Clinical Psychology Consortium

MICHMED is a large, academic medical center occupying 128 acres on the University of Michigan campus in Ann Arbor. MICHMED has more than 28,000 employees, including about 3,000 faculty, and provides more than 2.5 million outpatient and emergency visits each year. Major clinical care facilities of MICHMED include the University Hospital; the Rogel Cancer Center; C.S. Mott Children's Hospital; Von Voigtlander Women's Hospital; and the A. Alfred Taubman Health Care Center on the main medical campus, and at outpatient health centers in close proximity, including the East Ann Arbor Health and Geriatrics Center, Commonwealth Neuropsychology Outpatient Facilities, Kellogg Eye Center, Turner Geriatric Center, and the VA Ann Arbor Healthcare System (VAAAHS, with its psychology and psychiatry training programs). The Medical School alone has 25 academic departments, 19 clinical and 6 basic sciences, as well as the Unit for Laboratory Animal Medicine and Department of Medical Education. MICHMED is highly ranked in the nation and number one in Michigan by U.S. News and World Report (2017-2018). At $1.39 billion, the University of Michigan is the top public university in research spending in the United States, with over half a billion awarded each year to the Medical School, supporting many research strengths. 

The Ann Arbor VA Medical Center is located adjacent to the main Michigan Medicine Medical campus. The VAAAHS is a 105-bed general medical-surgical hospital, which includes an inpatient psychiatric unit, inpatient consult-liaison psychology, outpatient mental health clinics, substance abuse disorders treatment and extensive medical and other psychiatric outpatient and recovery services. The Community Living Center (CLC) is attached to the VAAAHS and largely provides post-acute rehabilitation for veterans and also serves acute medical needs in the context of the COVID-19 pandemic. Community Based Outpatient Clinics (CBOCs) provide outpatient mental health services and Health Psychology services to Veterans in the VAAAHS catchment area but residing nearer to Jackson, Michigan; Flint, Michigan; and Toledo, Ohio. Mental Health facilities have been fully updated in the past few years. Offices for fellows have modern support facilities, with full computer access to the University of Michigan information systems and library, as well as VAAAHS information systems. 

The Adult Anxiety Clinic conducts initial consultations and follow-up visits (individual and group therapy) for adults with anxiety, stress, obsessive-compulsive, and related disorders. We have been treating anxiety disorders since the mid-1970s using evidence-based approaches. We are one of the oldest such clinics in the country and are committed to the integrated utilization of both psychological and pharmacological approaches to the treatment of anxiety. We are a large multidisciplinary team consisting of clinicians and researchers including psychiatrists, psychologists, social workers, and nurse practitioners. We work with adults experiencing a wide range of anxiety disorder presentations. Fellows will attend integrated team meetings and will learn to provide specialized assessments and individual cognitive behavioral therapy for a variety of anxiety disorders, including Exposure and Response Prevention (ERP) for OCD, cognitive processing and prolonged exposure therapy for PTSD, habit reversal therapy for body focused repetitive behaviors, and other related approaches. There are also opportunities for fellows to participate in our group therapy programs.

The Depression Clinic focuses on assessing and treating patients with depressive disorders, although cases commonly have psychiatric and medical comorbidities. The team is multidisciplinary and includes psychiatrists, psychiatric residents, social work fellows, psychologists, and at times postdoctoral psychology fellows. Participants gain skills in differential diagnosis, treatment planning, and providing evidence base treatments for mood and related disorders. Cognitive Behavioral Therapy (CBT), Interpersonal psychotherapy (IPT), Dialectical Behavior Therapy (DBT), and pharmacotherapy are the mainstay of evidence-based treatments provided, while acceptance and commitment therapy (ACT) may be included when deemed appropriate. In addition to assessment, diagnosis, and treatment planning, the depression clinic also contains a didactic component on specific topics of interest.

The Bipolar Clinic is housed within the Ambulatory Psychiatry Division of Michigan Medicine. It is affiliated with the Heinz C. Prechter Bipolar Research Program and offers clinical services for adults with bipolar spectrum disorders. Our mission is to provide assessment, referral, treatment, and research in the area of bipolar spectrum disorders. Our clinical program provides specialized evaluation/consultation and evidence-based treatment for adults with bipolar spectrum disorders with and without other psychiatric comorbidities. Specifically, we offer new patient evaluations for diagnostic clarity, consultation, medication management, and short-term evidence-based individual and group psychotherapy for bipolar disorder. We are an interdisciplinary team consisting of clinicians and researchers including psychiatrists, psychologists, social workers, nurse practitioners and physician assistants. Fellows will attend integrated team meetings and will learn to provide specialized assessments and individual and group cognitive behavioral therapy for bipolar disorder. Approaches include Cognitive Behavioral Therapy, Interpersonal and Social Rhythms Therapy, Dialectical Behavior Therapy Skills Training, and other related approaches. There are also opportunities for fellows to participate in our group therapy, LifeGoals, an evidenced-based psychoeducation program for bipolar disorder. Our clinic is unique in that it is forming a learning health community whereby real-world data from the clinic provides research insights that can be used to feed back to the clinic and improve care and has been selected as a site for the BD² (Breakthroughs Discoveries for Thriving with Bipolar Disorder) Integrated Network.

