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Lakeview Specialty Hospital and Rehabilitation Center CLINICAL PSYCHOLOGY DOCTORAL INTERNSHIP APPIC NMS Program #: Page 1 of 19 TRAINING MISSION Lakeview Internship Manual The major goal
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Lakeview Specialty Hospital and Rehabilitation Center CLINICAL PSYCHOLOGY DOCTORAL INTERNSHIP APPIC NMS Program #: Page 1 of 19 TRAINING MISSION Lakeview Internship Manual The major goal of the doctoral internship training program at Lakeview Specialty Hospital and Rehab is the development of psychologists who have the knowledge, skills, and self-awareness necessary to deliver psychological services to diverse populations, and who practice competently and independently in a professional, empathetic, and responsible manner. We provide opportunities for doctoral interns to examine a broad range of psychological problems, to develop depth of skill in particular areas of specialization, and to gain practical experiences as preparation for successful entry into post-doctoral or entry-level professional positions. INTRODUCTION The Department of Psychology Services at Lakeview Specialty Hospital and Rehabilitation Center has offered a doctoral internship program in clinical psychology which provides comprehensive clinical training to qualified students since The training program provides a major focus on assessment and treatment within the context of a child and adolescent residential program and a minor focus with adult health psychology and neuropsychology in an adult hospital setting. For the training year, three full time internship candidates will be selected. Lakeview Specialty Hospital and Rehabilitation Center offers a diversity of treatment programs to the patients and residents it serves, and all of the training experiences are contained within its immediate campus. Lakeview offers a comprehensive range of services to children from age six to geriatric in the following programs: day school with special education services child and adolescent residential treatment program adult residential (on site group home) long-term acute care hospital with neurobehavioral rehab program outpatient mental health clinic Through their supervised training experience, doctoral psychology interns have the opportunity to participate in and develop a broad array of clinical skills, including: personality and psychological assessment brief cognitive screening competency evaluation neuropsychological assessment behavioral analysis individual, group, and family psychotherapy suicide risk assessment staff consultation and training participation in interdisciplinary staffing and team meetings Page 2 of 19 individualized data collection individual behavior plan development IEP development and implementation neurobehavioral programming The doctoral intern can select from among the full range of services to suit their training goals and interests. The Lakeview Specialty Hospital and Rehabilitation Center Internship has been accepted and is a member of the Association of Psychology Postdoctoral and Internship Centers (APPIC). Lakeview adheres to all APPIC Match policies. TRAINING PHILOSOPHY The Lakeview Internship expects to contribute to the development of highly skilled professional psychologists who can apply their skills to clients with multifaceted needs. Our intent is to help interns create a flexible and individualized training experience that builds on their existing strengths and broadens their clinical experience. The Lakeview doctoral internship employs a variety of training supervisory methods (e.g., individual and group supervision, observation, demonstration, seminars, therapy group co-facilitation, staffings, team meetings, etc.). It is the goal of the doctoral psychology training program at Lakeview to incorporate research validated best practice techniques and interventions to bolster the interns skill development while providing the highest standards of treatment to the complex and varied needs of the consumers we serve. The comprehensive rehabilitation center and specialty hospital setting provides rich, diverse, and unique training opportunities for doctoral interns. In addition to the spectrum of psychological, neuropsychological, and behavioral disorders, interns become familiar with the goals, roles, practices, and struggles of interdisciplinary staff including occupational, speech, respiratory, activity, and physical therapists, dieticians, nurses, aides, behavior analysts, consulting physicians, psychiatrists, pharmacists, direct care staff, etc. Interns learn how to facilitate interdisciplinary team functioning and provide practical suggestions for working with distressed or behaviorally challenging clients and families. Interns learn to use their expertise in the biological and social bases of behavior to help staff understand maladaptive behaviors interfering with treatment and means of addressing or working around these obstacles. Interns learn the language of rehabilitation (e.g., functional independence measures) and participate in ethical deliberations on issues surrounding patient care, safety, confidentiality, autonomy, competency, etc. Interns learn and apply specialty skills needed for this setting, including skills in applied behavior analysis and intervention as well as rehabilitation oriented neuropsychological assessment and treatment. These guided experiences aim to hone skills that a clinician will need to develop a future psychological practice and especially to be able to apply these skills in the non-traditional but fastest growing areas of psychological practice. The Director of Training serves as an information source until the internship officially begins, then as advisor for the intern while planning their training program for the year. In consultation Page 3 of 19 with the Director of Training, interns may adapt their training schedule as new interests emerge. The Director of Training is available throughout the year for advice regarding problems that may arise, and for feedback concerning the intern's progress. Education and training are viewed as continuous and interactive processes, beginning with close supervision and working toward the development of critical thinking skills and conceptualization capacity toward clinical independence. Each intern will have at least two psychologists serving as direct clinical supervisors during the training year. Interns can expect at least 2 hours of individual face-to-face supervision per week as well as group supervision. The Director of Training and the Training Committee will monitor the overall quality of the training experience and the quality of the specific supervision arrangement. CORE COMPETENCIES