Rehabilitation Neuropsychology Track – Psychology Internship Program

General Information

(APPIC/NMS program code = 161915)

Track Coordinators:
Ivan Molton, PhD: imolton@uw.edu | Jeffrey Sherman, PhD: jeffreys@uw.edu

Training faculty
Core neuropsychology training faculty
• Nick Dasher, PhD, ABPP-CN
• Gina Formea, PhD, ABPP-CN
• Myron (Moe) Goldberg, PhD , ABPP-CN
• Kati Pagulayan, PhD
• David Sheppard, PhD
• Non-neuropsychology training faculty will vary by specific rotation placement

Overview

The Rehabilitation Neuropsychology track was created to provide residents with an opportunity to receive more focused training in neuropsychological assessment and neurorehabilitation. Importantly, this track does not consist solely of neuropsychological testing and interpretation. Rather, residents in this track will receive specific education and training in neuropsychological aspects of typical rehabilitation populations, diagnostic interviewing skills, test selection, test interpretation, report writing, conducting testing feedback sessions, and using neuropsychological test results and knowledge about brain-behavior relationships to inform multidisciplinary rehabilitation programming.

The training experiences in this track are designed to be consistent with the Division 40 Houston Guidelines, and to prepare trainees for further postdoctoral study in Clinical Neuropsychology. Prior experience in a medical rehabilitation setting is helpful but not necessary to have a rewarding training experience. Prior experience in neuropsychology is expected for the resident in the Rehabilitation Neuropsychology track. We accept one Rehabilitation Neuropsychology resident per training year.

Importantly, the Rehabilitation Neuropsychology track overlaps considerably with the general Behavioral Medicine track, and residents in the Rehabilitation Neuropsychology track will receive general training in rehabilitation psychology analogous to those in the Behavioral Medicine Track. In this way the track may be seen as an extension or additional specialty within the Behavioral Medicine track, and one that emphasizes neuropsychological assessment and neurorehabilitation in patients living with conditions that affect cognitive function. Many applicants to our program apply for both tracks, depending on their interests and career goals.

Many (most) of our Rehabilitation Neuropsychology residents go on to Div 40 approved 2-year postdoctoral fellowships in Clinical Neuropsychology, and we provide mentorship support during the application process. Others may find that they prefer a career as a neuropsychology-informed general health or rehabilitation psychologist, and do not pursue a neuropsychology focused post-doctoral fellowship. We work with each resident to support their own goals for training and career development.

Rotation Description

Both the Behavioral Medicine and Rehabilitation Neuropsychology residents at the University of Washington complete a total of three, 4-month rotations during the residency year. For the Rehabilitation Neuropsychology resident, two of these rotations will include a focus on neuropsychology and neurorehabilitation within the medical setting. These will include experiences at Harborview Medical Center, or affiliated clinics, and at the University of Washington Medical Center-Montlake. All of these sites afford the resident ample training experiences in evaluating adults with a range of cognitive, central nervous system, and medical disorders, including traumatic brain injury, stroke, brain tumor and systemic forms cancer, multiple sclerosis, neurodegenerative disease, and organ transplant.

The third rotation will not have a neuropsychology focus and is meant to provide more general behavioral medicine/rehabilitation psychology training. This rotation may include training in consult/liaison psychology, in the HMC Burns or Pediatric Clinic, at the Madison Clinic, or in another hospital affiliated clinical service. This rotation structure is designed to give the Rehabilitation Neuropsychology resident a training experience that includes both in-depth work in neuropsychology and exposure to more general behavioral medicine content.

Regardless of specific rotation placement, the Rehabilitation Psychology resident will be offered an array of clinical experiences to train clinical psychologists within a multidisciplinary team framework in a medical setting. Residents will have opportunities to work collaboratively with physicians, nurses, speech pathologists, physical therapists, occupational therapists, vocational counselors, therapeutic recreation therapists, and social workers, from within the medical center as well as from the community in developing and implementing treatment plans.

Rehabilitation Neuropsychology residents will have an opportunity to evaluate and treat patients with a variety of presenting medical conditions, including spinal cord injury; acquired brain injury due to trauma stroke, tumor, aneurysm, hemorrhage, hypoxia, etc.; multiple sclerosis; muscular dystrophy; post-polio syndrome; amyotrophic lateral sclerosis; cancer; and large organ transplant (heart, lung, and liver). All rotations provide a mix of inpatient and outpatient assessment and treatment opportunities.

