Review Of Practicum Site: Toronto General Hospital - Eating Disorders Program Name of Site: Eating Disorders Program, Toronto General Hospital Duration of practicum: Full-time, May to September, 2007 Process of Application and General Information to Consider What was the process/ requirements for applying? Spoke with a site representative at the practicum/internship day in fall of 2006. Then, emailed a cover letter indicating interest and training goals, along with an updated CV to the site also, in fall of 2006. Did you apply to the site or directly to a supervisor? I applied to the program/site via the person in charge of coordinating the practicum students. Is there a brochure or website for the site? There was an information sheet disseminated at the practicum/internship day. Do you have the contact information for this site? If so, can you specify the name of the site contact person, phone number, address and email address. At the time that I applied, the contact was Dr. Kathryn Trottier, Kathryn.trottier@uhn.on.ca, 416-340- 4800, ext. 4067. When was the deadline to apply? At the time, there wasn t an official deadline date, however, spaces fill quickly, so I would stick to the general guideline of applying in January for the following fall/winter and in the fall for the following summer. When does the practicum start and finish? This seems to be flexible. They offer practicum placements over the academic year, as well as over the summer. What s involved in the interview and who conducts it? The interview generally consists of three members of the treatment team. Since the program follows a group CBT model, they are interested in your experience/working knowledge of CBT. Also, given the treatment area, you will be asked questions about your own comfort to participate in behavioural experiments where you would be required to model a non-dieting approach to food and weight. They are also very interested in hearing about your previous therapy experiences and practicum training goals.
How many days per week or hours per week were you at the site? Was there flexibility? Who determined the schedule? Since I conducted the practicum over the summer, I was at the site 4 to 5 days per week. There is definitely flexibility, however, given the structure of the program, they prefer that students be able to commit at least 3 days per week. Your schedule is determined with the team based on your experience, training goals, and the number of hours you need to complete within a given timeframe. Was there flexibility to move around the site (i.e., doing rotations in various departments?) Clinical Training Opportunities for assessment? (if so, what type of assessments did you do? Note: an intake interview for a potential therapy client is not the same as full a psychological assessment; also there are different types of psyc assessments). What assessment instruments were you trained on? Consultation assessments were conducted for clients referred to the site for a suspected eating disorder. These consults consisted of using SCID-informed semi-structured interview to diagnose Axis I disorders. If clients were further referred to the Day Hospital Treatment program through this consult, additional psychological measures would be given (e.g., BDI, Eating Disorder Inventory (EDI), Eating Disorder Examination (EDE), Personality Assessment Inventory (PAI)). What was the process of training? o Direct observation of your supervisor? Yes. Another psychologist sits in on the interviews with you. You then write-up the report and your supervisor provides you with feedback to incorporate into the final copy. o Reading on your own? Yes, as needed. Opportunities for treatment? Most opportunities are for experience with group therapy, but there are some opportunities for individual therapy experience. What was the client population? (approximate ages) Mostly female clients, 18+. While most clients range in age from 18 to 30, clients do range in age from 18 to 60. Male clients are not uncommon. Opportunities to conduct couples therapy? Group therapy? Many types of group therapy. What percentage of time was devoted to direct contact, report writing, other? At least 60% of your time is involved in direct client contact. Report writing can take up an additional 20 to 30%, depending on the number of assessments you conduct. The remaining 10% of your time you
would spend in treatment rounds, writing progress notes, reviewing client homework, etc. What was the theoretical orientation used for treatment? Cognitive-Behavioural Therapy. Did you receive any specialized training (i.e., to work with specific populations or deal with specific mental health issues)? Training is focused on teaching you how to work with eating disorder clients and their co-morbid conditions (e.g., depression, anxiety, substance use). What was your case load (i.e., number of psychotherapy cases and/or the number of assessments a student is expected to get)? Supervision You can expect to co-facilitate at least one group per day, as well as supervise several meals over the course of a week. You might also expect to conduct one to two assessments per week. Your case load is flexible depending on your training goals and your comfort within the clinic. How many supervisors were involved in your training? Four. I had one primary supervisor for therapy and one primary supervisor for assessment, as well as two additional psychologists I received feedback from when I co-facilitated groups with them. How many hours of supervision per week? At least one hour of therapy and one hour of assessment supervision. What was the supervision style? o Individual vs. group? Individual. o Use of audio-tapes? Audio-tapes were used for supervision of individual therapy sessions. Supervisors also watch via a one-way mirror when you co-facilitate groups if another supervisor is not co-facilitating with you. During assessments your supervisor is present in the room and feedback is given based on your interview and written report.
Other Opportunities Were research opportunities available for you? Yes. I was able to become an individual therapist for a research trial being conducted. Were teaching/ didactic opportunities available? You are free to attend training workshops and research rounds which the clinical staff are invited to attend. Did you attend clinical rounds? Professional workshops or colloquia at the site? Yes all. Were there future opportunities following your practicum such as paid assessment work, research work, and does the site formally train interns? Future opportunities are often available. Practicum Facility How many other trainees were at the site with you? (interns, post-docs, etc.) There were 2 practicum students including myself. What other professionals did you work with? (social workers, psychiatrists, etc.) Psychologists, Psychological Associates, Social Workers, Occupational Therapists, Psychiatrists, Medical Students. Did you have your own office? Yes. Did you have computer access? Yes shared. Any concerns about accessibility of the site by public transit? No it is located just beside Queen s Park subway station. How wheelchair accessible is the site? Very both within the site and getting from the subway to the site.
Overall Experience of the Practicum Other Provide a rating on a five-star scale of 0 stars (not recommend) to 5 stars (highly recommend) and comment on your overall experience at this practicum. 4 stars, if you are interested in obtaining this type of specialized training. I would give 5 stars if the assessment experience was more comprehensive, but this is something the site is presently working on. What did a typical day look like at the site? The program is a Day Hospital Treatment setting, so patients arrive at the program at around 10am and leave at 6:15pm. Patients eat two meals and a snack in program. They also attend approximately 3 groups per day these range from symptom check-in behavioural type groups, to CBT groups, to more experiential groups dealing with body image issues and interpersonal relationships. In a given day, a student might co-facilitate a check-in group, as well as another CBT or experiential group, supervise either a meal or snack, attend team rounds, and write chart notes. What was the perception of psychology as a profession within the site? The head of the program is a psychologist in addition, there are 3 other full-time psychologists. The opinion of the psychology professionals seemed to be taken seriously and on par with the psychiatrists. How was conflict resolved at this site? (e.g., what would happen in the event of a problem between supervisor/supervisee). Not sure, since I didn t experience a conflict, however, given you are supervised by several individuals, I would suspect that any conflicts would be handled appropriately.