Child and Adolescent Psychology Doctoral Internship

The internship program is structured to be a full-time, 12-month experiential training experience. Each internship year begins on July 1 and ends on June 30 the following year. Interns work five days per week between the hours of 8am and 5pm, including the possibility of one late evening per week. Hours worked per week generally range from 40-45. There is no "on-call" coverage. The internship program has an emphasis on clinical child and pediatric psychology and focuses on evidence-based assessment and intervention services. Doctoral interns work with a range of clinical presentations, as well as largely underserved patients and families. Clinical services and training activities are conducted in-person, following safety guidelines, and via virtual/telehealth platforms.

Both brief and longer-term outpatient and day treatment interventions, in group and individual formats, are available. Measurement-based care is emphasized, and interns will gain skills in assessment in several settings. Interns work collaboratively with a team of providers (e.g., medical residents/fellows, nurses, pediatricians, social workers, licensed professional counselors, psychiatrists, etc.), and are actively involved in clinical teaching and supervision. Upon successful completion of the internship program, trainees are expected to have met all doctoral internship requirements (1,750 hours) needed for licensure (as outlined in Texas statutes).

• Interns dedicate time to direct service activities related to assessment, intervention, consultation, and inter-professional collaborations. About 80% of time is spent in clinical service-related activities.
• Interns may gain experience and expertise with a range of clinical child presenting problems, including disruptive behaviors, anxiety, depression, trauma, and suicide and self-harm.
• Interns may gain experience and expertise with a range of pediatric psychology presenting problems, including pain, feeding and eating disorders, and hematology/oncology.
• The amount of time that is devoted to direct service delivery varies, but ranges from 16-18 hours of face-to-face services per week.
• Time for preparation, documentation, phone calls, care coordination, etc. will be built into weekly schedules.

• Interns can spend 10% of their time (4 hours per week) in research activities. Interns can work on their dissertation during this time, and they are also expected to complete a scholarly activity during their internship year (e.g., poster or manuscript submission, conference talk, quality improvement project, program development proposal, etc.).
• Interns participate in a monthly seminar to support them in meeting their scholarly requirements and receive mentoring from faculty who are engaged in similar scholarly activities.
• TTUHSC Lubbock is a part of two state-wide research networks that may be of interest to interns:
  • Texas Childhood Trauma Research Network
  • Texas Youth Depression & Suicide Research Network

Didactics focused on evidence-based assessment and intervention:

• Case Conference: discussion of cases, biopsychosocial case formulations, assessments, differential diagnoses, interventions, and video review of sessions
• Disease Specific Topics: a 4-part series focused on one mental health disorder. The first week of the month focuses on diagnosis. The second week provides a brief overview of assessments/interventions. On the third week of the month, psychology and psychiatry divide to take a closer look at evidenced based assessments/interventions within their respective disciplines. On the fourth week, learners engage in a Problem-Based Learning assignment, where they work in interdisciplinary groups to solve an open-ended vignette.
• Special Topics: discussion related to various mental health disorders, healthcare systems, and supportive interventions.
• Morbidity and Mortality Conference: a critical examination of system processes related to assessment, treatment, and overall care to plan for or avoid trouble-spots in the future

• Invited Speaker/Grand Rounds: in depth discussion regarding a special topic of expertise and clinical cases

   

Didactics focused on scholarly inquiry:

• Journal Club: critical examination of research articles, conclusions, and clinical implications
• Research Seminar: accountability and support for completion of scholarly requirements

• Scholars Symposium: learner presentations of scholarly activity

   

Didactics focused on general competencies related to health service psychology:

• Professional Development Seminar: discussion of professional development topics relevant for advanced learners and early-career psychologists
• Healthcare Competences/Ethics Seminar: discussion of various topics necessary to work successfully within the healthcare field as well as the study and application of ethical principles and decision-making
• Supervision Seminar: development of skills related to consultation, supervision, and teaching
• Training Director Meeting/Program Evaluation Retreat: reflection on program strengths and growth areas and time for shared governance
• Team Building/Volunteering: opportunity for internship and engagement with the local community
• Connections Curriculum: discussion of individual and cultural factors in thoughtful ways to increase connections with others
• Wellbeing Activity: activity to enhance individual and group wellness and wellbeing

