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: Samuel.fasulo@nyumc.org
 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.