PREDOCTORAL INTERNSHIP
IN
CLINICAL PSYCHOLOGY
2008-2009

OUR MISSION
CORNERSTONE BEHAVIORAL HEALTH
THE INTERNSHIP PROGRAM
INTERNSHIP STRUCTURE, ACTIVITIES AND CLIENTELE
TREATMENT SERVICES
THE PSYCHOLOGY STAFF
BENEFITS FOR PSYCHOLOGY INTERNS
EVANSTON AND THE WESTERN WYOMING AREA
APPLICATION PROCESS

MISSION

The APA accredited predoctoral internship program in clinical psychology at Cornerstone Behavioral Health is committed to developing the skills, competencies, and rigorous scientific attitude necessary for entering the professional practice of psychology, with special sensitivity to the personal and professional growth of the interns while simultaneously improving the quality of life for the persons served.

2007-2008 interns (left to right): Kim Kent, Chris Smith, Richelle Fitzsimmons, and Clinical Director - Director of Internship Training Dr. Adam Fuller.

PHILOSOPHY AND TRAINING MODEL
The Local Clinical Scientist

The Cornerstone Behavioral Health internship in clinical psychology recognizes that becoming a professional psychologist is a developmental process. It is a core belief of our program that the path from student to expert is illuminated by developing a working knowledge of a coherent theoretical model of the mind, personality, psychopathology, and therapeutic change that serves as a basis for not only techniques and strategies of practice, but as a unifying way of thinking and clinical judgement.

The practicing psychologist typically is presented with unique, complex, multi-determined, and often ill-defined, emotionally-charged problems immersed in an intensive interpersonal matrix. At Cornerstone, like many other clinical settings, we are practitioners repeatedly faced with demands to solve problems that are influenced strongly by unique local factors for which there are no clear answers provided by the research literature. As for most practitioners, our clientele are more likely to be those people who would be excluded from research protocols. Yet, as psychologists, we accept the challenge of developing well-reasoned, empirically-based solutions, whether serving as therapist, consultant, or formulating useful recommendations in a well-conceptualized psychodiagnostic report.

Under these circumstances, we view ourselves as clinicians who approach problems scientifically, with the same discipline, rigor, logic, critical thinking, and openness to falsification, described by Stricker and Trierweiler (1995) as the essential nature of the local clinical scientist, which serves as our model of training. We approach each person seeking services with a commitment to understanding their individuality and the diversity of human experience and backgrounds. There is no "one-size-fits-all" approach to treatment. Instead, each clinical situation represents a problem to be solved in the context of the uniqueness of the individual immersed in a therapeutic relationship, using theory-driven hypotheses and a scientific attitude of inquiry as our guides.

Our approach to training is to provide interns with the tools and the theoretical framework for making sense out of the complex and seemingly disparate data of the practitioner's world and coming up with practical solutions that are sound, empirically-minded, and respectful of human diversity. These tools and theories we teach are firmly rooted in empirical demonstrations of the efficacy of psychodynamic/psychoanalytic approaches to treatment, among others, yet applied in the local context. In addition to learning specific techniques and strategies, our interns develop a style of thinking and a structure for clinical judgment–an over-arching guide to negotiating and making sense out of the complexities of clinical practice– which can be applied in any setting.

In accomplishing this, we recognize that the developmental process of becoming a psychologist is best facilitated by a learning environment that contains a number of essential elements. First, the ideal internship environment requires complete immersion of the intern in intensive work that gradually progresses in complexity and responsibility in a way synchronized with each intern's individual development. This intensive environment places demands on the interns’ abilities, thus stimulating growth, and adds levels of responsibility beyond what was experienced in graduate school. Despite the intensity of the work, it is also essential that the interns have enough time where they are not over-burdened by demands, leaving them the opportunity for contemplation, reading, thinking, and personal time which allow for thorough incorporation of their internship experiences.

The internship offers plentiful direct-care clinical experience interwoven with didactic training and in-depth supervision. Didactic seminars continue to deepen the interns’ knowledge while the clinical work provides opportunities to directly apply new knowledge and broaden the interns’ view of the diversity of human experience through exposure and empathy. The performance of clinical work occurs under supervision that focuses on development of new skills, application and integration of new learning in the context of direct clinical work with individuals, clear feedback on progress, and overall professional development and support.

