Clinical Opportunities for Students

The Possibilities Clinic offers unique opportunities to develop strong clinical skills. Most mental health disorders have high comorbidities—so diagnoses rarely exist alone. At Possibilities, we give potential comorbidities the thorough investigation they require. That’s why our assessments involve a team of experts from different fields—like psychology and psychiatry—working together to determine diagnoses and develop comprehensive and integrated Treatment Plans. Clinical Team Meetings take place daily where experts from different fields collaborate to review data, make diagnostic formulations, and discuss scientifically supported treatments. Students in our Residency Program, and post-graduates in Supervised Practice, are welcome to join these meetings to discuss their clients and to learn more about clinical formulations and treatments.

The Possibilities Clinic leverages science and expertise to provide services to children, adolescents, and adults. Through our expertise in neurodevelopmental disorders, we provide evidence-based assessments and intervention for ADHD and Learning Disabilities and their common comorbidities including but not limited to Autism Spectrum Disorder, Anxiety and Mood Disorders, Obsessive-Compulsive Disorder, and Tic Disorders. Our Head Office is located at Yonge and Davisville in midtown Toronto, but we provide services virtually across the province of Ontario. 

The Possibilities Clinic’s residency program is in the process of changing from a virtual residency to a hybrid one as the Clinic moves to a new setting close to the end of summer 2024. In the 2024-25 year, residents will be expected to attend 2 to 3 week-long in person residential visits to the Clinic over the course of the residency year to complete in person assessments and meet and network with the current local staff and practicum students. We are also able to provide residents relocating to or currently living in the Greater Toronto Area office and assessment space at the Clinic to provide a hybrid residency.

PSYCHOLOGY AT THE POSSIBILITIES CLINIC

There are 12 Psychologists at the clinic registered at the Ph.D. level who are eligible to supervise residents. Of these, 8 are registered in Clinical Psychology.

Residents will participate in processes that provide clients with truly coordinated care. Compartmentalized approaches to assessment and treatment can decrease diagnostic accuracy and limit positive outcomes. Right from the start, Possibilities Clinic assessments combine clinicians from Psychology and Medicine because the clinical presentations we see are complex and require integrated approaches and expertise. 

The Director of Psychology Training, Dr. Debra Lean, is a Clinical and School Psychologist registered to work with children, adolescents, and adults in the province of Ontario. Dr. Lean has dedicated time for her duties as Director of Psychology Training. Dr. Lean is responsible for the selection (with other clinic staff) of residents, monitors and evaluates the training program’s goals and activities and documents and maintains the resident’s training records.

MISSION, PHILOSOPHY, GOALS AND OBJECTIVES

The Possibilities Clinic Predoctoral Residency Program provides excellent training in Child and Adolescent, Adult or Lifespan Clinical Psychology. At the conclusion of the program, our residents are ready for supervised practice in Ontario and other relevant levels of early career practice in other jurisdictions. Our mission is to train residents to provide culturally responsive psychological care to a diverse population with a wide breadth and depth of presentations and experiences. This mission is accomplished through a combination of supervised applied direct service, consultation with other providers, didactic work, training in supervision, and evaluation of an internal program. The Residency Program follows a scientist-practitioner training model and a philosophy that is developmental in nature. Training experiences are offered in a principled and organized way so skills and expertise grow systematically, moving residents forward to entry-level independence in clinical service. 

Our goal is to develop resident competencies in the following areas: 

• Interpersonal Relationships 
• Assessment and Evaluation 
• Intervention and Consultation 
• Research
• Ethics and Standards 
• Supervision  
  
  

These goals are measured by several methods: (1) the ratings given by the rotation supervisors, which should be at the level expected for practice entry; (2) the monthly resident forms (clinical work hours, breadth and level of diversity, seminars attended and supervision received) reviewed by the Director of Psychology Training to be at the expected level each month and (3) discussions with the supervisors and the Director of Psychology Training, (4) attendance at biweekly psychology meetings; (5) resident’s attendance at the Resident Training Committee meetings (6) evaluation by the supervisor of the resident’s supervision of a practicum student’s work; (7) resident’s work on a program evaluation project as determined by the supervisor and/or Director of Psychology Training.

