How To Help A Child And Family Mental Health Program

Transcription

1 INTERNSHIP/ PRACTICUM PROGRAM IN CLINICAL PSYCHOLOGY For Student Placements in LAKERIDGE HEALTH OSHAWA

2 INTERNSHIP/PRACTICUM IN CLINICAL PSYCHOLOGY The Setting Lakeridge Health Corporation is an amalgamated health care system consisting of 4 hospital sites, of which the Oshawa location is the largest. It is located in Durham Region, outside of Toronto. Lakeridge Health Oshawa is one of the busiest acute care community hospitals in Ontario. The Mental Health and Pinewood Centre Program has a broad range of ambulatory and inpatient components with a 39 bed inpatient adult psychiatry unit. Pinewood Centre is one of Ontario s largest addiction treatment centres and offers a broad range of services. There is an emphasis within this service on developing a Concurrent Disorders Program, for clients with both mental health and addiction issues. The Child Youth and Family Mental Health Program currently provides urgent care/ crisis services, day treatment and traditional outpatient services. They also provide consultation and support to inpatient units where children and adolescents have been admitted for mental health reasons. The Eating Disorders Program is a newly funded multidisciplinary program by the Ministry of Health and Long- Term Care. The aim of the program has been to enhance services to adolescents aged 12 to 18 years and to develop services for young adults aged 18 to 25 years that are residents of Durham region. Adult Outpatient, Adult Day Treatment and Child, Youth and Family Outpatient Services are located at a community clinic in Oshawa. Psychology at Lakeridge Health Oshawa Currently at LHO there are 9 Psychologist positions and several other psychotherapist/psychometrist staff. They work in the Mental Health and Pinewood Centre Program, the Child Youth and Family Program, and on the Medical floors providing:. Psychotherapy (individual, group, family). Psychoeducational/ support groups. Psychodiagnostic assessments. Neuropsychological assessments and consultation. Rehabilitation services. Consultation to other professionals in the hospital and community. Research The Mental Health Program is multidisciplinary in nature and consists of the following: Psychiatric Adult Inpatient Unit, Crisis Services, Adult Day Treatment Program, Adult Outpatient Service, Eating Disorders Program, Early Psychosis Intervention Program and Interact, a community based treatment clinic. Pinewood Centre provides a continuum of addiction services, including Assessment, Case Management, Outpatient Treatment, Withdrawal Management (detox), Crisis Support, Problem Gambling Treatment. The Child Youth and Family Program includes Outpatient Services (treatment/assessment & psychiatry), Urgent Care and an Intensive Services Day Program. Inpatient and outpatient psychological services are also provided through the Rehabilitation, Continuing Care and Medicine, and Family Health Programs.

3 The Philosophy and Goals of the Program The goal of the internship program at LHO is to assist interns and practicum students in developing the appropriate skills and knowledge for future practice as a Clinical Psychologist (doctoral level) or Psychological Associate, Psychotherapist or Psychometrist (master's level). Depending on their background and program, students will be expected to master the fundamentals of psychological assessment, treatment planning, and the provision of psychotherapy within a hospital setting. They will be expected to acquire a sound grasp of ethical issues and procedures and to accustom themselves to appropriate professional conduct in a health care setting, including interaction with professionals from other disciplines. While the actual objectives for the internship will depend on the educational requirements for each student, specific goals to be undertaken under supervision may include: Read chart notes to extract information regarding patient history, current medication, risk factors and any other relevant information. Formulate assessment questions based on all the available information and select appropriate assessment tools and procedures to address the questions. Conduct a clinical interview to assess and evaluate emotional, social, cognitive and behaviour factors which impact on the patient's well being; to assess suicidal risk; to establish DSM IV criteria when appropriate. Administer, score, and interpret results of a psychological battery including data obtained from a clinical interview as well as intellectual, cognitive status, and personality assessment procedures; and make formulations, including diagnosis as stipulated by Health Professional Legislation (RHPA). Develop a plan for psychological treatment with clearly defined goals. Write formal assessment reports including information from the patient's history, assessment results, diagnostic impressions, formulation, and recommendations for treatment and/or referral. Communicate the results of assessments to other professionals involved in the clinical management of the patient, being sensitive to the complexity of issues involved in the process. Give feedback to the patient and family regarding assessment results and implications as well as indications for treatment.