Interns are expected to participate in a wide range of training experiences, regardless of whether they have already identified a specialty focus. Core competencies that the doctoral can expect to enhance through the Lakeview internship program include facility with a variety standardized assessment instruments (cognitive, intellectual, and psychological), ability to integrate available client information and facts into a full conceptualization and understanding of social, environmental, developmental, neuropsychological, etc. that contribute to the resident s current presentation, and to develop the doctoral intern s ability to formulate a related treatment plan with research validated interventions and measureable outcome objectives. Additionally, each intern will become proficient in exercising the ability to communicate, orally and in writing, and to enhance their ability to appreciate the perceptions and perspectives of others, in ways that are necessary to perform as successfully as a member of an interdisciplinary care team member. Treatment of consumers within a residential care setting is a core skill identified by the Training Committee to be part of every Lakeview intern s training experience. The doctoral intern will have opportunities to participate in treatment team meetings (with psychiatry to review medication management, with the core team to review treatment interventions and related responses, with direct care staff to provide instruction on implementation of individualized behavior plans policy implementation, and with the program s behavior analysis team to work jointly on development and ongoing updates with individualized behavior plans) and resident staffings, offer individual, family, and group psychotherapy, and offer milieu programming including behavioral intervention, feedback, training, and coaching. The intern will also have opportunities to refine and apply specialty skills including behavioral consultation (functional analysis, plans, monitoring, coaching, etc.). The Residential Treatment requirement is intended to meet the following training goals: to learn diagnostic interviewing and develop treatment strategies; to gain proficiency in administration of cognitive, intellectual, and psychological assessment instruments to build skills with case conceptualizations and ability to integrate client data into functional therapy goals with measureable outcome objectives Page 4 of 19 to utilize the range of therapeutic options available in inpatient medical and residential treatment settings; to function as an integral member of a multidisciplinary treatment team; to develop facility in performing behavioral assessments, developing behavior intervention plans, and training staff through modeling, coaching, debriefings, and feedback; to express logically and concisely (both verbally and in writing) the relevant history, formulation, recommendations and treatment progress; to gain familiarity with medical-related issues relevant to psychological disorders, such as pharmacotherapy and co-existing medical illnesses as well as to appreciate the role of psychological factors in the treatment of medical disorders; and to gain familiarity with legal issues, such as patient's rights, commitment laws, confidentiality, etc. Creating a Training Schedule The Lakeview Internship provides training through concurrent major and minor rotations throughout the twelve month internship calendar. Key to training schedule development is the assurance of close and ongoing supervision and that doctoral interns are providing at a minimum, 25% of their time in direct face-to-face clinical service activity. The major rotation will involve the intern in the provision of care to children and adolescents on a residential treatment program that also houses an onsite day school program. The day school program serves both residents of Lakeview as well as students within the community who struggle with behavior management needs that cannot be met within their own school districts. Minor rotation opportunities will be available through a 20 bed CBRF (on site group home), an adult long-term acute care hospital based program (housing medically complex, rehabilitation, and neurobehavioral patient treatment programs), and an outpatient mental health clinic. The doctoral intern will be offered flexibility in creating a training schedule for the year in consultation with their Director of Training to both meet core competency requirements and allow focus on each intern s specific and unique training interests. DESCRIPTION OF PROGRAMS AND SERVICES Child and Adolescent Residential Lakeview Specialty Hospital and Rehab s Joint Commission and CARF certified Child and Adolescent Residential Care Program excels in meeting the emotional and social needs of children and adolescents with medical, physical and cognitive challenges compounded by behavioral issues. Our multi-disciplinary program integrates medical management, nursing care, and education in an environment where young people can play, grow, learn, and thrive. This unit provides residential treatment services for up to 25 clients ages 6-17 referred from multiple counties, hospitals, schools, other states, etc. The patient population presents a full range of behavioral, psychiatric, medical, and neuropsychiatric conditions, including emerging presentations of severe mental illness (schizoaffective, bipolar, etc.), as well as substance abuse, conduct disorder, ADHD, PTSD, fetal alcohol effects/syndrome, autism, Asperger s, and oppositional-defiant disorder. Many of these children also have concomitant medical and neurological disorders (e.g., PKU, diabetes, encephalopathy, brain tumors, shunts, epilepsy, Page 5 of 19 juvenile Huntington s/parkinson s disease, etc.). Average length of stay is approximately six to nine months with some variability. Lakeview provides academic services to children and adolescents, both residents of Lakeview and from the community, within our onsite school program. Accredited by the North Central Association of Colleges and Schools (CASI), Hillside School s special education environment ensures Individualized Education Plans are tailored to meet the needs of each student in a highly structured program. Based on a behavior model, the accredited K-12 year-round curriculum combines academics with independent living and prevocational training. It is the mission of the Hillside School to provide the necessary skills and academic foundation to build the character, self-respect, and functional independence necessary to optimize each student s reintegration into the public schools and community. Training opportunities for interns provide a balance of assessment and treatment interventions including