological testing, Cognitive Behaviour Therapy for psychosis (CBT-p) and common co-morbidities (e.g., mood, anxiety, trauma), occupational and recreation therapy, psycho-education, family support, and peer support. The staff available to support client's recovery plans include: family educators, nurses, occupational therapists, psychiatrists, psychologists, recovery support workers, and recreation therapists. The model of service is recovery oriented. Research is available in the cognitive assessment and prediction of outcome in first episode psychosis.
The Schizophrenia Outpatient Clinic serves approximately 750 outpatients with schizophrenia and other psychotic disorders. While SOC functions on a case management model of care, the clinic adheres to HQO treatment standards, and actively incorporates self-management into standard case management encouraging and supporting clients to be active partners in their care and recovery journey. Residents have the opportunity to function as a psychological consultant, offering both assessment and intervention. Assessment includes psychodiagnostic assessment for complex presentations referred to SOC for specialized consultation, and may also include cognitive screening, or in-depth neuropsychological assessment, depending on the experience and training goals of the resident. Psychologists in SOC provide individual manualized CBT-p as well as integrative psychotherapy to outpatients on a referral basis. Research opportunities are available.
WSIB Specialty Clinic
Core Faculty:
- Stephanie Waechter, Ph.D., C.Psych.
- Samantha Longman-Mills, Ph.D., C.Psych.
Primary Locations:
- West 5th Campus
The WSIB Specialty Clinic provides comprehensive assessment and treatment to individuals with workplace injuries who are experiencing difficulties with functional recovery and returning to work. We are a busy outpatient clinic and receive over 250 referrals annually. Residents gain experience in completing comprehensive clinical assessments using structured and semi-structured diagnostic interviews and self-report measures (e.g., PAI; PCL-5; DASS-21). Opportunities are available for residents to provide evidence-based cognitive behavioural interventions for individuals with trauma and stressor-related disorders, mood disorders, anxiety disorders, chronic pain, and other difficulties. Residents are an active part of our multidisciplinary team and work closely with professionals from other mental health disciplines (e.g., psychiatry; occupational therapy) in providing services. Residents will also liaise with WSIB personnel, community providers, and health care professionals from other streams within the WSIB Specialty Program (i.e., Neurology and Musculoskeletal Programs). Residents will gain knowledge of the relevant legislation and familiarity with the research literature relevant to trauma, posttraumatic stress disorder, and workplace psychological injury. Opportunities for experience with neuropsychological assessment, clinical research, and supervision may also be available, depending on residents’ interests and their level of previous clinical experience.