|
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.
1. CHILD/ADOLESCENT INPATIENT ROTATIONS:
1.1 CHILDREN’S HOSPITAL OF MICHIGAN
(Available
for pediatric psychology interns only)
A. Educational Experience:
Pediatric psychology interns are typically involved in one
inpatient consultation a week when they are on the hospital-based
rotation. Cases include medical noncompliance, assessment of suicide
ideation, adjustment to recent diagnosis of chronic disease, impact of
an injury on the child and family, and behavioral programming to be used
during hospitalization and planning for discharge from the hospital.
Responsibilities include interviewing and assessment or supportive
therapy during the hospital stay. Involvement with each case varies from
brief consultation liaison assessment/recommendation to several weeks of
program development and treatment. Many patients and their parents are
followed as outpatients after discharge.
B. Description of Faculty and
Staff:
This experience provides interns with the opportunity for
professional interaction with pediatric medical specialists, nursing
staff and a variety of other health professionals. Interns are
supervised on all consultation liaison work by the senior psychology
staff, which consists of seven licensed pediatric psychologists and one
licensed pediatric neuropsychologist.
C. Patient Population:
Children’s Hospital of Michigan is a tertiary pediatric care
center and serves families living in both peninsulas in Michigan and
many other states and foreign countries. These families represent all
socioeconomic levels, ethnic and racial groups with a variety of
childhood chronic illnesses/conditions.
1.2 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.
ADULT PSYCHOSOCIAL REHABILITATION AND CORRECTIVE
PSYCHOLOGY ROTATIONS:
1.3 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.
The primary goal of the clinical
rotation is to further cultivate psychotherapeutic and psychodiagnostic
skills toward the development of a solidified and refined clinical
approach. Areas of training include report writing, assessment,
interviewing, behavior modification, therapeutic intervention, and
clinical consultation.
Within this context, specific goals of
the rotation include:
- Continuation of skill development in
psychotherapy and psychodiagnostics.
- Exposure to a variety of modalities used
in treating adult males and females of differing demographics.
- Development of a professional identity as
a psychologist, particularly in regard to other disciplines.
- Involvement in a multidisciplinary
"team" concept of treatment.
- Development of leadership skills.
- Continued professional growth through
seminars and other training experiences.
- Close interaction with and supervision by
experienced psychologists.
- Exposure to the administrative issues
which face psychologists in a comprehensive mental health
facility.
- Training in the ethical issues which face
psychologists in inpatient and outpatient treatment.
- Exposure to the fields of forensic
psychology and substance abuse treatment within the correctional
setting.
- 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.
1.4 STEP PROGRAM
The Services and Treatment for Early Psychosis Program
is a research oriented rotation.
A. Educational Experience:
Interns would conduct diagnostic evaluations (psychiatric interview and
psychological testing) on patients referred to the program for early
detection and treatment of psychosis. They would function as primary
therapists and conduct supportive psychotherapy, cognitive behavior
therapy, family therapy, psychoeducation and relapse prevention. Interns
would participate in team meetings and psychosocial rehabilitation
groups with senior faculty. Interns are encouraged to initiate and
implement research projects/dissertations with the support of the
research staff. Research that addresses psychosocial risk factors and
cognitive developmental factors, affecting the course and outcome of
schizophrenia and related psychotic conditions are most welcome. The
training objective of the rotation is to expose interns to the
psychosocial rehabilitation model in early stages of psychosis, and to
learn strategic assessments and treatment strategies for different
phases/stages of psychosis.
B. Description of Faculty and Staff
The STEP program is staffed by a dedicated group of
interdisciplinary professionals consisting of two senior faculty
psychiatrists, one PhD. psychologist, certified social workers/case
managers and counselors. This team carries out the initial comprehensive
assessment and evaluation, the maintenance and relapse prevention,
education and mutual support, rehabilitation, family support, case
management, medical management and research.
2. OUTPATIENT ROTATIONS:
2.1 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.
2.2 UNIVERSITY PSYCHIATRIC CENTER -
JEFFERSON
A. Educational Experience:
On the outpatient rotation, the intern has the responsibility for
evaluation, individual and group therapy of a number of patients. The
intern conducts intake assessments which include the interview, and
preparation of a diagnostic formulation and treatment plan of adults
with a wide variety of emotional disorders. Interns are expected to
conduct a minimum of 10 individual therapy hours per week. In addition,
they are expected to participate in at least one group. While on this
rotation, interns are required to conduct child and/or adult psychological assessments
if their experience reflects deficiencies. Interns can elect to spend
one day per week (8-10 hours) gaining experience in forensic psychology
or trauma psychology. Interns are also
scheduled to see one new patient a week for a diagnostic evaluation. New
evaluations are presented by the intern to the outpatient faculty, in
which diagnosis, formulation, treatment and/or disposition are
discussed. Interns spend 10-12 hours weekly in seminars and conferences
and journal club. Faculty members are available for consultation and
discussion. Interns will receive a minimum of two hours per week of
individual supervision and two to three hours per week of group
supervision.
