POSTDOCTORAL PSYCHOLOGY TRAINING: THE CENTER FOR CHILD AND FAMILY TRAUMATIC STRESS AT KENNEDY KRIEGER INSTITUTE INTRODUCTION: Kennedy Krieger Institute (KKI) is a specialty pediatric and rehabilitation hospital with an international reputation for treating children with developmental disabilities. Within KKI, the Center for Child and Family Traumatic Stress (CCFTS; formerly The Family Center) has the unique mission of “providing high quality, culturally relevant consumer driven and comprehensive services, for individuals and their families affected by or at risk for psychological trauma.” The CCFTS is located adjacent to, and affiliated with the Johns Hopkins Hospital system in downtown Baltimore, Maryland. The fellow has a clinical/research appointment with the title Postdoctoral Psychology Fellow through the Johns Hopkins University School of Medicine. The fellow’s clinical and research work is done at one location throughout the training year. An individual office, computer access, and administrative/scheduling support, are provided for the fellow. The outpatient clinic is in a modern building with offices for professional staff, and a psychiatry and nursing wing. The core faculty of the postdoctoral program currently is made up of three licensed psychologists, several of whom each have over 20 years of post-licensure experience in the field. All of the training supervisors specialize in the assessment and treatment of children and families exposed to trauma, each having particular expertise in specialty areas. The fellowship is funded as part of the CCFTS’s operating budget. Fellows receive a competitive NIH/NRSA recommended stipend (currently $42,840) in addition to medical and dental benefits, vacation and sick leave, a week of leave for conference attendance, and a stipend for conference-related expenses. The CCFTS’s outpatient program provides a range of evidence-based and promising practices to address childhood trauma. They include: Trauma-Focused Cognitive Behavior Therapy (TF-CBT) Parent-Child Interaction Therapy (PCIT), Alternatives for Families: Cognitive Behavior Therapy (AF-CBT) Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS) Yoga-based Psychotherapy Safety Mentoring Advocacy Recovery and Treatment (SMART) Family Live- a treatment for intergenerational family trauma Psychological evaluation and diagnostic interviewing are also important components of service provision at the CCFTS. CCFTS at Kennedy Krieger Institute 2 Postdoctoral Psychology Fellowship POSTDOCTORAL PSYCHOLOGY TRAINING: The central goal of the CCFTS postdoctoral program is to provide advanced specialty education in the evaluation and evidence-based treatment of traumatized children and families. The postdoctoral fellow gains knowledge and skills through a combination of supervised assessment and treatment, didactic seminars, group supervision and case conferences. The training goals are obtained through the following objectives: •Recruiting fellows with a demonstrated interest in the field of childhood trauma. •Providing quality supervision and seminar experiences with the flexibility to allow the fellow to choose from a range of training options. •Cultivating awareness of the pitfalls of vicarious trauma, and promoting self-care as a model for the fellows’ future practice. •Encouraging scholarly and scientific investigation in the field of childhood trauma, by building research time and mentoring in to the fellow’s weekly schedule. The fellow is expected to develop the following competencies through participation in training activities: •Postdoctoral fellows will demonstrate competence in the use of assessment tools including structured diagnostic interviews, to provide thorough diagnostic evaluations of clients seeking help for trauma related symptoms and a wide range of other mental health concerns. These skills are developed by carrying out approximately two diagnostic interviews per month during the training year. •The fellow will show competence in selecting, administering, interpreting, and integrating data from psychological testing to answer referral questions related to the treatment of children exposed to trauma. Training is provided through a didactic seminar and weekly supervision. The fellow is required to show proficiency using a range of cognitive tests, trauma-specific measures and behavior checklists, objective personality questionnaires, and projective measures, to complete 10 full psychological evaluations during the year. •The fellow will show initial skill at supervising students by training externs on scoring, interpreting, and integrating data from psychological testing. They practice under supervision in this training activity. •After choosing one or more sub-specialty areas or modalities, the fellow will take clinical cases in the area(s), attend regular case conferences, seminars, and other learning experiences relevant to the interest area(s). Training in evidence based practices is emphasized with opportunities for the fellow to develop advanced skills in such models as Trauma-Focused Cognitive Behavior Therapy, and Parent-Child Interaction Therapy. CCFTS at Kennedy Krieger Institute 3 Postdoctoral Psychology Fellowship •The fellow will have developed, carried out, and presented a research project related to child and adolescent trauma. The project will help the fellow grow in knowledge of the literature, and begin making contributions to the field. TRAINING ACTIVITIES: Didactic Seminars The fellow typically begins the training year with a two-day didactic workshop in TF-CBT directed by certified instructors. The fellow can also choose to attend a weekly seminar for trainees, taught by staff members, that covers a wide variety of trauma-related topics. Within-department didactic sessions include lectures on: Chronic Trauma & Its Psychobiology Attachment Regulation Competency (ARC) Model Vicarious Traumatization Adapting Treatment for Children with Intellectual and Developmental Disabilities Sexual Abuse SMART Training: Children With Sexual Behavior Problems Psychology staff also present a 16-week seminar entitled “Diagnostic and Personality Assessment of Children and Adolescents.” Throughout the year, the fellow can choose from a number of other educational offerings, depending on interest, such as the LEND Core Course through KKI Training and Media Services Department, grand rounds at KKI and Johns Hopkins, and seminars in professional development, assessment, and behavioral intervention through the KKI departments of Neuropsychology and Behavior Psychology. All