Psychology Internship
Dear Intern Applicant,
Welcome to the web site of the APA-accredited Predoctoral Internship in Clinical Psychology in the Department of Behavioral Medicine and Psychiatry at WVU School of Medicine in Charleston. This program offers an in-depth training experience in clinical and health psychology services at a large university-affiliated community medical center. With emphases on support and flexibility, our objective is to refine interns' clinical and scholarly skills so that they are prepared for work in a variety of settings.
The following information is designed to provide a comprehensive overview of our training program. We look forward to answering any specific questions you might have that are not included in this description.
The internship runs from July to July. The stipend is $28,657, and currently each intern is provided additional funds to use for pre-approved expenses such as travel to professional conferences. Along with sick days and holidays, interns have two weeks of paid vacation. “Vacation” here means lying on a beach, not defending a dissertation or attending meetings.
Our program participates in the AAPI online appication process.
After your application is complete, you may wish to schedule a visit. It is important to note that a visit is not necessary. The last time we checked, graduate students were pinched for time and not independently wealthy. As such, we find it ethically questionable to require applicants in some cases to spend vast sums of money and time to travel here, when many of our past interns were accepted solely on the basis of application materials and phone interviews. Many applicants still request a visit, but unfortunately not everyone can be scheduled. Three visit days are scheduled in 2012 at this time: January 13th, January 20th, and January 27th. A small group will visit each of these days.
If you are interested in visiting on one of these days, please contact me. Visit requests will be reviewed by the internship committee in terms of general goodness of fit between the applicant and our program. If a visit cannot be arranged, please remember that applicants are not “invited” per se on the basis of strength of application. Rather, we try to meet requests for visits, knowing applicants may want to see the setting where they might spend a training year. If for any reason you do not visit our program, your application will not suffer as a result. However, if you do not visit, it is important that if you wish to train here that you contact me and faculty in your area of interest, at the addresses noted, to discuss the program and have your questions answered. Our current interns are also available to discuss the program with you. We will do our best to make this as painless as possible. Thank you for your interest in our internship program. We look forward to hearing from you.
Best Wishes,
John C. Linton, Ph.D, ABPP
Chief Psychologist & Director of Training
Training Program Philosophy
In brief, the WVU/CAMC internship is a clinical psychology training program in a medical setting. It is designed to train predoctoral interns in the broad and general skills required to function independently in entry-level professional positions, following graduation and the requisite licensure or certification. Training is sequential, cumulative, and graded in complexity in each rotation over the year. It is best described as following a professional/scholar model, with mentoring, solid clinical training and the utilization of the scientific literature to inform and shape practice, teaching and scholarly work. We firmly adhere to the integration of science and practice for internship training. In addition to the generalist training recommended at the internship level, we also offer an emphasis in clinical health psychology, consistent with our medical setting. We stress multidisciplinary and interdisciplinary functioning, multitheoretical approaches, and diversity sensitivity/competence. Also stressed are personal development and the crafting of one's professional identity.
Who Should Apply?
We accept applications from graduate students in good standing from APA accredited doctoral programs in clinical and counseling psychology. When evaluating application materials, faculty reviewers consider the applicant’s goodness of fit with our training program. What candidates bring to us is important, but more essential is whether our site has what a student needs to advance her/his career to the next level, which is the independent practice of psychology. We are not only evaluating applicants, but also whether ours is the best program to support their professional development and chosen career path in the most desirable way.
Our faculty will consider the reputation of your graduate program, the quality of your clinical experience, the quality of your academic performance, teaching and scholarly work, and the specifics of your letters of recommendation. The internship provides generalist training, so we favor an applicant who is well rounded. In addition, having at least some experience and interest in health care settings typically means a better chance of a good fit between you and this program, given that we are a large academic health center.
Because interns are very involved in a wide variety of activities throughout the medical center, it is also necessary for them to be mature, ethical, and sensitive to the limits and boundaries that define their competence at this stage of training. Interns should be able to work smoothly with other health care professionals and function well on teams. Since part of the training is self-directed, successful interns make a significant contribution to planning their professional development. The environment here is intellectually stimulating, but warm and cordial, and we value interns with a pleasant social style and a sense of humor, which has helped many an intern through a demanding day.
Our program strongly encourages applications from minorities and those from other under-represented groups. We follow the non-discrimination policies of both West Virginia University, as follows from the WVU Office of Social Justice (www.wvu.edu/~socjust/ ):
West Virginia University is an Equal Opportunity/Affirmative Action Institution. The University does not discriminate on the basis of race, sex, age, disability, veteran status, religion, sexual orientation, color, or national origin in the administration of any of its educational programs, activities, or with respect to admission or employment. Faculty, staff, students, and applicants are protected from retaliation for filing complaints or assisting in an investigation under the University's Equal Opportunity Policy/Affirmative Action Plan. Inquiries regarding the University's non-discrimination policy may be directed to the Director, Affirmative Action/Equal Employment Opportunity, at West Virginia University. And the CAMC Health Education and Research Institute, as found in the Resident Handbook at http://camc.wvu.edu/
About Charleston
Charleston is the state capital of West Virginia, and the medical center campuses are located close to the impressive state capitol complex. Charleston is a beautiful river city, combining small town charm with larger city amenities. The Charleston metro area comprises a population of around 250,000. Getting around the city is easy with its extensive interstate system, and traffic jams are virtually unknown, saving the busy intern valuable time in commuting. Nearby Charleston are extensive areas for outdoor exploring, white water rafting, hiking and climbing, as well as downhill and cross-country skiing. The river supports pleasure craft and paddle wheelers, and festivals occur throughout the year. Cultural events from symphony to ballet, bluegrass to rock, little theater to Broadway road shows, combine to stimulate one’s evenings and weekends. And the low crime rate and community warmth make Charleston an ideal city in which to train. Please see the Charleston links on our website for further information.
About the city of Charleston
Training Program Overview
This internship is fully accredited by the APA Committee on Accreditation through the American Psychological Association, 750 First Street, NE, Washington, DC, 20002-4242, phone: 202-336-5979, and complies with all standards and regulations of the Association of Psychology Postdoctoral and Internship Centers (APPIC). The internship training year is July 1st to June 30th. The deadline for applications is December 1st. OUR APPIC INTERNSHIP MATCHING PROGRAM CODE # IS 163711.
