Interns on this track enhance their psychotherapy and behavioral medicine skills while experiencing psychologists’ various roles within a medical setting. They collaborate with psychiatric, medical primary care, and medical specialty teams in both outpatient and inpatient settings. Major experiences include Adult Outpatient, Primary Health Care, Oncology, Cardiology, Pain, and Weight Management Team. Minor rotations occur in Consultation-Liaison and Emergency Services, and the Psychiatry Inpatient Unit. Adult Outpatient Psychiatry
Interns conduct assessment and time efficient therapy with adults referred for a broad range of psychological and behavioral medicine problems. Depression, anxiety, relationship problems, adult ADHD, and substance abuse are the most frequent psychological referrals. Bariatric surgery evaluations, pain, and adjustment to illness are the most frequent behavioral medicine referrals. Interns observe and practice therapy using cognitive behavioral, biological, problem focused, and motivation interviewing models to assist patients in learning new skills to manage their lives. The psychologist’s task is to connect with the patient, understand the story, then collaborate to develop a therapy that offers clarity, hope, and self efficacy. Interns become adept at assessing disorders, core beliefs, and personality patterns; focusing treatment; and collaborating with medical teams. Primary Health Care
Collaborating with primary health providers is an integral part of the adult practice in all settings. Psychologists also practice part time in a family practice medical primary care clinic, collaborate with the medical team, and experience the unique culture of primary care – its pace, priorities, language and communication style. Interns learn about various collaboration models to deliver care to patients with depression, anxiety, pain, and somatoform problems. Oncology
Psychologists are integrated with the oncology department across several specialty programs, including the breast cancer clinic, the lung cancer clinic, and the bone marrow transplant program. Additionally, the psychologists facilitate a psychosocial conference for the oncology department designed to help the team discuss difficulty cases. The intern will have opportunities to assess patients at diagnosis and follow patients throughout treatment as a part of a multidisciplinary team. Through these experiences, the intern will become knowledgeable about the salient medical and psychosocial issues for patients with a cancer diagnosis and how to work effectively in integrated care settings. Cardiology
Psychologists are important members of several multidisciplinary teams in cardiology, including preventative cardiology, cardiac rehabilitation, and women’s cardiac services. Interns will work with patients across the diagnostic continuum from those who are at risk for cardiac disease to those who have experienced a cardiac event. The focus in these settings is on facilitating behavioral change in an effort to reduce risk factors. Interventions are brief and targeted. The interns will learn to identify the stages of change and use motivational interviewing techniques to help patients modify cardiac risk behaviors. Weight Management Team
Psychologists spend significant time as integral members of the Gastroenterology-led Weight Management Team that includes physicians, dieticians, nurses and physician assistants. Interns assist in evaluating and preparing patients for bariatric surgery, attend support group meetings for pre and post surgery patients, and assist individual patients with health behavior changes. This work offers the opportunity to learn about weight management issues, medical comorbidities, health behavior change and motivational interviewing. Adult Services - Minor rotations
Psychiatric Emergency Services
Geisinger Medical Center provides around-the-clock psychiatric emergency coverage seven days a week. During the day the intern functions as part of the emergency services team comprised of a staff psychiatrist, clinic triage case worker, physician’s assistant, and a medical resident. Patients are assessed either on site in the emergency department or in the outpatient psychiatry clinic. The intern learns basic emergency psychiatric assessment skills to include an understanding of medical conditions that may simulate psychiatric conditions, an ability to assess and triage suicidal or aggressive patients, a working knowledge of psychopharmacologic agents and somatic therapies, and an appreciation of psychiatric treatment resources that are available. This rotation is for one day a week for six months. Inpatient Psychiatric Services
Interns serve as members of the inpatient treatment team for adults on an inpatient psychiatric unit. As part of this rotation interns conduct personality assessments as well as assessment of cognitive impairment. Interns also provide brief psychological interventions with patients and families. Psychiatric Consultation/Liaison Service
Geisinger Medical Center provides full psychiatric services to patients hospitalized on the medical and surgical floors. The entire spectrum of psychiatric illnesses are diagnosed and treated, either as pre-existing conditions or conditions that arise as part of having a serious illness or being in the hospital. Short-term crisis-intervention and supportive therapies are also offered. Special attention is given to issues of dealing with difficult patients, chronic pain, terminally ill patients, and legal/ethical issues in consultation. This involves two to three half days per week for a minimum of
three months. |
