CLINICAL PSYCHOLOGY Predoctoral Internship: LIFESPAN HEALTH elective

Each year, we select predoctoral interns as part of the Lifespan Health Elective (formerly called the Integrated Brain Health Elective). Interns receive multidisciplinary training in individual, dyadic, and group mind-body interventions on the continuum from health to illness and across the lifespan.

We believe a biopsychosocial approach is necessary for prevention and treatment of injury and illness. Through multidisciplinary and community partnerships, interns deliver brief, evidence-based interventions across inpatient and outpatient medical, psychiatric settings, and community clinics. Within the context of randomized clinical trials and clinical settings, they learn to flexibly deliver skills from a variety of mind-body therapeutic approaches to diverse populations (e.g., cognitive behavioral therapy, acceptance and commitment therapy, dialectical behavior therapy, mindfulness based interventions, physical activity programs). Across settings, interns serve on multidisciplinary teams to enhance collaborations, team-based approaches, and healthcare delivery.

History and Leadership

In 2018, Dr. Ana-Maria Vranceanu founded the Lifespan Health Elective (formerly called the Integrated Brain Health Elective) within CHOIR (formerly called the Integrated Brain Health Clinical and Research Program) as part of Harvard Medical School/Massachusetts General Hospital (HMS/MGH) Clinical Psychology Predoctoral Internship Program. This program helps launch clinical and research careers that integrate mind, brain, body, and behavior.

The research and clinical breadth of this training program continues to grow. With an initial focus on chronic pain and neurological populations, training opportunities have expanded to diverse inpatient and outpatient medical (e.g., rehabilitation settings, neonatal intensive care units, sports medicine, neurodegenerative illness clinics like ALS, MS and dementia) and community settings (e.g., churches, underserved community clinics). Interns are encouraged to gain a variety of clinical experiences and build original, clinically meaningful research. Although our interns have a range of backgrounds and areas of specialization, they are unified in their desire to learn how to build effective and accessible clinical interventions that aim to enhance health and well-being.

All our interns have secured postdoctoral fellowships at CHOIR, NIH T32 fellowships at HMS/MGH, staff/faculty positions at MGH/HMS, NIH diversity supplements, NIH Loan Repayment Awards, and K23 Early Career Development Awards (see internship alumni for details).

The internship track is currently co-led by Dr. Vranceanu and Dr. Grunberg.

Candidates

Successful candidates have demonstrated a commitment to clinical research through in-progress or completed peer-reviewed publications (~3-5 published or in press), presentations, awards, or small grants. Ideally, interns have fully completed their dissertations (or nearly completed them) before starting the internship. Interns who are interested in an academic research career, intervention development and implementation, and team-based science are well suited for this training program.

We highly encourage applicants with diverse backgrounds to apply. We value diversity, inclusion, and equity in all aspects of our work. Interns develop expertise delivering integrated, manualized, in-person or virtual skills interventions to populations diverse in age, race, ethnicity, socioeconomic status, culture, religion, gender identity, sexual identity, physical and mental health conditions.

Overview of Training

Interns received training in a variety of multidisciplinary, integrated clinical and research teams across inpatient (e.g., ICU), outpatient (e.g., psychiatry; rehabilitation; embedded clinics such as dementia, MS, ALS, chronic pain), and virtual (e.g., live video interventions) settings.

Interns gain experience:

1.    Delivering psychoeducation and technology-enhanced, evidence-based mind-body skills within patient, dyadic, and group interventions that aim to:

• Preserve health and prevent chronic illness through lifestyle changes, such as mindfulness, exercise, social support, adaptive thoughts

• Optimize the management of chronic illness

• Promote recovery and prevent chronic illness after injury or surgery.

2.    Functioning on multidisciplinary, integrated, clinical and research teams in inpatient (e.g., Neuro-ICU, general ICU, medical-psychiatric unit) and outpatient (e.g., orthopedics, psychiatry, neurodegenerative) settings.

3.    Delivering integrated, manualized, in-person or virtual skills interventions to diverse populations (e.g., patients with chronic pain, stroke, brain injury, dementia/mild cognitive impairment, concussions, older adults) as part of federally funded clinical trials in hospital or community settings (e.g., Black churches, underserved community clinics).

This curriculum overlaps with the Cognitive Behavioral Therapy Elective and Behavioral Medicine Elective, but the research interests of interns in this track should be primarily in technology-enhanced, mind-body intervention development, testing and implementation to promote health, well-being, and resilience over the continuum of health to illness and across the lifespan.

Required Internship Rotations

1. Psychiatric Inpatient Unit at Blake 11 (½ year)

• Conduct brief, bedside, evidence-based interventions to patients with acute psychiatric and/or co-morbid medical concerns.

• Co-lead groups for inpatient psychiatric patients.

• Collaborate with a multidisciplinary team of psychiatrists, residents, nurses, social workers, occupational therapists, case managers and other staff.

2. Dialectical Behavioral Therapy (½ year)

• Co-lead weekly DBT skills group for patients with borderline personality disorder and other psychiatric comorbidities.

• Attend weekly DBT team meeting with clinicians and trainees.

 3. Outpatient Psychiatry Department (1 year)

• Provide outpatient individualized evidence-based care using cognitive-behavioral approaches (second and third wave) to patients with medical and/or psychological conditions.

4. Internet-Based Cognitive Behavioral Therapy Coaching (1 year)

• Provide brief CBT-based coaching to patients with medical and psychological problems.

Elective Internship Rotations

Elective rotations are assigned collaboratively with the intern and Dr. Vranceanu. They generally include 1-2 (full year) or 3-4 (half year) placements.