• State of the Department: learn about departmental growth, vision, and finances

   

Additional Unstructured Didactic Opportunities:

• Additional scheduled orientations to clinics, policies, curriculum, and basic therapeutic skills are scheduled in July during onboarding.
• American Psychological Association: https://www.apa.org/education-career#cetrain
• FIU Center for Children and Families: https://effectivechildtherapy.fiu.edu/
• TTUHSC Events
• Learners are encouraged to participate in workshops and conferences.

Interns receive at least four hours of supervision per week (10% of time) from licensed psychologists (in the state of Texas) who carry professional practice responsibility for the cases being supervised. At least two of those hours are regularly scheduled individual supervision. The other two hours of supervision are obtained in a variety of formats, including additional individual supervision, group supervision, and tiered supervision (e.g., with postdoctoral fellow and licensed psychologist). Supervisors will review documents, review video/audio taped sessions, and engage in live observation. Further, interns have access to consultation and supervision during times they are providing clinical services. 

Supervisors are responsible for reviewing with the interns the relevant scientific and empirical bases for the professional services delivered by the interns. Supervisors participate actively in the program's planning, implementation, and evaluation and serve as professional role models to the interns consistent with the program's training aims and expected competencies.

Training Settings

The internship program is housed within the Department of Psychiatry, which is a part of the TTUHSC School of Medicine. All child and adolescent clinical services (and intern offices) are housed within the Relational Health Center, which is a new unit in partnership with Covenant Children’s Hospital and Texas Tech Physicians. View this video to learn more about the vision of this new unit: Pediatric Mental Health Care in Lubbock. Child and adolescent training programs are interconnected so that trainees across disciplines learn and practice together. The Department of Psychiatry partners with several other community organizations, including University Medical Center, Texas Tech University, local independent school districts, the juvenile justice center, and the local mental health authority (StarCare Specialty Health System), and rotations may be available in partnership with these organizations. Interns are also involved in the Texas Child Health Access Through Telemedicine (TCHATT) Program. This program provides free mental and behavioral health services to PreK-12th grade students through telemedicine within their schools. Additional information about our TCHATT services can be found here.

Interns are supplied all necessary materials, resources, and technology to complete their job, including testing kits, treatment manuals, office supplies, workspace, computer/laptops, camera/microphone, online connection platforms (e.g., Zoom, Google Meet), etc.

Clinical Rotations

Doctoral intern schedules will be individualized based on the intern’s training needs and goals. Rotations are typically 6-12 months. Below is a list of possible rotations. Please note that rotation availability may vary each year.

• Feeding & Eating Behaviors Clinic
• Behavior Management Clinic
• Day Treatment Clinic
• Dialectical Behavior Therapy (DBT) Skills Clinic
• Hematology/Oncology Clinic
• Intake/Assessment Clinic
• Internalizing Disorders Clinic
• Parent Child Interaction Therapy (PCIT)/Child Parent Psychotherapy (CPP) Clinic
• Pediatric Psychology Clinic
• Trauma Clinic

Informal evaluations are conducted throughout the year. Formal evaluations are conducted at 4, 8 and 12 months of the internship. Evaluations are based on core competencies and serve to identify strengths and growth areas. Supervisors rate the intern’s knowledge base and professional practice on structured rating forms. Evaluations are shared with the interns by the Training Director so that goals can be defined and refinements can occur; remediation steps and corrective actions are outlined when needed. Both parties sign the evaluation following review. Additionally, there will be regular opportunities for interns to evaluate supervisors.

Interns will receive and review a document outlining the rights and responsibilities of the program and the interns related to due process and grievance procedures. Read more below.

Review the outcome data here.