individual and family therapy, group therapy (aggression replacement training, substance abuse prevention, relaxation, human development, tele-therapy, etc.), psychological assessment, neuropsychological assessment, behavioral intervention, and participation in interdisciplinary treatment teams and clinical conferences both on the unit and in our on-site accredited school as well as on therapeutic community outings. Adult Residential (minor emphasis) Lakeview has a 20 bed adult residential treatment program licensed as a community based residential facility (CBRF) for individuals with brain injuries or other medical disabilities and concomitant psychiatric and/or substance abuse conditions (including Wernicke-Korsakoff spectrum disorders). Training opportunities for interns provide a balance of psychological assessment and treatment interventions including individual and family therapy, group therapy (possible group choices include: social skills, anger management, brain injury support, coping skills, transition to adulthood, narrative therapy, etc.), assessment, neuropsychology, behavioral intervention, and participation within interdisciplinary treatment teams. Hospital (minor emphasis) The hospital program at Lakeview is a Joint Commission accredited program that houses the state of Wisconsin s only certified neurobehavioral treatment program and carries a long history of specialization in treatment of individuals who have suffered cognitive, behavioral, and personality alterations as a consequence of their neurological conditions. At Lakeview, our goal is to enable individuals with acquired brain injuries, neurobehavioral impairments, and other complex medical disabilities to achieve the highest level of functional independence possible. Due to the experience, dedication, and compassion of our staff, we can treat some of the most challenging and difficult to place individuals. Patients admitted to the hospital program typically receive interdisciplinary treatment either long-term acute care or rehabilitative for medical conditions such as traumatic brain injury, stroke, encephalitis, brain tumor resection recovery, orthopedic injury, kidney disease, wound care, morbid obesity, pulmonary disease, ventilator weaning, diabetes, etc. In addition to Page 6 of 19 psychology staff, other disciplines involved in treatment include nursing, various medical specialties (internal medicine, physical medicine and rehabilitation, pulmonology, nephrology, psychiatry), nutrition, pharmacy, occupational therapy, speech therapy, and physical therapy. Training opportunities for doctoral interns are available through a medical consultation model and include psychological and neuropsychological assessment, as well as treatment interventions including individual and family therapy and behavioral intervention. Outpatient (minor emphasis) Lakeview also houses an outpatient behavioral health clinic devoted to providing assessment, consultation, and treatment services. Outpatients may come in as part of aftercare from our hospital-based services to promote a successful transition to community-based living or come from the community to receive support and assistance in reaching their individual behavioral and mental health goals. Services provided, and which doctoral interns may select to participate with, include provision of competency evaluations, disability evaluations, evaluations for Department of Vocational Rehabilitation to facilitate job re-entry, neuropsychological evaluations, psychological assessments, and individual and family therapies for child, adolescent, and adult consumers. DESCRIPTION OF TRAINING ROTATIONS Child and Adolescent Residential, Major 12 month Rotation Principal Supervisors: Jamie Roberts, Psy.D. Cindy Sorenosn, Psy.D. Lakeview Specialty Hospital and Rehab's RCC treatment units serve up to 25 youth aged 6-17 with severe psychological, medical, and behavioral concerns. Children placed within the RCC units at Lakeview Specialty Hospital and Rehab have a history of various psychopathology including Schizophrenia, Bipolar Disorder, Attention Deficit Hyperactivity Disorder, Post Traumatic Stress Disorder, Depression, Anxiety, as well as a multitude of alternate concerns. In addition, youth served many times have accompanying medical diagnoses and illnesses that are long-term and / or progressive in nature. Medical diagnoses have incorporated Traumatic Brain Injury, Huntington's Disease, and severe Seizure Disorders in addition to many others. It is also important to note that the youth served within the RCC treatment program have a variety of attachment related concerns in addition to severe trauma histories that have impacted their growth and development in such a manner that it has impacted the nature of their family dynamics and interpersonal relationships. Page 7 of 19 In addition to the two RCC treatment units the Hillside School is an accredited educational facility that exists within the RCC treatment program. The Hillside School offers a year round educational program for the youth undergoing treatment at Lakeview Specialty Hospital and Rehab. There are four distinct classroom settings that offer instruction to elementary school youth, middle school / junior high school age students, senior high school program participants, and language based youth many of whom reflect varying levels of disability and children on the Autism spectrum. As part of the RCC treatment program Doctoral Psychology Interns will carry a caseload of 8-10 youth who reflect the aforementioned psychological and medical based concerns. In their treatment of these youth Doctoral Interns will complete intakes and psychosocial assessments in addition to a neuropsychological screen as part of their treatment process. As clinicians, the Doctoral Intern will conduct twice weekly, hour long psychotherapy sessions with all of the patients on their caseload in addition to group psychotherapy sessions. Group psychotherapy is designed by the Doctoral Interns in conjunction with and co-facilitated by the Psychology and Clinical Team participants. Group psychotherapy many times addresses concerns pertinent to the issues that are reflected by the youth in the therapeutic milieu with a focus on the development of healthy relationships. Aside from psychotherapy based treatment services Doctoral Interns will complete psychological assessments and complete psychological batteries when warranted, as determined by the Psychology team, on the youth that they serve. As members of a multidisciplinary treatment team Doctoral Interns are expected to be present and participate in monthly staffings and treatment team meetings that are conducted wi
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