The year-long internship is divided into eight months of required experiences and four months where interns choose from a number of optional experiences. The required and optional rotations are mixed over the year, so all required experiences do not have to be completed before optional training begins.
The following is a brief overview of the program schedule:
Required Rotations: These experiences are of fixed length, as noted below. They combine to total 32 weeks.
- Inpatient Psychiatry [more information] 6 weeks
- Outpatient Psychiatry (with electives) [more information] 10 weeks
- Consultation/Liaison [more information] 12 weeks
- Assessment Service [10 comprehensive assessments required] [more information] estimated at 4 weeks
Optional Rotations: These training experiences are of varying lengths, as arranged with faculty and staff. They combine to total 18 weeks. Each is described in more detail by clicking on "Optional Rotations."
- WVU Family Medicine
- WVU Child & Adolescent Psychiatry
- WVU Psychological Assessment Lab
- CAMC Family Resource Center
- CAMC Med Rehabilitation Center
- CAMC Cardiac Rehabilitation
- Critical Incident Stress Team
- Simulation Center
- CAMC’s Sleep Center
- WVU Disordered Eating Center of Charleston (DECC)
- Independent Research
- Other special interest rotations can be arranged, e.g. neurology, hospital administration
Total Training Time: 32 weeks of required + 18 weeks of optional rotations = 50 weeks.
Goals, Objectives & Competencies (click here for PDF)
Training Setting
The Charleston Division of the West Virginia University (WVU) School of Medicine is located in the state capital, and integrated with the Charleston Area Medical Center (CAMC). CAMC has three campuses totaling 1000 beds; these campuses are about five to 10 minutes apart by car.
The General Hospital Campus includes General Hospital, the Trauma Center, a physician's office complex, the community mental health center, and the Medical Rehabilitation Center.
The Memorial Hospital Campus includes Memorial Hospital, the Cancer Center, the Heart Institute, a physicians office complex, and the WVU Medical Education Building and Library. The WVU Departments of Behavioral Medicine, Family Medicine, Internal Medicine, Surgery, and Community Medicine are located here. The CAMC Health Education and Research Institute is also located on the Memorial Campus.
The Women and Children's Campus includes the Women and Children’s Hospital and the Family Resources Center. The WVU Departments of Obstetrics and Gynecology and Pediatrics are located here.
The Medical Center is the largest in the state, serving a population of over 600,000, with the entire socioeconomic spectrum represented in this group. WVU faculty and CAMC staff work together smoothly, providing a broad training base to students of many disciplines. The primary function of the WVU Department of Behavioral Medicine and Psychiatry is the training of WVU medical students and CAMC residents. Many non-medical graduate students are also trained in this department. The guiding philosophy is the integration of excellence in training and clinical care.
The WVU Department of Behavioral Medicine and Psychiatry is located in the RCB Training Center on the Memorial Campus of CAMC. The mailing address is Department of Behavioral Medicine, WVU/RCB Training Center, 3200 MacCorkle Ave. S.E., WV 25304. Our FAX number is 304-388-1031. The training director's e-mail address is jlinton@hsc.wvu.edu, and his direct phone number is 304-388-1032.
Required Rotations
*Supervisors are noted in (parentheses)
- Adult Psychiatry Inpatient Unit: It is clear mental health care in the US is moving away from inpatient facilities for all but the most severely impaired patients. However there is still an need for acute, short-stay units for crisis stabilization, with day patient units then used to care for those who no longer need inpatient, but do need intensive outpatient care.
This is a new and very modern 22-bed teaching unit, where front-line care is provided by third-year WVU medical clerkship students, non-medical graduate students, and psychiatry residents, with the support of WVU School of Medicine Faculty. The patient population includes many diagnostic categories, but highlights management of acute problems in a short period of time. Special care is offered for patients with medical problems or chemical dependency. Day patients receive the core of the inpatient day, but return home in the evening. Each patient is randomly assigned to a treatment team comprised of a medical student, a psychiatric resident, a nurse and at times a non-medical graduate student. The team follows the patient throughout the inpatient stay.
Psychology interns have access to all inpatient records, and are expected to note their observations, impressions and recommendations in patient charts. During inpatient interns attend medical student lectures daily, as well as grand rounds and various other seminars. There is therefore a good deal of didactic and tutorial teaching provided to a variety of trainees on this service. The inpatient rotation is required and full-time for 6 weeks (Wilhelm)
Emergency Department: As part of the Inpatient Rotation, interns work in the Emergency Department (ED). Behavioral Medicine and Psychiatry is on call to the busy General Division ED at all times. When a patient has an emotional or behavioral problem, an on-call third year medical student and psychiatric resident is consulted to the ED to evaluate the individual and suggest an intervention plan. Psychology interns take ED call with residents for a 24-hour period several times during the inpatient rotation. During this time they function as medical students with resident colleagues. They may clinically evaluate and plan for as many as 12 ED patients in a 24-hour period. Scrubs and sleeping quarters are available for interns in the evening, although sleeping through a call night is unusual. This is excellent crisis intervention experience, and draws on the intern’s flexibility and resourcefulness. (Faculty as assigned).
- WVU Outpatient Psychiatry Service: This is a busy training clinic where patients of all ages enter through referral from inpatient, from other parts of the hospital, through physician and community referral, or by self-referral. Doctoral interns function as staff during this rotation. They can follow former inpatients, select cases from the ED crisis service, and do scheduled intakes. Faculty members of all disciplines welcome doing co-therapy with psychology interns, both for initial intakes and also longer term case management and psychotherapy. Interns are required to carry a modest caseload, but the focus of the clinic is teaching, not service. The outpatient clinic does not need intern labor to function. Therefore, students and their supervisors can select cases, which are best suited to fill the intern’s clinical experience gaps.
All therapeutic modalities are encouraged in this setting, and interns are often consulted by other staff regarding advice in areas of the intern’s particular interest and expertise. Conversely, interns are expected to explore new clinical techniques to insure their time in the outpatient department is one of training and not merely service. On outpatient, interns may choose to work with children, adults, families and groups. Again, the problem is tailored to the needs of the student as much as possible, and faculty members involved with specific areas are available for supervision and guidance. (Cloonan, Linton, Wilhelm).
