Dialectical Behaviour Therapy
Health Psychology/Behavioural Medicine
Long Term Psychotherapy
Schizophrenia and Severe Mental Illness
Other Training Opportunities
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.
Randi E. McCabe, Ph.D. (Clinic Director)
Karen Rowa, Ph.D.
Wendy Freeman, Ph.D.
Martin Antony, Ph.D.,
(Director of Research)
Lisa Bourque, Psy.D.
Susan M. Chudzik, M.Sc.
Richard P. Swinson, M.D.
Linda Cox, M.S.W.
Mark Watling, M.D.
||Anxiety Treatment and Research Centre (ATRC), Charlton Site
The ATRC is an outpatient specialty unit staffed by professionals with a
background in psychology, psychiatry, or social work. The Centre receives
more than 800 new referrals per year, predominantly for individuals suffering
from panic disorder, agoraphobia, social phobia, obsessive-compulsive disorder,
and generalized anxiety disorder. Opportunities are also available for working
with patients who suffer with other anxiety related difficulties (e.g., specific
phobias, posttraumatic stress disorder, hypochondriasis, body dysmorphic disorder,
and trichotillomania). Residents gain experience in clinical assessment using
structured interviewing techniques for anxiety and other disorders, report writing,
liaising with other treating professionals, and individual and group treatments for
anxiety disorders using evidence-based, cognitive behavioural 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 pertaining to their assessment
cases from the previous week. Residents are also expected to become familiar with
the relevant research literature.
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, and biological factors in the etiology
and treatment of anxiety disorders. Opportunities are available for residents to become
involved in ongoing research projects.
For more information about the ATRC, refer to the website: www.stjoes.ca/anxiety
Dialectical Behaviour Therapy
Lisa Burckell, Ph.D.
Amy Wojtowicz, Ph.D.
Marilyn Korzekwa, M.D.
St. Joseph’s Healthcare, Hamilton has
implemented a strategic plan to provide people with
borderline personality disorder (BPD) with an
empirically validated treatment. This treatment is
based on a Dialectical Behaviour Therapy (DBT)
framework, which was originally developed by Marsha
Linehan. DBT is recognized to be an effective best
practice approach that supports both people with BPD
and clinical care teams in providing a consistent
approach to care.
Residents will have the opportunity to provide
time-limited skills training, individual therapy and skills coaching
in an Outpatient DBT program. Residents will learn how to conduct
assessments to diagnose BPD and to assess for the presence of
suicidal and non-suicidal self-injurious behaviors. As part of this
rotation, residents will have the opportunity to attend
interdisciplinary consultation teams and provide additional
training/consultation as needed. In addition, there are
opportunities for participation in ongoing outcome research or other
special interest research projects.
This rotation is designed to teach residents how to
conceptualize and to treat the complex, multi-diagnostic problems
that individuals with BPD experience. Residents will learn and
participate in all four components that comprise outpatient DBT: 1)
individual therapy; 2) skills training; 3) consultation team; 4)
skills coaching. Supervision will focus on 1) case conceptualization
from a DBT perspective, including application of the biosocial model
and behavioral principles, and 2) application of DBT strategies.
After completion of the rotation, residents will possess knowledge
of strategies to work effectively with challenging, complex, and
difficult-to-engage clients in an outpatient setting.
DBT is currently available only as a Major Rotation.
||Michele Laliberté, Ph.D.
Cathy McCutcheon, RN
Kofi Ofosu, M.D.
||Eating Disorders Clinic, Charlton Site
The Eating Disorders Clinic at St. Joseph's Healthcare is the
regional centre for the treatment of adults with eating
disorders in the Central South region of Ontario,
providing consultation and treatment to approximately
100 patients annually. The program offers services to
patients with a range of eating disorders, including
Anorexia Nervosa, Bulimia Nervosa, Binge Eating
Disorder, and the spectrum of disordered eating
understood as Eating Disorders Not Otherwise Specified.
