Rotations and Electives

DESCRIPTION OF ROTATIONS:

While interns are required to meet the rotation requirements of their internship, they have the option to request rotations that are of specific interest or that fulfill specific training needs. The following is a list of all rotations offered by this program. Please see the program requirements for rotation possibilities available within a specific internship.

ADULT PSYCHOSOCIAL REHABILITATION AND CORRECTIVE PSYCHOLOGY ELECTIVE: WAYNE COUNTY JAIL

The Mental Health Department at the Wayne County Jail provides a continuum of psychiatric services for all inmate residents within a three(3) jail system. The primary mission of the Department is to deliver quality services that are commensurate with the needs of each individual patient. Most inmates involved in the program have a history of being serviced by the State or Community Mental Health (CMH) systems. The Department is funded by the Detroit-Wayne County Community Mental Health Agency and is linked with the larger CMH system.

Services begin with screening for all 38,000 inmates booked annually. Programs, post screening include a 138 bed special housing unit for inmates with moderate to severe psychiatric symptoms/disorders. The special housing unit is modeled after a traditional inpatient psychiatric service. The patients are treated by an interdisciplinary treatment team including psychiatry, psychology, social work, therapeutic activities, and nursing. "Inpatient" beds are separated into nine units that are serviced by five distinct treatment teams. The team psychologist operates as the primary therapist. A Master Treatment Plan is developed for all patients residing at this level of care.

Approximately 250 inmates with more mild symptoms, but still in need of treatment, receive "outpatient" medication reviews and case management services from psychiatry and social work respectively. Inmates can be directly admitted into the "outpatient" program or transferred to "outpatient" from the special housing unit.

The Wayne County Jail maintains a 20 bed unit at Aurora hospital. Inmates in acute psychiatric crisis are often transferred to the Aurora facility for crisis stabilization and the benefits of a hospital milieu.

The Jail operates an in-house pharmacy and utilizes a full formulary of psychoactive medications. Discharge planning is a routine element of service and inmates are regularly linked to CMH or the Michigan Department of Corrections for continuity of care and follow up services. Inmates can also receive community/court advocacy services dependent upon their mental health and legal profile.

Overall, the Wayne County Jail Mental Health Program functions much like an inpatient psychiatric facility with an in-house crisis center. For example, significant resources are directed toward screening, assessment, and crisis stabilization. The special housing unit also has several features that are consistent with a residential treatment program; most evidently a length of stay that can, for many inmates, last six months to one year. Outpatient services supplement inpatient and residential programming for those inmates who are stable or with mild symptoms.

A. Educational Experience:
The Psychology Internship rotation at the Wayne County Jail provides a comprehensive inpatient experience in which a predoctoral psychology intern begins the transition from an academic orientation to a professional identity and perspective. Because of the wide variety of clinical diagnoses treated at the Wayne County Jail, interns gain a broad perspective on mental health treatment.

Within this context, specific goals of the rotation include:

1. Continuation of skill development in psychotherapy and psychodiagnostics.
2. Exposure to a variety of modalities used in treating adult males and females of differing demographics.
3. Development of a professional identity as a psychologist, particularly in regard to other disciplines.
4. Involvement in a multidisciplinary "team" concept of treatment.
5. Development of leadership skills.
6. Continued professional growth through seminars and other training experiences.
7. Close interaction with and supervision by experienced psychologists.
8. Exposure to the administrative issues which face psychologists in a comprehensive mental health facility.
9. Training in the ethical issues which face psychologists in inpatient and outpatient treatment.
10. Exposure to the fields of forensic psychology and substance abuse treatment within the correctional setting.
11. Exposure to and experience regarding formal case presentations discussing assessment techniques, diagnosis and treatment goals and progress.