Outpatient Electives: In addition to work in the Behavioral Medicine Outpatient Clinic, interns can take a number of outpatient electives, which are targeted learning experiences available to those who wish to develop special expertise. The time commitment is typically about 4 hours per week, which is applied to the required outpatient hours. Current Outpatient Electives are:
Virtual Reality Treatment for Anxiety Disorders (Sirbu)
Anxiety Disorders Clinic, including GAD Group and Panic Disorder Group (Wilhelm)
Geriatric Clinic for older patients with physical/psychological problems. (Griffith)
Trauma Program for victims of trauma from crime, physical injury, etc. (Linton)
Outpatient Groups. Sexual Abuse (Dash)
Eating Disorders (Luzier)
DBT (Kerr)
CBT Supervision/training (Wilhelm)
Parent/Child Interaction Therapy (Cloonan)
Specially arranged electives
- Consultation/Liaison Service: Physicians on other medical services often consult Behavioral Medicine regarding their patients who are having behavioral or emotional problems. Typical referrals are for depression, anxiety, pain control, substance abuse, competency determination, family crises, and adjustment to trauma. C/L Team trainees (residents, psychology interns) make first contact with the patient, and perform an initial assessment. The case is then presented to attending staff and the team for review. Each patient is then revisited during teaching rounds led by a faculty member. The rotation on C/L presumes only basic competence in traditional clinical skills. Exposure to the role of the psychologist in general medical settings is the primary goal of the C/L Team, and experience with the interdisciplinary team forms the core of the rotation.
Interns interact daily with physicians, nurses and other hospital personnel. They may do liaison activities such as consultation with the Renal Dialysis or Transplant programs, the Trauma Center and intensive care units, Medical Rehabilitation, Cancer Center and the Heart Institute. Primary to this service is a development of a sense of the health delivery system, and assigned readings supplement experiential aspects of the rotation. This is a full-time rotation, but interns are “eased” into this busy service for the first few weeks. Consults are assigned with concern for the intern’s level of experience, and while previous work in health psychology may help, it is not necessary. (Linton, Wright).
- Assessment Service: In order to integrate psychological assessment with the other duties performed by a psychologist, and to expose the intern to a variety of approaches to psychological evaluation, the psychological assessment rotation will consist of a requirement to perform 10 psychological assessments over the course of the year. The assessments are not designed to be hard labor, but will be very flexible and designed to reflect the interest of the intern as well as address any deficits in skills. Factors included in the assessment process may include: researching relevant clinical issues, clarification of referral questions, patient interviewing techniques, test selection and interpretation, report writing and patient feedback. Although a psychometrician is available to administer tests, in order to gain experience interns may elect to perform their own testing. The intern may choose to evaluation any combination of adults or children, psychiatric or non-psychiatric medical patients, the chemically dependent, etc. Evaluations may include IQ testing, assessment of developmental disabilities or ADHD, pain management evaluations, personality testing, or development of proficiencies with new techniques. The intern will develop an individualized plan with the guidance of the director of the psychological assessment service, which will require flexibility over the course of the year (DiPino).
Optional Rotations
As mentioned earlier, in addition to required experiences, interns may design a program from the list of optional rotations. This is done by consulting with supervising faculty of the desired rotations. Interns do not need to “compete” with one another for these settings, and it is no problem if everyone wants some and not others. Interns do not need to choose optional rotations in advance, since informed choices can only be made after interns are here for a while and get to know the programs and supervisors. Some optional rotations can be done part-time, so interns can be involved in several at once.
Managing several assignments at one time is consistent with the demands on professional psychologists in health care settings, and is a valuable learning experience. Transition from one rotation to another is designed to be smooth so little time is wasted.
The Following Rotations Are Optional for Psychology Interns:
- CAMC Family Resource Center (FRC): Located on the Women and Children’s Campus, the FRC is a full service outpatient mental health facility serving adults, children, adolescents, couples and families. Clients are treated for a wide range of problems including depressive disorders, anxiety disorders, eating disorders, domestic violence, and bereavement. The FRC also provides consultation to Women and Children’s Hospital on the inpatient units as well as outpatient clinic settings. Interns can work with individuals, couples and families. Consultation opportunities include pediatric oncology, and working with patients with encephalitis, diabetes, and other chronic and acute illnesses. Experiences in infertility consultation and evaluation are anticipated (Walker-Matthews, Morales).
- CAMC Cardiac Rehabilitation: Is a multidisciplinary program within the large and active Heart Institute, consisting of four phases from acute to long-term follow-up of patients who have experienced cardiac events. Interns can be involved in psychological consultations to cardiac care inpatients, individual therapy with outpatients in the rehabilitation program, group therapy focused on various mental health issues related to cardiac problems, consultation with other medical staff, and research on psychosocial outcomes following interventions for cardiac events. (Chelf-Sirbu).
- WVU Department of Family Medicine: Psychology faculty coordinate the behavioral science component for the Family Medicine residency training program. This provides a unique opportunity for interns to participate in program development in primary care health psychology. Interns can round with family physicians, provide consultation to them about psychological issues in patients, and participate in didactic presentations for residents. In addition to the Charleston Area clinics, rotations in two rural primary care settings can be arranged. The rotation is tailored to the interests of the intern as much as possible. (Fields)
- WVU Child and Adolescent Psychiatry: Interns may spend two or more months in Child and Adolescent Psychiatry, working with a child psychologist, a social worker/family therapist, child psychiatrists, and psychiatry residents. Patients range in age from 2-17 years and present with a variety of emotional/behavioral disorders and issues. Interns may receive training in parent-child interaction therapy, family therapy, and cognitive-behavioral approaches to intervention. Monthly didactics are included in the rotation. (Cloonan, Luzier)
- WVU Psychological Assessment Laboratory: This provides an opportunity for additional assessment experience for the interns. While the primary focus of the rotation is typically neuropsychological in nature, the Psychological Assessment Service provides the entire medical center with evaluations, and the opportunity exists to arrange other assessment experiences. Relations with neurology, neurosurgery and physical medicine are excellent, and assessment experiences can also be arranged through special clinics or upon referral for clinical problems of interest to the intern. Testing is done primarily by psychometric staff, but interns may administer some or all of their own testing to develop and sharpen assessment skills (DiPino, other staff as assigned).
