Acute/Crisis Evaluations (10 weeks, one half-day per week for adult and child interns; UCHC interns complete ER/acute assessments in the prison setting:
Interns in both General Adult and Child tracks spend time working in the Psychiatric Emergency Room housed in University Hospital or at the Crisis Unit of UBHC. Individuals of all ages are seen in this unit for evaluation of possible admission to inpatient psychiatric units. Working alongside psychiatry residents and fellows, interns participate in the assessment of clients who walk-in or are brought into the facility in a crisis state. This rotation affords interns the important experience of learning how to assess and intervene in a psychiatric crisis situation, and to develop a level of confidence in their ability to conduct rapid safety assessments.
Forensic interns obtain experience with crisis assessment in the prison setting, including having rotations in the Stabilization Units (SU) of Northern State Prison and Edna Mahan Correctional Facility for Women. In the prison-based SU rotation, interns spend 30 hours in total and share the psychologist's responsibility of participating in initial interviews. This occurs in coordination with psychiatry, as the bulk of treatment involves a combination of medication management as well as understanding and resolving the environmental issues that contributed to the need for a crisis placement. Each inmate on the SU must be seen 6 days/week until being evaluated as ready for discharge; the intern is thus only responsible for a portion of their overall care. Interns observe the work of more experienced clinicians, gradually assuming more responsibility for direct assessment and intervention in the presence of these clinicians. Supervision is provided both in-vivo and individually.
Intake Evaluations (adult and correctional/forensic interns: on a rolling basis; child interns: half day once per week for 4 months):
In this experience, interns learn to take histories, conduct mental status exams, form diagnostic impressions, and formulate cases for the full range of presenting problems from adjustment reactions to major and chronic psychiatric difficulties. Initially, the experience is an apprenticeship one, in which interns participate in joint intake assessments with senior staff, before taking on clients on their own.
Child track interns fulfill this required experience in the UBHC Child and Adolescent Outpatient Service, whereas the general adult track intern fulfills this requirement in the UBHC Adult Partial Hospitalization Service and in Adult Outpatient Services. Forensic adult interns fulfill this requirement in one of the prison settings in UCHC, typically on the inpatient units. Newly assigned cases also receive psychosocial assessments which serve as part of the basis for treatment plans. Supervision is initially conducted in an apprentice fashion, where interns observe and participate in intakes with senior staff. Interns then are given responsibility for conducting intakes independently and provided supervision for this activity. Within the child track, this experience begins with interns first observing senior staff and then conducting intake interviews with new clients and families through the use of our one-way mirror.
Psychological Testing (half day, full year):
All students are expected to devote an average of one half day per week throughout the year to formal psychological testing, and to complete at least 8 testing reports. Alternating weekly individual and dyadic supervision is provided for the testing experience. The testing requirement can be met in several ways, depending upon the skill level and interests of the students.
As students in different graduate programs have significantly different levels of training and experience in testing, basic skills in testing are assessed by the testing coordinator at the beginning of the internship year. Students who require further training and/or experience to establish these basic skills are provided with testing assignments designed to develop these skills. For interns in the child track, testing assignments typically come from our Child and Adolescent Outpatient Service or our Child and Adolescent Partial Care Service. For interns in the adult track, the testing assignments come from Adult Outpatient Services and Adult Partial Hospitalization Services. The correctional/forensic track interns will have significant testing experience within the prison setting, but may elect to have some of their testing in UBHC as well. Within the prisons, the focus is generally on diagnostic clarification, risk assessment, and identification of possible malingering. All interns may also elect to have experiences with the assessment of individuals who are outside their developmental specialization.
Within each of these experiences, the intention is to develop basic competencies in the following areas for any student completing our internship program:
- Preparation of written reports that are useful to those receiving them (e.g., parents and teachers, therapists).
- Effective communication of testing results orally to clients, parents, clinicians, and school personnel.
- Preparation of at least two basic reports with minimal correction. Interns receive weekly individual supervision of their testing experience.
The following are typical areas of emphasis, and interns may express a preference for certain types of referrals towards building their skills, also based on client availability:
- Cognitively-focused evaluations: focused on assessment of learning disabilities, intellectual disability, and other special needs.. For children, interaction with schools concerning educational needs may also occur. Some neuropyshcological testing experience may also be warranted in these cases.
- Emotional/personality-focused testing: many clients are referred for diagnostic and/or personality clarification, which may involve the use of objective and projective instruments, including MMPI-2, PAI, TAT, Rorschach, and drawings. The focus will be on improving clinical formulation of clients to inform treatment interventions.
- Neuropsychological assessments: Some clients are referred for evaluation of memory or neuropsychological status following head injuries, epilepsy, or other neurological conditions, and interns may see a few cases with this emphasis within UBHC.