Behavioral Medicine Rotation A: Chronic Pain and Illness - The Miriam Hospital
Faculty Supervisor(s): Megan Pinkston-Camp, MA, PhD, Abigail Mansfield Marcaccio, PhD, Kristy Dalrymple, PhD
The Chronic Illness and Sexual Health rotation at The Miriam Hospital provides a broad range of training experiences in behavioral medicine. The rotation emphasizes training in assessment, treatment and consultation skills for psychologists in medical settings. Training provides exposure to individual, as well as group, modalities of intervention and a variety of patient populations. The clinical psychology resident functions on multidisciplinary teams that may include psychology, psychiatry, a variety of medical specialties, clinical social work, nursing, nutrition and exercise physiology. Rotation components include:
The Behavioral Medicine Clinical Service of the Immunology Clinic at The Miriam Hospital provides clinical services tailored to the individual needs of patients diagnosed with HIV and chronic Hepatitis C virus. The clinic serves 1500 patients and is the largest medical provider of HIV care in the state of Rhode Island. Patients are often diagnosed with co-morbid mental health conditions and disorders associated with substance use. Working with this patient population can offer a rich experience in cultural and clinical diversity among patients who experience significant stigma and barriers to accessing care. As HIV is now viewed as a chronic condition, the population is aging and experiencing health conditions such as obesity, heart disease, chronic pain, diabetes, and cancer similar to that of populations without HIV, and therefore there is a great need to assist patients with living healthy in addition to managing their HIV diagnosis, mental illness, sexual risks, and addictions.
In the Men’s Health Center, the clinical psychology resident assesses and treats men and their partners who present with sexual and gender problems. The Men’s Health Center is an outpatient clinic with referrals from Urology, Cardiology, Internal Medicine, and various mental health professionals. Patients referred to the clinic may present with chronic or acute medical problems, as well as co-morbid psychiatric conditions contributing to problems with sexual functioning. The clinical psychology resident in conjunction with the rotation supervisor assesses and treats the psychological aspects of sexual dysfunction, atypical sexual behavior and gender dysphoria. Treatment interventions range from patient and partner education to therapy for individuals and couples. The Men’s Health Center is a multidisciplinary service consisting of an urologist, internist, and psychologist. Assessment and treatment include integrative collaboration among the three services.
The Rhode Island Hospital Comprehensive Spine Center, Behavioral Pain Management Experience emphasizes training in assessment, treatment and consultation skills patients presenting with chronic pain in neck and back and concomitant psychological distress and disability . The experience is within Rhode Island Hospital Spine Center which offers spine-specific physical evaluations, interventional procedures, minimally invasive and complex spine surgeries, as well as physical and occupational therapy. The Clinical Psychology Resident functions as part of an integrated care multidisciplinary team that includes physicians, nurses, physical therapy, massage therapy, and psychology.
Individual psycho-diagnostic evaluations for both pre-surgical and non-surgical patients are conducted collaboratively with the Supervisor. Clinical psychology residents see individual outpatients in warm handoffs and post-evaluation recommendations follow-up meetings as necessary. Patients are treated in a group psychotherapy format co-led by the Supervisor and Psychology Resident using a cognitive-behavioral framework (ACT combined with CBT) that includes evidence-based components as well as lifestyle modification, skills training for management of medical symptoms, self-regulation, and relapse prevention skills.