- Medical Rehabilitation Center: The CAMC Rehabilitation Center is located on the General Division Campus. It is a modern, 40-bed facility, and treats patients suffering the effects of spinal cord injury, CVA (stroke), closed head injury, amputation, and other acute problems requiring rehabilitation services. The intern participates as a team member under supervision doing clinical assessments, providing individual and family treatment from ICU through acute care, through rehabilitation to discharge, and attending regular patient staffings and conferences. (Linton)
- Critical Incident Stress Management (CISM) Team. The Department is the lead mental health agency for response to critical incident stress in emergency responders. in southern West Virginia. Team membership requires specific in-house training, as well as time in the field responding with emergency services personnel. The request for stress management service occurs unpredictably throughout the year around the region, so this is not a rotation with clear time boundaries. Debriefings and educational workshops are usually done in the early evening or weekends. (Linton)
- Simulation Center:CAMC’s Patient Simulation Center (Center for Innovative Learning and Assessment) is a dedicated simulation teaching laboratory encompassing approximately 7,000 square feet located on the General Division Campus. The center enhances medical education as an adjunct to teaching healthcare profession students and practitioners using advanced simulation technology. Opportunities for interns include assisting medical faculty members with curriculum development, developing and evaluating measures assessing teamwork skills, developing and assisting in projects aimed at improving communication skills of healthcare professionals, and research on educational outcomes. (Drake)
- CAMC’s Sleep Center: is located on the General Division Campus and is the first Sleep Center in West Virginia to be accredited by the American Academy of Sleep Medicine. This Center provides comprehensive care for all sleep-wake disorders, from initial consultation through diagnosis, treatment, patient education, and follow-up. The medical director of the center makes appropriate referrals to the psychologist when a patient’s disordered sleeping is suspected to have underlying psychological roots. The intern participates in assessment and treatment of individuals with a focus primarily on techniques involving sleep hygiene psychoeducation, sleep restriction, stimulus control, relaxation training, and cognitive-behavioral strategies. (Drake)
- WVU Disordered Eating Center of Charleston (DECC): Interns may spend time on an interdisciplinary treatment team for individuals with disordered eating, including feeding and eating disorders and obesity. This cross-disciplinary team includes an Adolescent Medicine Physician (WVU Department of Pediatrics), a nutritionist, and a team of psychologists from Behavioral Medicine and the Family Resource Center (Drs. Luzier, Kerr, Linton, and Morales). Further, Dr. Scott Mizes will serve as our expert consultant for this project. Interns may receive training with disordered eating patients in therapy, may observe and consult on cases with the pediatrician and nutritionist, and attend weekly DECC team meetings. Opportunities for clinical research are also available. (Luzier)
- Independent Research: In addition to time made available during the other rotations of the internship, interns may elect to take a month to focus upon a particular research project. Such a project might be carried out alone, or in collaboration with others in the Department. Doctoral dissertations do not qualify unless data are being collected on site. (Sirbu, Kerr, Various faculty)
WVU Behavioral Medicine Faculty & Staff (Full-time Clinical Psychology Faculty)

Front Row: Drs. Chelf Sirbu, Cloonan, Linton, Morales
Back Row: Drs. Kerr, DiPino, Wilhelm, Drake, Fields, Walker Matthews, Luzier, Sirbu
- Melisa Chelf Sirbu, PhD (Virginia Tech): ; melisa.chelfsirbu@camc.org : Clinical Assistant Professor. Coordinator of Psychology, CAMC Cardiac Rehabilitation Program, clinical and health psychology, individual psychotherapy, psychoeducational group interventions.
- Scholarly Interest Areas: Psychosocial functioning and cardiac health, psychosocial functioning after trauma, assessment and treatment of anxiety disorders.
- Holly A. Cloonan, PhD (Purdue); holly.cloonan@camc.org: Associate Professor and Coordinator, Child Psychology. Parent-Child Interaction Therapy, cognitive behavioral interventions with anxious/depressed/angry school aged children, treatment of OCD.
- Scholarly Interest Areas: PCIT treatment efficacy in various populations.
- Raymond Kim DiPino, PhD (George Mason University) raymond.dipino@camc.org : Associate Professor, Neuropsychologist, Director of Psychological Assessment Lab
- Scholarly Interest Areas: Mild traumatic brain injury, neurocognitive functioning following trauma, test development, toxic exposure, detecting of malingering, chronic fatigue syndrome.
- Elise A. Drake, PhD (Virginia Tech): elise.drake@camc.org : Clinical Assistant Professor, CAMC Sleep Center. Clinical and health psychology, sleep disorders, cognitive-behavior therapy.
- Scholarly Interest Areas: large-scale behavior change, simulation in clinical and educational settings.
- Scott A. Fields, PhD (Ohio University): scott.fields@camc.org : Associate Professor, Director of Behavioral Sciences, Department of Family Medicine. Clinical psychology, health psychology, cognitive-behavioral therapy, tobacco cessation.
- Scholarly Interest Areas: Outcomes assessment, the continuum of mental health care, prevention programs.
- Parick L. Kerr, PhD (North Dakota): patrick.kerr@camc.org : Assistant Professor, Outpatient psychotherapy, Associate director of research.
- Scholarly Interest Areas: Suicide and suicidality; non-suicidal self- injury (NSSI); emotion regulation/dysregulation; Dialectical Behavior Therapy (DBT); treatment outcomes research; psychobiological components of severe psychopathology; evidence-bases treatment development and outcomes; suicidality in emergency settings; Borderline Personality Disorder (BPD); bipolar Disorder: PTSD and traumatic stress.
- John C. Linton, PhD, ABPP (Clinical Psychology, Health Psychology)(Kent State); john.linton@camc.org : Professor, Chief Psychologist and Director of Psychology Internship Training. Vice Chair and Coordinator of Medical Student Education. Clinical health/rehabilitation psychology, adult outpatient, ethics and professional affairs, traumatic stress, brief interpersonal psychotherapy for depression. Director of Trauma Assessment and Recovery Program.
- Scholarly Interest Areas: Adjustment to acute trauma, medical crises as traumatogenic, critical incident stress in emergency personnel, bariatric surgery, high performance relations team training, males injured in the workplace, professional ethics.
- Jessica L. Luzier, Ph.D. (Ohio University): Jessica.luzier@camc.org : Assistant Professor, Outpatient child and adolescent psychotherapy, Clinical Director of the WVU Disordered Eating Center of Charleston (DECC).
- Scholarly Interest Areas: Eating disorders, feeding disorders, pediatric obesity, emotionally dysregulated adolescents, Dialectical Behavioral Therapy (DBT) for adolescents and disordered eating populations, EST’s, treatment outcome research.
