Training and Supervision

Generalist Psychology Training Program

The Postdoctoral Residency Program has trained residents for over ten years! This unique experience provides outpatient treatment across the lifespan in a primary care integrated behavioral health setting. We offer residents the opportunity to select from four specialized concentrations to complement their generalist training while nurturing their other interests. 

Addiction Psychology Concentration

The Addiction Psychology Concentration will focus on providing the resident with specific skills to assess, understand, appropriately refer, and treat clients with substance use disorders (SUD) including opioid use disorder (OUD). Residents in this concentration will participate in co-facilitating and/or leading a Medication for Opioid Use Disorder (MOUD) group and will be provided didactic training specific to SUD/OUDs. Residents will also engage in the Weitzman Institute’s Substance Use Health (SUH) ECHO, integrated care meetings for SUH patients at CHC, and will be provided supervision specific to working with patients with a substance use disorder. Residents in the Addiction Psychology concentration will receive additional training on Motivational Interviewing (MI) and will be given direct feedback on their MI skills from CHC’s Clinical Director of Substance Use Disorder Services. Residents will also participate in observations of community-based recovery activities, including attending peer support meetings such as Narcotics Anonymous (NA), Alcoholics Anonymous (AA), and Celebrate Recovery, to help gain an understanding of the broader culture of recovery. Residents in this concentration will complete a rotation through CHC’s Wherever You Are (WYA) program and provide direct care to patients with an SUD in our shelter settings. Additional training opportunities at conferences will be made available and residents in this concentration will be encouraged to seek educational opportunities at conferences that provide more information on the neuroscience of addiction as well as novel approaches to medication for substance use disorders. The purpose for developing this specialized area of training is to contribute to the development of a workforce of psychologists trained in the integrated behavioral health model of care with specialized experience in the treatment of clients who are living with substance use disorders.

Child and Adolescent Concentration

The Child and Adolescent Concentration will focus on providing the resident with specific skills, interventions, and supervision related to treating children, adolescents, and their families.  Additionally, all child concentration residents will be trained on the Attachment Regulation and Competency (ARC) framework. Residents in this concentration have an opportunity to be placed at one of CHCI’s Hartford, Middletown, Stamford sites and/or in one of the School Based Health Centers located across the state of Connecticut. Residents in this concentration will provide three days of clinical care in a child-based setting and one day in a lifespan based setting. 

• Hartford, Middletown and School Based Sites: At the Hartford site all clients are 18 years old or younger and the Middletown site houses the Lillian Reba Moses Child Guidance Clinic. School Based Health Centers are located in nearly 100 schools across Connecticut.  Individuals assigned to the Middletown, Hartford or school based locations will be trained in and will administer Multidisciplinary Evaluations (MDEs): evaluations of all children newly taken into custody by the Department of Children and Families (DCF), and also will participate in Multidisciplinary Team Meetings (MDTs). 

• Stamford (Child Guidance Center of Southern Connecticut): Trainees assigned to the Child Guidance Clinic in Stamford will participate in a specialized training experience commensurate with their training experience and interest (including but not limited to developmental evaluations, mobile crisis, and specialized treatment in an evidence based practice).  

All residents will also participate in a monthly child focused case presentation meeting, facilitated by a rotation of CHC psychologists who specialize in working with children. Supervision for residents in this concentration will be provided by CHC psychologists with specialized experience in the treatment of children, adolescents, and their families. Those working in this area may have the opportunity to receive training and participate in evidence-based programs like Trauma Focused Cognitive Behavioral Therapy (TF-CBT) and Cognitive Behavioral Intervention for Trauma in Schools (CBITS).  The purpose of this concentration is to contribute to the development of a workforce of psychologists trained to the integrated behavioral health model of care with specialized experience in the treatment of children and adolescents and their families.

Center for Key Populations Concentration

RResidents in this concentration will be assigned one to two days a week to either a shelter placement or the Gender Diversity and Resiliency Program. They will be provided specific didactic training in working with LGBTQIA+ clients, clients with health conditions such as HIV and Hepatitis C, harm reduction and preventative practice, and be paired to co-facilitate a Medication Assisted Treatment (MAT) group.  They will also be paired with a primary care provider who provides medical services specifically to populations associated with the Center for Key Populations. 