 Disciplinary or Adverse Action- Due Process Procedure 

Purpose 

The purpose of the Due Process Procedure is to provide a mechanism to fairly and systematically address concerns regarding a doctoral intern’s (Intern) performance, behavior, or conduct. All Interns are expected to understand and conduct themselves in accordance with the performance criteria for their particular job and with all rules, procedures, and standards of conduct established by the System, University, and the Intern’s department or unit. 

Rights and Responsibilities of Interns 

• Interns have the right to receive information about the program’s expectations and procedures for evaluation. 
• Interns have the right to receive regular and timely feedback regarding their performance and/or concerns of problematic behavior. 
• Once Due Process procedures have initiated, Interns have the right to receive information regarding decisions within the timeline outlined in this policy. 
• Interns have the right to respond to and/or appeal the program’s decisions as outlined in this policy. 
• Interns have the responsibility to conduct themselves in a professional, respectful, and ethical manner. 
• Interns have the responsibility to make every reasonable attempt to remediate deficits. 
• Interns have the responsibility to adhere to the rules, procedures, and standards of conduct established by Texas Tech University System, Texas Tech University, and the Intern’s specific department or unit. 

Rights and Responsibilities of the Doctoral Internship Program 

• The program and its representatives have the right and discretion to initiate Due Process procedures including observation, probation, suspension, and dismissal as outlined and within the limits of this policy. 
• The program and its representatives have the right to be treated in a professional, respectful, and ethical manner. 
• The program and its representatives have the responsibility to make reasonable attempts to support Interns in remediating concerns and deficiencies. 
• The program and its representatives have the responsibility to make reasonable attempts to support Interns in successfully completing the program. 

Problems Identified and Defined 

Interns will be formally assessed and their performance will be documented throughout the training year. Deviations from standard training practices that may be identified as deficits include, but are not limited to, the following: 

• Unprofessional and/or unethical behavior; 
• Failure to demonstrate an acceptable level of competency; 
• Failure and/or unwillingness to integrate professional standards into one’s practice; 
• Problematic behavior that negatively impacts other Interns; and/or 
• Problematic behavior that may cause harm to patients. 

It is expected that any Intern who qualifies for this internship program is able to progress satisfactorily through the program. However, when performance and/or progress are unsatisfactory, actions of a disciplinary or adverse nature may be taken as follows:

1. Observation. Observation is defined as an informal remediation measure that is generally utilized prior to probation. The purpose of Observation is to provide the Intern with an interactive process of open communication, in which the Intern has an opportunity to voice any concerns or disagreements with the evaluation of their performance, to address potential issues or deficiencies before they rise to the level of probation or suspension. It is the duty of the Training Director to establish a mechanism for evaluating the performance of each Intern. In the event an Intern’s clinical or educational performance is found to be unsatisfactory, the Training Director shall meet with the n at the earliest possible date, outline in writing the deficiencies, specify how they are to be corrected, and indicate the period of time in which correction or improvement is to occur. If, after a specified amount of time, progress has not been demonstrated, the Intern may be placed on probation. However, observation is not a prerequisite if probation or disciplinary measures are more appropriate. Observation may not be appealed. 

2.01 Hearing Required. When a formal review or disciplinary action, such as probation, suspension, or dismissal, is warranted, the Intern will be notified in writing by the Training Director that the issue has been raised to a formal level of review and that a Hearing will be held. 

2.02 Hearing. The supervisor or faculty/staff member will hold a Hearing with both the Training Director and the Intern within 14 business days of issuing a Notice of Formal Review to discuss the problem and determine what action needs to be taken to address the issue. Other faculty/staff members may be present at the Hearing at the discretion of the Training Director or at the request of the Intern. The Intern will have the opportunity to present the Intern’s perspective at the Hearing and/or to provide a written statement related to the Intern’s response to the problem. 

2.03 Outcome and Next Steps. The result of the Hearing will be determined by the Training Director and other faculty/staff member(s) who were present at the Hearing. This outcome will be communicated to the Intern in writing within 5 business days of the Hearing. Potential outcomes include the following: probation (as set out below), suspension with or without pay (as set out below), or dismissal (as set out below). 