- Lori Remily A. Morales, PhD (University of Toledo): lori.morales@camc.org: CAMC Family Resource Center. Clinical and health psychology, individual and couples psychotherapy, infertility, pregnancy loss, reproductive health issues, binge eating, obesity, and psychoeducational and supportive group interventions.
- Scholarly Interest Area: Knowledge and awareness of infertility; couples coping with infertility
- Emily Selby-Nelson, PsyD (Marshall University): enelson@cchcwv.com: Clinical Assistant Professor. Cabin Creek Health Systems. Clinical interest
areas: primary care psychology, clinical and health psychology, cognitive-behavioral therapy, outpatient psychotherapy, and rural populations.
- Scholarly interest areas: health behavior change, optimizing access to and use of healthcare and mental health treatment in rural areas, and use of simulation centers and standardized patients in professional training.
- Susan Walker-Matthews, PhD (UNC-Greensboro) susan.matthews@camc.org: Clinical Assistant Professor, CAMC Family Resource Center, pediatric psychology, women’s health services, individual psychotherapy, psychotherapy for adolescents.
- Scholarly Interest Areas: Patient and familial coping with pediatric cancer, cognitive changes following chemotherapy and radiation therapy.
- Laura R. Wilhelm, PhD (Ohio University) laura.wilhelm@camc.org :Assistant Professor. Individual psychotherapy with adults, adolescents and children, cognitive behavior therapy, psychoeducational and supportive group interventions, health psychology.
- Scholarly Interest Areas: Interventions that improve coping with painful medical procedures, patient and family adjustment to serious injury/chronic illness.
Current Psychology Interns

(l-r)Dana Nevedal, Sam Scott, Kasaan Holmes
Please Note: This year's class of psychology interns can each be contacted through the office phones or email addresses noted above. Please feel free to contact them with any questions about their training experiences at WVU.
Full-Time Social Work Faculty
- Rachel Dash, ACSW (Maryland); Child/Adolescent; Family Therapy, Sexual Abuse
- Elizabeth Kent, ACSW (WVU); Women’s Issues, Career Planning
Full-time Psychiatry Faculty
- Veena Bhanot, MD (Columbia University); Director, Outpatient Services
- T.O. Dickey, III, MD (WVU); Director of Residency Training, Child Psychiatry
- Carol Freas, MD (Kentucky) Child/Adolescent Psychiatry
- James Griffith, MD (WVU); Adult Medicine/Psychiatry Clinic, Inpatient Co-Director
- Martin Kommor, MD (Louisville); Chair, Adult Outpatient
- Kawar Sidhu, MD (Medical College, Amristar); Adult Psychiatry
- Tiffany Sparks, MD (WVU); Consult Service, ED
- Glen Wright, MD (WVU); Director, Consultation/Liaison Service

Psychology interns work closely with psychiatry residents, and often form close social relationships with them during internship. Here interns are seen during orientation with first year psychiatry residents.
Intern Handbook (Click here)
Evaluation Forms
Previous Psychology Interns & Their Post Graduate Employment
- 1976-77
James Dalton, PhD (Connecticut) Department of Psychology, Pennsylvania State University, Bloomsburg, PA
Jack Schaffer, PhD (North Dakota) Center for Health and Family Psychology, St. Paul, MN
- 1977-78
Frances Haemmerlie, PhD (Florida State) Department of Psychology, University of Missouri, Rolla
Thomas Ellis, PsyD (Baylor) West Virginia University School of Medicine, Charleston
- 1978-79
David Hopkins, PhD (South Dakota) Schwab Rehabilitation Center, Chicago, IL
Marsha Driscoll, PhD (Ohio State) Department of OB/GYN, Ohio State University
- 1979-80
Connie Bradley, PhD (Peabody) Family Medicine, University of Wisconsin, Milwaukee
Joseph Foote, PhD (Vanderbilt) Kelsh Associates, PA and NJ
- 1980-81
Paula Litchfield, PhD (Peabody) Training/Development, Union Carbide Corporation, Danbury, CT
Judith Peoples, PhD (Virginia Tech) Norton Pavilion, Louisville, KY
- 1981-82
Steven Dobbs, PhD (Mississippi) Private Practice, Clinton, Mississippi
Dale Wisely, PhD (Memphis State) The Vaughn Clinic, Birmingham, AL
- 1982-83
Karen Anderson, PhD (Memphis State) Pain Clinic, University of Massachusetts Medical School, Wooster, MA
Debra Mendlowitz, PhD (Peabody) Psychiatry Dept. Kaiser Permanente, Pleasanton, CA
Deems Ortega, PhD (Kansas) Med /Psych, The Johns Hopkins Hospital, Baltimore, MD
- 1983-84
William Ferguson, PhD (South Dakota) Behavioral Medicine, Lancaster General Hospital, Lancaster, PA
Kurt Moehle, PhD (Memphis State) Department of Psychology, Indiana/Purdue, Indianapolis, IN
Katie Ratliffe, PhD (Auburn), Indiana Central University, Indianapolis, IN
- 1984-85
Carol Bugglin, PhD (Connecticut) Tressler Center, Dover, DE
Deborah Couk, PhD (North Dakota) Physical Medicine and Rehabilitation, University of California, Sacramento, CA
Liz Kalb, PhD (Iowa State) Clinical Psychology/Medical Education, St. Mary’s Medical Center, Evansville, IN
- 1985-86
James Snowden, PhD (South Dakota) Parkview Psychological Services, Sioux City, IA
Maria Waddell, PhD (SUNY Albany) Dept. of Psychiatry, Indiana University School of Medicine Indianapolis, IN
Nancy Woodward, PhD (Peabody/Vanderbilt) Behavioral Medicine/Oncology,University of Pittsburgh School of Medicine, Pittsburgh, PA
- 1986-87
Vincent Culotta, PhD (Memphis State) Dept. of Psychology, Cumberland Hospital, Richmond, VA
Dorinda Leudke, PhD (UHS/Chicago Med School) Behavioral Medicine, Radford Community Hospital, Radford, VA
Rosemary Smith, PsyD (Florida Institute of Technology) Private Practice, Charleston, WV
- 1987-88
Nancy “Tate” Brunner, PhD (Florida Institute of Technology) Datahr Rehabilitation Institute, Brookfield, CT
Timothy Freeman, PhD (West Virginia University) Clinical Child Private Practice, Charleston, WV
- 1988-89
Christina Donnell, PhD (UHS/Chicago Med School) Anxiety Disorders Clinic, St. Paul Ramsey Medical Center, St. Paul, MN
Miriam Lerner, PhD (Virginia Tech) Center for Teens at Risk, Western Psychiatric Institute and Clinic, Univ. of Pittsburgh, Pittsburgh, PA