B. Description of Faculty and
Staff:
The faculty consists of five licensed psychologists, one social
worker and three board-certified psychiatrists. In addition, a number of
voluntary or paid consultants each spend about two to five hours per
week at the University Psychiatric Center. Full-time faculty with
expertise in research, psychoanalysis, cognitive therapy, behavior
modification, biological psychiatry, medication management and family
therapy are available for formal and informal teaching and supervision.
C. Patient Population:
Adults: There is a great diversity of patient characteristics with
respect to SES, race, religion and severity of psychiatric disorders
with various sources of
referral. The patient population includes schizophrenia, psychotic
disorders, affective disorders, personality disorders, substance
abuse/dependency, and adjustment disorders. Anxiety disorders research at this center attracts a
significant number of patients with panic disorders, obsessive
compulsive disorder, phobias and other anxiety disorders.
2.3 UNIVERSITY PSYCHIATRIC CENTER -
LIVONIA
A. Educational Experience:
Interns are involved in a variety of learning experiences, including
the taking of psychosocial histories, psychological assessments,
psychotherapy, early childhood intervention (ECI) programming for
children ages 2 through 5 and specialized evaluations (e.g., child
custody and sexual offender). Treatment modalities include individual,
group and family therapy. Interns are closely supervised in all phases
of the program by fully licensed psychologists. Interns carry an active,
often changing caseload that conforms to the 40 percent clinical service
requirement for the internship.
B. Description of Faculty and
Staff:
The staff is comprised of fully licensed psychologists, certified
social workers and child psychiatrists. The staff’s theoretical
approach is generally eclectic, although staff have specific expertise
in a variety of areas, including behavior modification,
cognitive-behavioral, psychodynamic and family systems.
C. Patient Population:
The clinic provides comprehensive outpatient mental health services
for children and adolescents between the ages of 2 and 17. The client
population generally reflects the population of Wayne County. A variety
of disorders are evaluated and treated, including ADHD, Oppositional
Defiant Disorder, depression, anxiety, eating disorders and learning
problems.
3. SPECIALTY ROTATIONS:
3.1 NEUROPSYCHOLOGY ROTATIONS:
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.
a. CHILDREN’S HOSPITAL PEDIATRIC
NEUROPSYCHOLOGY SERVICE
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, physiatry 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).
b. DETROIT MEDICAL CENTER CAMPUS
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.
3.2 CLINICAL HEALTH PSYCHOLOGY ROTATIONS:
Behavioral Medicine - Desired
Competencies and Outcomes:
Goal 1 - Develop
consultation-liaison skills.
Objective A: Demonstrate the ability
to review inpatient medical charts and obtain information from nursing
and medical staff.
Objective B: Demonstrate the ability
to interview adult inpatients efficiently, formulate a working
diagnosis and a treatment plan.
Objective C: Communicate diagnostic
information and findings to other professionals in a sensitive,
respectful and clear manner.
Outcome Measures: Supervisor
evaluations, feedback from inpatient medical and nursing staff,
discussions with primary supervisor, written consultation forms, and
discussion of cases during seminars.
Goal 2 - To develop
intermediate to advanced competency in making differential diagnostic
decisions.
Objective A: To develop intermediate
to advanced skills in conducting differential diagnostic interviews
with medically ill adults with comorbid psychiatric diagnoses.
Objective B: Demonstrate
intermediate to advanced skills in using ratings scales, and
observational measures to make differential diagnostic decisions.
Outcome Measures: Observation of
interviews, supervisor evaluations, collaborative clinical information
from staff, lab reports, review of cases during supervision and
seminars.
a. CONSULTATION-LIAISON PSYCHIATRY- DETROIT MEDICAL
CENTER
A. Educational Experience:
The function of this program is to provide psychological and
psychiatric services to acute and chronic hospitalized medical patients.
