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 and 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 and diverse training opportunities, including but not limited to: serving as a primary clinician and representing psychology on interdisciplinary treatment teams; providing individual and group treatment; developing positive behavioral support plans; providing case management; conducting assessment and psychodiagnostic testing; 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 exclusively in outpatient services.

Placement Options

PRIMARY PLACEMENT - A full year, 45 hour 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: Forensic Addiction Service / Forensic Drug Division Clinic; Hispanic Behavioral Health Services / The Hispanic Clinic; Substance Abuse Services / Substance Abuse Treatment Unit; or Consultation, Prevention, & Program Evaluation Services / The Consultation Center.

Number of Fellows

Primary Placement: 2

Secondary Placement: Varies by year

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 idea that, 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 interdisciplinary outpatient and inpatient teams that specialize in serving adults with a range of SMI and co-occurring disorders, including affective, 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 interdisciplinary treatment teams.

Fellows with a primary placement in ACMH generally spend about 15 hours per week in face-to-face clinical contact: 8-10 is in outpatient services and 4-6 is 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. Fellows also conduct a range of brief and more comprehensive psychological assessments. 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 16 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 most of these EBPs through 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. In addition to a clinical interview and record review, the psychology fellow typically will use selected 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 main 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 or disposition planning. Other types of assessments may be explored.

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. CMHC’s Trauma and Gender (TAG) initiative, which emphasizes a system-wide gender-sensitive approach to care with special attention to trauma, is one of many examples of how diversity is a focal point at the Center. CMHC’s Education and Training office also offers educational events that focus on diverse populations. For example, the 2017 CMHC Education Series features one four-session course on working with people who identify as LGBT and another that focuses on working with immigrants and refugees. 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
Rebecca Miller, Ph.D., Supervisor
Elizabeth Flanagan, Ph.D., Supervisor
Larry Davidson, Ph.D., Research Advisor

Supervision

Supervision is provided by the fellow's primary advisor as well as by numerous 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. As such, individuals from scientist-practitioner programs are especially encouraged to apply.

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

For Further Information

Contact Dr. Thomas Styron at thomas.styron@yale.edu or 203-974-7174.

Adult Community Award

Psychology Fellows Ruth Firmin, left, and Susan Mao, right holding daughter, with faculty members Rebecca Miller, Erika Carr, Tom Styron, and Allison Ponce at the 2017 graduation.

Adult Community Award

APA Division 18 bestows the Excellence in Training Award to the Adult Community Mental Health internship placement. Dr. Erika Carr, right, accepts the award on behalf of placement faculty, including: Dr. Carr and Drs. Thomas Styron, Allison Ponce, and Rebecca Miller. Read more.