4 Conduct psychotherapy (individual, group, and family as available) and psychoeducational/support groups; prepare initial assessment and treatment reports, therapy notes, and discharge reports. Be aware of ethical considerations and guidelines for professional practice and conduct themselves in a manner consistent with college standards. Know own limitations and be able to identify when to refer to other professionals. Practice methods of continuing education; be aware of current research findings in the field; be able to apply them to clinical practice. Be aware of the implications of multicultural and gender issues within professional practice. Become aware of issues and best practices involved in provision of a Concurrent Disorders Program serving clients with both mental health and addiction difficulties Internship/Practicum Program This program provides a number of possible concentration areas and actual rotations will be individualized for each intern or practicum student according to student goals and interests and staff availability. Students generally work in several areas concurrently throughout the year. MAJOR ROTATION PLACEMENTS ADULT MENTAL HEALTH A doctoral practicum, half time internship, or full time internship is available. Adult Outpatient Service The Adult Outpatient Service is currently staffed by a full time Psychologist, a part time Psychologist, and a Social Worker. The department offers individual and group psychotherapy to patients age 18 or older. Psychotherapy groups (e.g. with an interpersonal/dynamic focus) and psychoeducational groups (e.g. teaching cognitive behavioural skills and strategies) are offered. Patients present with a wide range of anxiety, mood and personality disorders and many have experienced abuse or other trauma. Most referrals are received from other services within the Mental Health Program (Crisis, Day Treatment, Inpatient Unit). While the goal is to provide brief therapy when possible, some patients are seen on a longer basis. Some formal psychological assessments are also performed as part of the treatment planning. Interns/ practicum students will have opportunities, depending on previous experience and skill level, to provide individual

5 therapy, co-lead a group, do initial assessments and formal psychological assessments, write notes and reports, and liaise with other professionals in the hospital. Interns will participate in regularly scheduled meetings within this service. Day Treatment Program The Mental Health Day Treatment Program offers a variety of services to patients with a wide range of mental disorders, adjustment difficulties and co-occurring addictions. Program candidates are adults between the age of years who are referred from the Inpatient Unit, Psychiatry, or the Crisis Intervention Team. The staff is an experienced multidisciplinary team and includes a Psychologist, Occupational Therapist, Nurses, and Social Workers. Patients attend an Orientation Group and are then placed in a four week program that is tailored to their identified needs. Groups, which vary from time to time depending on the population treated, generally include: process oriented psychotherapy groups, psychoeducational groups, relationship groups, cognitive behavioural groups for depression and anxiety, life skills and activity oriented groups. Group therapy is often augmented by crisis intervention, and psychological testing for diagnostic clarification and to assist with treatment planning issues. Interns/ practicum students may have the opportunity to co facilitate groups and conduct comprehensive intellectual and personality psychological assessments. Early Psychosis Intervention Program (EPI) The Early Psychosis Intervention Program (EPI) is a specialized multidisciplinary program that provides early intervention to young people from years of age experiencing a first episode of psychosis. There is evidence to show that there is improved clinical outcome when comprehensive clinical assessment and intervention occurs as quickly as possible following the onset of psychosis. The longer the delay in treatment, known as the duration of untreated psychosis, the poorer the clinical outcome. Early intervention may prevent the significant biological, social and psychological deterioration that can occur in the early years following the onset of a psychotic disorder. The EPI team includes a psychologist/clinical leader, 2 social workers, a youth worker, a registered nurse, an occupational therapist and an addiction counselor. There are 2 psychiatrists who provide diagnostic support to the program on a limited basis. Interns/practicum students will have opportunities to assist with diagnostic assessments in this service. They will also be encouraged to work collaboratively with other members of the team as they provide treatment to our clients. Service modalities include individual, group, and family therapy. Acute Care Medicine - Family and General Medicine (FGM) Program: The Acute Care Psychologist provides clinical psychological and neuropsychological services to the emergency, nephrology, cardiopulmonary, geriatric, and general medical units of LHO. With special arrangements and as time permits, clinical services can be provided to the psychiatry and oncology units at LHO as well as affiliated sites (i.e., LHW - GRU and Positive Care Clinic, Respiratory Care Clinic, etc). Currently this position is not filled and there are no training opportunities.