GENERAL RESIDENCY INFORMATION

The Residency Program offers an organized and coherent sequence of activities so training experiences and expectations increase in complexity commensurate with residents’ developing knowledge and skills. This developmental structure cultivates and consolidates skills over time. Residents will be ready for an entry level/supervised practice Psychologist position after the completion of their residency and doctoral program.

The total number of residency hours for the internship is 1,880. Residents provide approximately 12 hours a week of direct face to face clinical service. Individual supervision is provided, comprising 3 hours of weekly supervision activities with a doctoral level psychologist. One hour of weekly group supervision, delivered by a doctoral level psychologist, is also provided. Residents are supervised by at least two psychologists. Residents spend no more than two thirds of their time in direct and indirect psychological services to patients. There is an average of 8 hours a month (approximately two hours a week) of didactic training which includes seminars, other group training opportunities and observation of, or participation in, grand rounds. There are clearly defined standards for the completion of the residency program. Written feedback about progress is provided mid-way through and at the end of the program and at the end of each six month rotation. Feedback is also provided to each resident’s university program. Residents are given an opportunity to contribute to program planning, development, and a program evaluation project for one service area at Possibilities. 

Residents are provided supervised clinical training in the following areas: 

o Evidence-based psychological assessment 

o Evidence-based intervention 

o Consultation in interdisciplinary team functioning in clinic, and in other organizations such as schools and community agencies 

o Program development and evaluation for one of the Clinic’s existing programs (e.g., methodology for quality management and interprofessional service development and evaluation) 

o Interpersonal relationships (e.g., therapeutic relationships, therapeutic alliance and professional rapport, self-knowledge and the impact of therapist characteristics on professional relationships and effective communication) 

o Professional standards and ethics 

o Equity, diversity, and inclusion 

o Supervision of practicum students 

All clinical activities are clearly informed by science and inform science. Training is provided for assessment as well as intervention with individuals, groups, and families. Training for residents is provided in a sequence of increasingly independent practices, building in complexity as the residents’ skills and knowledge advance towards the level required for professional psychological practice. The Resident Training Plan is completed by the Director of Psychology Training at the beginning of the program. It includes training goals and objectives as well as caseload expectations. 

Residents have a place on the Residency Training Committee, which plans and evaluates the Residency Program. 

Residents will participate in and be able to observe (and participate in, for their own cases), daily Clinical Team Meetings (Grand Rounds) where diagnoses and treatment plans are discussed among Psychology and Medicine, including Psychiatry, Family Medicine and Pediatrics. 

The residents are considered to be junior colleagues. They are fully integrated into the Psychology Department, joining the department’s biweekly meetings as soon as they start their residency. While training in assessment procedures, they join the psychometry rounds, and also join the intervention rounds once they begin intervention observation. They start by observing assessments, then they are observed doing assessments, then they do assessments on their own under supervision. The same approach is used for intervention. Their direct service hours never exceed the requirement of the Accreditation Standards of the Canadian Psychological Association.

The Residency Program is subject to continuous review and evaluation by the Residency Training Committee regarding standards for preparedness of applicants to the residency and expectations of residents for successful completion. This task is accomplished by regularly and reliably examining success in meeting the program’s goals and objectives through valid measures and review and revision.

There are minimum standards required for successful completion of the Residency Program that are presented to residents in written form in advance of the residency year. Those residents who do not meet standards will be advised and offered time and support to achieve standard performance with a written remediation plan developed by and agreed to by the resident and their supervisors.

In addition to being supervised by registered psychology practitioners, residents will also work with Psychotherapists, Psychiatrists, Paediatricians, Family Physicians, Nurses, Social Workers, Occupational Therapists, Speech-Language Pathologists, and Certified Teachers.

A certificate of completion is presented to all residents who successfully complete the program. 

