The Clinical Psychology Internship Program at Loma Linda University School of Medicine's Department of Psychiatry offers an integrated training that aims to do the following:

  1. Foster the development of a primary professional identity as a psychologist, which is congruent with LLU's commitment to "whole-person care," namely a bio-psycho-social-spiritual perspective in clinical care. Emphasis is placed on the scientific underpinnings of the practice of psychology, with special attention given to the biological, social, cultural, and spiritual factors present in clinical situations.
  2. Train entry-level generalist psychologists who have been exposed to various clinical contexts in which professional psychologists work. We believe a "generalist" should develop core competencies in clinical psychology, and aim to train interns to function competently in psychological assessment and diagnosis, psychological intervention, supervision, professional consultation, and program evaluation/development.
  3. Expand and extend basic assessment and intervention techniques to meet the needs of diverse settings and problems. In addition to developing "generalist" skills, the program provides the opportunity for each intern to gain some experience in a particular elective concentration.

Infused in all training experiences and rotations are elements of training and professional development which we consider foundational, including enhancing interns’ ability to make sound and scientifically informed professional judgments, to understand and apply professional laws and ethics in a variety of clinical contexts, deepening their appreciation of individual and cultural diversity and the impact of difference and diversity on people’s lives, and developing interpersonal and professional collaborations. We emphasize direct experience with patients at various stages of development, with a wide breadth of presentations and demographic characteristics, in varied contexts and service delivery systems (i.e., outpatient mental health, psychiatric inpatient, medical setting), and employing a variety of modalities or approaches, which we believe prepares interns to enter comfortably into a range of professional roles and settings. Our interns develop core competencies in the general areas of clinical psychology, including assessment and diagnosis, psychological intervention, supervision, professional consultation, and program evaluation/development; in addition, each intern gains experience in a placement within a behavioral medicine clinic (including eating disorders, adolescent partial hospitalization, adult partial hospitalization, and geropsychology/neuropsychology), as well as a medical placement focused on health psychology (including psycho-oncology, psycho-cardiology, bariatric surgery, and diabetes specialty clinic) which may serve as a springboard for future professional and clinical development. These placements are assigned based on interns' prior experience and professional aspirations, and provide interns with the opportunity to begin to flexibly transfer and apply the foundational and general skills to working with a range of patients, and across a range of settings.

The parent organization to the internship program, Loma Linda University, has identified its motto as “To Make Man Whole.” As a religiously affiliated organization, it seeks to be congruent with its heritage by translating the ideal of “wholeness” into a bio-psycho-social-spiritually integrated approach to health care. The internship program seeks to assist the intern in the development of competencies in all areas of cultural diversity, and in addition, provide opportunities for more focused theoretical, scientific, and clinical explorations in the area of religion and spirituality as this may pertain to emotional health. The approach is “patient-centered,” in that neither the religion of the parent organization, nor the intern’s, has a central consideration, but the patient’s. This approach is founded on cumulative and significant scientific evidence for the consideration of religion and spirituality as a factor in emotional health, both as a strength and as a source of distress.

Program Structure

The Psychology Internship Program currently has four full-time predoctoral positions. The training year begins on or about September 1st and concludes at the end of August the following year. Psychology interns are "on duty" 40 hours per week, Monday through Friday, and are expected to complete a minimum of 2000 hours during the course of the 12-month internship year. All psychology interns are assigned to general services (assessment and diagnosis, outpatient psychotherapy, supervision of practicum students, multidisciplinary treatment team, and program development/evaluation) as well as one or more concentrations/placements for concurrent experience in multiple sites. This multiple-placement system provides a comprehensive training experience with diverse psychopathology across the developmental continuum, exposure to numerous treatment modalities and assessment techniques, as well as experience with a variety of supervisors and professionals from other disciplines (physicians, social workers, nurses, occupational therapists, etc.).