- 1989-90
Jeannie Clark, PhD (Ohio University) Sharpe Hospital, Weston, WV
Randy Pascale, PhD (Memphis State) Western Psychiatric Institute and Clinic,University of Pittsburgh, Pittsburgh, PA
Nancy Rubin, PsyD (Denver) College of Community Health Sciences, University of Alabama, Tuscaloosa, AL
Elizabeth Wagner, PhD (Illinois) Shawnee Hills CMHC, Charleston, WV
- 1990-91
Jodi Brooks PhD (Mississippi) Children’s Hospital of Alabama, Birmingham, AL
Mary Gentile, PhD (Alabama, Birmingham) Behavioral Medicine, Sacred Heart Medical Center, Spokane, WA
Kathleen Ritchey, PhD (Ball State) Well-Choice Enterprises, Dublin, OH
- 1991-92
Jean Guy, PhD (Mississippi) Lakeshore Rehabilitation Hospital, Birmingham, AL
Debra Lancaster, PhD (Wright State) Community Mental Health Center, Lancaster, OH
Mary Pat Noonan, PhD (South Dakota) Medical Psychology, The Johns Hopkins Hospital, Baltimore, MD
Valerie Williams, PhD (Alabama, Birmingham) VA Medical Center, Reno, NV
- 1992-93
Megan Gregg, PhD (Kentucky) St. Camillus Rehabilitation Center, Syracuse, NY
Gail Lehman, PhD (SUNY, Buffalo) Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Charleston, WV
James Luther, PhD (Indiana) Lafayette Clinic, Lafayette, IN
- 1993-94
Melodye Gaskin, PhD (Florida) Womens Studies Program, University of Florida, Gainesville, FL
Lynette Menefee, PhD (Iowa) Medical Psychology, The Johns Hopkins Hospital, Baltimore, MD
Kitti Virts, PhD (Vanderbilt) Kim Dayami Medical Center at Vanderbilt University, Nashville, TN
- 1994-95
Judith Holder, PhD (Southern Illinois) Occupational Health, Duke University, Durham, NC
Joseph Mills, PhD (SUNY, Buffalo) Private Practice, Seattle, WA
Janice Triplett, PhD (West Virginia University) Psychiatry and Behavioral Sciences, Duke University, Durham, NC
- 1995-96
J. Christopher Cruise, PhD (Wyoming) Family Resource Center, Charleston Area Medical Center, Clinical Assistant Professor, WVU School of Medicine
Matthew L. Herridge, PhD (Virginia Tech) Cardiac Rehabilitation, Charleston Area Medical Center, Clinical Assistant Professor, WVU School of Medicine
Susan Walker-Matthews, PhD (UNC-Greensboro) Family Resource Center, Charleston Area Medical Center, Clinical Assistant Professor, WVU School of Medicine
- 1996-97
Michelle E. Gaines, ABD (Bowling Green) Rural Resiliency Project, Lincoln Co., WV, Clinical Assistant Professor, WVU School of Medicine
Kevin B. Handley PhD (Fairleigh Dickinson) Anxiety Disorders Program, Rappahannock Area Community Services, Spotsylvania, VA
Donna J. Winslow PhD(Wyoming) CAMC Newborn Intensive Care Unit, Department of Pediatrics, Charleston, WV
- 1997-98
Shelly Johns PsyD (Indiana State) CAMC Cancer Center, Charleston, WV, Clinical Assistant Professor, WVU School of Medicine
Michelle Martin PhD (University of Alabama, Birmingham) Assistant Professor, Department of Clinical/Health Psychology, UAB.
Charles Sarchione PhD (University of North Carolina, Greensboro) RHR International Consulting, Dallas, TX
Erica Van Der Haden PsyD (Florida Inst. Of Technology) Private Practice, Ocala, FL
- 1998-99
Laura Capage, PhD (West Virginia University) Curtis Center, Department of Psychology, West Virginia University, Morgantown, WV
Gina Hummel, PhD (University of Mississippi) Cherokee Health Systems, Knoxville, TN
Jessica Lehman, PhD (University of Miami) Lincoln County Rural Resiliency Project, Lincoln County, WV
- 1999-2000
Sara Matteson, PsyD (Indiana University of PA) Division of Behavioral Medicine (Oncology), University of Rochester Medical Center, Rochester, NY
Stacy Sanders, PhD (Nova Southeastern) Nova Southeastern University, Ft. Lauderdale, FL
Laura Wilhelm, PhD (Ohio University) Assistant Professor, Dept. of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Charleston, WV
- 2000-2001
Marci Barton, PhD (Ball State), Director of Cancer Patient Support Programs, Charleston Area Medical Center, Clinical Asst. Professor, WVU School of Medicine, Charleston, WV
Shannon Froese, PhD (Ohio University), Psychological Assessment and Intervention Services, Charleston, WV
Randy Petersen, PhD (Nova Southeastern), Post doctoral trainee in neuropsychology, University of Virginia, Charlottesville, VA
- 2001-2002
Dana Busch. PhD, MPH (University of Denver) Post Doctoral Internship, Behavioral Medicine, University of Pittsburgh, Pittsburgh, PA
Scott Fields PhD (Ohio University), Assistant Professor, Department of Family Medicine, WVU School of Medicine, Charleston
Amy Mixon PhD (Auburn University) Sparks Clinic, University of Alabama at Birmingham, Birmingham, AL
- 2002-2003
Angela Boland, PsyD (Nova Southeastern) Private practice, Williamsburg, VA
Kim Dixon, PhD (Alabama) Pain Research, Duke University Medical Center, Durham, NC
Valerie Harwell Myers, PhD (Drexel) Pennington Biomedical Research Center, LSU, Baton Rouge, LA
Shazia Mulkana, PhD (Southern Mississippi), University of Mississippi Center, Jackson, MS
- 2003-2004
Melisa Chelf, PhD (Virginia Tech) Post-doctoral resident, Virginia Tech, Blacksburg, VA
Lisa Hale, PhD (Finch/Chicago Medical School), University of Kansas Medical Center, Kansas City, KS
Julie Rickard, PhD (Washington State), Columbia Valley Community Health, Wenatchee, WA
- 2004-2005
Maria Coiro, PhD (University of Central Florida) Moffit Cancer Center, University of South Florida, Tampa
Liz Moore, PhD (University of Nebraska) Mayo Clinic, Rochester, MD
Karen Zeff, PhD (University of Maine), Brown University Medical Center, Providence, RI
- 2005-2006
Michelle Fortier, PhD (Nebraska) - Mayo Clinic, Rochester, MN
Terry Ransom-Flint, PhD (Ohio State) - OSU, Rehabilitation Medicine
Christine Wagner, PhD (Indiana-Purdue) - Rush Presbyterian Medical Center, Chicago
- 2006-2007
Kristin Grasso,PhD (Virginia Consortium) - Shepherd Pratt Hospital, Baltimore, Maryland
Jennifer Tiano,PhD (WVU) - WVU School of Medicine, Dept. Behavioral Medicine & Psychiatry, Charleston, WV
Jason Vogler,PhD (Univ. Nebraska) - John Ulmstead Hospital, UNC, Butner, NC
- 2007-2008