Residents work within a multidisciplinary team including
psychologists, a psychiatrist, a nurse, an occupational
therapist, and a dietician. Residents gain experience in
the assessment of eating disorders, clinical report
writing, individual treatment, and group therapy for
eating disorders (including a CBT based
symptom-interruption group, a family education session,
a body image group, and a DBT based emotion-regulation
The Eating Disorders program is developing a number of research
initiatives looking at factors influencing response to treatment,
relapse prevention, and family factors that contribute to or protect
against the development of eating disorders. Residents are expected
to familiarize themselves with the research literature relevant to
the treatment of eating disorders, and are encouraged to participate
in ongoing research projects.
Mini Mamak, Ed.D.
Heather Moulden, Ph.D.
|| Gary Chaimowitz, M.D.
||Forensic Service, West 5th Campus
The Forensic Service at the West 5th Campus houses a busy 20-bed minimum-security inpatient unit, as well as a 20-bed medium security inpatient unit. There is also a very active outpatient department. On this rotation, residents focus on the intersection of psychological disorders and the criminal justice system, conducting forensic psychological assessments that are used by the multidisciplinary team to inform their recommendations to the court about issues concerning fitness to stand trial and criminal responsibility. Residents also participate in risk assessments, conducted in the context of pre-sentence assessments for the court or for the provincial review board. Residents can expect to assess a broad range of psychopathology on this rotation including Schizophrenia, Bipolar Disorder, Antisocial Personality Disorder, and various other personality disorders and Axis-I conditions. The focus of this rotation is forensic assessment, on occasion opportunities also exist to provide individual treatment or become involved in the Forensic DBT program. The focus of treatment is typically criminogenic risk factors such as, substance abuse or anger management, in order to ameliorate risk. Interested residents have the opportunity to participate in clinical research within the forensic program.
Sheryl Green, Ph.D.
Joseph Pellizzari, Ph.D.
Peter Bieling, Ph.D.
Cindy Kington, R.N.
Patricia Rosebush, M.D.
Carmen Weiss, Ph.D.
|| Charlton Site
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; within both inpatient and
outpatient medical/surgical settings. Training
experiences are negotiated in advance with the
expectation that there will be a combination of general
behavioural medicine consultation along with
opportunities to explore sub-speciality interests
according to resident preferences and supervisory
availability. The following opportunities are
Health Psychology Consultation Service
This is a general consultation service for
those medical inpatients or outpatients requiring psychological
assessment and/or intervention. Our main partner is the
Consultation-Liaison Psychiatry Service. However, referral sources
also include other mental health and medical subspecialty services.
Brief psychological interventions target mood, anxiety,
somatization, adherence, and adjustment-related concerns for the
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 psychiatrists,
psychologists, 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 participate in clinical/research team
meetings. Lastly, residents will participate in an ongoing group
intervention for menopausal symptoms in women based on
Pain Management Centre
Primary Location: Hamilton Health Sciences
Centre (Hamilton General Hospital)
Psychological consultation is offered to
patients of this large, tertiary care, interventional pain
management clinic. Delivery of service is on-site, within the
clinic, in a collaborative care model that includes
anesthesiologists, neurologist, and nurses. Residents on this
rotation will perform psychological consultations and conduct brief
psychological interventions both individually and in the form of
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 inpatient
and day treatment pulmonary rehabilitation programs. This involves
both individual and group-based modalities and working in an
interprofessional model of care that includes respirologists,
nurses, occupational therapists, physiotherapists, social worker,
pharmacist, and respiratory therapist.
Reasons for psychological consultation include
anxiety and mood-related concerns, adherence issues, adjustment
difficulties, and smoking cessation.
Training opportunities are available in
collaboration with the palliative care consultation service. This
interprofessional collaboration involves team-based and individual
consultation for patients (and their family members) dealing with
end-of-life issues. Both inpatient and outpatient opportunities are
available in this emerging area of psychological practice.
The Bariatric Surgery Program is one of four
centres of bariatric excellence in Ontario, providing services such
as pre- and post-surgical care, counseling and weight loss
treatment. Training opportunities exist in all these areas, both
individual and group-based, within the context of an
interprofessional model of care that includes surgeons, general
internal medicine physicians, endocrinologist, psychiatrist, nurses,
social worker, and dietitian.