Training Components

  1. Foundational Elements ~ infused and interwoven across all training experiences

    1. Integration of science and practice
      • Goal: The development of scientifically minded professional psychology trainees who are competent in the selection of culturally sensitive evidence-based processes and interventions
    2. Ethical and legal issues
      • Goal: Adopt or adapt one’s own ethical decision-making model and apply it with personal integrity and contextual sensitivity
    3. Individual and cultural diversity
      • Goal: Expand current vision of the world and further develop one's ability to understand the perspective of others. Successful graduates demonstrate mature understanding of broad and general issues of diversity, including but not limited to, ethnic, cultural, gender, and sexual diversity
    4. Emotional health and religion/spirituality
      • Goal: LLU has identified as its motto as "To Make Man [Humanity] Whole." As a religiously affiliated organization, it seeks to be congruent with its heritage by translating the ideal of “wholeness” into a bio-psycho-social-spiritually integrated approach to health care. The internship program seeks to assist the intern in the development of competencies in all areas of cultural diversity, and in addition, provide opportunities for more focused theoretical, scientific, and clinical explorations in the area of religion and spirituality as this may pertain to emotional health. The approach is “patient-centered,” in that neither the religion of the organization, nor the intern’s, has a central consideration; rather, the patient's worldview and religion are central. This approach is founded on cumulative and significant scientific evidence for the consideration of religion and spirituality as a factor in emotional health, both as a strength and as a source of distress
  2. General Domains of Training ~ broad training experiences in general areas within the practice of clinical psychology

    1. Psychological assessment and diagnosis
      • Our program recognizes psychological assessment and diagnosis as a core professional activity of clinical psychologists. This training experience provides all interns with opportunities to enhance and hone their skills/competencies in the cognitive and personality assessment, risk assessment, and diagnosis of patients across a broad spectrum of clinical settings
    2. Psychological intervention
      • Psychological interventions are at the heart of the practicing clinical psychologist. Interns gain experience providing direct psychological services, including individual psychotherapy (in an outpatient mental health setting which includes the LLU Student Counseling services), group psychotherapy (typically on inpatient psychiatric units, as well as day-treatment programs), and crisis and behavioral health interventions (typically, in a medical care setting). Interns also provide indirect services, through consultation with other health professionals, treatment teams, and patients' family members or other community agencies, as needed.
    3. Professional consultation
      • Congruent with the profession of psychology’s efforts to establish itself as a health profession, interns actively participate in multidisciplinary contexts in health and mental health settings. Interns develop expertise in conveying psychological findings and principles to professionals from different disciplines. In addition, interprofessional education, training and scholarship prepares psychologists to work in a respectful collaborative, integrative, and informed manner within our field and with other disciplines and professions. Interns will gain experience providing professional consultation to individuals, groups, systems, and organizations that may have diverse values, ethical perspectives, worldviews, and may be accountable to different constituencies
    4. Supervision
      • Our program recognizes clinical supervision as a core professional activity of clinical psychologists. This general training experience provides all interns with a didactic foundation and then supervised practice of clinical supervision of practicum students
    5. Program development/evaluation
      • By adequately completing a program evaluation/development project, interns will demonstrate an intermediate to advanced level of professional psychological skill, abilities, proficiencies, competencies, and knowledge in the areas of theories and/or methods of evaluation. They will apply knowledge of research principles to clinical practices, and deepen their knowledge about various programs, interventions, and/or outcomes. In addition, they will learn to function independently as a “local clinical scientist."
  3. Placements/Concentrations ~ in-depth training experiences and focus areas within the practice of clinical psychology