Inpatient services are provided primarily to persons admitted for bone
marrow transplantation at Harper University Hospital. Outpatient
evaluation and treatment (psychotherapy) is also provided to persons who
are under consideration for, or as follow-up to, kidney and/or pancreas
transplantation at Harper University Hospital. Additional outpatient
consultation and treatment services are available within the Adult
Cystic Fibrosis Clinic and with sleep-disordered (insomnia) patients,
both at Harper University Hospital. Limited opportunities also exist for
inpatient consultation-liaison services for the general medical
populations at Harper University Hospital and Detroit Receiving
Hospital. Services include evaluation, differential diagnosis,
behavioral management, and short-term psychotherapy. The emphasis is on
functioning as a member of a multi-disciplinary (medical) team.
B. Description of Faculty and
Staff:
In addition to regular supervision with licensed psychologists on
the service, interns will have the opportunity to work closely with
psychiatrists (in selective settings), as well as with physicians from a
wide variety of specialty areas (including oncology, pulmonary medicine,
nephrology, and transplantation surgery),
providing a diversity of approaches and viewpoints in the training
experience.
C. Patient Population:
The patient population at Harper University Hospital comprises a wide age range, from
infancy through geriatric (from southeast Michigan and beyond). Although
the consultation-liaison team may be called upon by any hospital medical
service, the primary training areas for psychology interns are in bone
marrow and solid organ transplantation, cystic fibrosis, and sleep
medicine. Some research opportunities are available to supplement the
clinical training, if desired.
Emergency Psychiatry (Optional)
Effective for the 2006-2007 academic year, interns who elect the
Consultation-Liaison Psychiatry Service for their required health
psychology rotation will have the opportunity to spend some of their
time in the Crisis Center at Detroit Receiving Hospital if desired.
Interns would spend a day in the crisis center/ER conducting psychiatric
evaluations along with the psychiatric residents. Interns can also
accompany a staff psychologist from the inpatient unit at DRH to court
to observe involuntary commitment proceedings. Interns would receive
onsite supervision in the crisis center from a fully licensed
psychologist and board certified psychiatrist.
Learning Objectives for Emergency Psychiatry
- Exposure to the various levels of care in a Crisis
Response System.
- Exposure to the continuum of care with severe
chronic and acute mentally ill.
- Learn the components of a crisis-response system
- Emergency room stabilization and disposition
- Crisis stabilization/crisis-residential
Competencies
- Conduct psychiatric evaluations in acute
psychiatric emergencies.
- Diagnosis and evaluation.
- Crisis-Intervention.
- Risk-Assessment (substance abuse, violence,
suicide, etc.).
- Commitment criteria
- Best Practices/Evidence-Based Practices (case
management, psychoeducation, illness self-management, medication
management).
- Learn the evaluation skills and best practices
(treatment interventions) with severe chronic and acute mental
illness.
Patient Population:
This patient population is appropriate for the rapid stabilization
program, admitted for a brief 48 hours up to 8 days, during which they will be
re-started on their medications, assessed for self-destructive
tendencies, and then referred to less intensive outpatient care. This
treatment approach is intended to reduce the need for lengthy
hospitalizations for chronic patients who have a history of numerous
inpatient stays.
b. GERIATRIC PSYCHOLOGY
Geriatric Psychology - Desired
Competencies and Outcomes:
Goal 1 - Develop intermediate
to advanced competency in geriatric assessment and diagnostic skills.
Objective A: Demonstrate the ability
to interview geriatric patients efficiently, using observation, age
appropriate interview techniques, screening tools, and collateral
report from caregivers
Objective B: Demonstrate the ability
to integrate the medical history obtained from medical charts, nursing
and medical staff when appropriate.
Objective C: Demonstrate the ability
to make informed decisions for appropriate referrals for
neuropsychological and psychological testing, medical consultation,
and diagnostic testing to further determine diagnosis.
Objective D: Demonstrate the ability
to formulate a working diagnosis, based on psychological, medical, and
collateral information and determine a treatment plan specific to the
elder’s needs.
Objective E: Communicate the
diagnostic information and findings to other professionals and
caregivers in a sensitive, respectful and clear manner.
Outcome Measures: Supervisor
evaluations, feedback from interdisciplinary geriatric team,
discussions with primary supervisor, written psychological assessments
and treatment plans, and review of cases during treatment team,
supervision, and seminars.
Goal 2 - Develop intermediate
to advanced competency in psychotherapy approaches with a geriatric
population.
Objective A: Demonstrate the ability
to identify appropriate treatment methods and modalities for diverse
geriatric abilities, and different types of psychopathology.
