Psychologists at TIRR Memorial Hermann function as part of an interdisciplinary team, which includes physiatrists, rehabilitation nurses, physical therapists, occupational therapists, speech language therapists, social workers, case managers, chaplains, vocational counselors, music therapists, recreational therapists, respiratory therapists and consultative physicians (including psychiatrists and neuropsychiatrists). Interns are housed in the Rehabilitation Psychology/Neuropsychology department. There are clinical neuropsychologists and clinical psychologists on the interdisciplinary teams at TIRR Memorial Hermann in the Texas Medical Center, TIRR Memorial Hermann - Kirby Glen, TIRR Memorial Hermann – The Woodlands, TIRR Memorial Hermann Outpatient Rehabilitation - West University and Memorial Hermann Rehabilitation Hospital - Katy. Additionally, there are three neuropsychologists, and two clinical psychologists in the TIRR Memorial Hermann Research Center. Interns have the opportunity to interact with and receive supervision and training from many of these staff members.
The core training experiences are divided into four three-month rotations: Inpatient Brain Injury and Stroke Program, Inpatient Spinal Cord Injury and Specialty Rehabilitation, Outpatient Rehabilitation Psychology/Neuropsychology Clinic, and the TIRR Memorial Hermann Challenge Program (an outpatient post-acute brain injury rehabilitation program focused on community integration). In addition, interns will have the choice of focusing on two 6-month minor rotations which are detailed below.
While on the inpatient rotations, interns are involved in performing medical record review, intake evaluations, neuropsychological evaluations (bedside screenings and more comprehensive evaluations), and evaluations of emotional and behavioral functioning. Interns are responsible for test administration, interpretation and integrated report writing with supervision from staff neuropsychologists. Interns share results of evaluations with the interdisciplinary team, patient, and family members and gain significant experience in formulating recommendations to assist the team in working most effectively with the patient. In addition, interns are involved with providing brief individual psychotherapy to inpatients, focused on specific issues that will enhance the individual’s ability to participate maximally in the rehabilitation program. Given the relatively brief lengths of stay (3-6 weeks on average), interventions are necessarily solution-focused. Additionally, interns gain experience in patient and family education, behavioral assessment and behavior management; and co-treatment with other specialties. Rehabilitation is a collaborative process and experience with other disciplines as part of the interdisciplinary team is an invaluable part of the training experience.
This rotation will expose the intern to acute rehabilitation of patients who have suffered from spinal cord injuries and various other injuries or conditions requiring medical intervention and rehabilitation. Patients on the specialty rehabilitation service are quite varied and include amputations, orthopedic interventions (i.e. hip replacements, spinal surgery, etc.), as well as patients suffering from various neurological conditions such as Guillain-Barré syndrome, multiple sclerosis (MS), burn injuries and chronic inflammatory demyelinating polyneuropathy. The intern will perform psychological and neuropsychological screenings, provide family education and supportive psychotherapy to aid with adjustment. The intern will provide targeted interventions for conditions that may impede progress in rehabilitation including pain, sleep, anxiety, and depression.
This rotation provides the intern with exposure to acute rehabilitation with patients who have suffered from acquired or traumatic brain injuries. The intern gains experience assessing patients with varying levels of consciousness and functional abilities by performing bedside evaluations that require adaptations of standardized measures to assess the abilities of persons with varying sensory and motor functioning. The intern will perform neuropsychological screenings/comprehensive testing and report writing. In addition, interns gain experience in assessment of problem behaviors, will lead development of behavior management plans in collaboration with the interdisciplinary team, and will provide patient/family education and supportive counseling.
The intern participates in the provision of outpatient services in the TIRR Memorial Hermann Challenge Program and in the Rehabilitation Psychology/Neuropsychology Outpatient Clinic.
The TIRR Memorial Hermann Challenge Program is an outpatient rotation in a holistic post-acute brain injury rehabilitation setting which focuses on community reintegration. Clients in this program focus on returning to independent living, school, or work settings. Interns gain experience in working with clients with acquired brain injury who are in the post-acute phase of recovery and transitioning back to community life. This milieu-focused treatment program involves multiple group therapies, including cognitive rehabilitation, psychoeducational, and process groups. Interns are involved in providing group therapies and individual interventions, including psychotherapy and cognitive rehabilitation. Additionally, interns participate in conducting cognitive screening evaluations and comprehensive neuropsychological evaluations. Supervision is provided by staff neuropsychologists. This rotation takes place in our off-site outpatient facility about two miles from the Texas Medical Center.
The outpatient RP/NP clinic rotation primarily focuses on the provision of comprehensive adult neuropsychological evaluations under the supervision of our outpatient neuropsychologists. Interns gain experience and independence with all aspects of the assessment process including clinical interviewing, test selection, test administration and scoring, case conceptualization and report writing, and provision of feedback. While on this rotation, the intern may also have the opportunity to participate in psychological evaluations (including pre-surgical evaluations for spinal cord stimulator), and psychotherapeutic services using evidence-based treatments. Typical referrals for psychotherapy include: treatment of insomnia or other sleep disorders, pain management, depression, anxiety, PTSD, and adjustment to disability, although other referrals may be received. The breadth of issues with which patients present to our outpatient clinic is broad, including brain injury, stroke, amputation, anoxic injury, spinal cord injury, complex orthopedic injury, neurodegenerative diseases and other complex medical conditions.
The intern is expected to complete minor rotations in conjunction with major rotations. Time spent on a minor rotation will approximate one day per week and each minor rotation would be six months long. The intern may choose from the minor rotations offered:
Interns in this track gain experience working with patients with a broad array of neurological, orthopedic, and medically complex conditions. During each major rotation, the intern works with patients ranging in age from adolescence to older adulthood (13-90+). Patients served at TIRR Memorial Hermann have enormous diversity with respect to race, ethnicity, and socioeconomic status. TIRR Memorial Hermann has a strong international program as well, such that interns will frequently be interacting with patients from countries outside of the United States.
In addition to the core didactic series offered by the overall clinical psychology internship, the intern at TIRR Memorial Hermann will also participate in a didactic series focused on core topics in rehabilitation psychology and neuropsychology, which is also attended by graduate student trainees and postdoctoral fellows at TIRR Memorial Hermann.
Intern will receive at least one hour of individual supervision as a part of their major and minor rotation, for a minimum of two hours of formal supervision per week. However, given the collaborative interdisciplinary setting at TIRR Memorial Hermann, the intern will have frequent opportunities for in vivo supervision on the patient care units.
The intern is encouraged to become involved in ongoing research activities at the hospital, including work exploring sleep, pain, and emotional factors and their relationship to outcomes for our brain injury and spinal cord injury populations. In addition, access to the TIRR Memorial Hermann Research Center allows interns to become involved in preparation of manuscripts based on archival data that has been collected as part of several federally-funded studies from National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).
All application materials must be submitted through the Association of Psychology Postdoctoral and Internship Center's online application service.
For full details on the application process, please see the Baylor College of Medicine Psychology Internship Admissions.