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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-behaviour therapy). Many members of the clinical training faculty contribute regularly to the scientific literature, and all faculty are committed to keeping abreast of the latest research in their respective fields to inform their clinical practice. St. Joseph’s Healthcare 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 are seasoned clinicians, managers, trainers, 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. 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. 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. A half 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). The Residency Program runs from September 1 through August 31. The program requires 2000 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 follows:
The residency incorporates a combination of concurrent and sequential rotations, varying in length from three to twelve months, allowing residents to follow some patients on a long term basis in predominantly intervention-focused rotations, but also affording them the opportunity to become immersed in more intensive, short-term rotations in assessment and diagnosis. Some time 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. 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 1Schizophrenia: September through August (12 months, half time) Mood Disorders: September to February (6 months, half time) Neuropsychology: March to August (6 months, half time) Resident 2 Anxiety: September through February (8 months, full time) Eating Disorders: March to August (4 months, part time) Health Psychology/Behavioural Medicine: March to August (4 months, part time) Workspace Each resident is assigned an office, telephone extension, and computer with on-line access to high speed e-mail, the internet, and various hospital and library resources. For residents who have concurrent rotations that require them to divide their time between the Charlton site and the Centre for Mountain Health Services, office space will be available at each site on the days relevant to the respective rotations. Some residents also complete minor rotations in other centres that are affiliated with McMaster University, but are not part of St. Joseph’s Healthcare. For example, as part of the Health Psychology/Behavioural Medicine rotation, residents may be involved in a half day pain management intervention program at Hamilton Health Sciences. Didactic ExperiencesSeminar 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: www.stjoes.ca/psychology Hospital Rounds and McMaster Grand Rounds Residents are encouraged to attend weekly Clinical psychiatry educational rounds held at the Charlton site every Thursday at noon (organized by the Mental Health and Addictions Program at St. Joseph’s Healthcare). Rounds are presented by psychologists, psychiatrists, social workers, and other professionals, both from within St. Joseph’s Healthcare and from elsewhere. Residents are also encouraged to attend Grand Rounds for the Department of Psychiatry and Behavioural Neurosciences, McMaster University (also held at St. Joseph’s Healthcare, Charlton Site) at 9:00 AM each Wednesday during the academic year. Residents are required to present at either Clinical Psychiatry or Grand 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: www.fhs.mcmaster.ca/psychiatryneuroscience/education/psych_rounds/index.htm 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 at the Hamilton Convention Centre. 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 Day each October organized by the Education Coordinating Committee in the Department of Psychiatry and Behavioural Neurosciences that typically focuses on various aspects of clinician-educator development. Staff and residents are highly encouraged to attend. Information about the Annual Research Day may be found on the Department website: www.fhs.mcmaster.ca/psychiatryneuroscience/research_clinical/research_day.htm 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 relationship between perfectionism and treatment outcome across anxiety disorders, the influence of catastrophic predictions on the course of panic disorder, and a cross-validation of a risk-assessment instrument in a forensic population. SupervisionResidents 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. EvaluationIn 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 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, initiative, 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. AccreditationThe Clinical Psychology Residency Program at St. Joseph’s Healthcare is accredited as a Predoctoral Internship in Professional Psychology by the Canadian and American Psychological Associations. 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 about 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
The American Psychological Association Commission on Accreditation Office of Program Consultation & Accreditation 750 First Street, NE Washington DC 200002-4242 Tel: 202-336-5979 Web: www.apa.org
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