Adult Inpatient Services / Inpatient Services Unit

APPIC #118324

Overview

The Inpatient Services Unit is based at Connecticut Mental Health Center (CMHC), which serves adults who experience a wide range of serious mental health concerns. As an academic-based community mental health center, CMHC offers not only a broad range of traditional mental health services, but many other wellness oriented programs or treatments designed to enhance recovery for those with mental illnesses. The internship experience is based on providing crisis intervention, symptom stabilization, and individual and group psychotherapy to adults through an interdisciplinary team model with an emphasis on helping clients develop and achieve goals designed to maximize their mental health.

Placement Options

Primary placement, full time for a full year.

Number of Fellows

Primary Placement: 1

The Setting

The Inpatient Services Unit is designed to provide inpatient mental health services to adults who experience serious mental illness and live in the New Haven catchment area. CMHC’s treatment model is firmly grounded in the concept of recovery. This involves a focus on empowerment as well as individualized, person-centered treatment to help individuals achieve their highest potential. The recovery emphasis at CMHC is built around the principle that for a mental health system to provide the best care, it must include not only clinical services but also a range of other opportunities including housing and residential services, employment and social supports, and avenues for creative expression. Furthermore, from a recovery-oriented foundation, CMHC seeks to partner with individuals and the community to foster hope and increase the opportunity for all individuals to live lives of personal meaning

The Inpatient Services Unit is a 20-bed adult (age 18+) service that serves as an integral part of CMHC's crisis, ambulatory, and community-based system of care. The Inpatient Services Unit, utilizing a multidisciplinary team approach, provides comprehensive assessment, crisis intervention, symptom stabilization, treatment and discharge planning to uninsured or under-insured residents of the local community. Each client’s length of stay is determined by their presenting problem and specific care requirements. As a result, the stay may vary from a few days to several months or longer.

Upon admission, each client is assigned to a primary clinician and a team comprised of an attending psychiatrist, nurses, social workers, mental health assistants, and trainees of various disciplines. Within the context of team discussion, individualized outcome-oriented plans of care are developed, typically in direct collaboration with the client and his/her outpatient care providers. The involvement of the client's family and/or significant others is also sought (in accordance with the client's needs and wishes) to ensure that a comprehensive and workable plan is established.

Client-specific treatments are selected and evaluated on an ongoing basis to guide the client's care throughout the hospitalization. The client’s medical, housing, financial, social, spiritual, and vocational needs are assessed to inform the type and level of services that are optimal. Individual, group, occupational, recreational, milieu and pharmacological therapies are employed in accord with the specific needs of the clients. Comprehensive disposition planning is undertaken to ensure that the client is returned to the community in a safe and expeditious fashion.

The Internship

This Adult Inpatient Services (AIS) placement offers skills development in assessment, treatment, consultation, and clinical research. The fellow will clinically manage and observe clinical problems reflecting the full spectrum of psychiatric disorders. The fellow will carry direct care responsibilities within the unit as a primary clinician. Responsibility for coordinating a client's overall plan of care rests with the primary clinician (who may be a staff social worker, staff nurse, resident in psychiatry, or the doctoral psychology fellow).

As a valued member of the multidisciplinary treatment team on the Inpatient Services Unit, the fellow will acquire or further develop their skills in: comprehensive admissions assessments; differential diagnosis; case formulation; treatment planning; case presentations; individual and group psychotherapy; disposition planning; and preparation of progress notes and discharge summaries.

The fellow will also have the opportunity to administer psychological assessments, participate in psycho-educational programming, provide case management, and assist in the formulation and implementation of positive behavioral support plans for clients on the unit. Fellows also have the opportunity to lead groups on the unit based on unit needs and the fellow's expertise.

The fellow plays a central role within the psychology service on the unit, which is overseen by a variety of faculty members based at CMHC and also includes two part-time doctoral fellows.

There is also an opportunity to see one or two individuals for outpatient psychotherapy at CMHC if this is an interest of the fellow. This experience offers the opportunity to diversify the training experience and work with individuals on a different part of their recovery journey. This enables the fellow to collaborate with an outpatient team at CMHC, adding further depth to the training experience and knowledge of how outpatient interdisciplinary teams operate within the CMHC system.