The program actively demonstrates understanding and respect for variability in human diversity in recruitment and evaluation of staff and residents. Didactic instruction and practical experience are provided regarding the variability in human diversity. The residency program also makes accommodations for residents and staff with diverse needs, such as people with disabilities and other unique needs. 

RESIDENCY PROGRAM STRUCTURE 

The Possibilities Clinic currently has 2 Clinical Psychology residency positions. There are 2 residency tracks:

• Child and Adolescent Track
• Adult Track (can include Seniors)
  
  

Residents have a major rotation in assessment (ADHD and LD and comorbidities) and intervention (major therapies including ADHD coaching, CBT, DBT) and can choose from several minor rotations listed below. The major rotation is 3 days a week and there are 2 minor rotations of 1 day a week for 6 months each. The fifth weekday is reserved for didactics, program evaluation, and research or dissertation work. Residents are supervised by Ph.D. level Clinical Psychologists registered in either Child and Adolescent, Adult, or both populations. There are a sufficient number of registered Clinical Psychologists at the Possibilities Clinic who receive dedicated time to provide supervision for the Residency Program. Supervision is provided for the required number of hours set by the Canadian Psychological Association Accreditation standards. At 1880 hours, the residency offers more than the CPA Accreditation requirement of at least 1600 hours over the course of the year.

CLINICAL ROTATIONS

A. Major Rotation: The major rotation for the Child and Adolescent, Adult and Lifespan Tracks includes assessment (focusing on ADHD and LD and comorbidities) and intervention therapies (e.g., CBT, DBT)

B. Minor Rotations: 

1. Assessment:
   • Autism Assessment (Child and Adolescent Track, Adult Track)
   • Neuropsychology Assessment (Child and Adolescent Track) 
2. Intervention:
   • CBIT Intervention for Tic Disorders and Tourette Syndrome (Child and Adolescent Track)
   • Direct Instruction in Reading, Mathematics, Writing (Child and Adolescent Track)
   • Group therapies for Adult ADHD (Adult Track) 

DUE PROCESS AND GRIEVANCES

There are clear, written policies provided for all residents regarding Due Process Complaints and Grievances. Information regarding Due Process is clearly provided at the beginning of the residency regarding policies and procedures for residents who do not meet minimum evaluation standards, and appealing any program decisions. There is also a process for resident’s grievances regarding the residency program.

DURATION, STIPEND, AND BENEFITS 

The current stipend for the 2024-5 year is $40,000. The Residency Program for 2024-25 starts on September 5, 2023 and ends on August 30, 2025. 

Benefits include: 

• 10 days paid vacation 
• 10 days paid statutory holidays 
• Sick leave aligned with provincial Ontario legislation
• Funding for one out of town conference for virtual residents 
• Several week long sessions at the Clinic for in-person clinical practice 
• $500 travel/education fund for workshops, conferences, books relevant to training
• Group insurance offered after 3 months 
• OHIP basic coverage immediately if residing in Ontario
• We are planning on getting permission from the Clinic to cover the resident’s malpractice insurance, unless appropriate malpractice insurance is provided through the resident’s university program for the purposes of a residency. 

FACILITIES AND RESOURCES 

The Possibilities Clinic’s residency program is in the process of changing from a virtual residency to a hybrid one as the Clinic moves to a new setting close to the end of the summer of 2024. In the 2024-25 year, residents will be expected to attend, at no cost to them, 2 to 3 week-long in person residencies over the course of the residency year to complete in person assessments and meet and network with the current local staff and practicum students. The Clinic is equipped with fully accessible work spaces, secure and confidential online access, clerical support, audio-visual resources for supervision, and assessment materials and supplies.

RELATIONSHIP WITH CPA ACCREDITATION PANEL AND APPIC

The Possibilities Clinic is not accredited by CPA. Application for APPIC membership is submitted and awaiting decision.