1. Chronic Pain

• Pain Clinic: Conduct assessments and clinical work.

• Doorstep study (NCCIH R34): Lead or co-lead virtual mind-body activity pain management groups with adult patients with knee osteoarthritis, depression, and unhealthy weight from rural Kentucky.

• GetActive study (NCCIH R01): Lead or co-lead mind-body activity pain management groups with patients with chronic pain. Participate in MGH, Duke and Rush multisite meetings.

• Toolkit for Optimal Recovery (NCCIH U01/R01): Lead individual mind-body live video interventions with patients with orthopedic acute pain at risk for chronic pain. Participate in MGH, Kentucky, Vanderbilt and Texas multisite meetings.

• iHOPE (R01/R33): Lead or co-lead mind-body activity pain management groups (English-speaking or Spanish-speaking groups) with older adults experiencing chronic musculoskeletal pain from underserved community health centers

2. Neurofibromatosis (NF)

• Resilient Youth with NF (DoD R01): Lead or co-lead virtual mind-body groups for adolescents with NF from across the globe.

3. Neurosciences Intensive Care Unit (Neuro-ICU)

• Recovering Together (NINR R01): Provide brief evidence-based, manualized intervention (mindfulness, DBT, coping, mind-body skills) for patients with acute brain injuries (e.g., stroke, brain injury) and their family caregivers with emotional distress at the bedside (in-person) and over live video (Zoom). Function as part of a multidisciplinary team that includes nurses, physicians, psychologists, social workers, research assistants and volunteers.

4. Healthy Aging and Dementia

• Active Brains (NIA R01): Deliver virtual group, mind-body activity intervention to older adults with cognitive impairment and chronic pain..

• Bio-Experiential Approach to Support Wellbeing of Persons with Dementia and their Caregivers at Home (Robert Wood Johnson Foundation): Partner with industry to develop and implement a virtual reality toolkit to support persons with dementia and their caregivers.

• Physical Activity for Black Adults (NIA R01): Engage older, Black adults in churches to engage in and sustain physical activity.

• Mindfulness Self-Compassionate Care Program (NIA R01): Deliver a mindfulness self-compassion intervention alongside social workers to caregivers of persons with dementia.

• Calm Caregivers (NIA R21): Support caregivers of persons with dementia with using the mobile application Calm aim at reducing stress and improving emotional function.

5. Health Disparities

• Comorbidity of Chronic Pain and Early Cognitive Decline Among Older, Community-Based Black Adults (PCORI): Deliver culturally adapted mindfulness-based cognitive therapy for older Black adults with chronic pain and depression

• Physical Activity for Black Adults (NIA R33): Engage older, Black adults in churches to engage in and sustain physical activity

• iHOPE (R01/R33): Lead or co-lead mind-body activity pain management groups (English-speaking or Spanish-speaking groups) with older adults experiencing chronic musculoskeletal pain from underserved community health centers

6. Ocular Trauma Service @ Mass Eye and Ear

• Deliver in-person or live video interventions with patients with acute eye trauma and their caregivers. Co-lead resident and staff wellness initiatives, program development, and design. 

7. Stroke Rehabilitation at Spaulding Rehabilitation Hospital

• Deliver in-person bedside care (screening, evaluation, and therapy) to patients with stroke and families. Consult with medical team and attend interdisciplinary team meetings.

Research

The goal of this elective is to prepare interns for a career in academic research. Interns receive 1 day/week of protected time to complete dissertation projects, write manuscripts, and prepare small grants. Interns are supported to develop new research collaborations in medical practices that fit the mission of this program. Interns who stay on as postdoctoral fellows are encouraged to also develop a grant proposal idea during the second part of the internship year.

Inters have opportunities for clinical research in a variety of topics, including:

• Aging adults

• Chronic pain

• Mild cognitive impairment

• Dementia

• Orthopedics

• Critical care illness

Each week, interns receive the following research support:

• Protected research time

• Elective rotations with research component

• Grant and manuscript writing

• Presentations at professional conferences

• Mentorship on qualitative and quantitative methods

• Research and multidisciplinary seminars (e.g., “K-Club” seminar)

Mentoring and Supervision

A successful career requires effective mentoring. Interns receive mentoring, career planning, and additional mentoring in specific areas of research. They also receive individual and group supervision designed to provide training, support, and perspectives on the care of patients across medical and psychiatric settings.

Each week, interns receive:

• Individual supervision for each clinical rotation

• Group clinical supervision

• Group mentoring and career supervision

• Individual research and professional development supervision

Didactics

Interns attend weekly required didactics, including:

• Behavioral medicine seminar (½ year)

• CBT seminar (½ year)

• Proseminar (1 year)

• Integrative Seminar (1 year)

• Research Seminar (e.g., Methods, Journal Club, Works in Progress) (1 year)

Postdoctoral Training Opportunities

Interns who demonstrate outstanding performance and commitment to clinical research in an academic medical center may have the option to transition to a clinical research postdoctoral fellowship. Interested interns are encouraged to organize their research activities such that they can make a smooth transition to a fellowship year if positions are available. In addition, Lifespan Health interns have been successful in securing T32 postdoctoral fellowships, including the HMS Integrative Health Fellowship and MGH Translational Neuroscience Training for Clinicians, under Dr. Vranceanu’s mentorship.

Please contact Dr. Ana-Maria Vranceanu (avranceanu@mgh.harvard.edu) and Dr. Victoria Grunberg at (vgrunberg@mgh.harvard.edu) for more information.

CURRENT Interns

Internship Alumni