Long Term Psychotherapy
Sandra McNally, Ph.D.
Ian Smith, Ph.D.
||West 5th Campus
The Long Term Psychotherapy rotation provides
residents with the opportunity to obtain intensive supervision on an
individual psychotherapy case carried for up to one year. Clients
referred to this service are individuals whose circumstances and
symptomatology (e.g., diagnostically complex presentations,
personality psychopathology) are such that long term intervention is
indicated. Therapeutic modalities offered within this rotation
include psychodynamic, interpersonal, experiential, and
schema-focused therapies. Residents in this rotation typically see
1-2 clients once per week (seeing clients twice/week is an option if
indicated) and receive one hour of supervision per week. The goal of
this rotation is to develop residents’ competence in their knowledge
of the theory and practice of long term modalities, and, for those
who have had prior experience in this area, to aid in extending and
refining existing skills.
Long Term Psychotherapy is
available as a Minor Rotation only.
|| Peter J. Bieling, Ph.D.
Ian Smith, Ph.D.
Susan Chudzik, M.Sc.
Gary Hasey, M.D.
||Mood Disorders Service, West 5th Campus
The Mood Disorders Service employs a multidisciplinary team of psychologists, psychiatrists, nurses, social workers, vocational rehabilitation 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 (e.g., personality and intellectual 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 comorbid
mood-anxiety conditions. Residents also have the opportunity to
develop brief relational and schema-focused treatment skills for
patients with co-morbid personality disorders.
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. Current projects involve studying cognitive changes in response to cognitive behaviour therapy vs. pharmacotherapy, the efficacy of mindfulness-based cognitive therapy for relapse prevention in depression, and psychological predictors of chronicity in patients with a first episode of mood disorder.
Jelena King, Ph.D.
Bruno Losier, Ph.D.
Stephanie McDermid Vaz, Ph.D.
Heather McNeely, Ph.D.
Bruce Christensen, Ph.D.
Catherine Dool, M.A.
||West 5th Campus
Options for residency training in clinical neuropsychology include a
Neuropsychology Stream for those candidates who intend
to pursue professional licensure as a clinical neuropsychologists.
Residents with a strong interest in neuropsychology but who do not
intend to declare competence in neuropsychology have the option of
completing a secondary major rotation or a minor rotation in
interested in being considered within the Neuropsychology Stream
should state this intention in their cover letter. The APPIC Program Code
for the Neuropsychology Stream for the purposes of the Match is
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., brain injury, stroke, neurodegenerative),
medical (respiratory, 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.
Neuropsychological services are provided to virtually all SJHH medical
and psychiatric programs. These include but are not limited to: (1)
the Schizophrenia Service, where neuropsychological assessments are
provided as a consultation service for 3 inpatient units and 1
outpatient clinic; (2) the Mood Disorders Program, where
neuropsychological consultation is provided to both the inpatient
unit and outpatient programs; (3) the Community Psychiatry Services,
where neuropsychological evaluations are often requested in the
context of complex diagnostic considerations, as well as the basis
for access to community based support services; (4) the Acute Mental
Health programs, where neuropsychological consultations are
incorporated in the treatment plan and discharge disposition of
patients; (5) The Cleghorn Early Intervention in Psychosis Program,
where comprehensive cognitive and psychological evaluations are
provided for those in the early stages of psychotic illness; and (6)
medical programs such as Respirology, Nephrology, Neurology and
Training provided within the context of the Neuropsychology Stream
meets Division 40 Guidelines for Neuropsychology Training. All
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 in the Neuropsychology Stream will
spend a minimum of 50% of the training year, up to a maximum of 80%
of the training year, in neuropsychology services. Stream
residents will collaborate with
other medical professionals in the implementation of individualized
rehabilitation programs including cognitive remediation and adaptive
skills training for both inpatients and outpatients. New in 2012 –
2013 will be the implementation of cognitive remediation
intervention groups for outpatients of the Mental Health and
Addictions Program. Stream residents will co-facilitate at
least on cognitive remediation group. Stream residents will
also be required to attend weekly neuropsychology didactics and team
triage meetings and will present at least 1 case during the
neuropsychology seminar series. Stream residents will be
expected to participate in longitudinal assessment of patients
undergoing electroconvulsive therapy (ECT) treatment. In
addition, Stream residents will be required to attend a minimum of 5
relevant Neurology/Neurosurgery rounds at the Hamilton General
Hospital, and will have access to human brain anatomy samples for
educational purposes. Stream residents are encouraged to
become involved in ongoing team based clinical research endeavours.