CANDIDATE ELIGIBILITY, APPLICATION, AND SELECTION PROCEDURES 

Applications are considered by a group of Psychologists at the Possibilities Clinic, under the direction of the Director of Psychology Training. Those candidates who are selected will be invited for a virtual interview. Candidates for the residency must be in the final stages of a Doctoral program (PhD or PsyD) in a Clinical Psychology program in Canada. Candidates should be fluent in English. 

Application procedure: We expect residents to have completed all requisite coursework, and a minimum of 600 total (direct and indirect) hours of practicum experience in assessment and intervention strategies, before starting our Residency Program. We strongly recommend that thesis data collection and analysis are completed prior to beginning the residency year. Ideally, residents should also have completed a draft of the thesis. 

The Possibilities clinic is not yet a member of APPIC. Until that time, applications are accepted by the following process:

APPLICATION DEADLINE: March 30, 2024 

Please submit the following documents to: 

Dr. Debra Lean 
Director of Psychology Training 
The Possibilities Clinic 
debra.lean@possibilitiesclinic.com 

• Curriculum Vitae 
• Graduate School Transcript
• Three Reference Letters: one from the Director of Clinical Training at your program (including a statement that you are eligible to apply for a Predoctoral Clinical Residency) and two from supervisors of previous clinical work

• A Letter of Interest explaining how the Residency Program at Possibilities aligns with your career goals
• Four APPI-style essays:
  • Provide an autobiographical statement. There is no correct format for this question. Answer this question as if someone had asked you “tell me something about yourself.” It is an opportunity for you to provide the internship sites with information about yourself that may not be covered in other parts of the application. It is entirely up to you to decide what information you wish to provide along with the format in which to represent it.
  • Describe your theoretical orientation and how this influences your approach to case conceptualization and intervention. You may use de-identified case material to illustrate your points if you choose.
  • Describe how multicultural and diversity variables inform your case conceptualization and clinical practice. Use de-identified case material to illustrate your approach.
  • Describe your research experience and interests.

For individuals seeking supervised practice for registration with The College of Psychologists of Ontario, we offer supervision from licensed doctoral psychologists who have experience supervising students, residents, and post-graduates in supervised practice. Our psychologists are registered in a range of areas including Clinical Psychology, Counselling Psychology, and Clinical Neuropsychology.

We offer supervision on a part-time or full-time basis. Supervision opportunities include a mix of assessment and intervention experiences. We strive to nurture astute, current, and highly competent clinicians who will ultimately become independent practitioners. Supervision will be administered in accordance with CPO guidelines and will focus on case discussion and preparation for registration exams.

Psychologists in supervised practice will gain assessment experience with a range of options, including our Multidisciplinary Team Signature Assessment—a unique psychoeducational assessment that includes comprehensive ADHD testing plus mental health measures. Our Multidisciplinary Team Focus Forward 360 Assessment for ADHD provides additional assessment experience in supervised practice. Our psychologists also conduct Autism Spectrum Disorder (ASD) assessments, and there may be opportunities to participate in these assessments depending on interest and availability.

For assessment, clinicians in supervised practice will develop skills in diagnostic interviewing, administering standardized assessment measures, making clinical formulations and diagnoses, writing reports, collaborating with colleagues in Clinical Team Meetings where data are presented and discussed, and providing feedback to clients. Teaching related to evidence-based assessment, ethical practice, and jurisprudence guidelines is incorporated into our supervision for registration program.

Various intervention experiences are also available. ADHD Coaching and therapies for treating symptoms of anxiety, low mood, and emotion regulation are examples. Therapeutic approaches may include, but are not limited to, Acceptance and Commitment Therapy (ACT), and Collaborative and Proactive Solutions (CPS).

Currently, most assessments and treatments are provided over secure telemedicine sessions.

Regular supervision includes weekly meetings, opportunities to observe licensed clinicians while learning new skills, and opportunities to be observed to receive feedback and guidance. Participation in a Clinical Consultation Group, and attendance at clinic workshops and lectures on various topics related to diagnoses and treatments are also options in supervised practice.

If you are interested in either training opportunity, please send an updated CV along with a cover letter specifying the training program you are requesting to training@possibilitiesclinic.com.