Other essential ingredients include opportunities for observation of others performing the work of professional psychologists and opportunities to integrate information in written form. We recognize that observing, practicing, listening, reading, writing, contemplating, and verbally articulating thoughts are all ways of "knowing." Each is a learning modality, which, when combined in an intensive setting, creates the environment necessary for education at the predoctoral internship level.

Stricker, G. & Trierweiler, S. (1995). The local clinical scientist. American Psychologist, 50(12), 995-1002.

CORNERSTONE BEHAVIORAL HEALTH

Cornerstone Behavioral Health is a private, not-for-profit division of Mountain Regional Services, Inc. (MRSI). Established in 1985, and first accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) in 1987, Mountain Regional Services has earned a national reputation for ground breaking work with persons with developmental disabilities and co-occurring mental illness, using community-based residential and day-treatment services in contrast to traditional state-run facilities or inpatient units. Our work with people with developmental disabilities has left us profoundly changed, humbled, and dedicated to valuing the dignity and worth of people traditionally disadvantaged, abused, and socially outcast. Our experiences with these individuals have shaped the core values of our organization, acutely sensitizing us to the true extent of individual diversity as well as the common essence of what it means to be a human being. These same values and respect for the individual carried over into other dimensions of our work as Cornerstone expanded the breadth of services offered by MRSI by developing general mental health services in an outpatient private-practice setting, and an intensive substance abuse treatment program, both serving Evanston and surrounding rural communities in southwestern Wyoming. Cornerstone's substance abuse treatment program is one of only two in the State of Wyoming accredited by CARF. The mental health program received CARF accreditation in the fall of 1997, offering clients professional and confidential services traditionally found in urban environments. Taken together, the program for people with developmental disabilities and co-occurring mental illness, the outpatient mental health practice serving adults, adolescents and children, and the substance abuse program serving adolescents and adults provide a breadth of clinical experience for Cornerstone interns.

THE INTERNSHIP PROGRAM

INTERNSHIP STRUCTURE,
ACTIVITIES AND CLIENTELE

The primary experience for interns is working with adults who have developmental disabilities in individual and group psychotherapy. Over 90% of these clients have concomitant major psychiatric disorders, comparable to typical inpatient psychiatric hospital populations. In many settings, working with people who have developmental disabilities is a neglected and poorly understood area of psychology. For Cornerstone interns, the common course of development through the year is one that starts with limited awareness and often misunderstanding of people with developmental disabilities and moves toward an attitude of profound respect and admiration for a group of people who repeatedly demonstrate courage and resiliency in the face of overwhelming hardship, prejudice, abuse, and social rejection. Some interns have called their therapy work with people who have developmental disabilities the richest and most rewarding therapy experiences they have had. Psychological processes, symptoms, motivations for behavior, defense mechanisms and other strategies for managing tension and coping with trauma common to all people are often so vividly illustrated, interns are left with highly honed skills in recognizing such psychological concepts in any individual with whom they have clinical contact, including the general mental health and substance abuse clients with whom they work.

Additional activities for the interns include developing and coordinating behavioral interventions for their caseload of clients with developmental disabilities, consulting with staff members who work directly with the clients, and evaluating clients to determine eligibility for state funded services. Interns also have the opportunity to participate in statewide consultation and training using the University of Wyoming distance-learning video conferencing system.

The substance abuse treatment rotation includes spending a either a half or a full year co-leading intensive outpatient adult or adolescent after-care substance-abuse groups. Interns who participate in the half-year rotation spend the other half of the year working more intensively with outpatient private practice clientele.

In our private practice setting, interns have opportunities to provide individual psychotherapy to adults and adolescents who are referred for supplemental individual or couple's treatment by Cornerstone's intensive outpatient substance abuse program, or people from the local community seeking general mental health services. This smaller portion of the interns' caseload generally accounts for approximately one to four therapy hours per week.

Interns have three hours of didactic seminars each week. The first hour is devoted to the study of psychoanalytic theory. The second hour focuses on psychotherapy and assessment, including topics suchas the interaction of culture and psychotherapy, interpretation, the role of metaphor, transference and countertransference, brief models of psychodynamic psychotherapy, group psychotherapy, psychodynamic case formulation, using the Psychodynamic Diagnostic Manual, models of supervision, and specialty training in the Rorschach and MMPI-2. The third hour focuses on understanding and treating individuals with developmental disabilities including such topics as psychopathology in people with DD, character disorders, psychosis, mood disorders, the effects of trauma on ego development, seizure disorders, sexuality, aggression, and self-injurious behavior.