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.
Psychodiagnostic Assessment Opportunities
in the CNS also provide psychodiagnostic assessment services in
consultation to psychiatrists in the Acute Mental Health Programs.
Residents completing a neuropsychology rotation will also be
involved in psychodiagnostic assessment. In this work, the
resident assumes the role of the consultant, answering specific
questions about patients relating to the diagnosis of Axis I and II
factors. Residents will gain experience using a variety of
assessment techniques including structured and semi-structured clinical interviews
(e.g., SCID-I and SCID-II, MINI) and various self-report personality inventories
(e.g., PAI, NEO-PI-R, etc).
Schizophrenia and Severe Mental Illness
||Sandra McNally, Ph.D.
||Suzanne Archie, M.D.
Joel Goldberg, Ph.D.
||West 5th Campus
Community Schizophrenia Service (CSS)
The Schizophrenia and Severe Mental Illness rotation involves
opportunities to work in a number of settings. Primary settings
include: (1) Schizophrenia Services at the West 5th
Campus, a large program that includes inpatient and outpatient
services for individuals with schizophrenia and related problems,
and (2) Community Schizophrenia Services (CSS) a large
interdisciplinary outpatient service affiliated with Schizophrenia
Services and located in downtown Hamilton. Residents will complete
work in both of these settings, and may focus on developing their
skills in psychodiagnostic/personality assessment, and/or
intervention and treatment for both outpatient and inpatient
populations. Residents are encouraged to attend monthly
schizophrenia rounds, as well as applicable conferences and
The inpatient service, located at the West 5th Campus,
offers services in assessment and intervention to 250 adult
inpatients per year who have an established or suspected diagnosis
of schizophrenia or other psychotic disorder. The service is
located on three units: C2, the Assessment and Treatment Unit; A2,
the Psychosocial Rehabilitation Unit; and D2, the Intensive
Treatment Unit. Residents assume the role of consultant, providing
assessment of, personality functioning, personality dynamics, and
provision of diagnosis. Residents are supervised in the
administration, scoring and interpretation of psychological
assessment tools including, most commonly, the MMPI-2, the MCMI-III,
the PAI, and occasionally the WAIS
Training in outpatient treatment takes place
. Under supervision,
residents integrate information from various sources to arrive at a
diagnosis, write clinical assessment reports, and provide assessment
feedback to the interdisciplinary teams. Residents are also offered
supervision in a variety of interventions for patients with
psychotic disorders. Supervision in individual psychotherapeutic
treatment includes oriented cognitive-behavioural, and
interpersonal/insight-oriented approaches. Residents are also
offered the opportunity to co-lead patient education and support
groups, a Hearing Voices Psychotherap y Group, as well as
developing other groups for patients. primarily at
Community Schizophrenia Services (CSS) and the Cleghorn Program for
Early Intervention in Psychosis. CSS is an outpatient programme
affiliated with Schizophrenia Services that serves approximately 600
outpatients with schizophrenia and other psychotic disorders.
Residents are offered opportunities for training and supervision in
conducting psychodiagnostic assessments and individual and group
psychotherapy.. Current research within this program explores the
psychotherapeutic treatment of psychotic disorders, with a
particular focus on the phenomenon of voice-hearing and the role of
Other Training Opportunities
In addition to training opportunities provided in the context of
the residency, residents also have the opportunity to take formal courses such
as psychotherapy or supervision courses through McMaster University's Clinical Behavioural Sciences (CBS) Program, if they are so inclined. Information about the CBS program may be found at: www.fhs.mcmaster.ca/cbs
Return to Top