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A Day in the Life of a Clinical Psychology Trainee

A Day in the Life of an Extern

Carolyn Spiro, MD

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My name is Carolyn Spiro and I am a clinical psychology extern at the Columbia University Clinic for Anxiety and Related Disorders (CUCARD). I grew up not too far from CUCARD in Brooklyn, New York, and I am so happy to live and work in the city that I love.

On a typical day, I wake up around 7 am and give myself leisure time in the morning to enjoy my coffee. I commute from Brooklyn, so I leave my apartment around 8am to arrive at work by 9am. I don’t start seeing patients until 10, but I like to give myself some extra time to prepare my session materials and catch up on any paperwork from the previous day.

While each day of the week at CUCARD is different, a typical day is filled with a mix of activities: didactics, supervision, psychodiagnostic assessment, and providing individual or group therapy. CUCARD’s location makes it an ideal spot for the type of therapy that we offer. Given that most of the patients we see are seeking treatment for anxiety disorders, exposure therapy is an integral part of the work that we do. So on a typical day, I may be in Central Park with a patient challenging him to say hello to a stranger for a social anxiety exposure, or in the Time Warner Center looking over the glass railing to challenge a patient with a phobia of heights.

One of my favorite aspects of working at CUCARD is being a part of such a fun, compassionate, and hardworking team. When I am not seeing patients, I spend the majority of my time in the trainee workstation, which is where the externs and post-doctoral fellows are stationed. It has been a great experience to learn from one another through informal supervision, while also having the opportunity to get to know each other on a personal level.

The comprehensive training and clinical supervision offered at CUCARD is incredibly unique. Each week, I meet with Dr. Anne Marie Albano, an expert in CBT for anxiety disorders, to discuss my individual cases. Through supervision, I am learning to apply CBT for a range of disorders in both children and adults, including panic disorder, social anxiety disorder, and depression. The CUCARD team meets weekly for group supervision, where we present and discuss new or complicated cases. It is always interesting to hear different perspectives and work together to plan the best treatment for our patients. I am also learning to apply evidence-based treatments for externalizing disorders through both individual and group supervision with Dr. Vasco Lopes. Moreover, CUCARD offers invaluable didactic trainings that encompass a broad range of topics, from conceptualizing cases from a CBT lens to understanding gender dysphoria in youth.

After work, I try to take advantage of being in the city by meeting a friend for dinner. The CUCARD team is also famous for its karaoke nights- so keep your eyes peeled for a group of psychologists belting their hearts out somewhere in midtown!


A Day in the Life of an Adult Predoctoral Intern

Sidney Coren, MD

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My name is Sidney Coren, and I am a psychology intern in the adult track at Columbia University Medical Center. Each day I encounter the familiar – alive and challenging clinical work – and the unfamiliar – by way of spontaneous, invigorating interactions. I start each morning on an inpatient unit, where I provide individual psychotherapy to residential patients who receive comprehensive treatment for eating disorders. I see my patients every day of the week, which allows me to develop deep and meaningful relationships that facilitate growth and change. I work with my patients to help them understand their eating disorder so that they can make personal choices that lead them to feel a healthy sense of agency. One of my favorite parts of working on the eating disorder unit is that I get to be a part of a remarkably thoughtful and caring team of psychiatrists, nurses, and social workers.

I spend a significant portion of each day working in the adult outpatient mental health clinic. At the clinic, I provide individual and group psychotherapy to a diverse patient population varied in ethnicity, socioeconomic status and age (my current patients range from 22 years to 76 years-old.) One of my most rewarding, recurring clinical encounters is co-leading group therapy – one men’s group and one women’s group – with two senior clinicians. Both groups consist of individuals who suffer from traumatic life experiences. I am in awe at the courage and dignity of the members of the group who use inner resources to cope with and better understand their significant challenges in living. It is an invaluable learning experience to co-lead with senior clinicians. I get to observe and absorb their therapeutic expertise in real time and learn how to best integrate my skill set into helping the group process. My co-leaders communicate trust in me, which emboldens me to make playful, creative, and spontaneous interventions. I often leave group feeling humbled and amazed by my patients’ willingness to take interpersonal risks.

