Clinical Rotations

Clinical Rotations

The internship adheres to a practitioner-scholar model and is structured to provide a breadth and depth of child clinical and pediatric training experiences with diverse populations of youth and families.  Specifically, training is comprised of three four-month clinical service rotations, yearlong outpatient psychology services, and yearlong participation in didactics and supervision.  The clinical rotations are in pediatric consultation/liaison, pediatric specialty care, and child and adolescent acute inpatient psychiatry.  Outpatient services include individual/family/group therapy and psychological assessment in a child and adolescent mental health clinic and emergency psychiatric evaluations in a pediatric emergency department.  All work is performed under the supervision of licensed psychologists with expertise in child and adolescent psychology with the ultimate goal of preparing the intern for independent practice. 

Year-Long Experiences (12 Month)

Outpatient Services 

Outpatient services are housed in the Bingham Clinic, where interns and CAPP faculty have their offices. The Bingham Clinic has been in existence since 1913 and is one of the oldest child and adolescent mental health clinics in the country. The clinic is located in a family-friendly facility on the second level of Norton Hospital, a major health care facility in the region. 

Interns provide intake evaluations and individual and family psychotherapy for a diverse population of children, adolescents and families throughout the training year.  Patients range in age from 2 to 18 years old, present with a wide variety of emotional, behavioral, and medical concerns, and many are insured by Kentucky Medicaid. Interns have primary responsibilities for coordinating their patient caseloads with faculty guidance and have flexibility in selecting cases of particular interest to them or to maintain continuity of care across services (i.e., following a child from inpatient to outpatient care, or from diagnostic assessment to treatment). 

Psychological Assessment

Interns provide psychological assessments at the Bingham Clinic for patients referred primarily by other Bingham providers.  Typical assessment referrals include attention deficits, cognitive functioning, learning profile, and social/emotional and behavioral functioning.  Other evaluations may include pre-transplant evaluations or neurocognitive evaluations referred from the Hem/Onc team.  The assessments are geared to be comprehensive and aid in treatment planning, diagnostic clarification, and psychotherapeutic and medication management.  Interns complete approximately 9 comprehensive assessments over the course of the training year.

Emergency Department

The Bingham Clinic provides emergency psychiatric evaluations and re-evaluations for the Emergency Department of Norton Children’s Hospital. This is a consultation service; therefore, the primary team managing the patients is the emergency department. Interns and psychiatry fellows rotate in-house coverage of this service; they alternate weeks as the primary member doing evaluations.  This service is a yearlong rotation through the Bingham Clinic.

Children's Health & Illness Recovery Program (CHIRP)

CHIRP is a 12-session manualized cognitive behavioral and family systems intervention for adolescents with chronic illness, particularly conditions that involve chronic pain, fatigue and functional disability.  This multi-modal treatment was developed at the University of Louisville and is an important service provided by the Bingham Clinic free to families. Referrals often include adolescents struggling with CRPS, hypermobility, fibromyalgia, POTS, chronic headaches, RJA, and functional abdominal pain.  CHIRP is delivered through individual therapy as well as a group format.  Interns co-lead both the adolescent skills group and parent training group throughout the year.

Pediatric Consultation-Liaison Service (4 months)

Interns work with an interprofessional team of psychology and psychiatry faculty and learners to provide consultations for children and adolescents receiving inpatient medical treatment at the Norton Children's Hospital. Norton Children's Hospital is the primary pediatric health care facility in the region and sees the full range of medical problems that occur in children and adolescents. Consultations most often involve children with behavioral and emotional difficulties associated with acute or chronic physical illness or injury, psychophysiological disorders, adjustment disorders, treatment noncompliance, behavioral acting out, and suicidal behavior. Interventions are varied but include behavior management, support/guidance to parents and nursing staff, patient coping skills enhancement and anxiety reduction, biofeedback, and short-term supportive therapy. Patients are typically seen on medical units of the hospital. During the rotation, interns gain experience in consulting with primary care and specialty care physicians and other health care providers. Involvement with a variety of services is part of the rotation; these  include the Pediatric Hematology/Oncology service and Bone Marrow Transplant unit, Pediatric Cardiology and Heart Transplant Team, the Pediatric Intensive Care Unit, the Neurology Service, the Endocrinology Service, the Trauma Service, and Eating/Feeding Disorders among others. Daily rounds are conducted on this service, as well as individual supervision of all cases seen. (Service Director: Bryan D. Carter, Ph.D.)

Pediatric Specialty Care (4 months)

Interns spend from 2 to 2 ½ days per week providing behavioral health services to children, adolescents, and families in two different specialty care clinics affiliated with the University of Louisville School of Medicine: Pediatric Endocrinology (Wendy Novak Diabetes Care Center and Gender Clinic), and Pediatric Neurology (Headache Clinic).  Service provision follows a collaborative care model with interns seeing patients in conjunction with the pediatric residents and attending physicians.  Interns help screen for concerns with adherence, coping with chronic illness, behavioral/mental health concerns, provide brief problem-focused interventions, and make referrals for more extensive mental health services as needed.  Interns also have scheduled time for lengthier follow up visits to provide brief behavioral health interventions (improving sleep hygiene, increasing medication compliance, biofeedback and relaxation training for pain management, etc.).  (Service Directors: Kristie Schultz, Ph.D. – Wendy Novak Diabetes Care Center; Brooke Threlkeld, Psy.D. - Neurology; Christine Brady, Ph.D. - Gender Clinic)

Child and Adolescent Acute Inpatient Psychiatry (4 months)

The Ackerly Inpatient Psychiatric Service is located in Norton Hospital, and is functionally a part of the Norton Children's Hospital. The inpatient unit was established in 1975, and from that time to present has served as a short-term, diagnostic and treatment inpatient facility for children and adolescents experiencing acute psychiatric disturbance. Youth with a full range of psychiatric diagnoses and problems are treated on this unit.  Admission is typically precipitated by patient symptoms of psychosis, suicidality, or dangerous aggression towards others. As part of treatment, patients are involved daily in group, individual, and art therapy, along with educational instruction. Family therapy is generally conducted 1-2 times weekly by the unit social worker. The intern is an integral member of the interprofessional treatment team that includes a child psychiatrist (unit director), psychiatry fellows and residents, social workers, nursing staff, and an expressive therapist. The intern is responsible for carrying the role of primary therapist and case coordinator for two to three patients at any given time during the rotation period. The intern conducts the initial admission evaluation, constructs a treatment plan, conducts individual psychotherapy sessions (approximately three weekly per patient), and participates in unit rounds daily. (Service Director: Jennifer Le, M.D.)

Individual and Cultural Diversity

Our outpatient clinics and inpatient services serve a diverse range of youth and families, thus providing numerous opportunities for supervision and development in this area of clinical psychology. We also dedicate seminar time to diversity topics and incorporate issues of diversity in all didactics and supervision.  The University of Louisville has a strong commitment to providing competent and affirmative care to members of the LGBTQ community.  In addition to the content provided within our department, the university offers a LGBT Health Care Certificate series which interns can obtain throughout the course of the year.  Opportunities are also available for interns to gain experience working in an integrated pediatric transgender clinic within Pediatric Endocrinology.