    1. Eating disorders
      • This placement concentrates on the treatment and assessment of eating disorders, and provides interns with the opportunity to gain focused experience with a particular population (adolescent and adult patients being treated for Anorexia Nervosa or Bulimia Nervosa and their families) in a particular setting (partial hospitalization and intensive outpatient programs). The Eating Disorders placement emphasizes competencies in the assessment and treatment of Anorexia Nervosa and Bulimia Nervosa, as well as interdisciplinary collaboration. Particular emphasis is placed on utilizing empirically supported approaches, such as Dialectical Behavior Therapy, Cognitive-Behavioral Therapy, and Family-Based Treatment for Anorexia and Bulimia
    2. Adolescent assessment and intervention (with some access to child cases)
      • The Child and Adolescent Inpatient units at LLUBMC provide acute-care, intensive diagnostic evaluation and intervention programs to children and adolescents between the ages of 4 – 18 years. This placement provides the intern with the opportunity to gain focused experience working in an inpatient psychiatric setting, with children and adolescents with a wide range of diagnoses including mood disorders, psychoses, PTSD, developmental disorders, disruptive behavior disorders, and substance use disorders. Interns participate in a variety of assessment and intervention modalities, including comprehensive bio-psycho-social assessment and treatment, intensive family consultation, group therapy, and crisis intervention.
    3. Geropsychology/Neuropsychology
      • This placement concentrates on developing competency in the assessment and treatment of the elderly and other adults with neuropsychological issues.
    4. Bariatrics
      • This placement involves pre-surgery asssessment, and consultation within the treatment team. Bariatrics specific assessments and clinical interview are used to gather and subjectively report patients' mental health status, and give an estimate of prognosis after bariatric surgery.
    5. Clinics and Riverside University Health System (RUHS)
      • The intern at these clinic placement work with a team consisting of the attending physician, medical students, nurses, and dieticians to provide multi-disciplinary care. The intern's main role consists of consultation regarding mental health, self-care behaviors and motivation. In these clinics, interns screen for depression, anxiety, and substance use disorder. Although the medical diagnosis changes, and there may be population specific concerns, each clinic is selected to provide a comparable training experience in screening, consultation, and treatment for all interns. There are also opportunities to provide brief individual psychotherapy to patients.
        Clinics for 2016-2017 include:
      1. Diabetes Clinic: Screening for depression, anxiety and poor self-care behavior (exercise, diet and treatment follow-through). Common presentations in this clinic include: moderate to severe depression/anxiety, poor self-care behaviors, and psychosocial/financial hardship.
      2. Cardiology and Chronic Heart Failure: Screening for depression, anxiety and substance use disorders in a population struggling with heart problems. Main presentations include: depression, anxiety, substance abuse, chronic pain and fatigue, anger and psychosocial/financial hardship.
      3. Pulmonary Clinic/Smoking Cessation: Screening for depression and anxiety. Common presentations include COPD.
    6. Rotation considered for expansion during the 2016-2017 year include:

      • Continuity Care Clinic

      • Infectious Disease Clinic

      • Family Care Clinic

      • Oncology Clinic

      • Pediatric Care


Evaluation and Successful Completion of Program

Evaluation Process

Prior to the start of their training year, interns are asked to complete a thorough self-assessment delineating their current knowledge and skills in the following areas:

  • Individual psychotherapy
  • Group psychotherapy
  • Psychological assessment and diagnosis
  • Case conceptualization
  • Treatment planning
  • Addressing issues of spirituality in clinical situations
  • Individual differences
  • Consultation
  • Supervision of trainees
  • Professional ethics and responsibilities
  • Research

As part of this self-assessment, interns are also asked to consider their clinical strengths, as well as describe areas of perceived weaknesses and desired growth; based on this information, various aspects of training may be adjusted, including intensity of supervision, review of unfamiliar assessment measures and methods, and review of clinical populations with which the intern has limited or no experience.

The Training Committee meets on a monthly basis to discuss interns’ growth, strengths, and weaknesses for an ongoing, informal evaluation of the interns. Interns are formally evaluated by the Training Director and their individual supervisors on a quarterly basis. Formal, written feedback is provided to interns in the form of a completed Psychology Intern Competency Assessment Form.