Objective B: Demonstrate
intermediate to advanced skills in individual psychotherapy including
cognitive behavioral, interpersonal, and supportive therapy.
Objective C: Demonstrate
intermediate to advanced skill in group therapy; either cognitive
behavioral, skills training, or process oriented therapy.
Outcome Measures: Supervisors
evaluations, review of case during supervision, chart review of
treatment plans and progress notes, observation (video, live, audio),
input from geriatric interdisciplinary team, and discussion of case
studies during seminars.
a. UNIVERSITY PSYCHIATRIC CENTER -
JEFFERSON
A. Educational Experience:
The function of this program is to provide psychological and
psychiatric services to acute and chronic geriatric patients. Services
include evaluation, differential diagnosis, short-term psychotherapy,
group therapy, and family therapy. Lectures and case conferences
specific to geriatric issues are also incorporated into the rotation.
The psychology intern will evaluate patients and follow up with
appropriate treatment at each of the geriatric sites on a weekly basis.
Caseload may vary but will typically consist of 2 - 4 new evaluations
and 8 - 12 patient contact hours per week.
B. Description of Faculty and
Staff:
One-to-one supervision is provided on site by two licensed
psychologists with expertise in geriatric psychology. In addition,
interns will have the opportunity to work closely with board certified
geriatric psychiatrists, geriatric psychiatry fellow, psychiatry
residents, and a geriatric psychology fellow.
C. Patient Population:
The geriatric population is obtained through nursing home, assisted
living and outpatient referrals. These individuals are assessed and
treated in the nursing home setting, at the medical center associated
with the assisted living facility, or in University Psychiatric Center-Jefferson outpatient
clinic. The geriatric population is diverse with respect to SES, race,
psychiatric disorder, and cognitive ability. A variety of disorders are
evaluated and treated, including mood disorders, dementia, delirium,
anxiety disorders, obsessive-compulsive disorders, and Axis II
disorders. The geriatric population generally reflects the population of
Wayne County.
3.3 SUBSTANCE ABUSE
UNIVERSITY PSYCHIATRIC CENTER - JEFFERSON: ALCOHOL AND
DRUG ABUSE IN PREGNANT WOMEN--EFFECTS ON INFANT, CHILD, AND ADOLESCENT
DEVELOPMENT; ADOLESCENT ALCOHOL AND SUBSTANCE USE
A. Educational Experience:
Within this setting, the intern will receive supervised training in
alcohol and drug use ascertainment in a special high-risk population,
pregnant women, and the effects on their children. Interns will be
trained to conduct alcohol and drug use interviews with mothers and
their adolescent children, obtain family and psychosocial histories, as
well as to conduct an extensive cognitive and clinical evaluation of the
children and a clinical evaluation of the mothers. The assessment
battery includes standardized assessments: IQ testing (WISC-III,
PPVT-R); achievement testing (WIAT); DSM-IV clinical evaluations (KSADS,
SCID); executive function tests (Tower of London, Wisconsin Card Sorting
Test) as well as experimental child assessment of attention, memory, and
mother-child interaction. Interns can also receive training to
administer and score a new Child Attachment Interview. Self-report
measures of depression, anxiety, and dissociation, the Achenbach Child
Behavior Check List and Teacher Report Form, a measure of domestic
violence (Conflict Tactics Scale) and quality of parenting (HOME
Inventory) are also used. Opportunities to learn infant assessment and
participate in clinical research on an inner city and cross-cultural
cohorts will be available.
Interns may choose to devote a
proportion of their time gaining clinical research experience involving
analysis of data from the Detroit Alcohol and Drug Exposure Cohort or
data from Cross-Cultural research being conducted in South Africa,
northern Quebec, and Greenland under the direction of Dr. Sandra
Jacobson. Opportunities will also be available to conduct supervised
therapy with inner city adolescents, parent guidance, and treatment of
problem drinking pregnant women.
B. Description of Faculty and
Staff:
The faculty consists of three psychologists, two psychiatrists, and
case conferences with a board-certified psychiatrist. In addition to
clinical evaluation, the faculty is highly experienced in the evaluation
of infant and child development and attachment.
C. Patient Population:
The program provides the opportunity to evaluate high risk,
inner-city mothers and their adolescent children, with particular
emphasis on alcohol and drug use and co-morbid problems and to assess
the impact of domestic violence and trauma on the children’s emotional
development.
DESCRIPTION OF ELECTIVES
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
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
elective 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
elective is provided by a licensed psychologist. In general, the student
can expect one hour of supervision per week, but an open door policy is
maintained for trainees.
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
|