Health Psychology Concentration

The health psychology concentration will focus on providing the resident with specific skills to collaborate across disciplines to deliver care to clients with comorbid behavioral and physical health needs.  Residents will be provided with specific curriculum content for working with clients with health related needs in primary care.  Residents will be trained and will provide warm hand offs (WHOs) specific to addressing smoking cessation and chronic health conditions, as well as provide consultations related to bariatric assessments and sleep consults when available.  They will be expected to facilitate at least one group that addresses an integrated need (including but not limited to diabetes management, sleep, smoking cessation).  The purpose for developing this specialized area of training is to contribute to the development of a workforce of psychologists trained in the integrated behavioral health model of care with specialized experience health related concerns for clients.

Training

All residents will have the opportunities to:

• Conduct individual, family/couples and group therapy in a primary health care setting
• Receive opioid use disorder/substance user disorder specific assessment and treatment training
• Take part in a weekly didactic training seminar
• Learn and utilize telehealth initiatives to treat clients
• Participate in developing supervision skills through a didactic seminar and participating in a group and individual supervision training experience
• Work closely with medical and dental providers as part of CHC’s model of integrated care in a Patient Centered Medical Home
• Participate in weekly multidisciplinary clinical team meetings with other behavioral health disciplines
• Develop clinical and assessment skills with clients of all ages in a variety of settings, including in primary health care settings, with the opportunity to work in alternate settings such as schools, homeless shelters and domestic violence shelters for “Wherever You Are” clinical care
• Gain or build upon experience using integrated electronic health records and other state-of-the-art technologies to manage and deliver care
• Participate in a range of training seminars. See an example list here.
• Participate in a bi-weekly Quality Improvement seminar to learn process improvement skills to apply to clinical practice
• Participate in quality improvement initiatives offered by the agency such as the Institutional Review Board (IRB), Behavioral Health Quality Improvement Team (BHQI), and Agency Wide Performance Improvement Team (PI)
• Receive clinical and administrative support consistent with other behavioral health clinicians
• Receive mentorship on professional goals and areas of identity
• Participate in research
• Conduct psychological assessments
• Consult with peers during a multicultural case conference
• Join a multicultural committee focusing on addressing diversity factors in training, recruitment and retention

Specific trainings in the following areas will be offered:

• SUD/OUD treatment
• Telebehavioral health
• Trauma informed care across the life span
• Professional and ethical concerns in treatment
• Child and adolescent focused therapy
• Facilitation of groups
• Multicultural considerations
• Psychiatry
• Risk assessment
• Integrated care
• Quality improvement

Supervision

Supervision is provided by psychologists licensed by the state of Connecticut.

• Residents receive two hours of individual supervision with two different supervisors
• One hour of weekly group supervision is provided for all postdoctoral residents
• CHC psychologists work at our sites across Connecticut. Each resident will have a primary supervisor affiliated with the site where they are located. Secondary supervisors may work at a secondary location.
• Didactic training is provided by the multidisciplinary team at CHC. This includes but is not limited to psychologists, social workers, psychiatric providers, and medical providers.

Requirements for Licensure in the United States

CHC is willing to adjust supervision hours, as well as adjust total number of contact hours to ensure supervisor requirements are met for other state licensure requirements.  The current program structure meets requirements for the majority of state requirements.

Program Aim, Competencies and Elements

Aim Statement

The aim of the postdoctoral residency program at Community Health Center, Inc., is to produce professional psychologists equipped to serve individuals, families, and groups in a patient-centered medical home model, utilizing essential skills requisite of an advanced behavioral health clinical practitioner in an integrated primary care setting. The intention of the postdoctoral residency program is to develop professional, clinical, ethical, quality improvement, supervision, leadership and cultural skills under supervision and to provide a means for cultivating a resident’s professional identity as a clinical psychologist, a functioning member of a clinical team, and a community member.  Upon graduation from the residency, individuals will be able to confidently, ethically, and with cultural competency, provide psychotherapy to diverse underserved clients with various backgrounds across the lifespan.  Residents will enhance their capacity to provide care through a wide range of services and methods to improve the physical and emotional health of the individuals and communities in which we serve. 