Interns receive a minimum of seven hours of face-to-face individual and group supervision per week. Interns meet individually with their primary supervisor for two-hours each week, focusing on psychotherapy supervision and general professional development. Interns are assigned a separate supervisor for their assessment experience, with whom they meet individually for an additional one hour per week. Interns have group supervision with the Clinical Director, one hour per week, and an additional hour of group supervision specifically focused on group psychotherapy. Finally, for the substance abuse experience, interns have a two-hour substance abuse group supervision every week.

INTERNSHIP GOALS, OBJECTIVES, AND COMPETENCIES

Based on our philosophy of treatment and training model, we have developed the following broad goals for our program, supported by specific objectives for training and competencies to be achieved by each intern. The structured activities and clinical experiences of the internship provide the basis for each intern to develop the competencies listed below. To facilitate development of these competencies, interns work closely with their supervisors, receiving regular feedback as well as formal evaluation of their progress to help ensure satisfactory accomplishment of the objectives set forth by the program, all in the context of a supportive learning environment.

Goal 1: To produce graduates well-prepared for the practice of professional psychology who have a working knowledge of a core theoretical model of the mind, personality, psychopathology, and therapeutic change that serves as an over-arching guide to clinical practice.

Goal 2: To produce graduates capable of assuming multiple professional roles as psychotherapists, psychodiagnostic examiners, consultants, supervisors, and evaluators.

Goal 3: To produce graduates who identify with the broader role of the professional psychologist with respect to ethics, diversity, and science. Our program objectives and the competencies interns develop in the process of accomplishing these goals include:

Goal 1: Objective A: Achieve capacity for scientific thinking within a theoretical framework, using theory as a foundation for sound clinical judgement, conceptualizing clients, and clinical decision-making.

Competency 2: Bridge theoretical knowledge with clinical practice.

Competency 2: Proficiency in psychological assessment, diagnosis, and report-writing. Competency 3: Proficiency in consultation. Competency 4: Develop skills and knowledge related to supervision.

Competency 1: Ability to exercise good judgement and ethical behavior.

Competency 1: Respect for individual and cultural diversity.

Competency 1: Develop skills in accessing, evaluating, and applying existing research.

MORE ABOUT OUR TREATMENT SERVICES
(Offered by Mountain Regional Services, Inc. and Cornerstone Behavioral Health)

Developmental Disability Services provide evaluations, consultation, and long-term psychotherapy, incorporating a variety of theoretical models with an over-arching psychoanalytic perspective. Psychologists provide psychotherapy to a population of people with developmental disabilities and chronic mental illness in addition to writing treatment plans and guiding the multi-disciplinary team in implementing the plans. Rare in most clinical settings, Cornerstone’s psychology staff also treat disorders not typically found in the general clinical population such as Prader-Willi Syndrome, Rett’s Disorder, Asperger's Disorder, and Autism. Interns participate in these services as part of their primary experience.

Developmental Disability Consultation Services provide statewide video-conferencing and training sessions as well as on-site comprehensive evaluations. As Wyoming’s leader in psychological services to persons with developmental disabilities, Cornerstone offers fellow providers psychological expertise using the University of Wyoming compressed video network that spans the entire state. Rural providers who lack the ability to attract professional psychologists are able to consult with Cornerstone on specific client issues. Interns participate through observation of the consultation process.

Rural providers also benefit from monthly state-wide trainings presented by Cornerstone psychology staff. Recent video-conference presentations by Cornerstone psychologists include topics on managing aggression in clients with developmental disabilities, treatment team functioning, rare concurrent diagnoses, psychotic disorders and other major mental illnesses in people with developmental disabilities, using behavior modification in a therapeutic milieu, self-injurious behavior, eating disorders, sexuality, Autism, ethics and legal issues, and many more. Interns attend these didactic presentations every month, and some have chosen to participate as presenters.

Fellow providers across the state also use Cornerstone's comprehensive on-site evaluation services for people with particularly complex and challenging problems. Typically, these clients are brought to MRSI for an in-house, 28-day observation and assessment period wherein professionals from various disciplines perform detailed assessments. Psychologists incorporate these findings into a single comprehensive report with detailed programmatic suggestions for treatment and management of identified problems. Interns have the opportunity to participate in these evaluations as part of their assessment training.

