Commentary: Internship Training

Spirito et al. (this issue) provide a blueprint for discussion regarding the programmatic as well as competencybased skills necessary for psychologists to be recognized as pediatric psychologists. The purpose of the internship year is to complete training in the general practice of clinical psychology and to extend specialty preparation in didactic instruction, research, and clinical practice in pediatric psychology. In this intensive year of primarily clinical experience-based training, an intern prepares for the role of a practicing pediatric psychologist within the scientistpractitioner model and eventually assumes responsibility for providing direct patient care. We will now briefly discuss how the 11 areas of knowledge and skill competency proposed by Spirito et al. may be addressed during the year of predoctoral internship training. We have addressed these issues in our child internship program at the University of AlabamaBirmingham (UAB). Foremost is the stipulated clinical supervision provided by internship faculty. Most internship sites provide didactic training in the form of attendance at seminars or grand rounds routinely provided to all faculty and trainees, in addition to seminars specifically provided to the predoctoral psychology interns. Some internship sites also support other training activities, such as attendance at scientific-professional meetings, and allow for a specific percentage of effort for research. At UAB, all interns participate in weekly didactic seminars ranging from presentation of current research by faculty members, to issues in professional development and review of empirically based treatment interventions. Interns also are required to formally present their research (e.g., dissertation, project with a faculty member at UAB) to the faculty. In addition, child psychology interns participate in weekly specialty seminars focusing on neurodevelopmental disabilities as well as monthly seminars in pediatric psychology/ neuropsychology. The first two areas outlined by Spirito et al. typically receive little or no formal attention at most internship sites: life span developmental psychology and life span developmental psychopathology. Few distinct formal elements in internship training focus on these areas. Most interns obtaining specialty training in pediatric psychology will have had at least one course each in developmental psychology and psychopathology. Internship experience might provide opportunities for observing normally developing children as well as employing a developmental approach in the supervision process. Thus, internship training will primarily reinforce the acquired knowledge base in the context of clinical experiences both in settings (e.g., hospital-based inpatient, outpatient, ambulatory hospital clinic), as well as specific therapy cases. An example would be conceptualizing an individual child’s reaction to medical treatment for cancer in view of demonstrated cognitive toxicities and emotional issues related to the disease. Another example might be basing a diagnostic assessment protocol on a particular contemporary theory of attention-deficit hyperactivity disorder (ADHD). Moreover, many supervisors will have the intern review empirical literature in developmental psychology and psychopathology relevant to each case. However, the coverage of these two areas will vary across internship sites as well as between supervisors within a participating internship site. Few internship sites have formal training components devoted to research methods and systems evaluation. Adding explicit research training at the site is not the norm at the majority of internship sites. Nonetheless, some sites allow for research activities, by setting aside up to 1 day per week to be devoted to research and requiring all interns to complete a project during the year. The site may also support the intern presenting research at a conference. We believe this approach is valuable for reinforcing the scientist-practitioner role as the intern transitions from graduate school where research may have been readily espoused. The absence of some attention devoted to research training can suggest to the trainee that this role is only a theoretical notion. Therefore, even pri-