B. Description of Faculty and Staff:
There are four psychiatry, six psychology, 12 social work and 26 nursing/inmate faculty members. The Psychology Department subscribes to a supervisory model of training which encourages the growth of individual strengths, provides quality professional role models, and emphasizes the development of the psychologist as a scientist/practitioner. The psychology staff represent diverse theoretical orientations. These include psychodynamic, cognitive, cognitive-behavioral, existential and humanistic.

During the rotation, interns have at least two psychology supervisors. The primary supervisor is the psychologist on the treatment team to which the intern is assigned. Interns are formally evaluated at the end of the rotation. Verbal feedback is continuous. At the end of the rotation the Internship Director provides a narrative report to the intern’s graduate training program.

C. Patient Population:
The daily census of the Mental Health Department is roughly 400. This includes 138 "inpatients", 250 "outpatients", and 20 Aurora transfers. Inmate diagnoses traverse the continuum of psychiatric disorders including schizophrenia, bipolar-manic, major depression, adjustment disorder, PTSD, anxiety disorders, and substance related disorders. Near 90% of Mental Health Inmates have comorbid substance abuse problems. Many inmates present substantial Axis II psychopathology and related impulse control problems.

Psychosocial Rehabilitation and Corrective Psychology:
4-month adult Psychosocial Rehabilitation and Corrective Psychology rotation 20 hours per week at Wayne County Jail.

Desired Competencies and Outcomes of Inpatient/Rehabilitation Rotations:
Goal 1 - Consultation - To develop intermediate to advanced skills in working with multidisciplinary teams.

Objective A: Demonstrate respect for opinions and information provided by other disciplines, such as medicine, social work, dietitians and nursing staff.

Objective B: Demonstrate the ability to integrate information from other team members.

Objective C: Demonstrate the ability to provide feedback to team members in a constructive manner.

Outcome Measures: Supervisor evaluations, observation in multidisciplinary team meetings, review of cases during supervision, written reports and progress notes, and review of feedback from multidisciplinary team members.

Goal 2 - Evaluation - To develop intermediate to advanced competency in assessment and testing of adults with chronic/acute psychiatric and behavioral/emotional problems.

Objective A: Demonstrate intermediate to advanced skills in selecting, administering, scoring, and interpreting psychological tests suitable for adults with chronic/acute psychiatric illness, behavioral/emotional problems, and substance abuse problems. Administer two psychological test batteries per month.

Objective B: Demonstrate intermediate to advanced skills in making differential diagnoses based upon an integration of tests and interviews of patients with chronic/acute psychiatric illness, behavioral/emotional problems, and substance abuse problems.

Objective C: Demonstrate intermediate to advanced skills in communicating the results of such evaluations through written reports and verbal contacts with other team members.

Outcome Measures: Supervisor evaluations, written testing reports, review of cases during supervision and discussion of cases during diagnostic case conferences.

Goal 3 - To develop intermediate to advanced competency in stabilization of acute and chronic psychiatric disorders.

Objective A: Display intermediate to advanced skills in conducting brief problem-focused, psychoeducational psychotherapy.

Objective B: Display intermediate to advanced skills in tailoring individual and group therapy for the chronically mentally ill and substance abuse patients.

Outcome Measures: Supervisor evaluations, observation (live, video, audio), review of cases during supervision, chart review of treatment plans and progress notes, input from co-therapist/faculty for group therapy, final exam.

Goal 4 - To develop intermediate to advanced skills in treatment and discharge planning.

Objective A: Write treatment and discharge plans.

Outcome Measures: Treatment and discharge plans reviewed in treatment team meetings.

CENTER FOR FORENSIC PSYCHIATRY

The Center for Forensic Psychiatry, located south of Ypsilanti, Michigan, is a specialized 210-bed psychiatry hospital operated under the authority of the Michigan Department of Community Health. The hospital’s primary mission is to provide quality mental health services to individuals and the Michigan court system. In the fulfillment of this mission, the hospital provides comprehensive treatment services in a maximum security setting to individuals deemed by the courts to be in need of such services and provides forensic evaluation and consultation services to the Michigan court system. Additionally, the hospital provides training experiences in the forensic sub-speciality to psychiatric, psychology, and clinical social work interns, and to post-doctoral psychology fellows.

