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, and rural behavioral health. Rotation schedules and placement details are pre-determined based on the intern’s Primary Site placement.

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 rotations:

Detroit Lakes Clinic (DLC)

The Sanford Health Detroit Lakes Clinic (DLC) is a multi-specialty group practice located in Detroit Lakes, MN. The clinic is located 45-miles from the Fargo/Moorhead Metro area. It features providers of family medicine, internal medicine, audiology, general same-day surgery, women’s health, podiatry, dermatology, optometry, psychology, psychiatry, and physical therapy. Additionally, there are 20 specialist providers who rotate through DLC monthly to keep services close to home for their patients. Interns placed at Primary Sites located in the Metro area will have the opportunity to provide clinical services, such as individual psychotherapy and care collaboration, in a rural setting with a diverse patient population. This rotation will last 6-months, and interns are expected to be on-site one day per week. Interns will receive training in various therapeutic modalities, including but not limited to cognitive behavioral therapy, dialectic behavioral therapy, prolonged exposure, motivational interviewing, and solution-focused brief therapy.

Adult Inpatient Psychiatric Unit (AIPU)

The Adult Inpatient Psychiatric Unit (AIPU) is a 20-bed acute inpatient psychiatric treatment unit located at the Sanford South University Medical Center in Fargo, ND. This rotation will span 3-6 months based on the intern’s schedule at their Primary Site and will take place one day per week. 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. Psychologists offer 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 this service uses the MMPI-3 and MCMI-IV. Interns will have the opportunity to facilitate a group each day they are on rotation at this location.

Consult Liaison Hospital Service (CLHS)

The Consult Liaison Hospital Service (CLHS) 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 Pediatrics Services (IPS)

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. Patient presentations and conditions vary considerably between cases, but common mental health diagnoses and health conditions include adjustment disorders, depression, anxiety, acute trauma reaction, acute suicidality, traumatic injuries from accidents, traumatic brain injuries, complex broken bones, Crohn’s disease, diabetes, and Functional Neurological Disorders. 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.