1.   Integration of Science and Practice

1A: Displays clinical skills with a wide variety of clients and presenting concerns, including but not limited to: clients across the lifespan, varying diagnoses, and populations.

1B: Utilizes empirically supported treatments to inform therapeutic interventions.

1C: Demonstrates the flexibility to adapt interventions where appropriate for both in person and treatment over telehealth, specific to case and context.

1D: Provides diagnoses to clients that are clear, relevant and accurate, as well as provides comprehensive justifications for those diagnoses.

1E: Evaluates treatment progress and modifies treatment planning as indicated.

2.  Individual and Cultural Diversity

2A: Independently monitors cultural awareness of self (including an understanding of how their own        personal/cultural history, attitudes, and biases may affect how they understand and interact with people different from themselves) and seeks appropriate consultation if there is a gap in this awareness.

2B:  Considers aspects of the client’s identities (including but not limited to ethnicity, race, gender, age, developmental stage, religion, disability, socioeconomic and sexual identity) and how they intersect in conceptualizing, diagnosing, and treating clients.

2C: Demonstrates ability to address differences in colleagues’ intersecting identities, including the ability to integrate awareness and knowledge of individual and cultural differences in the conduct of professional roles (e.g., research, services, and other professional activities). Applies a framework for working effectively with areas of individual and cultural diversity not previously encountered over the course of their careers.

2D: Demonstrates knowledge of the current theoretical and empirical knowledge base as it relates to addressing diversity in all professional activities, including research, training, supervision, consultation, and service and can independently apply knowledge and demonstrate effectiveness in working with the range of diverse individuals and groups encountered during residency.

3.  Ethical and Legal Standards

3A: Independently utilizes ethical decision-making in all professional activities, acting in accordance with the APA Ethical Principles of Psychologists and Code of Conduct.

3B: Understands the ethical and legal considerations related to a client’s needs and can apply ethical decision- making processes in treating the client, including addressing exceptions that arise related to confidentiality.

3C: Proactively assesses and documents safety risk and interventions, including but not limited to: concerns of suicidality, homicidality, and suspicion of abuse, and seeks consultation in such situations.

3D: Documentation reflects expectations based on agency, professional, state, federal, and insurance laws, regulations, rules, policies, standards, and guidelines, including but not limited to: objectives being specific and measurable in the care plan, care plan including all diagnoses, goals in the care plan being in the patient’s own words, care plan reviewed consistently in the expected interval (30, 60, then 90 days thereafter), and following guidelines related to appropriate use of telehealth.

4. Primary Care and Integrated Service Delivery

4A: Gathers relevant information during Warm Handoff visits in order to respond to the requesting provider in a succinct and timely manner.

4B: Actively engages in virtual and in person team meetings and communicates effectively with behavioral health, medical, leadership and other staff using synchronous and a-synchronous forms of communication to enhance collaboration and treatment outcomes.

4C: Applies behavioral health knowledge when identifying, screening, assessing, and diagnosing behavioral health needs as part of a primary care team, including but not limited to anxiety, trauma related disorders, mood disorders, insomnia, psychosis, substance use, violence, and attention concerns.

4D: Exhibits an understanding of the external factors that contribute to health related behaviors and addresses a client’s psychosocial factors, including but not limited to: food insecurity, housing insecurity, community supports, employment, and any other related environmental stressors, when treating the client.

4E: Demonstrates the ability to provide behavioral health related feedback to common medical concerns in the primary care setting, including but not limited to: type II diabetes, chronic pain conditions, obesity, multiple sclerosis, HIV, and hepatitis-C.

5. Building and Running Groups

5A: Demonstrates the ability to build a group and select or develop an appropriate group curriculum.

5B: Conducts pre-group evaluations over the phone or telehealth video to establish rapport with patient and evaluate appropriateness for group and distinguishes between clients who are appropriate and inappropriate for the group modality of treatment.

5C: Appropriately refers clients to colleagues’ groups, and follows up with their referrals regularly, as well as advertises, explains, and elicits referrals from other staff members and clients, including but not limited to other behavioral health clinicians, medical providers, and patient service associates.