The training program for psychology interns is four-months in duration and requires a commitment of 8 hours per week. The program is a supplement to a clinical internship and is designed to provide a learning experience with goals of familiarizing interns with the basic principles of criminal forensic practice. Interns are assigned selected readings on topics such as the history of psychologists in forensic practice, conducting forensic assessments, use of psychological tests in forensic assessments, legal statutes governing forensic assessments, forensic report preparation, consultation with legal professionals, and the provision of expert testimony in a court room setting. Additionally, interns attend designated lectures offered by the hospital’s continuing medical education program. Also interns are required to observe at least three competency to stand trial and three criminal responsibility assessments conducted by experienced forensic examiners, and, if the opportunity presents itself, to observe expert testimony being provided at a trial by the examiners. Finally, interns are required to attend groups or treatment team meetings and to become familiar with treatment planning for forensic patients.

Trauma Psychology

Life Stress Center, Detroit Receiving Hospital, Suite 3S.14, 4201 St. Antoine, Detroit, MI 48201.

Detroit Receiving Hospital’s trauma program is an exciting and unique opportunity for the intern to work with physically injured crime victims and other trauma victims in both the Emergency Department and on the inpatient medical units. Support is also provided to the victims families when possible or indicated. Patients are often seen within a few to 24 hours after an injury, but in some cases the first intervention occurs several days later. Psychoeducational, normalization, and debriefing interventions are provided in the early stages of encounters. Many patients elect to continue seeing a therapist on an outpatient basis. Some individuals in outpatient psychotherapy may have physical limitations, but most patients difficulties are less overt and are related to psychological adjustment to the trauma. Homicide survivors are often referred here by the Prosecutor’s Office. Interns selecting this rotation will have the opportunity to participate in the full range of services. In addition, the student will have the opportunity to work within a major medical/surgical facility and learn to communicate effectively with different (non-mental health) disciplines. Students will become well versed in medical terminology and health psychology issues. A major portion of this program is funded by a grant from the State of Michigan’s Crime Services Commission. Supervision for this rotation is provided by a licensed psychologist. In general, the student can expect one hour of supervision per week for outpatient services and daily supervision for inpatient work. Supervisors also have an open door policy for trainees.

NEUROPSYCHOLOGY ELECTIVE: ADULT NEUROPSYCHOLOGY
Trainees should have some background coursework in neuropsychology; and previous experience in neuropsychological assessment is highly recommended. Rotation requests from interns without such assessment experience will be reviewed on an individual basis.

A. Educational Experience:
The objective of this rotation is to provide intermediate and advanced level training in the clinical practice of neuropsychology.  Interns will receive training in the administration and interpretation of neuropsychological tests using both the Bostson Process and Halstead-reitan approaches. Interns will complete a minimum of one assessment per week, including the administration and scoring of the battery and preparation of the report. Supervision is intensive and typically one-on-one; however, interns are also encouraged to sit in on supervision of other cases to enhance their experience. Interns are expected to attend the didactic series offered to practicum students. This series includes lectures on general topics in neuropsychology, as well as more advanced and domain-specific material, and case presentations. Neuropsychology interns are expected to attend Neurology Grand Rounds when their schedule permits. Attendance at Neurosurgery Grand Rounds, and brain cuttings is encouraged but not required. Interns may also attend didactics offered to neurology and clinical neurophysiology residents and fellows.

To fully exploit this training experience, students should have already completed at least basic coursework in neuropsychology and have prior experience with testing and report writing.

