Psychosis Track

Training is designed to establish competency in the following areas as they relate to psychosis:

• Outpatient psychotherapy
• Inpatient evaluation and treatment
• Neuropsychology
• Research

At the end of the internship, the intern should be able to function competently, autonomously, and with confidence in a variety of clinical and research settings. They will have a breadth of knowledge about psychosis and related problems, such as PTSD, mood and anxiety disorders, substance use, and cognitive deficits.  

The Psychosis Emphasis intern will spend 4.5 days/week engaged in the following:

Outpatient Psychotherapy: Interns gain experience providing psychotherapeutic interventions to individuals with a psychotic disorder and co-occurring disorders from experts in the field:

CBT for Psychosis: Interns will be trained in the formulation and delivery of CBT for psychosis. This will include implementation of empirically-supported treatments for persecutory delusions and hallucinations (e.g. the Feeling Safe Program). Interns will be trained to conceptualize psychotherapeutic targets, formulate appropriate interventions, and administer treatments for those at early and prolonged stage of illness, as well as working with families to best support recovery.

Recovery-Oriented Cognitive Therapy (CT-R): The Psychosis Internship training faculty includes Dr. Aaron Brinen, who developed CT-R with Dr. Aaron Beck in his previous role at the University of Pennsylvania. Interns will be trained in the delivery of CT-R, an empirically-supported extension of CBTp privileging negative symptoms and disorganization that facilitates engaging some of the most difficult to reach patients in effective treatments.

Navigate First Episode Team/AC-EPINET (Coordinated Specialty Care): Interns will have the opportunity to be the therapist for individuals served on the Navigate team, which includes psychotherapy, medication management, multi-family group, peer support, and vocational support for young adults managing a first episode of psychosis. Interns will participate in a weekly Navigate coordinated care meeting with all providers. Individuals on the Navigate team may also be enrolled in the AC-EPINET Learning Health Systems and clinical research, offering a unique view into the integration between clinical and research services.

Co-Occurring Disorders: Interns will gain additional training in outpatient psychotherapy for disorders frequently co-occurring with psychosis, including PTSD, mood disorders, anxiety disorders, insomnia, and substance use disorders. Interns will implement cognitive-behavioral approaches to the treatment of these disorders.

Faculty Supervisor(s):Julia Sheffield, PhD; Aaron Brinen, PsyD

Inpatient Rounding: Working as part of a treatment team on the VPH inpatient units, interns participate in the daily assessment of acutely ill patients, by rounding on inpatient units with the treatment team. Interns gain exposure to a variety of clinical presentations including frank psychosis, disorganization, affective disorders, catatonia, substance abuse, and intellectual and neurodevelopmental disabilities. This unique experience emphasizes detailed clinical phenotyping of psychosis and building case conceptualization skills.

Faculty Supervisor(s): Stephanie Fall, MD; Stephan Heckers, MD

Neuropsychological Assessment. Interns obtain experience conducting neuropsychological evaluations of adults with a variety of psychiatric and neurological disorders. Under direct supervision of a clinical psychologist, interns conduct clinical interviews; administer, score, and interpret neuropsychological tests; prepare neuropsychological reports; and provide feedback to patients and families. Referrals come from a variety of sources within Vanderbilt, including the Early Psychosis Program, the Vanderbilt Psychiatry Memory and Aging Clinic, Neurology, and Primary Care. Consequently, interns are exposed to wide range of patient populations in addition to psychotic disorders, including mild cognitive impairment, neurodegenerative disorders, and traumatic brain injury. 

Faculty Supervisor(s): Neil Woodward, PhD

Research. Interns will engage in research during the internship year. Interns wishing to emphasize research during internship may spend up to 25% of their time (1.5 days/week) engaged in research and will be expected to a complete a research project. At the beginning of the internship year, the intern, working in collaboration with the intern’s primary supervisor, will select a research project that is aligned with the intern’s research interests and graduate training, and is feasible within the constraints of the internship year and resources of the program. Research projects typically span one or more core areas of training: assessment and clinical phenotyping; intervention; and neuropsychology/neuroscience.

Current research areas and topics include:

• Neuroimaging brain structure, function, and connectivity. Areas of focus include the hippocampus, thalamus, insula, and BNST. (Woodward; Heckers; Sheffield)
• Cognitive and psychological contributors to the maintenance and recovery from delusions (e.g. social and environmental factors, predictive coding processes, reasoning biases, treatment) (Sheffield; Brinen)
• Intervention research – three clinical trials are currently being conducted, focused on the treatment of psychosis using psychotherapeutic approaches. This includes AC-EPINET research embedded in our Navigate first episode program, CBTp clinical trials research, and implementing CT-R in medication management appointments. (Sheffield; Brinen; Heckers)
• Dimensional and categorical approaches to psychosis and co-occurring disorders (Woodward; Heckers)

Recent intern research projects are listed below. 

Moussa-Tooks A, Rogers BP, Huang AS, Sheffield JM, Heckers S, Woodward ND. (2022) Cerebellar structure and cognitive ability in psychosis. Biological Psychiatry, 92(5):385-395.

Dean DJ, Woodward ND, Walther S, McHugo M, Armstrong K, Heckers S. (2020) Cognitive motor impairments and brain structure in schizophrenia spectrum disorder patients with a history of catatonia. Schizophrenia Research, 222:335-341.

Sheffield JM, Rogers BP, Blackford JU, Heckers S, Woodward ND. (2019) Accelerated aging of functional brain networks supporting cognitive function in psychotic disorders. Biological Psychiatry, 86(3):240-248.

Karcher NR, Rogers BP, Woodward ND. (2019) Functional connectivity of the striatum in schizophrenia and psychotic bipolar disorder. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 4(11):956-965.

Prior graduate training and experience in assessment, intervention, and/or research in psychotic disorders is preferred. Applications from interns whose achievements reflect a strong commitment to pursue careers in academic clinical and/or research settings will be viewed favorably.    

2021-2022: Arielle Ered, PhD | Postdoctoral Fellow, University of Pennsylvania Department of Psychiatry

2020-2021: Alex Moussa-Tooks, PhD | Assistant Professor, VUMC Psychiatry and Behavioral Sciences

2019-2020: Beshaun Davis, PhD | Assistant Professor, University of Maryland School of Medicine

2018-2019: Derek Dean, PhD | Business Analyst, Epilog Laser

2017-2018: Julia Sheffield, PhD | Assistant Professor, VUMC Psychiatry and Behavioral Sciences

2016-2017: Nicole Karcher, PhD | Assistant Professor, Washington University School of Medicine