Additionally, I get to work with individual patients using a multiplicity of theoretical and practical treatment approaches. I discuss my clinical work weekly with 8 seasoned psychotherapists in supervision. Each creates a lively space to think about clinical theory, multicultural influences in psychotherapy, consider alternative approaches to treatment, and reflect on my personal development, as I continue to refine my personal approach to psychotherapy. I see two patients twice-weekly, which has been my first opportunity to do such continuous, in-depth work. I also work with a couple and feel privileged that they have let me into the dynamics of their long-standing, loving and trusting relationship -- albeit intricately complex and challenging. Lastly, I provide therapy to individuals who are coping with a variety of life-stressors and relational challenges. As our work progresses, it is powerful to see these patients navigate their worlds with greater freedom and openness to new experiences, and to develop greater compassion for themselves. 

After a day of clinical interactions and supervision – often emotionally demanding – I like to temporarily detach from my work and recharge. I attend to myself and my own significant relationships through playing basketball, the cello, cooking, and spending time with the people I love. 


A Day in the Life of a Child Predoctoral Intern

Ellie Cobb, MD

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My name is Ellie Cobb, and I am a child psychology intern. One of my favorite parts of the training here is the wide array of experiences I get each day working in numerous clinics. The majority of my training is at the Morgan Stanley Children's Hospital (CHONY) child & adolescent outpatient clinic. I also train in the adult EYE6 outpatient clinic and in the School-Based Mental Health program. At CHONY, my rotations include the Anxiety & Depression Clinic, the Tics Tourette's and Related Disorders Clinic, the Evaluation Clinic, and the Toddler Parent Infant Interaction Clinic. Each day I get to work with a wide range of ages and diagnoses. The youngest patient I have seen was 1 years old and the oldest was 73. Each day, I am shifting treatment modalities depending on the clinic and on the patient. I use cognitive behavioral approaches, psychodynamic and relational frameworks, mindfulness-based work, as well as other techniques and approaches.

Two mornings a week, I go to an elementary school instead of the hospital to do my School-Based Mental Health Program rotation. While the treatment itself is mostly similar to what I do in the outpatient clinic at the hospital, the atmosphere is quite different, as I see patients in their natural school settings and collaborate with their teachers on a regular basis.

As an intern, every day, I attend one or more didactic classes to further my training. I have 9 supervisors, so each day I am meeting with at least one. I feel that one of the opportunities and challenges as a psychology intern is learning when to use a specific skill or approach to optimize the most effective treatment for a particular patient. Supervision consists of discussing patients, both in a detailed way of reviewing and planning for sessions and in a big picture way to ensure that treatment goals are being addressed each week and progress is being tracked. This is also when I get to explore, with guidance, my own developing style and preferences for modalities and approaches to treatment. Each workday brings such variability and opportunity for growth, so I'm always learning and expanding as a clinician!

Some nights after work, I just relax and enjoy cooking at home, and other nights I'm energized to explore, meet up with friends, and take advantage of all infinite possibilities NYC has to offer!


A Day in the Life of a Postdoctoral Fellow

Jenna Slutsky, MD

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My name is Jenna Slutsky, I am a post-doctoral fellow in clinical psychology at the Adult Outpatient Psychiatry Clinic at New York Presbyterian Hospital, CUMC. This is my first job since completing my internship in clinical psychology and I have been so happy with the variety of experiences I have had working in this hospital-based clinic setting. The majority of my clinical responsibilities are rooted in serving a diverse, community-based population presenting with a wide range of issues from psychotic-spectrum disorders to depression, anxiety, and adjustment disorders. I typically start my mornings by seeing a few individual patients before going to a team meeting or co-leading a group. In the afternoon, I often see more patients, meet with interns, or sit down to write a few notes or to coordinate an administrative task, whether reviewing an intern’s caseload or reaching out to experts in the field to arrange our Psychology Intern Colloquia Series.

In addition to my community-based individual and group caseload, I have also had the opportunity to hone my acute-care skills by carrying a caseload of individual patients through a full-year rotation on the Intensive Treatment Team (ITT). Through ITT, I work closely with a multi-disciplinary group to deliver short-term, acute outpatient care to patients requiring intensive treatment, typically after a recent suicidal gesture or attempt, psychotic episode, or psychiatric hospitalization.

This fellowship offers a unique balance between feeling both independent and supported. There is a great deal of autonomy in choosing how I build my schedule, giving me the ability to see patients in a way that feels a lot like private practice. At the same time, my supervisors are always happy to talk, and I often touch base with them about everything from clinical issues to my questions about professional development. This is a perfect job to continue to grow clinically while learning how to manage administrative skills and still maintain a genuine work-life balance. I have had time to study for the licensure exam and to present at a conference or two while still always feeling like a part of the team.


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