The service performs all pre- and post-operative assessments for the DMC Comprehensive Epilepsy Program (CEP). Interested interns would have the opportunity to be involved with the pre-surgical work-up of patients, including intracarotid sodium amytal perfusion testing (Wada's Test) for lateralization of language and evaluation of risk for post-surgical amnesia. Interns are strongly encouraged to attend the weekly CEP team meetings and have the opportunity to learn from nationally recognized neurologists, electrophysiologists and radiologist in a collegial environment. We also work closely with the Senior memory Evaluation Center by providing diagnostic testing for dementia. Interested interns would have the opportunity to be involved with team and family conferences.

B. Description of Faculty and Staff:
There is one licensed psychologist who is a graduate of specialized academic and internship programs in neuropsychology. Interns work along side practicum students receiving specialized education and training in clinical neuropsychology.

C. Patient Population:
The neuropsychology clinic services outpatient adults (age 17 years and older). Currently, most referrals come from the departments of Psychiatry, Neurology, Neurosurgery and Geriatrics. A wide range of disorders are seen, including dementia, TBI, tumor, stroke, epilepsy, and MS

CHILDREN’S HOSPITAL PEDIATRIC NEUROPSYCHOLOGY ELECTIVE

Trainees must have some graduate coursework in neuropsychology; previous experience in neuropsychological assessment is highly recommended. Rotation requests from interns without such assessment experience will be reviewed on an individual basis.

A. Educational Experience:
This rotation provides clinical experience and training in the Neuropsychology Lab at Children’s Hospital Department of Psychiatry. Attendance at the year-long ongoing Pediatric Neuropsychology Case Conference is strongly recommended . In addition to the clinical experience described below, training will include neuropsychological assessment, professional practice issues and the integration of personality and emotional factors with neuropsychological data. Interns will be provided readings and additional supervision where appropriate. Although research projects are ongoing in the lab, this rotation is designed to provide clinical training.
Clinical: Responsibilities include neuropsychometric assessment, consideration of a differential diagnosis, developing a treatment or intervention plan and completing the neuropsychological report. All assessments are completed under the direct supervision of a pediatric neuropsychologist.

B. Description of Faculty and Staff:
There is one fully licensed neuropsychologist with extensive training and clinical experience in pediatric neuropsychology. A modified Halstead-Reitan approach is used.

C. Patient Population:
Pediatric: Services are provided to preschool and latency aged children and adolescents with organic compromise secondary to injury or disease. Patients are referred from neurology, psychiatry and neurosurgery services of Children’s Hospital of Michigan with primary medical diagnoses of traumatic brain injury, epilepsy, brain tumor, muscular dystrophy, HIV and other neurological disorders (e.g. encephalitis, episodic dyscontrol).

Child Neuropsychology Rotations - Desired Competencies and Outcomes:

Goal 1 - To develop intermediate to advanced skills in conducting a neuropsychological assessment.

Objective A: Demonstrate intermediate to advanced skills in conducting a neuropsychological assessment with a heterogeneous outpatient child population.

Outcome Measures: Observation of assessments, supervisor evaluations, discussion of case formulations, review of cases in supervision.

Goal 2 - To develop intermediate to advanced competency in writing a report from a comprehensive neuropsychological assessment.

Objective A: Demonstrate intermediate to advanced skills in writing a report from a neuropsychological assessment with a heterogeneous outpatient child population.

Outcome Measures: Review of report writing, supervisor evaluations, discussion of case formulations, review of cases in supervision.

Goal 3 - To develop intermediate to advanced competency in determining treatment recommendations based on neuropsychological test results.

Objective A: Demonstrate intermediate to advanced skills in determining treatment recommendations based on neuropsychological test results with a heterogeneous outpatient child population.

Outcome Measures: Observation of treatment recommendations, supervisor evaluations, discussion of case formulations, review of cases in supervision.

Goal 4 - To develop intermediate to advanced competency in conducting parent history interviews.

Objective A: Demonstrate intermediate to advanced skills in conducting parent history interviews with a heterogeneous outpatient child population.

