Training Program

Training Opportunities

Our post-doctoral training program is a generalist program that provides post-docs with training in a wide variety of populations and conditions. However, we also offer ample opportunities for post-docs to develop areas of specific competencies related to our division’s specialties:

• OCD
• Brief Inpatient Psychiatric Treatment
• Psychoeducational Assessment
• PCIT
• Eating Disorders

Intensive OCD Outpatient Program (required). All post-docs participate in the Intensive OCD Outpatient Program two mornings per week throughout the training year. As part of this program, they see cases diagnosed with OCD and/or other forms of Anxiety for whom the prescribed treatment is Exposure with Response Prevention (ERP). Usually 1-2 cases are seen per morning, in teams of 2-3 therapists which may include faculty, other post-docs, and graduate practicum students. Patients may be children or adults and may be seen 1-5 times per week by the treatment team. Post-docs looking for more specialized training in OCD and ERP may also take on additional OCD/ERP cases, attend the weekly interdisciplinary case conferences (1 hour), and weekly psychology treatment team meetings (1 hour).

Brief Inpatient Psychiatric Treatment Program (required). All post-docs also participate in the Brief Inpatient Psychiatric Treatment Program at UF Health Shands Psychiatric Hospital (aka Vista), located adjacent to our clinic building, two mornings per week, throughout the training year. In this program, post-docs participate in treatment team rounds on the child and adolescent unit before meeting with patients for individual therapy sessions. In addition, post-docs conduct therapy with patients on the adult unit as well. Identified patients are seen daily throughout their hospitalization. This program affords post-docs the opportunity to engage in an interdisciplinary team environment, implement brief interventions, work with individuals with severe mental illness, substance abuse, and those in crisis, and supervise graduate students who are often part of the psychology treatment team.

Outpatient therapy (required). All post-docs carry a caseload of 13-14 outpatient cases. To promote post-doc’s ability to see a range of cases, they are required to see at least 4 adult cases, 2 family therapy cases, and lead one therapy group. Other cases can often be tailored to the post-docs training goals and objectives, such as incorporating PCIT cases, or cases involving post-partum depression as our clinic has a wide referral base and often a long wait list. Cases range in age from 2 to 92, and are seen for a variety of clinical concerns. Referrals come from the Divisions of Adult Psychiatry and Child and Adolescent Psychiatry, but also Gainesville community providers and self-referrals.

Psychoeducational Evaluations (required). Post-docs spend one day per week conducting psychoeducational evaluations. These evaluations are typically for youth under age 18, but occasionally for adults as well. Individuals are often referred due to concerns related to possible ADHD, Autism Spectrum Disorder, Learning difficulties, cognitive impairment, Depression, or Anxiety. However, most cases include complex features including complicated family and social histories, medical conditions that may affect psychosocial development, or severe symptoms. Testing is individualized depending on the referral question, but often includes standardized IQ and achievement testing, parent, teacher, and self-report measures, and additional measures as needed (e.g., Autism Diagnostic Observation Schedule-2^nd edition (ADOS-2), D-KEFS). Depending on post-doc interest, there is opportunity to learn to administer the ADOS-2 and gain more experience with Autism Spectrum Disorder assessments. In addition, we have two faculty members (Dr. Romero and Dr. Nelson) who specialize in the assessment of young children (0-5), and Dr. Romero has a neuropsychology background. As such, faculty are able to tailor the assessment experience each post-doc receives based on their training goals and objectives.

Parent-Child Interaction Therapy (PCIT; optional). Post-docs can opt to participate in the PCIT program. Opportunities are available to seek basic training in PCIT, leading to eligibility for certification as a PCIT therapist by PCIT International, Inc. Post-docs who begin fellowship with therapist certification may opt for training as a PCIT trainer, which may lead to eligibility for certification as a Level I trainer through PCIT International. Participation in the PCIT program generally includes formal training in the PCIT model, but may include the opportunity to participate in PCIT cases as a co-therapist with a PCIT-trained therapist for post-docs who would like some exposure to the model but who are not committed to pursue formal training toward certification. Other training activities within the PCIT program include a weekly meeting (1 hour) that includes additional PCIT training activities and case discussion, opportunities to see PCIT cases in co-therapy with faculty (Dr. Nelson is a certified Master Trainer in PCIT), and opportunities to assist in additional PCIT training and research activities that are ongoing in the division.