3. Probation. 

3.01 Criteria for Probation. Where an Intern’s performance fails to meet the standards set by the Psychiatry department, the Intern may be placed on probation by the Training Director. Probation occurs when an Intern is notified that their progress, professional development, or conduct is such that continuation in the program is at risk. 

3.02 Notice of Probation. The Training Director shall notify the Intern in writing regarding the probation, outline the reasons for the action, establish a time frame for the probation, provide a specific remedial plan with deadlines, and conduct a follow-up probation evaluation at the designated time, or sooner, if necessary. Notice of probation may be delivered to the Intern by certified mail, Return Receipt Requested, at their last known address, or hand-delivered to the Intern with written acknowledgement of delivery. In the event neither form of communication referenced above is successful, notice to the Intern may be given via email attachment with read/receipt notation. Unless precluded by special circumstances from doing so, the Training Director must meet in person with the Intern to discuss the probation. 

3.03 Remediation. As a rule, 60 calendar days will be allowed for the Intern to correct or remediate the identified deficiency or conduct. However, some probationary periods may be for a shorter period of time. If at the end of or during the probationary period the Training Director determines that the Intern has not corrected or remediated the identified deficiency or conduct, the Intern may be dismissed from the program. However, probation is not necessarily a prerequisite to dismissal if circumstances dictate otherwise. If at the end of or during the probationary period the Training Director elects to dismiss the Intern, the dismissal procedures outlined in Section 5 shall be utilized. 

3.04 Appeal of Probation. If an Intern is placed on probation, the decision may be appealed in accordance with the procedures outlined in Section 7. 

3.05 Satisfactory Completion of Probation. If the Training Director is satisfied that the Intern has corrected of remediated the identified deficiency or conduct, along with any other deficiency that may have arisen during the probationary period, the Intern will then be notified in writing that the probationary status has been lifted. 

3.06 Dismissal Following Appeal. If an Intern is dismissed at the end of the probationary period, the dismissal may be appealed in accordance with the procedures outlined in Section 7. 

4. Suspension. 

4.01 Criteria for Suspension. The Training Director may suspend an Intern with or without pay depending on the circumstances, which may include, but not be limited to, any situation where a serious charge is brought against the Intern, or concern exists that the Intern’s performance of their duties is seriously compromised or may constitute a danger to patients, others, or self. 

4.02 Notice of Suspension. The Intern will be notified of their suspension by certified mail, Return Receipt Requested, to their last known address, or hand-delivered with written acknowledgement of delivery. In the event neither form of communication referenced above is successful, notice to the Intern may be given via email attachment with read/receipt notification. 

4.03 Investigation. An investigation will be initiated within 5 business days from the date of the suspension and shall be completed within 30 calendar days. At the conclusion of the investigation, the Training Director shall confer with the Intern as soon as practicable, but in no event later than 30 calendar days from date of suspension, except as reference hereinabove. 

4.04 Appeal of Suspension. If an Intern is suspended, the decision to suspend may be appealed in accordance with the procedures outlined in Section 7. 

4.05 Lifting of Suspension. Suspension will be lifted when the investigation is completed on or before the 30th day following imposition of suspension. Upon completion of the investigation and its findings, a determination will be made as to the proper course of action. Such action will be communicated in writing to the Intern. 

5. Dismissal. 

5.01 Authority. The authority to dismiss an Intern resides solely with the Dean of the School of Medicine. 

5.02 Criteria for Dismissal. The Training Director may recommend that an Intern be dismissed for unsatisfactory performance, lack of professionalism, or conduct during the term of their annual program agreement/contract. Examples include, but are not limited to, the following: 

A. Performance that presents a serious compromise to acceptable standards of
patient care or jeopardizes patient welfare.
B. Failure to progress satisfactorily in fund of knowledge, skill acquisition and/or professional development.
C. Unethical conduct.
D. Excessive tardiness and/or absenteeism.
E. Illegal conduct.
F. Unprofessional conduct.

5.03 Notice of Dismissal. When recommending dismissal, the Training Director shall use the Disciplinary Action Form (DAF) and include any related documentation providing the basis for dismissal. The Training Director shall specify in writing the areas deemed unsatisfactory and state with specificity the reasons for the dismissal. A copy of the recommendation for dismissal must be provided to the Intern made the subject of the action. 