Outcome Measures: Observation of parent history interviews, supervisor evaluations, discussion of case formulations, review of cases in supervision.

Goal 5 - To develop intermediate to advanced competency in demonstrating basic to intermediate skills in providing feedback of neuropsychological assessment to parent.

Objective A: Demonstrate intermediate to advanced skills in providing feedback to parent from a neuropsychological assessment with a heterogeneous outpatient child population.

Outcome Measures: Observation of providing feedback of neuropsychological assessment to parent, supervisor evaluations, discussion of case formulations, review of cases in supervision.

CHILD/ADOLESCENT INPATIENT ROTATIONS: HAWTHORN CENTER

A. Educational Experience:
Inpatient experiences include psychological evaluations, psychotherapy, team meetings, case conferences and seminars. It is expected that approximately 40% of the internship hours will be spent in direct clinical service activities. Interns provide individual, family and group psychotherapy for children and adolescents, who present with a wide range of psychopathology. Interns administer psychological evaluations that include intellectual, visual-motor and personality (objective and projective) measures. Seminars focus on child/adolescent treatment issues. One-to-one supervision on a regular basis is provided by full-time licensed psychologists.

B. Description of Faculty and Staff:
The Department of Psychology has four full-time fully licensed psychologists and one full-time limited license psychologists. Training has been an important function of the department since the hospital was established in 1956. The theoretical approach is generally eclectic, but staff have specific expertise in cognitive-behavioral, psychodynamic, play, family and behavioral therapies. Seven child psychiatrists and ten social workers also comprise the clinical staff.

C. Patient Population:
Hawthorn Center is an 118-bed inpatient state psychiatric facility providing short-term and long-term care for children and adolescents from ages 5-17. Patients are referred to Hawthorn Center through community mental health agencies statewide, but mostly from Wayne County. Children and adolescents with a variety of acute and chronic disorders are admitted, including depression, psychosis, eating disorders, disruptive behavior disorders and personality disorders. The patient population strongly reflects the ethnic and socio-economic status of the referring communities.

CHILDREN’S HOSPITAL OF MICHIGAN

A. Educational Experience:
Children’s Multidisciplinary Specialty Clinics: This clinical service program for children under the age of 21 who have severe, chronic or handicapping conditions was established in 1992 with funding from the state of Michigan’s Department of Public Health and directed through Children’s Special Health Care Services (CSHCS). Each CMS team includes a physician, nurse, dietitian, social worker and psychologist, and is organized around a specific chronic illness or handicapping condition. As of September 1994, there are 20 active CMS clinics where a psychologist is a team member including Diabetes, Nephrology, HIV, Craniofacial, Infant Chronic Illness, Apnea, Cystic Fibrosis, Hemophilia, Myelomeningocele and Gastroenterology. Psychology interns who choose this rotation will be assigned to one or two CMS clinics during the four-month rotation. The primary functions of the psychology intern on CMS teams are: conducting psychological screenings as patients are scheduled for their yearly comprehensive evaluation, functioning as a member of the CMS team, contributing to the development of a Plan of Care following each comprehensive evaluation and providing psychological services to the child and family when recommended by the CMS team. The Pediatric Psychology Intern typically completes one outpatient evaluation per month during the CMS rotation. Cases include developmental disabilities, learning disabilities, enuresis/encopresis, phobias/fears, anxiety, depression, parent/teen conflict, eating disorders, adjustment reactions and conduct disorders. Responsibilities include interviewing, psychometric assessment, making a differential diagnosis, developing a treatment or intervention plan, completing the psychological report and providing interpretation of results and feedback to the parents, teachers and/or medical team.