Eating Disorders Program (optional). Post-docs have the opportunity to participate in the Eating Disorders Program, directed by Dr. Melissa Munson. This program focuses on the assessment and treatment of eating disorders in youth and adults through individual and group therapy. Post-docs are able to see patients with mild to moderate eating disorders for outpatient treatment, typically in conjunction with a psychiatrist and primary care physician. The Eating Disorders Program also offers group therapy, including a process group and a food challenge group that post-docs may help facilitate. Post-docs also participate in interdisciplinary treatment team meetings (1 hour) on a weekly basis to discuss patients in the program, therapeutic goals, and treatment progress.

Methods of Training

Our post-doctoral fellowship is much more than on-the-job training. We take our responsibility to provide high-quality training very seriously. As such, we provide post-docs with a variety of didactics throughout each week, as well as clinical supervision. In addition, we often use a cascading training model, or co-therapy, to promote learning and teaching of new therapeutic strategies.

Didactics

Didactic seminar (required): Every Tuesday 8am – 10am, 2 hours/week. Post-docs participate in a variety of planned educational activities (see schedule), including didactic lectures and workshops, case conferences, journal club, and group supervision.

Process Group (required): First Tuesday of the month @ 1pm, 1 hour/month. Post-docs meet to discuss issues related to training process and professionalism, systems, and administration as well as provide peer support.

UF Health Psychiatric Hospital Inpatient Unit Supervision (required): Daily after service, 0.5 hours/week. Post-docs participate in group supervision with faculty and practicum students to discuss patients treatment goals and progress. Post-docs are expected to participate in group supervision by providing information and insight about patients as well as learning vicariously through the experiences of others on the treatment team.

OCD Interdisciplinary Case Conference (optional): Thursdays @ 11am, 1 hour/week. Post-docs are able to meet with licensed psychologists, board certified psychiatrists, psychiatry fellows, other post-docs, and other students to present and discuss OCD cases seen in the OCD Intensive Outpatient Clinic.

OCD Group Supervision (optional): Thursdays @ 12pm, 1 hour/week. Post-docs are able to attend this meeting with licensed psychologists and peers to discuss challenging OCD cases, provide and receive feedback, and learn more about exposure and response prevention therapy.

PCIT Group Supervision (optional): Wednesdays @ 1pm, 1 hour/week. Post-docs are able to attend this group supervision meeting with peers and licensed psychologists to learn more about Parent-Child Interaction Therapy, seek feedback about PCIT cases, and offer insight and support regarding others’ PCIT cases.

Eating Disorder Team Meeting (optional): Wednesdays @ 11am, 1 hour/week. Post-docs are able to attend this meeting to discuss cases currently being seen in the Springhill 2 clinic for individual, group, or family therapy that focus on eating disorders.

Family Therapy Supervision (optional): Mondays and Fridays at noon, 1-2 hours per week. Post-docs may elect to attend this group supervision dedicated to family therapy cases. Additional training in family therapy theory and strategies is also included.

Providing Supervision

All post-docs are expected to supervise one practicum student per semester. The practicum student should be in at least their second semester of practicum with our division. Post-docs’ provision of supervision will be supervised by their primary supervisor. Post-docs are also expected to provide supervision to practicum students they conduct co-therapy with in the form of case discussion and feedback before and after therapy sessions. If additional opportunities for providing supervision are desired, please speak to Dr. Nelson.

Receiving Supervision

Supervision: All post-docs receive two hours of individual supervision per week. One hour is with the primary supervisor devoted to therapy cases and one hour is with the testing supervisor, devoted to testing cases. The primary supervisor is selected during orientation by the training director based on post-doc preferences and faculty availability. The testing supervisor is assigned based on which faculty is assigned to supervise on the post-doc’s assigned testing day each week. Supervision times are scheduled at times that are convenient for the post-doc and faculty member. Supervisors maintain professional responsibility for the cases being supervised by reviewing and co-signing treatment notes and therapy bills, as well as any other paperwork required for therapy cases (e.g., insurance paperwork, letters, etc.).