5.04 Appeal by Intern. Dismissal is subject to appeal, as it suggests poor performance, unprofessional conduct or malfeasance. Upon receipt of the written recommendation for dismissal and the Disciplinary Action Form, the Intern may initiate an appeal by submitting to the Psychiatry Program Chair within 5 business days a written notice of appeal, outlining in detail their issues regarding the appeal and the remedy sought. 

5.05 Timeliness of Appeal. In the event the Intern elects not to appeal the decision, or the Intern fails to appeal within the prescribed 5 business days, the Intern will be deemed to have waived the right to appeal. 

6. Job Abandonment. 

6.01 Definition. Job abandonment, defined as 3 consecutive days of unexcused absence from the program without notice to the Training Director, is tantamount to resignation. Any exception must first be approved by the Psychiatry Department Chair. 

6.02 Documentation. The Training Director shall use the DAF to report action taken and include information from the program for completing the DAF. The DAF and other documentation regarding such action shall be forwarded for signature to those individuals listed on the form. 

7. Appeal. 

7.01 Appeal Hearing Subcommittee. Upon receipt of the Intern’s written notice of appeal, if applicable, the Chair of the Psychiatry Department shall appoint an ad hoc Appeal Review Subcommittee (Subcommittee), which shall be charged with conducting an appeal hearing to review the recommendation of dismissal (suspension) of the Intern. 

7.02 Composition of Subcommittee. The Subcommittee shall be comprised of one TTUHSC faculty member selected by the Program, one TTUHSC faculty member selected by the Intern, one TTUHSC faculty member who serves as a chair, and another Intern representative. The Subcommittee chair shall set a date for the appeal hearing and notify all parties concerned of any other procedural information that will be observed. 

7.03 Documentation for Appeal. At least 5 business days prior to the appeal hearing, the Intern and the Training Director shall provide to each other and the Subcommittee all relevant documents that will be used in the appeal process to include, but not be limited to, 

the written request for appeal, all reports, evaluations and recommendations related to the action taken, and their file as maintained by the department. 

7.04 Witnesses. At least 5 business days prior to the appeal hearing, the Intern and Training Director shall provide to each other and the Subcommittee the names of witnesses, if any, that each will utilize at the appeal hearing. The Intern and Training Director shall each be responsible for arranging the participation of their respective witnesses for and during the appeal hearing. 

7.05 Legal Counsel. The Intern shall have the right to appear in person before the Subcommittee and may be accompanied by legal counsel retained by the Intern. If legal counsel is to accompany the Intern, they shall notify the Subcommittee in writing at least 5 business days in advance of the scheduled appeal hearing, at which time the Subcommittee shall immediately notify the Training Director and the Office of General Counsel (OGC). In the event the Intern is to be accompanied by legal counsel, a representative from the OGC shall attend on behalf of the university. Legal counsel may serve only in an advisory capacity to the Intern and TTUHSC and may not participate in the appeal hearing. 

7.06 Conduct of Appeal Hearing. At the beginning of the appeal hearing, the Chair of the Subcommittee shall review with the participants the procedural rules that shall be observed. 

7.07 Witness Available by Telephone. Only if a witness is not readily available to attend the appeal hearing in person, the Subcommittee may consider allowing the witness to participate by telephone. If applicable, the Intern and Training Director, respectively, shall notify the Subcommittee and each other at least 24 hours in advance of the appeal hearing that a witness will not be available in person. 

7.08 Audiotape of Appeal Hearing. The appeal hearing will be audiotaped, and either of the parties may obtain a copy upon written request. No transcript will be provided. 

7.09 Evidence. At the appeal hearing, the Intern shall present to the Subcommittee and the Training Director the basis of this appeal and may introduce evidence considered to be relevant and material to the case. However, all evidence offered must be reasonably related to the facts and statements concerning the reasons for dismissal and the Intern’s appeal. The Intern bears the burden of establishing that the dismissal (suspension) is unjustified. The Subcommittee shall determine whether information provided at the appeal hearing is relevant and material to the case and whether it is reasonably related to the matter of the dismissal. 

