Required Minor Rotations

An internship with Sanford Health prepares interns for doctoral-level independent practice in clinical psychology by providing interns exposure to various professional roles, treatment settings, and clinical acuities. All interns are required to participate in minor rotations during their internship year to gain training experience related to inpatient behavioral health, hospital consultation, rural behavioral health, and other specialized services offered in a robust integrated healthcare organization. Rotation schedules and placement details are pre-determined based on the intern’s Primary Site placement, as well as staff resources available during the training year.

Each rotation provides a unique learning experience that enhances the intern’s clinical, diagnostic, and assessment skills and knowledge. For each rotation, interns participate in treatment team meetings, site-specific didactic trainings, supplemental supervision, as well as other tasks that are delegated by the supervising psychologist. The following are brief descriptions of the rotation opportunities:

Adult Inpatient Psychiatric Unit (AIPU)

The Adult Inpatient Psychiatric Unit is a 10-bed acute inpatient psychiatric treatment unit located at the Sanford South University Medical Center in Fargo, ND. This is an adult facility treating patients 18 years and older. The AIPU patient population has variability in socioeconomic status, as well as diversity, ethnicity, and multicultural issues. Many patients treated in this setting have high comorbidity with substance use disorders. Psychology services are an integral part of Inpatient Psychiatric Services. Psychology receives requests for consultation from the AIPU psychiatry partners. Interns participate in evaluations for assistance with diagnostic clarification with complex patient presentations and to initiate therapy while patients are on the unit. Psychological testing is appropriate at times, and the AIPU uses the MMPI-3 and MCMI-IV. Interns will have the opportunity to facilitate a group when they are on rotation at this location.

Consult Liaison Hospital Service (CLHS)

The Consult Liaison Hospital Service is a service offered at the Sanford Medical Center Fargo (SMCF), which is a 300+ bed medical facility in Fargo, ND. The CLHS team consists of a multidisciplinary team comprised of a psychologist, psychiatrist, psychiatry residents, and social workers who respond to referrals for behavioral health services throughout the medical center, including the Emergency Department. Services are provided to adult patients from a variety of diverse cultures and from geographic areas across the rural Midwest region. In this acute hospital setting, psychology services are often requested for patients who are experiencing psychological symptoms in reaction to traumatic accidents, chronic pain, insomnia, depressive and anxious reactions, psychological trauma effects, suicidal ideations, and grief reactions. CLHS team members are also consulted for capacity evaluations to determine if patients have the capacity to make medical decisions for themselves. During their 3–6-month rotation, interns will have the opportunity to shadow CLHS team members, conduct psychological evaluations, and offer psychological treatment in an individual format. Interns are expected to be on-site one day per week during this rotation.

Inpatient Pediatric Services

This specialty service is located at the Sanford Children’s Hospital in Fargo, ND, which is the only Level II Pediatric Trauma unit in the state of North Dakota. Patients include children from birth to age 18 and parents of children currently in the hospital. The service area for the Children’s Hospital is the entire state of North Dakota, Northern Minnesota, Eastern Montana, and Northern South Dakota; therefore, individuals from both urban and rural areas, as well as from tribal communities are encountered at this facility. In the hospital environment, interns will be a member of a large, multi-disciplinary team consisting of pediatricians, critical care physicians, neonatologists, nurse practitioners, pediatric subspecialist providers, case managers, chaplains, nurses, speech therapists, physical and occupational therapists, dieticians, and medical residents. Interns will complete inpatient consultations and patient follow-up visits, which includes completing assessments and providing guidance for patients who have experienced a traumatic injury, assessing, and providing disposition for patients admitted following a suicide attempt, completing NICU family support consults and visits, and conducting consultations for new diagnoses and medical non-adherence. Interns will learn psychological first aid strategies, behavior modification techniques, and cognitive behavioral therapy strategies, as well as utilize mindfulness-based skills when working with NICU families. Interns will become familiar with the Columbia Suicide Screener, PHQ-9, GAD-7, Edinburgh Postnatal Depression Screening and STEEP screener as nursing evaluations of these assessments often result in a referral for psychological consultation.

Traumatic Stress Treatment Center (TSTC)

Located in Fargo, ND, the Traumatic Stress Treatment Center (TSTC) provides specialized trauma services, including clinical psychotherapy, psychological assessment, psychiatric management, case management, and social support services to children, adolescents, young adults, and families. There is significant collaboration with many multidisciplinary partners, including child protective services, law enforcement, and prosecutors. Patients present at TSTC from a variety of backgrounds for a range of behavioral health concerns. Some patients travel from geographically remote regions as child behavioral health specialty services are scarce in this region. Presenting problems for children and families include child abuse, sexual assault, medical trauma, motor vehicle accidents, traumatic grief, involvement in the foster care system, caregiver substance use disorders, and homelessness. Interns will conduct initial intake assessments and provide individual, family, and group therapy interventions. Interns are trained in a variety of modalities, including but not limited to, but are not limited to, Trauma-Focused Cognitive Behavioral Therapy, Child and Family Traumatic Stress Intervention, Cognitive Processing Therapy, Child Parent Psychotherapy, Dialectical Behavioral Therapy, Parent-Child Interaction Therapy, Cognitive Behavioral Therapy for Depression and Anxiety, and Exposure Therapy.