Training Experiences & Treatment Modalities (Model)

The training model emphasizes an empirically supported scientist-practitioner approach to assessment and treatment. During inpatient rotations, the Rehabilitation Neuropsychology resident will function as an integral member of an interdisciplinary rehabilitation team, which includes psychology, medicine, speech-language therapy, physical therapy, occupational therapy, nursing, and vocational rehabilitation. The Rehabilitation Neuropsychology resident will typically cover one team (of four patients) on an acute inpatient medical rehabilitation unit, which will include psychological and neuropsychological assessment and utilization of the assessment findings for rehabilitation treatment planning and development of behavioral programs.

Rehabilitation Neuropsychology residents will also be involved in intensive outpatient evaluation experiences, including comprehensive interview, integrative report writing, and feedback. Outpatient psychotherapy training is also an important component of the Rehabilitation Neuropsychology track and all residents in this track will follow outpatients to aid in psychological adjustment. Participation in weekly rounds and team/family conferences will also be an important part of the neuropsychology residents’ experience.

Training Experiences

Across rotation sites, typical patients present with need for assessment of psychological and/or neuropsychological functioning, identification of patient and family concerns, development and implementation of appropriate treatment programs, and mobilization of resources to integrate the patient into the community.

As described above, Rehabilitation Neuropsychology residents learn to function as an integral member of interdisciplinary rehabilitation teams. Rehabilitation Neuropsychology residents typically cover one team (4 patients) on the acute inpatient rehabilitation unit and follow outpatients (5-6) weekly in the rehabilitation clinic. Rehabilitation Neuropsychology residents will also participate in both brief inpatient neurocognitive screens and more intensive outpatient neuropsychological evaluation experiences, including interviewing, test selection, administration, scoring, and interpretation, results integration, differential diagnosis, and report writing, as well as feedback to patients, family, and referral sources.

There is also the opportunity to observe or participate in outpatient treatment groups focused on neurorehabilitation. Participation in weekly rounds and team/family conferences is an important part of the psychology residents’ experience.

Psychology residents in this track participate in a monthly rehabilitation psychology journal club. All Rehabilitation Neuropsychology residents attend a weekly neuropsychology seminar that involves relevant topic presentations and case reviews. Residents also have opportunities to attend the Department of Rehabilitation Medicine’s Grand Rounds which occurs twice per month and covers various rehabilitation topics, many of which are of interest to residents.

Expectations of Psychology Residents

Rehabilitation Neuropsychology residents participate in all aspects of the training experiences listed above. Residents in this track can typically expect to follow four inpatient cases, and 4-6 outpatient cases. Rehabilitation Neuropsychology residents will also be expected to be involved in at least one comprehensive outpatient neuropsychology evaluation case per week.

By the end of the rotation, Rehabilitation Neuropsychology residents are expected to:

have an understanding of a psychologist’s role on an interdisciplinary rehabilitation team
demonstrate an increased awareness of and ability to assess the emotional, behavioral, and cognitive sequelae of various traumatic and chronic medical conditions
have a strong understanding of the functional implications of neuropsychological test results in rehabilitation
develop the knowledge and skills necessary for basic competence in the neuropsychological evaluation of patients with known or suspected organic brain dysfunction
recommend and implement basic therapeutic interventions with patients and their families
apply ethical and legal principles to practice
have an awareness of personal strengths and limitations as they relate to providing psychological services to this population.

Supervision Experience

The faculty neuropsychologists will provide at least two hours per week of individual supervision for each assessment case, but the resident will also be involved in weekly group supervision that can be utilized to discuss neuropsychological cases. Outpatient neuropsychological assessment and report writing is supervised by ABPP board certified clinical neuropsychologists.

Rehabilitation Neuropsychology Rotations

As described above, Rehabilitation Neuropsychology residents will complete a total of three rotations during their training year. Two of these rotations will include a focus in Neuropsychology and Neurorehabilitation, while the third will not.

We list these rotation sites separately below.

