Adult Community Mental Health Services / 34 Park Street

APPIC #118319

Overview

The Adult Community Mental Health (ACMH) placement offers fellows the opportunity to learn about and deliver state of the art care for individuals with serious mental illnesses (SMI) and co-occurring disorders within a comprehensive, integrated system of services. This placement is based at the Connecticut Mental Health Center (CMHC), which serves individual adults with a wide range of SMI and co-occurring mental and substance use disorders. As a community mental health center, CMHC offers not only psychological and psychopharmacological services, but also many other wellness-oriented programs designed to enhance recovery. The placement provides a broad range of rich, diverse training opportunities, including but not limited to: serving as a primary clinician and representing psychology on interprofessional treatment teams; providing individual and group treatment; developing positive behavioral support plans; providing case management; providing training and consultation with community service agencies; and carrying out a scholarly project related to SMI. Fellows with a primary placement with ACMH are involved in both outpatient and inpatient care, while fellows with secondary placements spend their time in outpatient services.

Placement Options

Primary Placement

A full year, 50-hour (average) per week primary placement that combines outpatient and inpatient experiences, with no additional secondary placement.

Secondary Placement

A full year, 15 hour per week outpatient secondary placement, combined with a primary placement in one of the following:

The Setting

CMHC provides outpatient and inpatient mental health services to adults with SMI and co-occurring disorders who live in the greater New Haven area. CMHC’s treatment model is firmly grounded in the concept of recovery. This involves a focus on empowerment and individualized, person-centered services to help individuals achieve their highest potential. The recovery emphasis at CMHC is built on the principle that in order for a community mental health system to provide state-of-the -art care, it must include not only clinical services but also social support, assistance in finding housing, employment, and other interventions to promote community inclusion and citizenship.

The primary units of organization for the ACMH placement are interprofessional outpatient and inpatient teams that specialize in serving adults with a range of SMI and co-occurring disorders, including mood, anxiety, personality, substance use and psychotic disorders. Members of the teams include psychologists, psychiatrists, social workers, psychiatric nurses, peer recovery specialists, community clinicians, supported employment specialists, and social rehabilitation staff. Most commonly, people receiving services within the ACMH placement are engaged in individual and/or group therapy and medication management, depending on their individualized recovery plans.

The Internship

The ACMH placement is designed to develop a broad set of core competencies related to the delivery of psychological services to individuals with SMI and co-occurring disorders within a community mental health center using a recovery framework. At the core of the training experience is the fellow’s role as primary clinician on interprofessional treatment teams.

Fellows with a primary placement in ACMH generally spend about 15 hours per week in face-to-face clinical contact: 8-10 in outpatient services and 4-6 in inpatient services. Fellows with a secondary placement within ACMH spend approximately 6 hours per week in face-to-face clinical contact in outpatient services only. The majority of clinical time involves providing psychological services individually and in groups, as well as case management and other supports. Caseloads are selected to provide a variety of treatment experiences, as well as focused experience in a diagnostic area of particular interest.

While many individuals engaged in services are seen in long-term therapy, there are some opportunities for briefer, more focused interventions. In addition, fellows may participate in the development and implementation of comprehensive Positive Behavioral Support Plans for clients in need of such intervention. Within the recovery model, a variety of treatment modalities and theoretical models can be used, all grounded in a strengths-based, person-centered approach.

ACMH fellows may also devote, depending on their level of interest and available opportunities, an average of two hours per week to activities within the Community Services Network (CSN). The CSN is a collaborative of 15 community-based, not-for-profit organizations providing a wide array of recovery-oriented supports (e.g., supported housing, employment, education, socialization) for which CMHC serves as lead agency. Common activities for fellows involve providing trainings to frontline staff of network agencies on topics related to SMI and recovery or consulting to the service agencies.
The remainder of the fellow's weekly time is spent engaged in recovery planning and documentation, participating in supervision, and attending seminars and other activities which promote individual learning and growth.

Evidence-based Practices

A variety of evidence-based practices (EBPs) are used in an integrated manner in ACMH and may include Illness Management and Recovery, Seeking Safety, Social Skills Training for Schizophrenia, Motivational Interviewing, Dialectical Behavior Therapy and CBT for Psychosis. Other EBPs used within the ACMH placement include, but are not limited to, person-centered planning, peer support, supported housing, supported employment, strengths-based case management, integrated treatment for co-occurring disorders, family psychoeducation, and psychopharmacology. Fellows are exposed to a variety of these EBPs through didactics, supervision and their work on the interdisciplinary teams.

Psychological Assessment

The psychological assessment experience for ACMH fellows involves routinely conducting a number of brief assessments to assess the presence and severity of symptoms, or to assess change in symptoms over time. Fellows usually conduct at least two comprehensive psychological assessments during the course of the training year, typically behavioral assessments focused on Positive Behavioral Support Planning.

Diversity

Individuals who receive services at CMHC are diverse on a variety of dimensions, including gender, gender identity, race, ethnicity, sexual orientation, socio-economic status, culture, geography, country of origin, and disability status. As a public mental health center, most individuals receiving services experience lower socio-economic status and live with mental illnesses. One in eight residents of New Haven is foreign-born and that international diversity is reflected in those who come to CMHC. In addition to the rich diversity among service recipients at CMHC, the staff also represents our diverse community. Psychology fellows are invited to participate in CMHC’s “Dialogues on Difference,” a multiracial space where staff engage in conversations frequently focused on our experiences of racial identity and equity in our work and in our lives. Within the ACMH placement, attention to diversity is emphasized in our recovery-oriented case conference seminar and in individual supervision.

Scholarly Activity

Scholarly activity in ACMH can take many forms. In cooperation with the primary advisor, the fellow can choose to engage in an ongoing research project, often in conjunction with the Yale Program for Recovery and Community Health; evaluate a clinical service or program; or design and implement a consultation or performance improvement project. The advisors for ACMH are eager to engage fellows in a collaborative process to determine the scope and content of the scholarly project.

Faculty

Thomas Styron, Ph.D., Primary Advisor
Allison Ponce, Ph.D., Primary Advisor
Erika Carr, Ph.D., Supervisor
Elizabeth Flanagan, Ph.D., Supervisor
Larry Davidson, Ph.D., Research Advisor

Supervision

Supervision is provided by the fellow's Primary Advisor and by other full-time and voluntary faculty. Each primary fellow is provided with at least four hours of individual supervision each week with licensed psychologists from a range of theoretical orientations. Secondary fellows typically have at least two hours of weekly supervision pertaining to their ACMH placement. The focus 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.

Seminar

In addition to the internship core seminar, the fellows in this placement participate in one to two additional weekly seminars based at CMHC. One is a continuing clinical case conference, focusing on recovery-oriented care and person-centered planning (primary and secondary fellows). The other is a didactic and interactive seminar focused on the topics related to the delivery of care on an inpatient unit (primary fellows only). These seminars provide fellows with an opportunity to present and discuss their work at CMHC and to develop professional relationships with other trainees and faculty seminar leaders.

Applicant Qualifications

Strong applicants for this placement have substantive experience and demonstrated commitment to working with adults with SMI, often including research focusing on an aspect of SMI.

Applicants selected for this placement must be able to successfully pass background checks conducted by Yale University.