6 CHILD, YOUTH AND FAMILY PROGRAM (CYFP) Please be aware that the CYFP does not currently offer an internship, although practica are available. Inpatient The Child/Adolescent Inpatient Service is currently contained on the general paediatrics floor and the adult psychiatry floor when appropriate. The children's inpatient team consists of Nursing Staff, Child & Youth Workers, Psychiatry and Social Work. The primary goal of the program is crisis stabilization and assessment and linkage to either the outpatient program at LHO or a community mental health program. Patients on the unit are provided with a structured 3 tiered management program while hospitalized. Individual treatment plans are determined in consultation with the multidisciplinary team. There are currently no opportunities for practicum students to do rotations on the inpatient unit. However, there may be opportunities for educational visits to the unit. Outpatient The Child, Youth and Family Outpatient Service is staffed by a multidisciplinary team including psychiatry, psychology, social work, and an occupational therapist. It provides service to children and adolescents between 5 and 18 years who have emergent and acute needs. This population is referred by family physicians or from other Child Youth and Family programs. Clients are typically contending with features of many Axis I diagnoses, including suicide risk/intent and severe depression/anxiety,. The Outpatient Service offers assessment and psychotherapy to individuals, families and groups. Also, staff members regularly engage in case consultation with community agencies and local schools. Practicum students will have the opportunity to complete clinical interviews, psychological assessments, individual, group and family treatment, as well as participate in team meetings and peer consultation. Urgent Care The Urgent Care program is designed to provide rapid assessment and treatment services to children, youth and their families after being seen in the emergency room of the hospital or their physicians office. The mandate of the program is to provide assessment, brief treatment and referral services to anyone aged 5 to 18 and their families who present in crisis but do not require hospitalization. Clients may be seen for up to 4 sessions and then are referred to another program or discharged. There are currently no opportunities for practicum students to do rotations through urgent care, although some observation may be possible.

7 Intensive Ambulatory Program The intensive ambulatory program is designed to meet the treatment needs of children and youth who do not require hospitalization, but are also not amenable to traditional outpatient services. The program treats adolescents over the age of 12, though younger children will also be considered on a case by case basis. Referrals to this program may come from family physicians, or from other components of the Child, Youth and Family Program. This is a fullday program that is tailored to the individual needs of the client, but the typical length of stay is 8 weeks. Practicum students will have the opportunity to complete comprehensive psychological assessments, individual and group therapy and participate in the multidisciplinary team rounds. Educational Opportunities Attendance at seminars or presentations led by psychology staff for educational/training purposes Monthly attendance at our Clinical Education Seminar Opportunities for formal case presentations Direct observation of student's clinical interviewing, intervention, and diagnostic skills. Occasional opportunities to attend workshops conducted by outside clinicians and sponsored by the hospital In addition, students may attend scheduled meetings of:. Child, Youth and Family or Adult Outpatient Services as appropriate. Mental Health Program meetings. Inpatient In-service meetings Hospital Grand Rounds Supervision and Evaluation Full Interns will receive 3-4 hours of supervision weekly from members of the College of Psychologists to discuss case material and clinical/ professional issues pertinent to professional growth and development. Practicum students will receive at least 2 hours weekly, depending on the design of their program and the number of hours at the site. Interns and practicum students are encouraged to consult with other psychology staff and members of other disciplines working within the various programs. All written reports, notes and correspondence are reviewed and co-signed by a supervising psychologist. At the outset each student and supervisor will jointly develop specific goals for the internship or practicum. These will be based on student needs and interests tailored to the goals of their