Jennifer Cameron, PhD (UAB) - Virginia Commonwealth Univ Med Center, Richmond, VA
Grace Chang, PhD (Nebraska) - University of Virginia, Charlottesville, VA
Patrick Kerr, PhD (North Dakota) - WVU School of Medicine, Dept. Behavioral Medicine & Psychiatry, Charleston, WV
- 2008-2009
Karl Chiang, Ph.D. (University of Denver) - Siteman Cancer Center Washington University School of Medicine St. Louis, MO
Elise Drake, PhD (Virginia Tech) - Director, Patient Simulation Center Charleston Area Medical Center Charleston, WV
Colleen Sheehan, PhD (Nova Southeastern) - Department of Physical Medicine and Rehabilitation - The Ohio State University, Columbus, Ohio
- 2009-2010
Veronica Chavez, Ph.D. (University of Nebraska) Harbor UCLA, Dept. of Psychiatry, Los Angeles, CA
Sarah Jarvis, PsyD (Marshall University) River Park Hospital, Huntington, WV
Jessica Luzier, PhD (Ohio University) Assistant Professor, WVU School of Medicine, Dept of Behavioral Medicine and Psychiatry, Charleston, WV
Lori Morales, PhD (University of Toledo) Family Resource Center, Charleston Area Medical Center, Charleston, WV
- 2010-2011
Rachel Novosel, PhD (Connecticut) Children's Hospital of Philadelphia
Christine Peat, PhD (North Dakota) Eating Disorders Center, UNC, Chapel Hill
Danielle Probst, PhD (Ohio University) The Ohio State Medical Center
Emily Selby-Nelson, PsyD (Marshall University) Cabin Creek Primary Care, Sissonville, WV
Supervision
Supervision is provided by psychology faculty as well as faculty from other disciplines. While supervision is regularly scheduled, the internship’s goals stress the fostering of a sense of the intern’s professional independence over time and experience. Supervision will be close at first, less close as you progress in training. Psychology interns are viewed as residents by the medical center, and junior colleagues by faculty. They are involved in constant daily clinical give and take. Interns often spend long blocks of time with faculty members as they engage in professional activities. It is through these interactions that the majority of mutual assessments of ability take place. However interns will be required to demonstrate a certain level of competence in a variety of specific areas of clinical psychology. While individual differences in theoretical orientation are expected, we feel well-trained clinical psychologists must have a core of traditional clinical and research skills at their disposal.
Exposure to diversity in race, culture, lifestyle, socioeconomic status, physical status, etc. is an important training objective here. West Virginia is largely White and European, although Charleston has a significant population of African American, Middle Eastern and Asian/Pacific Basin residents. Perhaps best represented in terms of diversity are the rural Appalachian poor, who are concentrated in areas an hour south of Charleston. Over the years, our interns and residents have come from various racial, cultural, and lifestyle backgrounds. All of the rotation facilities are completely accessible, so applicants with physical challenges will have no environmental barriers to their training. Diversity is discussed in clinical presentations and supervision, through didactics, and in Diversity Dialogue, which involves evening meetings at the homes of faculty.
Research
Research is encouraged and supported both professionally and administratively in this setting. One half day per week is earmarked for research pursuits. Ongoing faculty research projects are available, although interns are encouraged to develop, implement and evaluate a project of their specific interest during the internship. Interns often present at the medical center’s annual Resident Research Day. They may present dissertation research, studies done on-site, or unique case studies from their clinical practice. They often win small cash prizes, as well as the admiration of department students and faculty who come to cheer them on in the audience.
Perhaps most important is that we consider the clinical internship to be a special year to focus on single case designs. This is an excellent way to incorporate research into a professional/scientist program. The department strives to maintain an attitude of inquiry. Interns are encouraged to do literature searches on their challenging new patients, regardless of which rotation they are on. Pursuing the literature on specific disorders or situations as they present clinically allows one to be in touch with cutting edge assessments and interventions. It also sensitizes interns to prevailing professional or ethical issues that may accompany working with such individuals. Literature searches can be done in a few minutes from many sites. They provide article summaries, as well as the opportunity to follow up with the original sources. So each patient can become a single case research project, steering interns toward specific interventions and outcomes. Hopefully, this helps set the intern on a life-long course of continuing professional development and connection with psychology’s scholarly roots.
A. Library Facilities: The WVU School of Medicine Charleston Division Library is located in the Medical Education Building on the Memorial Campus. It has a wide variety of volumes, journals and abstracts necessary for research. Library staff will obtain any references unavailable in the library within a couple of days through inter-library loan. Located in the library and the Department are computerized search terminals, allowing the intern immediate access to annotated references through MEDLINE and PsychInfo. See their website at www.hsc.wvu.edu/charleston/library
Didactic Training
The WVU Department of Behavioral Medicine and Psychiatry is a setting that stresses support and nurture for students in training. We are busy and we are good, but that doesn't mean we can't take time to care for one another. Visitors to our program often comment on the sense of warmth and interpersonal respect that is obvious among staff, faculty, and trainees across disciplines.