Therapy Supervision: Therapy supervision is conducted for at least one hour per week individually with the post-doc and their primary supervisor. Although supervisory styles may vary, this generally involves a discussion of current therapy cases, as well as issues related to setting training goals and overall professional development. Therapy supervision may also involve live supervision or review of video or audio recordings of therapy sessions at the supervisor’s discretion.

Testing supervision: Testing supervision takes place for at least one hour per week between the post-doc and their testing supervisor, who is the faculty supervisor who supervises the post-doc’s testing cases. This supervision includes a review of the testing cases seen by the post-doc, including case conceptualization, battery selection, review of measures, and report writing. Testing supervision may also involve live supervision or review of video or audio recordings of testing sessions at the supervisor’s discretion.

Group supervision: Group supervision is not required for post-docs, but it is offered by faculty members every day at 1pm. post-docs are welcome to attend to discuss cases as needed.

Ad-hoc supervision: There is always a faculty member and licensed psychologist available for supervision as needed, known as the attending psychologist. There is an e-mail sent out each morning identifying the attending psychologist of the day, and the attending psychologist is list on the white board in the work room. If a post-doc needs any immediate supervision, such as to address concerns related to suicide assessment or child abuse reporting, the attending psychologist is available for immediate consultation at any time during clinic hours. All faculty also have an open door policy in that post-docs are welcome to approach any faculty member with questions or concerns at any time.

Cascading training model (Co-therapy)

We ascribe to the cascading training model in which more experienced clinicians see cases with less experienced clinicians in co-therapy to teach them skills and procedures. Post-docs are involved in this process at all levels. For those that are new to new forms of therapy, they may observe therapy with faculty or other therapists and develop into an active co-therapy role, ultimately taking the lead with other therapists observing or serving as co-therapists. In this way, post-docs are able to explore new models of therapy, potentially with more challenging cases as can be the case in severe OCD or eating disorders, with high levels of support and supervision. Once the therapeutic skills are mastered, post-docs are encouraged to continue to see some cases in co-therapy to solidify their skills by teaching others, but also to see cases independently to prevent over-reliance on others.

Post-doc Schedule

Didactics: 8-10am Tuesdays

Grand rounds via streaming Fridays at noon

Supervision 2 hours per week (flexible scheduling)

Supervise one practicum student 1 hour per week per semester

Vista/Shands Psychiatric Hospital: 2 mornings per week (8-10am weekdays except 10-12 on Tuesdays)

OCD: 2 mornings per week (9-12pm, except Tuesdays 10-12)

Testing: 1 testing case per week (one admin testing day per month devoted to scoring/report writing)

Intake: 9am

Testing 10am-3pm

Feedback: as needed

Family Therapy: At least 2 family therapy cases

Groups: Lead one group

Adult Therapy cases: At least 4

Intakes: 1 per week

Individual cases: 13-14 per week (includes family, adult, intake, PCIT)

Division Meeting: Last Wednesday of the month 12-1pm

Post-doc Contact Hours

30 patient contact hours total per week

• OCD/Vista: 6-8 contact hours/week
• Testing: 9 contact hours/week

Outpatient Cases: 13-15 contact hours/week

Duration of Program

The post-doctoral fellowship is intended as a one-year training program, for a total of 2000 hours of supervised training experience. This program meets the licensure requirement for the State of Florida (and most other US jurisdictions, but post-docs are encouraged to research the requirements for any jurisdiction in which they may seek licensure). Post-docs receive a certificate upon successful completion of the training year. If desired the fellowship may be extended to two years. PDAs are asked to notify the Training Director no later than January 15^th of their training year if they would like to be considered for a second training year. Decisions regarding extending the term of the fellowship are made by the faculty based on the PDA’s training needs and performance. PDAs are notified of the faculty’s decision no later than January 30^th.