Evidence-Based Practices

The following evidence-based practices (EBPs) are used in this placement setting. Fellows generally have exposure to most of these EBPs though do not necessarily receive training or supervised experience in all of them. The EBPs include, as part of a recovery-oriented model of care: person-centered planning, peer support, supported housing, supported employment, strengths-based case management, integrated treatment for co-occurring disorders, social skills training, dialectical behavior therapy, cognitive behavior therapy, illness management and recovery, family psycho-education, and psychopharmacology.

Psychological Assessment

The psychological assessment experience for AIS fellows involves routinely conducting a number of brief assessments to assess the presence and severity of symptoms or change in symptoms over time. In addition to a clinical interview and record review, the psychology fellow typically will use standardized symptom measures. Fellows will also conduct at least two comprehensive psychological assessments during the course of the training year; of which there are three types: ( 1) psycho-diagnostic assessments that include measures of cognitive abilities, executive functioning, and personality; (2) behavioral assessments focused on Positive Behavioral Support Planning; and (3) specialized assessments that focus on risk assessment, residential placement needs, and the assessment of a course of treatment.

Diversity

The Adult Inpatient Unit placement offers a rich, diverse experience. As the program focuses on serving individuals with serious mental illness, fellows have the opportunity to learn, from a social justice perspective, about the unique needs and challenges that individuals with these illnesses face in our society. The clients being served also represent the richness of the New Haven community with diversity that may include: race, ethnicity, culture, gender, gender identity, sexual orientation, socio-economic status, geography, country of origin, and disability status. There is also a rich diversity among the staff on the inpatient unit, as well as interdisciplinary students who, in addition to psychology, come from the disciplines of social work, rehabilitation, psychiatry, and nursing. The interdisciplinary environment creates a very rich systemic training experience with exposure to diverse perspectives and a variety of theoretical or intervention approaches.

Scholarly Activity

TThe fellow’s scholarly activity can take many forms. In consultation with the primary advisor, the fellow can choose to engage in an ongoing research project, evaluate a clinical service or program, or help design and implement a new project that will benefit the individuals receiving services on the unit or elsewhere in the CMHC service system. Ideas for other projects can be explored; the advisors for the internship are eager to engage fellows in a collaborative process to determine the scope and content of the scholarly project.

Faculty

Erika Carr, Ph.D., Primary Advisor

Rebecca Miller, Ph.D., Supervisor
Thomas Styron, Ph.D., Supervisor
Allison Ponce, Ph.D., Supervisor
Keith Hawkins, Ph.D., Supervisor

Supervision

Supervision is provided by the fellow's primary advisor as well as by numerous other full time and voluntary faculty. The fellow is provided with at least four hours of individual and group supervision each week with licensed psychologists from a range of theoretical orientations. The exact nature of each supervisory relationship is determined by the supervisor-fellow dyad but normally will include discussion of clinical material, the fellow's role on an interdisciplinary team, research and scholarship as it applies to the clinical work, and professional development issues.

Seminars

In addition to the core seminar series, the fellow in this placement participates in two additional weekly seminars based at CMHC. One is a didactic and interactive seminar focusing on the topics related to the delivery of care on an inpatient unit. The other is a continuing clinical case conference, which provides an opportunity for trainees to present and discuss clinical material related to work with their clients at CMHC and to further develop relationships with fellow trainees and seminar leaders.

Applicant Qualifications

Strong applicants for this placement generally have experience working with adults with serious mental illness in both inpatient and outpatient settings. Fellows who match with this placement usually have an interest in community-based and recovery-oriented services and their future goals often include doing clinical work with people who have significant mental health problems and/or conducting research related to serious mental illness.

Applicants selected for this placement must be able to successfully pass background checks conducted by Yale University and the State of Connecticut.

For Further Information

Contact Dr. Erika Carr at erika.carr@yale.edu or 203-974-7854