Attention Deficit Hyperactivity Disorder Clinic: In 1986 the psychiatry/psychology and ambulatory pediatrics divisions of Children’s Hospital of Michigan established an innovative, multidisciplinary ADHD clinic to provide comprehensive services for children with attention deficit hyperactivity disorder, to train health care professionals in the latest treatment methods and to advance knowledge about ADHD. This clinic was expanded in 1996 into an ADHD Lifespan Center in cooperation with the departments of Internal Medicine and Pediatrics. This center is committed to providing continuity of care across the lifespan to families with more than one member with ADHD. Services include: diagnosis, psychological testing and school advocacy. Psychology interns, along with medical residents, receive training in this center, which meets once a week. Each psychology intern participates one day each week during the outpatient clinic-based rotation. Interns function in the center as participants throughout the entire assessment procedure, including recommendations and follow-up for center patients under the supervision of a senior staff supervisor. Interns will become familiarized with the IEPC process and Section 504 as it applies to the school setting for students with ADHD. Participation in this clinic is only available to Pediatric Psychology Interns.

Pediatric Neuropsychology Service: This service provides neuropsychological evaluation, consultation (inpatient and outpatient), and brief intervention to patients with chronic or acute medical conditions affecting neurologic functioning. Children with epilepsy, traumatic brain injury, stroke and central nervous system neoplasm, toxic exposure and developmental disability comprise the remaining 15%. Interns participate in the neuropsychology assessment lab, conducting comprehensive neuropsychological evaluations (modified battery approach), integrating data with patient history (obtained from parent interview, school and medical records), and rendering neuropsychological interpretations regarding brain-behavior relationships (lateralization, localization, chronicity, etc.) and intervention needs. Interns complete 6-10 (depending on experience and performance) full neuropsychological evaluations during the 6-month, part-time rotation. Interns also participate in a year-long, weekly case conference and may observe or participate in selected other activities (pending availability) such as Behavioral Neurology Clinic, Difficulty Behavior Disorders Clinic, Intracarotid Sodium Amytal Procedures, Brain Stimulation Mapping, Epilepsy Surgery Team and post-acute rehabilitation team.

Autism Assessment Center: In September 1993, this clinic was established to optimize the assessment of children with autism and related developmental disorders. It is an interdisciplinary program where the children are seen by a psychologist, neurologist, audiologist and speech therapist. The scope of this program encompasses assessment, parent support and research. This clinic meets two times per month.

Participation in this clinic is limited to Pediatric Psychology Interns.

Individual and Family Therapy: The child psychiatry and psychology staff use a wide variety of theoretical approaches to encourage behavioral changes with their clients. Interns carry three therapy cases throughout the year in the following areas: play therapy, family therapy and individual/pediatric psychology therapy.

Play Therapy: Play therapy makes use of the therapeutic aspects of play while relying on an integration of theoretical orientations to guide the therapists’ case conceptualization and technical strategies. Under clinical supervision, the interns will treat at least two children from initial evaluation through termination. Cases include anxiety and post-traumatic stress disorders, externalizing behavior problems, adjustment reactions and attachment disorders. Interns will attend two workshops during the training year covering play therapy theories and techniques. Interns will also participate in weekly group supervision of cases. Participation is only available to Pediatric Psychology Interns.

B. Description of Faculty and Staff:
The psychology staff includes five licensed doctoral-level pediatric psychologists and one licensed pediatric neuropsychologist. The staff functions professionally with a variety of theoretical orientations, mainly, cognitive-behavioral, family systems and behavior modification. Interns also work closely with various members of the medical staff and with pediatric residents.

C. Patient Population:
Patients are generally referred from the Detroit metropolitan area and southeast Michigan and present with a wide range of problems including developmental disabilities, learning disabilities, enuresis/encopresis, phobias/fears, anxiety, depression, parent/teen conflict, eating disorders, adjustment reactions and conduct disorders.

Psychology Training Program

General Clinical Psychology Training Program

Pediatric Psychology Training Program

Child/Adolescent Clinical Psychology Training Program

Psychology Seminar Schedule

Rotations and Electives

Training Faculty

Return to Education and Training Programs