of these programs are in locations that are immediately adjacent to the CCFTS. Training in Evidence-Based Practices and Other Treatment Approaches Following the TF-CBT seminar, assignment is made to a supervision group consisting of staff level clinicians who practice TF-CBT in their daily work. This bi-weekly group is attended throughout the fellowship year and provides important opportunities to share cases, expand knowledge and fidelity to the model, and gain support with difficult clinical situations. Depending on the fellow’s interest and background with other evidence based treatments, opportunities exist for further training in models such as PCIT, Family Live and family therapy, Birth to 5 interventions, and others. The fellow may choose to join group supervision meetings in any of these areas. The fellow may also choose to co-lead with an experienced clinician, a variety of group therapy interventions, depending on clinical need and availability, including Yoga-Based Psychotherapy, SPARCS, and group programs for homeless youth and families. CCFTS at Kennedy Krieger Institute 4 Postdoctoral Psychology Fellowship Individual Supervision The fellow receives a minimum of 2.5 hours per week of individual supervision by doctoral-level, licensed psychologists. One hour (or more as needed), is dedicated to discussion of therapy cases currently seen by the fellow. Another hour is for supervision of psychological evaluations and diagnostic intake assessments. The fellow also meets weekly with the training director to support the fellow’s plan for professional development, to supervise their supervision of pre-doctoral externs at the clinic, and to facilitate progress on individual goals, i.e., research, plans for licensure, etc. The CCFTS’s research director meets regularly with the fellow to guide and mentor research projects. Provision of supervision. The fellow obtains supervisory experience by supervising pre-doctoral externs from local graduate psychology departments who have part-time training appointments at the CCFTS. The Fellow meets regularly with externs to review psychological evaluation materials, including selecting measures, scoring, and interpreting tests. As mentioned above, the fellow is supervised in this work by the training director. The fellow also attends a monthly staff supervisors’ training seminar to increase knowledge of theory and supervisory approaches. APPLICATION REQUIREMENTS: Successful applicants for the postdoctoral fellowship will have a doctoral degree (Ph.D. or Psy.D.) in Clinical, Counseling, or School Psychology from an APA accredited graduate program as well as an APA accredited pre-doctoral internship. Formal proof of matriculation or completion of all graduation requirements, from the degree granting institution, is required before the fellow can obtain appointment through the Johns Hopkins School of Medicine. Application is made through the APPA CAS electronic application section on the APPIC.org website APPA Postdoc Application Information and is due December 15, 2015. Correspondence can be directed to Daniel Hoover, PhD, ABPP Director of Postdoctoral Psychology Training The Center for Child and Family Traumatic Stress at Kennedy Krieger Institute 1750 East Fairmount Ave., 2nd Floor Baltimore, MD 21231 Phone: 443-923-5922 FAX: 443-923-7905 e-mail: hooverd@kennedykrieger.org CLINICAL ACTIVITIES AND TIME DEMANDS: Clinical work is the centerpiece of the postdoctoral fellow’s experience at the CCFTS. The fellow is expected to fill a minimum of 18 hours per week of a combination of therapy and assessment with children, adolescents and their families. In addition, indirect services such as case management, attendance at IEP or other school meetings, contact with collaterals such as foster care workers, CPS CCFTS at Kennedy Krieger Institute 5 Postdoctoral Psychology Fellowship professionals, and multi-disciplinary consultation are often required to meet the complex needs of CCFTS clients. Assessment is done both in formal psychological testing and intake diagnostic evaluations. Referrals for psychological evaluation typically come from therapists, psychiatrists, and/or family members. The questions include requests for diagnostic clarification, the influence of cognitive factors on the child’s functioning or treatment progress, and recommendations for getting therapy “unstuck.” The fellow conducts the testing and provides feedback to the clinical team, the child and the family. The fellow regularly performs intake evaluations to assess clients’ diagnoses and treatment needs. These diagnostic interview reports are then used to assign clients to evidence-based or other treatment modalities that are matched to the client’s presenting concerns. Fellows see a combination of therapy cases drawn from clinics in which they have an interest. A typical day may begin with family or individual therapy the morning hours to accommodate children’s school schedules, then seminars, supervision, research, and paperwork in the later morning and early afternoon. Later afternoon schedules are commonly filled with after-school evaluation or therapy appointments. Fridays are reserved by some fellows for research or paperwork. The fellowship is 40 hours per week, Monday through Friday. However, flexibility is possible in the daily schedule, as some fellows have chosen to work four 10-hour days or other arrangements, as approved by the training director. The fellow is required to see clients through at least one “late night,” per week, until 7:00pm. There is no requirement for postdoctoral training in order to obtain Maryland licensure as a psychologist. However, the fellowship satisfies supervised practice hours that are required for several surrounding jurisdictions (i.e., Delaware, New Jersey, New York, Pennsylvania). EVALUATIONS AND DUE PROCESS/GRIEVANCE PROCESS: The fellow is evaluated four times per year using a competency-based form on which each supervisor rates level of competence achieved in the areas of General Professional Competence, Assessment Competence, Competence in Psychotherapeutic Interventions, and Scholarly and Research Competencies. Each area is rated on a scale from “Needs Remedial Work” to “Ready for Autonomous Practice.” If the fellow has a “Remedial” rating in an area, the supervisor and fellow produce written goals to the situation. The fellow receives a copy of the Due Process and Grievance Procedures documents at orientation, with discussion of the procedures for notification of program concerns about the fellow, and the appeals process.