8 academic program as well as the needs of the hospital. Progress will be formally evaluated 4 times during the year for interns. Letters summarizing the intern's achievements are sent to the Director of Clinical Training of their respective universities or professional schools at the mid way point and at the conclusion of the program. The intern will participate in the evaluation process. Practicum students will be evaluated mid-way through the practicum and again at the end or more if required by their programs. They will also participate actively in the evaluation process and copies will be sent to their schools. Individual supervisor styles and requirements vary. However, all intern and practicum students should expect to complete thorough written psychological assessments (when applicable), initial assessment reports and case conceptualizations. Moreover, they may be asked to provide audio and/or videotaped sessions for supervision purposes and for completion of case conceptualizations. Live supervision may also be required of practicum students and interns. Qualifications Applicants for an internship must have completed or be near completing all course work for a doctoral program in clinical psychology at an accredited university or professional school. This will normally include a minimum of 600 hours of supervised experience in basic assessment, interviewing and psychotherapy. Practicum applicants should have completed most or all or the core courses in a masters program in clinical or counseling psychology. Preference will be given to candidates who are in a doctoral program and who have completed previous practicums in assessment or psychotherapy. Stipend Currently no stipend is available. Application Procedure Interested applicants should submit the following: 1. A curriculum vitae 2. A letter of application outlining the applicant's reasons for being interested in the field of psychology as well as internship or practicum goals with a preliminary indication of preferred rotations. 3. Letters of recommendation from 3 psychologists who are familiar with the applicant's clinical skills and academic performance. 4. An official graduate transcript or copy.

9 Qualified applicants will be contacted to arrange an interview. Please send applications to: For Adult Mental Health: For Child, Youth and Family Deborah Azoulay, Psy.D., C. Psych. Lorne Sugar, Ph.D, C. Psych. Psychology Training Co Coordinator Psychology Training Co Coordinator Lakeridge Health Oshawa Lakeridge Health Oshawa 850 King St. West 850 King St. West Oshawa, Ontario L1J 2L5 Oshawa, Ontario L1J 2L5 Tel: (905) ext 3810 Tel: (905) ext 4442 Deadline for application for C,Y and F Program: January 12, 2009 Applicants for the Adult Mental Health Program are encouraged to submit applications by this deadline as well. After January 12 check with the coordinator to see if applications can still be submitted Psychology Staff (Note that not all staff are available for student supervision.) Ozge Akçali, Ph.D., C. Psych. (McGill University, 2001). Psychologist in the Eating Disorders Program. Clinical Interests: Assessment and treatment of adults and adolescents with eating, depressive and anxiety disorders, relationship difficulties, couples issues, stress and time management, life transitions, and career issues; individual cognitive-behavioural and multicultural psychotherapy; and program evaluation. Research Interests: Psychology of women; eating disorders; multicultural counselling; ethical issues in psychotherapy; and vocational psychology Deborah Azoulay, Psy.D., C. Psych.. (Adler School of Professional Psychology, 1999) Psychologist in Adult Outpatient Service. Interests: Individual psychotherapy for adults and adolescents integrating cognitive-behavioural/ Adlerian and psychodynamic treatment models; group psychotherapy using cognitive-behavioural and interpersonal models; treatment of trauma and dissociation, including development of affect management strategies and use of EMDR to treat traumatic memories; psychological assessment including use of projective techniques; anger and anger management; student training and supervision. Graham Bean, Ph.D. (Med. Sci, University of Toronto, 1991), Ph.D., C. Psych., (Supervised Practice) (University of Toronto, 2006). Mental Health Clinician; Adjunct Professor (Psychology) York University. Clinical Interests: Adult neuropsychlogy and rehabilitation, diagnostic assessment and treatment, mindfulness based psychotherapy,