7.10 Failure to Appear. The Intern is expected to attend and participate in the appeal hearing. If the Intern elects not to attend an appeal hearing after appropriate written notice, the dismissal (suspension) will be reviewed as scheduled on the basis of the information available, and a recommendation will be made by the Subcommittee.

Purpose

The purpose of the Grievance Policy is to provide a prompt and efficient collegial method for the formal review and resolution of grievances filed by a doctoral intern (Intern).

Scope

Interns may file grievances regarding any element of the training program (e.g. complaints about evaluations, supervision, stipends/salary, harassment, hours, working conditions, etc.). Retaliation against an employee who files a complaint under this policy is strictly forbidden.

The doctoral internship program follows the “Non-Faculty Employee Complaint Procedures” (HSC OP: 70.10). Notably, “immediate supervisor” is the Training Director, “second level supervisor” is the Psychiatry Department Chair, and “employee” is the Intern.

See detailed Grievance/Complaint Procedures here: https://www.ttuhsc.edu/operating-policies/op7010. 

As noted in the operating procedure, TTUHSC reserves the right to interpret, change, modify, amend, or rescind this policy, in whole or in part, at any time without notice or consent of its employees.

Verbal Discussion

• Except in the case of harassment, an Intern should attempt to resolve the issue by first meeting with the individual(s) involved and discussing the specific incident or clearly defined matter within 5 calendar days of the incident’s occurrence.
• For complaints based on harassment, or another continuing series of less clearly defined matter, an Intern should bring any work-related problems to the attention of their Training Director within a reasonable time.
• Interns are encouraged to speak with their Training Director first, but when problems arise with their direct supervisor, Interns are permitted to speak with department leadership without retaliation.
• Each Training Director and Intern should attempt to resolve on-the-job complaints in an atmosphere of mutual respect in an effort to resolve the problem.

Written Complaint

• If action is not taken by the Training Director to resolve the problem, or if the Intern is not satisfied with the Training Director’s response, the Intern should formally submit an Employee Complaint Statement to the Intern's Training Director and Human Resources within 10 business days after the Training Director’s initial response to the employee’s verbal discussion.
• The Employee Complaint Statement is located on the Human Resources website or at the following link: https://hscweb.ttuhsc.edu/humanresources/documents/OP7010_Complaint_Form.pdf
• The Training Director has 10 business days to respond, in writing, to the Intern’s complaint. A copy of the response shall be sent to Human Resources.

Written Complaint to the Psychiatry Department Chair

• If no resolution is reached with the Training Director, the Intern may appeal the Training Director’s decision to the Psychiatry Department Chair by submitting the Employee Complaint Statement and Training Director’s response, if any, to the Psychiatry Department Chair and to Human Resources. 
• The written complaint must be filed with the Psychiatry Department Chair within 10 business days from the time the Intern receives the written response from the Training Director.
• The Psychiatry Department Chair will investigate the complaint, attempt to reconcile differences, and propose a solution. The Psychiatry Department Chair has 10 business days, or to the extension date provided by Human Resources, to communicate its proposed solution(s) in writing, to the complaint. A copy of the response shall be sent to Human Resources and the Training Director.

Final Review

• If the complaint is against the Psychiatry Department Chair, or if a resolution has not been achieved up to this point, the Intern is to present the complaint and a written request for review in writing within 10 business days to the appropriate Vice President/Dean.
• The Final Review will consist of an examination of the (1) Employee Complaint Statement; (2) Training Director’s written response, if any; and (3) Psychiatry Department Chair’s written response, if any.
• An independent investigation of the original complaint will not be conducted. This must be done within 10 business days after the second-level supervisor provides a response.
• The responsible administrator shall have 20 business days, or to the extension date provided by Human Resources, to review the complaint and provide a written determination to the Intern. This determination will be final.

Please view our most recent edition of the TTUHSC Intern Handbook.