The Psychology Intern Competency Assessment Form examines the interns’ competency and progress in the following areas:

  • Professional conduct, ethics and legal matters
  • Individual and cultural diversity
  • Theories and methods of psychological diagnosis and assessment
  • Theories and methods of effective psychotherapeutic intervention
  • Scholarly inquiry and application of current scientific knowledge to practice
  • Professional consultation
  • Supervision
  • Identification and potential utilization, if appropriate, of spiritual resources

The Clinical Psychology Internship program continually assesses each intern's performance and conduct. At the completion of each quarter, supervisors provide written evaluations and meet with the interns to discuss the assessments and offer recommendations. When differences between interns' and supervisors' appraisals surface in these meetings, it is expected that in most cases they will be resolved between supervisor and supervisee. After meeting, the supervisor and intern sign the written evaluation and forward it to the Training Director. The Training Director obtains additional evaluation data through consultation with supervisors and talks with other professional staff who have significant contact with interns.

Members of the Training Committee review the evaluation data. The Committee is chaired by the Training Director who consults with each of the members. Based on the evaluations and on input from the trainee, the Training Director may modify the intern’s clinical experiences to better meet the interns' training needs.

Performance Feedback

A variety of means are utilized to assess interns' progress. The most frequent method of assessment is through direct observation and supervision, as well as the review of case notes and assessment reports. Interns are also observed during case presentations to judge the quality and clarity of their case conceptualization and treatment plan. In addition, the intern functions as part of a multidisciplinary team, and feedback from team members may be solicited.

Feedback to the intern is provided through various means. The most common comes through direct feedback from the supervisor after direct observation or supervisory discussion. Besides being the most frequent, we believe this is the most important feedback that the intern receives. More formal feedback occurs at the end of each quarter, based on the Psychology Intern Competency Assessment form. Given the frequency of observational feedback and supervision, it is our goal that the formal feedback sessions do not contain any "surprises" for the intern. During quarterly evaluation feedback sessions, recommendations are made by the primary supervisor and training team and conveyed to the intern. In addition, the intern is expected to provide feedback regarding their experience and progress through internship, and quality of supervision provided. There are quarterly meetings in which the Training Director, supervisors and interns participate, and discussion is focused on the exchange of constructive feedback between faculty and trainees, particularly as it relates to interns training experience.

Requirements for Completion

  1. At the beginning of internship, interns sign 2 (types of) contracts: one for administrative/employment/payroll purposes, and the other as a “training contract.” The Training Contract specifies that the internship is to be completed between specific dates (this year’s contract is for 9/1/2016 to 8/31/2017). A Certificate of Completion is based on interns’ fulfillment of the Training Contract.
  2. Internship requirements include completion of one calendar year (12 months/52 weeks/260 days) and 2000 SPE hrs.
    1. Within the 52 weeks, interns may take 15 “Personal Days” (vacation and illness days), with the exception of calling in for unexpected illness (no more than 5 days per year, with consideration given to extenuating circumstances).
    2. A Leave of Absence may be requested in special circumstances (extended illness, FMLA); however, anything that is in addition to the 15 Personal Days will be added to the end of the internship period, so that all interns complete the exact same requirements (including time requirements). Interns must have documented a minimum of 2000 hours of activity over the course of the year on their monthly activity logs. The internship requires one year of full-time training to be completed in no less than 12 months. Paid federal holidays are included, and interns accumulate some paid annual leave that can be taken during the year
    3. Interns are expected to obtain approval of time off from Primary and Delegated supervisors, Unit or Program contact person, and Training Director as early as possible, but at least 2 weeks in advance. Permission to take the requested days off depends on availability of coverage for the particular program(s)/training activities affected by intern’s absence.
    4. There are also 7 observed holidays (total of 8 days/year; 2 days for Thanksgiving); these are set dates, and time off has to be taken on the actual holiday and not a substitute day.
    5. During RUHS observed holidays – intern is expected to be present onsite at LLU.
  3. To successfully complete the internship, interns must demonstrate competency in all core areas identified on the Intern Competency Evaluation Form. Competency standards require that interns receive an average rating of 3 ("Intermediate") or above on each of the eight program goals, and no individual objectives rated 1 ("Needs remedial work") on all evaluations completed mid-year or later. Ratings range from 1 to 5. For end-of-year evaluations, successful interns are expected to receive an average rating of 4 ("High Intermediate") or above on at lease seven of the eight goals, and no individual objectives rated 2 ("Entry level") or below. Interns must also complete a minimum of 2000 training hours, successfully present a final Case Conceptualization Presentation, and an Assessment Case Conference.

    1. If an intern’s performance falls below competency standards, Due Process Procedures are followed. The trainee needs to meet competency standards by the conclusion of their training.

Remediation of Problems

Minor deficiencies in intern preparation or performance are generally remediated through the course of normal interaction with the intern's supervisor(s). The remediation may consist of didactic supervisory instruction, modeling of techniques by the supervisor, and/or reading in the appropriate literature. When the deficiency is in the domain of experience, the intern may be assigned additional relevant cases to provide the needed exposure. Minor deficiencies in experience, training, or performance are communicated to the intern's graduate program Director of Clinical Training in the context of the quarterly evaluation form. Interns are regularly apprised of their progress in training during the course of ongoing supervision. In addition, supervisors review all written evaluations in person with the intern. Since interns undergo ongoing informal evaluation and receive formal quarterly evaluations from supervisors, major deficiencies are generally detected early and addressed as soon as they become apparent.

Concerns about a student's performance in the training program may be raised by the intern's primary or secondary supervisors, other program faculty, Training Director, or other staff who interact with the intern in a professional role. The Training Director and internship faculty may convene to discuss the concerns and possible avenues of redress. Except in cases of extreme departures from the standard of care (e.g., a flagrant violation of the APA Ethical Principles) which would precipitate immediate action towards termination of the intern from the program, concerns are addressed through informal discussion between/among the intern and supervisor(s) and/or Training Director regarding the nature of the concern and possible solutions. If the concerns are not ameliorated after a reasonable time following such a discussion, more formal remediation process may ensue.

1. Remediation

Remediation actions are initiated in response to an intern’s deficient skill level in a major competency area, unwillingness to accept supervisory input to make positive changes, and/or violation of ethics, legal, or professional behaviors. The supervisor initially discusses the issue with the intern, may adjust the frequency of supervision meetings accordingly, and, in writing, designate specific remediation steps. These problems are discussed with the Training Director and a copy of the remediation plan is provided to the Training Director. If after several meetings positive resolution does not occur, a meeting is scheduled with the intern, supervisor(s), and Training Director. A plan of action is discussed, developed, and written within that meeting to assure all agree and understand. The intern’s graduate program Director of Clinical Training is provided with a copy of the plan.

2. Probation

If the remediation actions are not successful, the Training Director will then meet with the rest of the program faculty to consider probation. A probationary period would involve close supervision with active involvement from both the immediate supervisor(s) and Director of Training. All details, requirements, and expectations of the probation period will be in writing. The supervisor(s) and the Training Director will meet a minimum of once a month during the probationary time to monitor the intern’s progress in addition to the intern’s weekly supervision. It is the decision of the Training Director as to whether or not the intern, during this time, should continue providing direct services to patients. The Training Director will discuss the intern’s status with the graduate program Director of Clinical Training.

3. Termination from Training Program

Dismissal from the internship may occur if probationary attempts are deemed to have little or no behavioral impact or there are APA ethical violations and/or state legal violations. This action is decided by the Training Director and program faculty and will also involve consultation with LLU’s legal counsel and HR representative. The intern will be notified, if appropriate, in person and provided with a written letter of the decision to dismiss. The Training Director will report the decision to the intern’s graduate program training director. APA will also be informed in writing of this action.

The intern may appeal the decision to terminate by writing a letter to the Training Director requesting an informal hearing.

Intern Grievances

Formal procedures exist to help interns safely discuss concerns about their supervisors, the Training Director, the training provided to them, or other issues regarding the program. These are included in the Intern Handbook, which is given to the intern at the start of internship.

1. Grievance Regarding a Rotation or Supervisor

If the grievance is related to a specific rotation, it is recommended that the intern express his/her concerns to the specific supervisor. The supervisor and the intern are expected to engage in problem-solving to attempt to meet resolution. Should satisfactory resolution occur, the intern and supervisor may agree that formal written documentation is not necessary. Conversely, either party may request and develop written documentation to which the other party has the opportunity to attach a formal statement with their comments.

If a satisfactory resolution is not achieved, or if the intern deems it unsafe to begin communication with the supervisor, the intern may take the grievance directly to the Training Director. The Training Director will offer a variety of responses, including direct problem-solving with the intern, the possibility of meeting with both the intern and the supervisor to assist in forming a plan to resolve the issue, and the possibility of including members of the intern’s academic advisors. The Training Director will document the nature of the grievance, the steps taken to form resolution, and the outcome. The intern will also provide a written formal statement for our record regarding the issue.

3. Grievance Regarding the Training Director

Intern’s issues with the Training Director should initially be discussed with their immediate supervisor. The intern may request to have the grievance addressed at the next monthly meeting of the Psychology Training Committee or the intern may request a special session of the Psychology Training Committee without the Training Director present. Written documentation is prepared regarding both the grievance and the Training Committee’s resolution.

4. Grievance Regarding the Psychology Training

If the grievance is related to the training program, it is strongly encouraged that the intern express his/her concerns to the Training Director. The Training Director may offer to include supervisors and/or a member of the intern’s academic program in discussing the concerns. The intern and the Training Director may agree that formal written documentation is not necessary. Conversely, either party may request and develop written documentation to which the other party has the opportunity to attach a formal statement describing the situation.

If the intern is not satisfied at this point he/she may request to present the grievance to the Psychology Training Committee. The intern may request a special session of the Psychology Training Committee. The intern presenting the grievance and the other interns and psychologists will work together with the goal of finding a satisfactory resolution. At this step, documentation is also prepared to be presented to the Training Director.

Should the Committee and intern be unable to form an agreement on a resolution, the Committee will select the plan deemed most appropriate and meet with the intern to present the selected plan. This final selection and presentation of a plan will occur within two weeks of the complaint. This step will also be formally documented. Written documentation will be kept in the intern’s file and the intern will also be provided with a copy.

5. Harassment

Should the intern experience inappropriate workplace behaviors, such as sexual harassment, from any staff at LLU, the LLU Human Resources (“HR”) department should be informed by the intern. This will be handled through designated LLU HR policies concerning harassment. If the intern is comfortable in so doing, he/she should involve the Training Director and/or immediate supervisor(s) to direct him/her to the appropriate LLU resources.

Other Administrative Policies and Procedures

Compensation and Benefits

Psychology interns receive a salary of approximately $21,000/year.

In addition to our great work environment, benefits include:

  • Medical, dental, and vision insurance
  • Employer paid life insurance
  • Vacation leave
  • Sick leave
  • Paid Holidays
  • Pay to jury duty service
  • Employer contributions to retirement
  • Opportunity for tuition reimbursement (~$800/unit for 8 units per year)

Work/life benefits help interns balance responsibilities in their professional lives with commitments and opportunities in their personal lives. Below is a list of some of the current work/life benefits that can be found on the Loma Linda campus:

  • Banking
  • Discounts on tickets and services
  • Fitness center
  • On campus pharmacies
  • Post office
  • Bookstore
  • Take-home meals through our cafeterias and catering services
  • Grocery store