5D: Shows ability to conduct group sessions independently.

5E: As a group facilitator, works to be inclusive of all members in the group process and comfortably addresses group dynamics as they arise.

6. Interpersonal Skills and Professional Development

6A: Verbal, nonverbal, and written communications are professional, informative, articulate, succinct, and completed in a timely manner, in accordance with agency policy and culture.

6B: Proactively addresses colleague conflicts in the workplace and seeks consultation when appropriate.

6C: Proactively addresses client ruptures, understands their role and the client’s in the situation, and seeks consultation when appropriate.

6D: Conducts self in a professional manner across settings and situations.

6E: Demonstrates receptivity to corrective and constructive feedback from supervisors and staff as demonstrated by their verbal and non-verbal responses, and taking accountability is observed through their actions to resolve the matter.

6F: Provides feedback to supervisors and staff using effective and constructive feedback approaches.

6G: Exhibits the ability to reflect on one’s reactions and behaviors in different interpersonal interactions.

6H: Provides presentations on clinical topics in team meetings and didactics in an organized, well-informed, professional and proficient way.

7.  Supervision Development

7A: Articulates awareness of identity and value differences among trainee, self and clients, and articulates how these differences may affect dynamics between these groups.

7B: Fosters the trainee’s consciousness of the identity and value differences among the resident, the trainee and the clients, and address these differences in therapy.

7C: Develops a supervisory alliance despite potential differences between supervisor and trainee.

7D: Shows awareness of supervisory developmental models and provides support to the trainee in a way that meets their current developmental need.

7E: Demonstrates the abilityto provide both formative and summative feedback to trainee.

7F: Actively applies ethical, legal, and administrative considerations related to supervision of a trainee.

8.  Quality Improvement

8A: Demonstrates knowledge of quality improvement processes and relevant healthcare innovations within an integrated healthcare service system.

8B: Systematically analyzes and utilizes appropriate tools to measure quality and impact of changes within an integrated healthcare service system.

8C: Contributes to performance improvement by identifying areas for change (e.g., issues related to clinical workflow) and uses appropriate quality improvement procedures to facilitate the change process.

9.  Utilization of Telehealth

9A: Presents professionally while delivering telehealth services, including but not limited to the use of appropriate lighting, camera angle, professional attire and appearance, professional virtual setting, clear audio and picture quality, displaying professional credentials, setting up professional voicemail, and communicating absences.

9B: Conducts and adapts evidence-based treatments via telehealth by explaining and delivering exercises using virtual mediums, or uses technology to provide psychoeducation and explain key concepts to clients, such as those provided by Zoom, including but not limited to sharing their screen and utilizing the white board function, to augment their treatment when appropriate.

9C: Proactively addresses professional boundaries and challenges due to limited control over the client’s environment, including but not limited to discussing appropriate client attire, the client being in an appropriate setting (i.e. not driving, in a quiet environment), clarifying expectations regarding others in the room and their expected participation during the session, and setting boundaries around online communication.

9D: Provides technical support to clients by assisting them in navigating minor technical challenges, assists clients with video capability to use video consistently, and effectively transitions to telephonic appointments when technical difficulties cannot be resolved or when a client does not have video capability.

10.  Treatment of Opioid Use Disorders/Substance Use Disorders (OUD/SUD)

10A: Routinely assesses and diagnoses all clients and diagnoses all relevant OUD/SUDs, including but not limited to appropriately assessing tolerance and withdrawal, and identifying appropriate level of severity.

10B: Exhibits awareness of how social justice elements intersect with personal biases and          transference/countertransference towards individuals with substance use disorders, and proactively addresses concerns as they arise in supervision.

10C: Uses specific MI interventions in line with the stage of change of the client, including understanding the role of ambivalence in treating SUDs.

10D: Uses harm reduction as a primary lens for treating clients and determining whether to engage or discharge clients in care at CHC, and when discharges are appropriate, can articulate the reasons for discharge within a harm reduction framework.

10E: Can explain and utilize the Substance Use Health (SUH) program model and how it is implemented including interdisciplinary care and care coordination and seeks consultation when appropriate.

10F: Relapse prevention plans created with clients are specific, multi-step and strengths based.