10 interpersonal psychotherapy. Research Interests: Premorbid risk factors associated with the major mental illnesses especially bulimia nervosa and first episode, nonaffective psychosis, developmental processes particularly self-esteem. Michelle Bissonnette, Ph.D. (York University, 2006) Psychometrist, CCC/Geriatrics/Rehabilitation and Day Hospital, Oshawa and Whitby sites. Clinical Interests: Adult neuropsychology; Neurological disorders (dementia, cerebrovascular disorders, movement disorders); Traumatic brain injury; Diagnostic assessment.research Interests: Role of alcohol and violence outcome expectancies in predicting adult alcohol use and dependence. Contribution of familial risk factors in later alcohol and drug use. Neuropsychological correlates associated with a family history of alcohol use. Neuropsychological changes associated with binge drinking in young adults. Kathy Fitzsimmons, Ph.D., C. Psych. (University of Western Ontario, 2001). Psychologist in the Adult Outpatient Mental Health Day Treatment Program. Interests: Cognitive-Behavioral and Insight-oriented psychotherapy with individuals and groups; psychological assessments. Research Interests: program evaluation; the impact of early attachment relationships on adult functioning; emotion regulation. Currently on Maternity Leave Gary Johnston, M.A. (University of Ottawa, 1982). Mental health therapist in the Interact Community Mental Health Program. Clinical Interests: Individual and group psychotherapy using integrated/transtheoretical models of treatment. Insight and readiness for change in psychotherapy. The use of existential models of psychotherapy (Frankl, Buber, May, etc...) as applied to client issues of grief, pain, loss, hopelessness and meaninglessness. The adjunctive use of meditation, music, art, reading and writing within psychotherapy. Program evaluation. Research Interests: The use of qualitative research models in exploring complex psychological phenomena. The use of qualitative research models in exploring the client's experience of psychotherapy. Client agency and self-reflexivity/awareness in psychotherapy. Relational models of feminist therapy and their relationship to authenticity within all therapeutic relationships. Philosophical and practical problems with current cognitive models of brain/mind. Program evaluation. Ivan Kiss, Ph.D., C.Psych.(Concordia, 1989) Neuropsychologist, LHC CCC/Geriatrics/Rehabilitiation, Whitby and Bowmanville sites Assistant Professor (Psychiatry), University of Toronto; Adjunct Professor (Psychology) McMaster University. Clinical Interests: Adult and adolescent neuropsychology; Neurological disorders (dementia, cerebrovascular disorders, movement disorders); Traumatic brain injury; Capacity/competence, disability. Research interests: Electrophysiological and neuroimaging investigations of cognitive processes (attention, working memory); Normal and pathological age-related cognitive changes Perception of affect

11 Lorne Sugar, Ph.D., C. Psych. (York University, 2001) Psychologist in Child Youth and Family Program. Clinical interests include: Diagnostic assessment with preschoolers, latency-aged children, and adolescents incorporating cognitive and socialemotional components; Multi-systems consultation; Systemically informed models of treatment and the incorporation of other theoretical schools including cognitivebehavioural, psychodynamic, and existential; Clinical supervision and training. Research interests include: Social support processes among children, adolescents, parents, and friends; The interrelations between and impact of parent-offspring relationships, social support, and personality on well-being; Coping with transitions; The application of the above-stated research interests within a developmental psychopathology framework. Nancy Wilkinson, Ph.D., C. Psych. (University of Windsor, 1989). Clinical Leader/ Psychologist in Outpatient Mental Health, Mental Health Day Treatment, and the Early Psychosis Intervention Team. Interests: Psychodynamic oriented psychotherapy with adults; interpersonal group psychotherapy; clinical supervision and training ; program development and outcome; currently working on developing a new program in Early Psychosis Intervention. Skevoulla Xinaris, Ph.D., C. Psych. (Queen's University, 1992).Psychologist and Clinical Leader of The Eating Disorders Program-Mental Health. Interests: Assessment and treatment of eating disorders in adolescents and adults; primary prevention of eating disorders; cognitive-behavioural and interpersonal psychotherapy with individuals and groups; assessment and treatment of affective and anxiety disorders; program development and evaluation.