In addition to informal contacts, learning also takes place in a number of scheduled presentations and seminars. Didactics are presented at two levels for psychology interns:
1. All psychology interns meet for Intern Seminar with one psychology faculty member on Monday mornings from 8:00 to 9:00 am. Material presented in this seminar is specific to the needs of psychology interns. From 9:00 am to 10:00 am trainees participate in the intern case conference, which is coordinated by different psychology faculty each month. [click here for date and topic list]
2. Rounds and seminars of general interest to all profession in the Department are presented on Tuesday and Thursday mornings. A wide variety of topics are presented. Some are in a continuing format, while others such as Grand Rounds offer different topics each week. Each intern gets a listing of the next week’s didactics in his/her mailbox the week before, and the information is also updated weekly on the departmental website.
Some conferences are required for a given rotation. Others can be attended as the intern’s time allows. All are open to everyone who can make it, regardless of professional specialty or level of training. On Thursdays at noon the department plays psych jeopardy, where one side of the room competes with the other with the chief resident as master of ceremonies. The teams are totally mixed, with faculty and students, residents and interns scrambled together, and the teams change weekly. Interns frequently know answers residents don’t, and vice versa. It’s a great place to recall all of the trivia we were all forced to learn in school. The prizes are underwhelming.
Frequently Asked Questions
Why do you offer both required and optional rotations?
Because we feel certain basic experiences and skill sets are vital to independent functioning, and we have to be sure these are mastered and demonstrated by trainees. But we also believe by this stage of training, advanced graduate students need to fine tune their careers in directions of their choice, which is why we offer optional rotations. The end result is a structured flexibility in an ideal training environment, which allows for basic skill development but also the acquisition of experience with specialized populations.
How many positions are available?
There are three funded predoctoral internship slots. We also train medical students, graduate students and residents from several specialties, so there are about 30 students around at any given time.
What is it like to live in Charleston?
Charleston is clean, attractive and safe, with a diverse population. The politics tend to lean on the liberal side. It is easy to get around Charleston, with large, modern interstates connecting the various sections of the city. The river provides for water activities, and the surrounding mountains, lakes and rivers make West Virginia an ideal location for recreation. It is a very easy city to “break into”, with friendly people who are warm and accepting of newcomers.
How is the cost of living in Charleston?
Housing is about the national average, although past interns have found some real bargains. Housing is available year round, and we suggest interns start looking in late May for July rentals. We help interns find the best and cheapest places to live, and current interns will drive you around to different areas to check out the available apartments or houses. Food and entertainment is a bit lower, but gas a bit higher. Most interns live within ten minutes of the medical center, so little gas money is spent on commuting. Also, parking is free for interns on all three campuses.
Where do we park?
Interns park in the medical staff parking buildings on all three campuses at no charge. Parking buildings are connected to the General and Memorial Divisions by underground tunnels. At Women’s and Children’s, bring your umbrella.
How about insurance?
Excellent individual or family medical coverage is available at a nominal fee. Malpractice insurance is provided at no cost to psychology interns.
Are there travel funds?
Available as budget permits for conferences, etc. Interns also get vacation, sick days, all the usual stuff.
What is the department like?
The WVU Department of Behavioral Medicine is a fun place to be. The disciplines get along great. Faculty and residents don’t get hung up on their Mdeity or PhDeity. Psychiatry residents, medical students, and psychology interns attend rounds and seminars together, learn from one another, help each other with cases, and socialize a lot. There is no student “pecking order”. Interns bring a tremendous amount of knowledge and experience to the program, and that is noted and respected across disciplines. People learn best when the stress level is low.
How are the facilities?
Beautiful, modern, well appointed. Interns have a large office together where they put their stuff, get phone messages, email messages, etc. But each rotation has space available for interns, so they never feel they are living out of their briefcases or backpacks. Each intern has an individual phone number and confidential voice mail, which can be accessed either on or off campus. They typically keep their own email addresses. They have computers and internet access in the intern office.
All interns are issued pagers the same as residents, and these pagers can be activated from anywhere on or off campus. Along with residents and medical students, all psychology interns are issued PDAs with substantial psychiatric and medical information pre-loaded. This is helpful when on rounds or otherwise separated from your computer or reference material. Faculty typically “beam” information to your palm from theirs.
What is the theoretical orientation of the psychology faculty?
Largely cognitive-behavioral and interpersonal. Supervision is available in dynamic therapy, and we have a strong family therapy department. Our child department is developmentally oriented. We are partial to empirically supported assessments and treatments.
Do I have to do all the required rotations first, before I can do the optional ones?
No, the rotations are interwoven throughout the year. As long as all the required rotations are completed by the end of the training year, the requirements are met.
Are all the rotations full-time?
No, some are part-time. There are rotations that can be put together, so you might be at the Family Resource Center on Monday and Wednesday, the Heart Institute on Tuesday and Thursday, and Outpatient Psychiatry on Friday. When you do Inpatient and the Consult Service, most of your week is devoted to those demands. Assessments are done throughout the year.
Will I be required to do certain optional rotations?
No, optional means optional. If you want to do all your optional rotations at a particular site, that is your choice.
Do I have to choose all my optional rotations at the beginning of the training year?
No, we encourage interns to choose nothing until they have been here for a few weeks and have visited all the sites and met all the faculty supervisors. Then as the year progresses, interns choose what they want to do for the next several months. They are free to change their minds, to choose something different or add something new before the rotation is started.
Can more than one intern take a given optional rotation, or do interns compete for them or have to swap around or trade?
All interns can take optional rotations of their choice. There are some where the workload or supervisor suggests one intern at a time is best, but, for example, if everyone wants to do child psychiatry, or everyone wants to do the Cancer Center, over the course of a training year that can be arranged. Interns are not put in the difficult position of having to do an optional rotation they dislike, just so they can get one they like. You choose what you like and get to do it, regardless of what your classmates choose. There is no need to trade around.
How can you do that?
Intern stipends come from the Institute’s medical education department. We do not have funds being collected from various training sites. As such, we don’t “owe” an intern to any site. If no intern wants to do a particular optional rotation that year, that’s fine. You will be exposed to all faculty through their presentations, and may want to work with some on special projects.
Who can I ask about any specific questions or interests I might have?
You can contact the current interns, or any of the faculty you feel has similar interests to yours. We have also listed our graduates, and one of them might be in your area. We would encourage you to contact them as well. The training director is always willing to answer your questions, either by email or phone. We understand this is a big decision, and you will want to gather as much information as you can to make an intelligent choice.
Application Process
The deadline for completed applications is December 1st