General Mental Health Services offer psychotherapy and evaluations for children, adolescents and adults. Psychotherapy services are conducted in individual, marital, or family modalities. Psychological evaluations include psychodiagnostic testing using objective and projective techniques, and specialty assessments for learning disorders and attention problems. Interns have the opportunity to work with outpatient general mental health clients in a traditional private-practice setting. This smaller portion of the interns’ caseload generally accounts for approximately one to four therapy hours per week, plus assessments depending on availability.

Substance Abuse Treatment Services consist of evaluations and intensive outpatient programs for adults and adolescents. These multifaceted, highly comprehensive programs are designed to help individuals with chemical dependencies and substance abuse issues through individual, group, and family therapy. Cornerstone also offers adult and adolescent aftercare programs, co-dependency workshops, DUI school, drug and alcohol education, and prevention seminars. Interns participate in these services as co-therapists in the adult and adolescent aftercare group psychotherapies, plus providing individual or couple’s psychotherapy to clients enrolled in the intensive outpatient treatment. Interns also attend the weekly substance abuse staff meetings and specialized substance abuse supervision.

THE PSYCHOLOGY STAFF

Cornerstone's psychology staff (left to right): (front) Dr. Joshua Clauson, Dr. Mikaela Bernthaler, Dr. Brian Schaffer
(back) Dr. Robert Matzelle, Dr. Cora Courage, Dr. Suzanne Petren, and Dr. Adam Fuller.

Mikaela Bernthaler, Psy.D., MS.Ed., M.B.A.
Psychological Resident

Dr. Bernthaler earned her doctoral degree in clinical psychology from the George Washington University. She also completed a one year fellowship at the Washington-Baltimore Institute for Psychoanalysis. Throughout her training, she worked primarily in residential and inpatient settings with chronic, multi-problem, under-served and culturally diverse adults and their families. In these settings, she provided individual therapy, psychodiagnostic assessments and co-lead groups. Dr. Bernthaler completed an APA accredited internship at the Albert Einstein College of Medicine - Bronx Psychiatric Center, a state inpatient facility specialized in the psychodynamic treatment of chronically mentally ill and forensic clients, where, in addition to working with adults, their families and co-leading groups, she also received training in Emergency Room intervention, psychodiagnostic assessment of children as well as neuropsychological assessment. Dr. Bernthaler also holds a Master's Degree in Marriage and Family Therapy from the University of Miami and provided couples and family therapy from structural and strategic systems perspectives. She also worked with children and was a volunteer in the Guardian ad Litem Program at the 11th Judicial Circuit in Florida. She has considerable experience working with the Hispanic community andis a bilingual therapist. She is a member of the APA Division of Psychoanalysis. Prior to turning to the field of psychology, Dr. Bernthaler worked for a multinational corporation throughout Europe and South America in various managerial capacities. Her primary interests are in the role of language in the structuring of internal and external experience, as well as the interweaving influences of trauma, gender, and culture to human development.

Joshua Clauson, Psy.D.
Staff Psychologist

Dr. Clauson completed his undergraduate studies at Gustavus Adolphus College, and continued on to earn his masters and doctoral degree in clinical psychology at the Minnesota School of Professional Psychology. He completed an APA accredited predoctoral internship at Cornerstone Behavioral Health. While completing his internship, Dr. Clauson received training in psychodynamic theory and practice, and worked with a wide variety of clients from this perspective. Following his Internship, Dr. Clauson went on to work in several correctional facilities, providing both individual and group therapy to a diverse population. He has also had training in working with a multicultural population. His interests include both long-term and brief psychodynamic psychotherapy, correctional psychology, and psychotherapy with chronically mentally ill.

Cora Courage, Psy.D.
Clinical Psychologist

Dr. Courage holds a doctoral degree in clinical psychology from the Minnesota School of Professional Psychology and received training in psychodynamic theory and practice during several field training experiences. She brings twenty years of experience in dual diagnoses to her practice. The APA accredited predoctoral internship at the VA Medical Center of the Black Hills in South Dakota she completed emphasized outreach to rural, underserved, culturally diverse communities, and treatment of minority populations. Her master's degree in counseling psychology from Saint Mary's University integrated the application of psychodynamic orientation with family systems approaches in the treatment of addictions. Her primary interests are in psychodynamic theory and therapy with children and adolescents, trauma and critical incidents, sexuality/gender issues, and the impact of multi-cultural diversity in psychoanalysis. She is a licensed psychologist and a member of the American Psychological Association (Div. 33, 39, 53). Dr. Courage is a Team Leader for the state of Wyoming in the Child Trauma Treatment Network of the Intermountain West, part of the National Child Traumatic Stress Initiative, as well as many local organizations serving the needs of children and adolescents. Dr. Courage is also a commissioned officer in the Medical Service Corps, serving as the psychologist for the 34th Infantry Division of the Minnesota Army National Guard, and a member of the National Health Service Corps.