The BSM Clinic conducts initial consultations and follow-up visits (individual and group therapy modalities) for adults 18 years of age and older with sleep disorders amenable to evidence-based sleep treatments (e.g., CBT for insomnia). The primary referrals to the BSM clinic are for insomnia, hypnotic discontinuation, circadian rhythm sleep-wake disorders, and adherence to medical regimens (e.g., Continuous Positive Airway Pressure, CPAP). Many initial consultations are conducted in a multidisciplinary context, where clinical psychologists work side-by-side with sleep medicine physicians. Fellows are additionally encouraged to rotate through other Michigan Medicine sleep-related clinics, including the General Sleep Disorders Clinic, Pediatric Sleep Clinic, and Alternatives to CPAP Clinic, where they gain exposure to various medical specialties involved in the care of patients with sleep disorders. (e.g., Neurology, Pulmonology, Pediatrics, Otolaryngology, Oral and Maxillofacial Surgery).

The PREP Clinic conducts initial consultations and early interventions for adolescents and young adults 14-30 years old presenting with early psychosis or symptoms suggestive of increased risk for developing a psychotic disorder (attenuated psychosis syndrome or “prodromal” psychosis). We are a Coordinated Specialty Care (CSC) clinic providing a range of services to facilitate recovery, including individual and group CBT for psychosis (CBTp), family psychoeducation, multifamily groups, social skills training, medication management, and care coordination. We are a multidisciplinary team consisting of clinicians and researchers from multiple disciplines, including clinical psychologists, neuropsychologists, psychiatrists, social workers, and nurse practitioners. We are part of the learning health system within an Early Psychosis Intervention Network (EPINET) funded by the NIMH. Fellows have opportunities to learn and provide specialized assessments and individual, family, and group interventions for this young population.  Fellows are also encouraged to participate in local educational outreach activities to help promote early detection and intervention on campus and in the community.

The University of Michigan Addiction Treatment Service is an outpatient substance use disorder treatment center located in the Department of Psychiatry, Rachel Upjohn Building. In addition to psychiatric services (medication management, outpatient detoxification, and opioid substitution treatment), psychotherapy services include intensive outpatient programming, aftercare groups, dual diagnosis groups, family/couple’s therapy, individual therapy, and treatment for healthcare professionals. Fellows will work collaboratively in our interdisciplinary team of psychiatrists, social workers, psychologists, and nurses to treat patients with substance use or dual diagnoses. Fellows will have the opportunity to conduct individual and group therapies using evidence-based practices. Additional experiences in our multi-disciplinary collaborative care clinic focused on Alcoholic Liver Disease in the main hospital may also be available.

The WIMHC is an outpatient clinic in the Department of Psychiatry in the University of Michigan Health System. Our clinic is staffed by a multidisciplinary team of psychiatrists, nurse-practitioners, psychologists, and social workers. Trainees on the team include psychology practicum students, psychiatry fellows, and social work interns and fellows. As a tertiary care clinic, we specialize in assessment and treatment of mental health conditions in women, primarily during pregnancy, postpartum, and other times of hormonal change (e.g., perimenopause). We also offer dyadic-based psychotherapy services for mothers and their infants and young children. As one of very few clinics in Michigan that specialize in perinatal mental health, we serve a diverse population, often with medical and psychiatric comorbidities. As part of this rotation, postdoctoral fellows complete a mentorship in Interpersonal Psychotherapy.