Rotations With A Specific Neuropsychology Focus

University of Washington Medical Center Department of Rehabilitation Medicine

Training faculty

Jeanne Hoffman, PhD, ABPP-RP (inpatient consultations and outpatient rehabilitation)
Ivan Molton, PhD, (inpatient rehabilitation, outpatient rehabilitation Clinic)
Lauren Schwartz, PhD, (outpatient rehabilitation clinic)
Myron (Moe) Goldberg, PhD, ABPP-CN, (Director, Neuro Rehabilitation Program & Neuropsychology Service)
Nickolas Dasher, PhD, (outpatient Neuropsychology Service)

Rotation Description

The UWMC Rehabilitation Neuropsychology rotation provides an array of clinical experiences to train clinical psychologists within a multidisciplinary team framework in a medical setting. Residents will have opportunities to work collaboratively with physicians, nurses, speech pathologists, physical therapists, occupational therapists, vocational counselors, therapeutic recreation therapists, and social workers, from within the medical center as well as from the community in developing and implementing treatment plans. Psychology is an integral part of the medical team. Our patients are diverse in terms of medical conditions and problems, ethnic and socioeconomic backgrounds, and ages.

Rehabilitation Neuropsychology residents will have an opportunity to evaluate and treat patients with a variety of presenting medical conditions, including spinal cord injury; brain injury due to trauma stroke, tumor, aneurysm, hemorrhage, hypoxia, etc.; multiple sclerosis; muscular dystrophy; post-polio syndrome; amyotrophic lateral sclerosis; cancer; and large organ transplant (heart, lung, and liver). The rotation provides a mix of inpatient and outpatient assessment and treatment opportunities.

Training Experiences

Like their counterparts in the Behavioral Medicine track, Rehabilitation Neuropsychology residents learn to function as an integral member of an interdisciplinary rehabilitation team. Rehabilitation Neuropsychology residents cover 2 teams on the acute inpatient rehabilitation unit and follow outpatients weekly in the rehabilitation clinic. Typical patients present with need for assessment of psychological and/or neuropsychological functioning, identification of patient and family concerns, development and implementation of appropriate treatment programs, and mobilization of resources to integrate the patient into the community. Rehabilitation Neuropsychology residents will also participate in both brief inpatient neurocognitive screens and more intensive outpatient neuropsychological evaluation experiences, including interviewing, test selection, administration, scoring, and interpretation, results integration, differential diagnosis, and report writing, as well as feedback to patients, family, and referral sources.

There is also the opportunity to observe or participation in outpatient treatment groups focused on neurorehabilitation. Participation in weekly rounds and team/family conferences is an important part of the psychology residents’ experience.

Expectations of Psychology Residents

Rehabilitation Neuropsychology residents participate in all aspects of the training experiences listed above. Residents in this track can typically expect to follow 4 to 8 inpatient cases, and 5-6 outpatient cases. Rehabilitation Neuropsychology residents will also be expected to be involved in at least one outpatient neuropsychology evaluation case per week.

By the end of the rotation, Rehabilitation Neuropsychology residents are expected to:

have an understanding of a psychologist’s role on an interdisciplinary rehabilitation team
demonstrate an increased awareness of and ability to assess the emotional, behavioral, and cognitive sequelae of various traumatic and chronic medical conditions
have a strong understanding of the functional implications of neuropsychological test results in rehabilitation
develop the knowledge and skills necessary for basic competence in the neuropsychological evaluation of patients with known or suspected organic brain dysfunction
recommend and implement basic therapeutic interventions with patients and their families
apply ethical and legal principles to practice
have an awareness of personal strengths and limitations as they relate to providing psychological services to this population.

Training Methods

All psychology residents will have an orientation session with tours of the facility. Residents will then have an opportunity to accompany and observe the supervising psychologist(s) performing clinical work. Residents will then have opportunities to see patients with direct observation and supervision provided. The eventual goal is for psychology residents to work fairly independently with patients and to move towards a co-treatment model. Psychology residents are provided with examples of psychological /neuropsychological evaluation reports, progress notes, and other written communications as models. All residents have access to a training manual and numerous articles and books to supplement their learning experiences. Residents participate in weekly scheduled individual supervision as well as weekly group supervision. They have additional opportunities for contact and supervision with the supervisors during weekly rounds and conferences. Residents are encouraged to drop by or page the supervisors with day-to-day questions concerning patients. Supervision is provided by the attending psychologists, and additional supervision may be provided by the post-doctoral fellow.

Evaluation of Psychology Residents

Supervisors provide frequent, ongoing feedback on the psychology resident’s performance throughout the rotation. Residents and supervisors discuss the resident’s progress and training needs at the mid-rotation point. Psychology residents participate in standard evaluation practices that are part of the overall internship which includes self-evaluation, evaluations by their supervisors, resident evaluation of their supervisors and resident evaluation of the rotation site.

Last Modified: August 29, 2024