CAMS Summer Internship Program Supervisor Template 1. Supervisor name & full contact information: Name: Samuel Fasulo, PhD Address: 1 Park Avenue, 7th Floor, New York, NY 10016 Phone: 646-754-4893 Email: [email protected] Fax: 646-754-9538 2. Direct supervisor name & full contact information (if different from above): Name: N/A Address: Phone: Email: Fax: 3. Name and brief description (1 – 2 paragraphs) of the Project requiring an Intern(s): The DBT-A program is in its early stages of developing an outcome data set, which will be used first for program evaluation/QI purposes, and eventually for the purposes of applied, longitudinal treatment research looking at various factors that impact the relative effectiveness of the DBT-A treatment on an individual level. Program director’s vision is to eventually develop ongoing mixed-methods data collection as well, using qualitative methodologies to augment and contextualize objective data, as well as to inform concrete program-level QI, and the intern may have some opportunities to participate in qualitative data analysis as well for a focus group study which was recently approved by NYULMC IRB. 4. Location and hours of Internship (building name, expected availability if known): Fieldwork location: 1 Park Avenue, 7th Floor Expected start & end times: Regular daytime hours, likely up to 20, exact days/times currently TBD and can be worked around student’s schedule to some degree 5. Number of Interns requested: 1 6. Brief summary of proposed Intern responsibilities: Primary role: Ongoing management and possible analysis of quantitative patient and family-level progress/outcome data tracking, utilizing a variety of validated psychological assessment measures to inform utility and areas for quality improvement of Adolescent Dialectical Behavior Therapy program Secondary/potential role: Possible participation in data analysis and poster development for IRB-approved, qualitative research project utilizing a focus group methodology to assess aspects of DBT-A program in need of quality improvement CAMS Summer Internship Program Supervisor Template Secondary/potential role: Possible opportunities for participation in grantwriting and/or writing for IRB approval of additional DBT-A research projects 7. Weekly or monthly meetings at which Intern attendance is expected: Weekly DBT Administrative meeting Weekly Program Evaluation/outcome assessment meeting As-needed additional meetings TBD 8. Three goals that the Intern(s) will be expected to achieve during placement: 1) Develop a working theoretical understanding of the structure and function of a comprehensive Adolescent DBT program 2) Develop the proficiency to collect, score, and enter data into Excel data set 3) Develop basic proficiency to summarize this data for programmatic purposes as appropriate under the direction of DBT-A program director. 9. Description of planned deliverable(s) at the end of the 12-week Project: Successful data entry and management of programmatic outcomes data set, including as-needed f/u with patients and families to ensure measure completion and return Contribute to development of a successful poster abstract for submission to Fall 2016 10. Skills or prerequisite experience required: Computer/Software: Excel, Word Languages: English only is acceptable 11. Any other requirements (e.g., special clearances required, etc.): Clearance for patient contact preferable in order to increase student’s flexibility with gathering f/u program assessment data. General interest in learning more about Child&Adolescent clinical programming is optimal.