Integrated, health psychology offerings emphasize brief functional assessments and interventions for Veterans presenting in a wide range of ambulatory care settings. Exposure to interprofessional practice and the “medical home” primary care as well as Whole Health models are important elements in learning. The fellow can gain experience with primary care mental health integration, chronic pain management, MOVE! weight management and other patient education programs, as well as tobacco cessation services.  Working with the Pain Clinic and Primary Care, the fellow learns comprehensive, bio-psychosocial assessments and provides integrated CBT-based chronic pain management services. Fellows can be integral components of the weight management, accredited diabetes education, or cardiac and pulmonary rehabilitation programs, facilitating behavior change enhancement and stress management classes.  Using Motivational Interviewing (MI) and Acceptance and Commitment Therapy (ACT) principles, fellows may collaborate with Pharmacy and Nursing to offer tobacco cessation services as well.  Integrated care opportunities are also available with Oncology, Sleep and Women’s Health Clinics. The fellows may also conduct organ transplant and/or bariatric surgery mental health evaluations.  Therefore, assessment and consultation skills, and both individual and group intervention modalities are available experiences.  We aim to provide the fellow with experience in working as part of medical teams across the ambulatory care settings and in-patient integrated care opportunities can also be pursued. Fellows can enhance consultation and health coaching skills with other healthcare clinicians, and practice serving as a representative of the field of psychology in the broader healthcare setting.

Training opportunities in the Mental Health Clinic include thorough diagnostic assessment and psychotherapy training with a wide variety of outpatient clients. Fellows may learn risk assessment and crisis intervention strategies, interviewing and assessment skills, and other screening techniques. Individual therapy cases and group therapy experiences (e.g., depression and anxiety) are available. The clinic offers opportunities to work closely with a variety of mental health professionals. Treatment approaches include empirically supported strategies, such as CBT, Dialectical Behavior Therapy (DBT), Motivational Interviewing, and Solution-Focused/Strategic Therapies. There are opportunities for fellows to work with individuals from diverse backgrounds who present with a wide range of psychopathology. There is flexibility to accommodate individual fellow interests in terms of caseload, development and implementation of treatment groups, and program assessment and evaluation activities.

The PCT functions as an outpatient specialty clinic within the medical center. This multi-disciplinary team provides comprehensive assessment, treatment, and research-based protocols to patients with PTSD. The fellow may attend teaching rounds, perform assessments, and follow cases within this specialty clinic. Fellows will have opportunities for training and practice in specialized PTSD evaluation and empirically supported treatments, including Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). In addition to weekly individual supervision, fellows participate in weekly PCT staff meetings. This includes clinical case presentations, evaluation presentations, and didactic presentations on topics related to PTSD.

The SUD experiences include opportunities for training in assessment and diagnosis, treatment planning, participating in multidisciplinary treatment, and training in empirically supported intervention approaches for individuals with substance use disorders with and without comorbidities. Psychological treatment approaches across levels of care include Cognitive Behavioral Therapy (CBT), Motivational Interviewing/Enhancement Therapy, Behavioral Couples Therapy, Harm Reduction, Mindfulness Based Relapse Prevention, and Contingency Management. The clinic provides core therapy groups using CBT.). There are opportunities for fellows to work with individuals presenting with a wide range of psychopathology from diverse backgrounds in both inpatient, intensive outpatient, and outpatient settings. There is also flexibility to accommodate individual fellow interests in terms of caseload, program assessment/evaluation, and research activities.

This experience involves evidence-based care in the outpatient mental health clinics (MHC, SUDC, and PCT) and/or health clinics.  The Women’s VAAAHS Fellow may elect to focus in a single clinic or can collaborate with supervisors to incorporate clinical care opportunities from multiple clinics and sites.  The focus on women’s mental or behavioral health training may involve participation in both individual and group therapy offerings specifically for women Veterans and training in common intersections between military culture, gender issues, and other aspects of diversity.  Options include trauma-focused treatments for PTSD (CPT, PE), DBT, Interpersonal Violence, Wellness Group for Women, Military Sexual Trauma evaluation and interventions for women.  Fellows with interest in providing trauma-focused therapy with Women Veterans diagnosed with PTSD are required to attend the PE and CPT trainings at the beginning of the fellow year.  Fellows may be integrated into the Women’s Health Clinic (4 hours per week) to provide consultation/liaison and/or brief interventions to women presenting for specialty medical assessments or care. There are several current research options available throughout the service.  Fellows are afforded many opportunities to be integrally involved in administrative activities (i.e., membership in the Women Veterans’ Mental Health Working Group, projects associated with mental health service aspects of the VA Ann Arbor Healthcare System’s Women Veterans’ Programming Committee).

Fellows have the opportunity to see couples utilizing the Behavioral Couples Therapy Model (BCT), Behavioral Family Therapy for SMI, and the Integrative Behavioral Couples Therapy model (IBCT). Cases may be referred for numerous presenting problems (marital distress, substance use, SPMI, etc.). Fellows may also provide evidence-based CBT for partner abuse (Strength at Home).  Opportunities for providing parenting skills training for Veterans and family education are also available. Opportunities for administrative activities are available as well. As there are interns on the couples/family rotation, this experience also offers the opportunity to supervise an intern in this area of focus. Research projects in this area utilize data sets from an RCT and from the clinical data.