Adam K. Fuller, Ph.D.
Clinical Director
Director of Internship Training

Dr. Fuller earned his doctoral degree in clinical psychology from the Department of Clinical and Health Psychology at the University of Florida. He completed an APA accredited predoctoral internship at the State University of New York, Health Science Center in Syracuse (SUNY Upstate Medical Center). In both settings he received extensive experience in outpatient psychotherapy and psychodiagnostic testing with adults, adolescents, and children. In addition, Dr. Fuller has worked on a number of inpatient psychiatric units focusing on group therapy, crisis intervention, and psychotherapy with chronically mentally ill clients. Coming from a scientist- practitioner tradition, Dr. Fuller has published several research articles related to chronic pain and pain perception. Prior to joining Mountain Regional Services in 1997, he worked in a group private practice which provided him the practical experience of applying a psychologist's skills within a managed care environment. Dr. Fuller's special interests are related to psychoanalytic theory and therapy, the empirical basis for psychoanalytic principles and treatment, and applications of psychodynamic concepts in brief psychotherapy. Dr. Fuller is a member of the American Psychological Association (Divisions 12, 29, and 39) and the Wyoming Psychological Association.

Robert Matzelle, Psy.D.
Staff Psychologist

Dr. Matzelle completed his undergraduate studies at the University of St. Thomas in Houston, Texas. He continued his education at John Jay College of Criminal Justice earning a Masters degree in Forensic Psychology. Presently, Dr. Matzelle completed an APA pre-doctoral internship at Cornerstone Behavioral Health. Furthermore, and will continue his training with Cornerstone Behavioral Health as a post-doctoral psychology resident beginning in August 2006. Dr. Matzelle received training in psychodynamic theory and practice throughout his graduate studies. He has worked with a wide variety of populations from this perspective, including children, families, couples, and adults. Dr. Matzelle's areas of interest include psychodynamic psychotherapy with an interpersonal emphasis, trauma and posttraumatic stress, couples therapy, sexual orientation and gender issues. Additionally, Dr. Matzelle has focused on working with underserved populations throughout his training and clinical experiences.

Suzanne Petren, Ph.D., J.D.
Staff Psychologist

Dr. Petren holds a Ph.D. degree in counseling psychology from the University of Missouri-Kansas City. She is also a licensed attorney, having earned her J.D. degree from the University of Missouri School of Law-Kansas City. She completed an APA accredited predoctoral internship at Cornerstone Behavioral Health where she received training in psychoanalytic theory and practice. She has also received training in existential phenomenology and biofeedback from the University of Missouri-Kansas City. Her clinical interests are in psychoanalytic theory and practice with individuals suffering from severe and chronic mental illness. The psychophysiology of emotion and individual differences are her special areas of interest in research, and she received a National Institute of Health Predoctoral Fellowship in the research area of emotion. In 2007, Suzanne Petren was awarded a Fellowship by the American Psychoanalytic Association as an outstanding early-career psychologist. She is a member in good standing of the American Psychological Association (APA). Her publications are in the area of emotion and group treatment methods.

Brian Schaffer, Psy.D.
Staff Psychologist

Dr. Schaffer completed his undergraduate studies at Michigan State University, and continued on to earn his doctoral degree in clinical psychology at Nova Southeastern University. He completed an APA accredited predoctoral internship at Cornerstone Behavioral Health. While completing his graduate studies, Dr. Schaffer received training in psychodynamic theory and practice, and worked with a wide variety of clients from this perspective. He continued to receive psychodynamic training while on internship. His interests include long-term psychodynamic psychotherapy, and psychotherapy with those who suffer from severe emotional disturbance.

BENEFITS FOR PSYCHOLOGY INTERNS

Cornerstone Behavioral Health offers interns a stipend of $18,000 plus benefits for the one year, full-time (2000 hour) program.

Fringe benefits include the following: