Interns are given an opportunity to select 1-3 elective rotations (depending on goals and timing of elective rotations) to complement their training goals for internship year.

Gastroenterology Service

The MGH Behavioral Medicine psychogastroenterology rotation embedded within the MGH Digestive Healthcare Center offers interns an opportunity to provide consultation to gastroenterology providers, and assessment and treatment to individuals diagnosed with disorders of gut-brain interaction (DGBI), such as irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), gastroparesis, and cyclic vomiting syndrome (CVS). Interns work within a multidisciplinary team comprised of physicians, advanced practice providers, nurses, and nutritionists.

Interns who choose this elective will spend half a day per week for 6 months within the psychogastroenterology rotation, and will be supervised by Jonathan Lerner, Ph.D. Dr. Lerner joined Behavioral Medicine in 2005 and became faculty in 2011. Dr. Lerner has been embedded in the GI Center for over a decade, and this service has been very well received by staff and patients alike. In July of 2019, Dr. Lerner started the rotation in psychogastroenterology for MGH predoctoral interns in the Behavioral Medicine track. Past interns have enjoyed the rotation, in particular Dr. Lerner’s collaborative, warm, and open style of supervision, as well as the opportunity to work with a unique range of problems.

Typical referrals include (1) patients having difficulty adjusting to a recently diagnosed chronic GI condition, (2) patients facing challenges around adherence to medication, diet, or lifestyle changes, and (3) patients for whom stress and anxiety management strategies could improve their medical conditions either directly (by reducing episodes) or indirectly (by improving coping). Directly addressing these challenges often yields noticeable benefit after just a few sessions.

In addition to standard CBT, the psychogastroenterology service offers clinical hypnosis for IBS and GERD. Often referred to as gut hypnotherapy, clinical hypnosis is an evidence-based treatment developed by Dr. Olafur Palsson at the University of North Carolina, Chapel Hill. Dr. Lerner received training and certification in clinical hypnosis from the American Society for Clinical Hypnosis (ASCH). As part of the psychogastroenterology rotation, interns will receive supervision in clinical hypnosis from Dr. Lerner. Past interns have elected to attend the ASCH training in clinical hypnosis and become certified.

Mind-Body Medicine

Mind-body resiliency groups for individuals with medical illnesses Interns can spend 3-6 months on this rotation, which includes observing and then co-leading a 2 hour/week 9-session group-based mind-body program for patients which integrates relaxation training with cognitive-behavioral therapy and positive psychology principles. Groups are available for cancer survivors; special interest groups for cancer survivors will also be available, including mind body groups for adolescent and young adult survivors, groups for Spanish speakers, etc. The intern can also train in working with patients diagnosed with Von Hippel-Lindau Disease, a rare genetic disease that predisposes individuals to develop multiple tumors (malignant and benign) throughout their bodies or patient with Sickle Cell disease.

Oncology specific elective rotations

• Survivorship Sleep Program: Survivorship Sleep Program. Interns can spend one half-day per week at the SSP. Interns will learn and deliver cognitive behavioral therapy for insomnia (CBT-I) to cancer survivors in virtual, Zoom-delivered sessions.
• Collaborative Care and Community Engagement Program (Serious Mental Illness and Cancer): Interns can spend one half-day per week at the Collaborative Care and Engagement Program for six months of the internship year Participate in a collaborative care program focused on serious mental illness and cancer including engagement of patients with cancer and preexisting serious mental illness in hospital, outpatient, and community settings to gain expertise in cognitive behavioral therapy for psychosis, motivational interviewing, person-centered care, and collaborating with social work, psychiatry, and navigation.
• Center for Psychiatric Oncology & Behavioral Sciences: Interns participating in the Psycho-Oncology experience at the Mass General Cancer Center’s Center for Psychiatric Oncology & Behavioral Sciences will conduct short-term, individual, evidence-based therapy with patients with cancer-related distress. Interns will also spend approximately one half-day on the Consultation-Liaison service providing brief behavioral interventions to patients with cancer during inpatient admissions. Interns will have the opportunity to observe interdisciplinary team meetings, comprising psychiatry, social work, nursing, and oncology, and work together with the inpatient care team to identify and provide patients or family members with brief targeted interventions (e.g., mindfulness or relaxation exercises, distress tolerance, coping effectiveness training) at the bedside.
• Cancer Center Lifestyle Medicine Clinic: The Lifestyle Medicine Clinic within the MGH Cancer Center serves people in treatment for cancer, as well as long-term survivors. Patients meet with a multidisciplinary team of providers, including oncology, internal medicine, lifestyle medicine, nutrition, and psychology. Interns will have the opportunity to work with patients individually and in groups, focusing on the six pillars of lifestyle medicine: physical activity, healthy eating patterns, restorative sleep, social support, stress management, and avoiding risky substance use. Psychology interventions are short-term and focus on behavioral, cognitive, and, and mind-body aspects of lifestyle interventions specific to this population. Psychiatric co-morbidities will also be treated as they interact with lifestyle behaviors. Supervision will emphasize CBT, ACT, motivational interviewing, and DBT skills.

Sleep Medicine

Using extremely effective and well-validated Cognitive Behavioral Therapy for Insomnia (CBT-I) protocols, interns will have the opportunity to work with patients struggling with insomnia and other co-morbid sleep and psychiatric disorders using a brief CBT-I intervention to help improve sleep. Interns will complete a well-regarded training that they can utilize to help with the common disorder of insomnia going forward in other settings as well, and will have access to referrals from neurology colleagues at the MGH Sleep Medicine Department. CBT-I-specific supervision and ongoing training in behavioral sleep disorder treatment is provided.

Smoking Cessation

MGH Cancer Center Smokefree Support Service: Interns can spend one half-day a week for 6 months at the MGH CC Smokefree Support Service. Interns will be trained to deliver outpatient evidence-based individual and group interventions (integrating cognitive behavioral therapy, mind-body techniques, and motivational interviewing) for people with cancer who smoke/vape. All treatment is delivered via telehealth.

Substance Use

Interns can spend one half-day per week at the Collaborative Care and Engagement Program for six months of the internship year. Interns can be involved in evidence-based individual and group therapy for treating SUD and dual diagnoses. Interns can train in either the West End Clinic An outpatient facility for those with substance use disorders and co-occurring mental health disorders. Interns can provide individual psychotherapy or co-lead a DBT group), the ARMS clinic (An outpatient clinic for those with SUDs and co-occurring mental health disorders focused on youth and young adults. Opportunities for individual and group psychotherapy.), or the HOPE clinic (An outpatient clinic that provides care for pregnant women with substance use disorder and their infants from conception through early childhood).

Weight Center

The Mass General Weight Center rotation affords BMed interns a rare opportunity to receive training and experience in the fast-growing specialty of obesity medicine. With over two-thirds of Americans having overweight or obesity, the knowledge and skills that the intern obtains during this rotation will be useful throughout their future clinical and scientific endeavors. The BMed intern works within the framework of a multidisciplinary team (which may include an obesity medicine physician or nurse practitioner; a dietitian; and/or a metabolic/bariatric surgeon), carrying out consultations, treatment planning, and providing psychosocial intervention specific to the unique needs of this population. Interventions may include treatment for emotionally-triggered or binge eating; CBT to address barriers to healthy eating/physical activity or medical treatment; sleep-related interventions; psychosocial preparation for, and/or adjustment after, metabolic surgery; interventions to address body image; and other specific interventions based on the patient’s individual needs. The BMed intern will have the opportunity to contribute to the care of patients pursuing metabolic/bariatric surgery, treatment with anti-obesity medications, and/or behavioral/lifestyle interventions. Interns work closely with the other team members to provide coordinated care and receive one hour of formal supervision weekly, with informal supervision contact as needed. There is also a strong didactic component to this rotation, with assigned readings of scientific articles on a wide range of topics related to obesity and its treatment, which are discussed during supervision. The BMed intern spends 6 months at the Weight Center rotation for one half-day per week at the MGH Weight Center rotation, under the supervision of Stephanie Sogg, PhD, who is a leader in the field of obesity medicine psychology, and a favorite among past trainees, who have more than once honored her with the Excellence in Teaching and Mentoring Award.

Women’s Health

• MGH Heart Health Mindful Living Center: Interns can spend one half-day a week for 6 months int eh Heart Health Mindful Living Center. Interns will be trained to deliver outpatient evidence-based individual and group mindfulness-based CBT interventions for women with co-occurring cardiovascular disease and emotional problems. All treatment is delivered via telehealth and psychologists interact closely with the cardiology team.
• HOPE Clinic: Interns can spend one half-day per week at the HOPE clinic for six months of the internship year. The HOPE clinic is an outpatient clinic that provides care for pregnant women with substance use disorder and their infants from conception through early childhood).