Philosophy of the Program and Educational Training Model
The Tulane University School of Medicine clinical psychology internship program is a highly integrated and cumulative training experience, incorporating didactic and clinical opportunities in a wide range of general and specialty areas. Training and supervised practice experiences emphasize adherence to responsible, ethical and empirical approaches to the practice of psychology, in which there is modeling of respect for patients’ rights. The program is based on a cohesive overall philosophy, which is comprised of several basic and interrelated tenets:
1. The Tulane Psychology training faculty endorses the scientist-practitioner model of education and training for the professional practice of psychology. We train interns to competently and ethically engage in psychological practice, basing clinical decisions on a thorough understanding of the relevant contemporary scientific literature pertaining to assessment, treatment, consultation, and other aspects of professional practice. The overall program of training, as well as training in the major tracks, is consistent with current knowledge regarding the science and practice of psychology. Specifically, the interns are provided training materials, including journal articles and book chapters, pertinent to special topics, didactic seminars, and case presentations. This material is an integral aspect of scheduled didactic sessions, case conferences, topic seminars, and supervision.
We train interns to critically evaluate and appropriately use relevant professional literature and to apply that knowledge to the practice of psychology. At every training site, faculty psychologists and trainees use an approach to the practice of psychology that incorporates the current state of our scientific knowledge. We train interns to be effective consumers of the literature, to use this knowledge as a springboard for their own practice of psychology and to develop life-long patterns of critically reviewing professional publications in general and in their particular psychological specialties.
2. We train interns to use a biopsychosocial approach to the practice of clinical psychology. Interns learn to assess patients presenting with a wide range of disorders, and to assist patients in improving psychiatric status, personal adjustment, interpersonal relationships, and daily functioning in work, family, and social contexts; and in reducing or eliminating undesirable and/or maladaptive behaviors. We approach our analysis of human behavior and functioning from a strengths-based perspective that incorporates knowledge and understanding of biological/medical, psychological, social, environmental, and contextual (e.g., individual, dyadic, systems) factors. We train interns to apply assessment and intervention techniques in an individualized fashion, evaluating and working within the unique intrapersonal and interpersonal contexts presented by the patient.
3. We train interns to identify and to be sensitive to individual variations in development and functioning. Faculty members model through our own practice respect for individual and group diversity in its numerous forms as they impact the individual patient’s clinical presentation. Appreciating diversity adds significant information to the effective practice of psychology regarding individual, cultural, and societal variations in behavioral and attitudinal adaptation. Acknowledging differences also presents the opportunity for an open dialogue about their importance to the functioning of the society at large. Interns are able to work with patient populations that are highly diverse in several ways, including age, race, ethnicity, culture, physical and emotional differences, gender, sexual orientation, and socioeconomic status. Across sites, diverse patient populations are well represented. Interns are taught that learning about patients’ degree of acculturation within various groups is important in understanding the individual’s status and clinical presentation. Diversity issues are emphasized across all training venues during supervision, didactics, case conferences, discussions and mentoring.
4. Throughout the internship year, we subscribe to a supervisory mentorship approach that is incremental and cumulative, in which the faculty members model the practice of psychology and provide hands-on supervision appropriate to the level at which the intern is operating. As the intern gains knowledge, skills, and confidence, the complexity of expectations and responsibilities increase accordingly to facilitate optimal growth and development. Eventually, the intern functions with increasing independence to most effectively develop his/her unique professional identity and method of practice. Nevertheless, at no time does the intern function without the direct supervision and guidance of the faculty. Upon entering the internship program, each intern chooses a psychology faculty mentor who remains with the intern for the entire year, regardless of where he/she may rotate. This allows mentoring continuity. In addition, each intern has a supervisor who is at the primary rotation site the entire year. Use of the same mentor and primary supervisor encourages professional modeling and provides the intern with stable anchors as the training year progresses. Clinical training sites are diverse in structure as well as in patient populations served. Clinical responsibilities of the interns vary and increase during the training year, preparing the interns for the multifaceted roles they will assume during their professional careers.
5. We train interns to work within a multidisciplinary framework. This tenet is manifest in two ways. First, at every site, members of other professional disciplines (psychiatric, other medical and allied health professionals), in addition to psychology, both practice and train; we encourage interaction, cooperation and dissemination of knowledge and input across these various fields. We believe that such multidisciplinary interaction and training encourages an appreciation of both the multidimensional nature of the human condition and the need for multidimensional and multidisciplinary solutions to complex problems of living. We teach interns to be intelligent consumers of other related disciplines’ knowledge bases and to consult with fellow-professionals regarding the value of psychological input. Second, the interns work with other systems outside the mental health field, including medical, social services, educational, legal, rehabilitation and correctional programs. In this way, they learn to consider and include, as needed, the contributions and potential resources of other systems in their intervention planning and delivery of care. Understanding their patients’ roles within other systems allows the interns to understand the larger framework in which the patient lives and operates, and allows the intern to advocate for the patient in multiple ways. Working with other systems also educates individuals from those systems about the important role that psychology plays and what it can add to a full understanding of the patient.
6. All intern training for clinical practice, consultation and research occurs according to a logical sequential plan that is cumulative, building upon previously learned material and techniques and graded in complexity over the course of the internship year. Logical beginning intern assignments are based on documented graduate school practicum experiences, with each successive clinical activity being based on previous training experiences during the internship program. The internship program is a highly integrated training experience, incorporating didactic and experiential clinical opportunities in a wide range of general and specialty areas. Upon completion of the internship, each intern should be fully prepared for specialized postdoctoral training or clinical practice (either independent in those states licensing psychologists after the internship year or under supervision in those states requiring an additional year of supervision).