Hispanic Behavioral Health Services / The Hispanic Clinic

APPIC #118318

Overview

Placement at the Hispanic Clinic provides an opportunity for the fellow to receive intensive clinical training and preparation for working with an under-served and growing Latina/o community. Specific skill development in intervention, consultation, and assessment with this population is offered throughout the course of the training year. Using a culturally informed approach to care, the fellow is encouraged to integrate recognized cultural constructs in their interactions with consumers, community partners, and family members. Beyond the provision of direct services, fellows also have the opportunity to develop competence working in complex systems of care. As a member of the outpatient clinical treatment team, the fellow consults with staff members at the Clinic, CMHC, other local providers, and area hospitals.

Placement Options

PRIMARY PLACEMENT - A full year, 30 hour per week primary placement, which is combined with one of the following secondary placements: Adult Community Mental Health Services / 34 Park Street; Child & Adolescent Services / West Haven Mental Health Clinic; or Consultation, Prevention & Program Evaluation Services / The Consultation Center

SECONDARY PLACEMENT - The Hispanic Behavioral Health Service is not offered as a secondary placement.

Number of Fellows

Primary Placement: 1

The Setting

The Hispanic Clinic of the Connecticut Mental Health Center is an outpatient mental health and addictions service that offers clinical evaluation and treatment to the Hispanic monolingual community of Greater New Haven. In addition to serving as an APA-approved training site for doctoral psychology fellows, the Hispanic Clinic also serves as a training placement for psychology postdoctoral fellows, psychiatry residents, and nursing, social work, and medical students.

The Clinic is staffed by a multidisciplinary team of bilingual-bicultural clinicians who provide a comprehensive range of services to an adult population aged 18 and over. These services include, but are not limited to: diagnostic evaluation, case management and community linkage, pharmacotherapy, and individual and group psychotherapy for persons with mental health, addictions, and co-occurring disorders. Many of the clients originate from the Caribbean and Central and South America. They often present with challenging life circumstances, exacerbated by the process of migration, trauma, loss of family supports, and acculturative stressors. The Clinic provides recovery-oriented interventions, which are designed to enhance quality of life and community integration.

As an established provider of outpatient behavioral health services for the Spanish-speaking community and recognized partner in the promotion of culturally and linguistically appropriate care, the Hispanic Clinic has served as the coordinating hub for the Connecticut Latino Behavioral Health System (LBHS) since 2007. The overarching goals of LBHS are to improve access to behavioral health care to the monolingual Latina/o community, and to support workforce development efforts that will build regional capacity to deliver culturally informed treatments.

The Internship

The fellow is expected to gain proficiency in the conceptualization of clinical issues based on a comprehensive and culturally informed treatment formulation. Specifically, the training year will provide an opportunity for the fellow to acquire further skill in the following: 1) differential diagnosis in the context of culture; 2) adapting evidence-based interventions to culture and language; and 3) test administration and interpretation of assessment results with consideration given to cultural and linguistic characteristics.

Core therapy training experiences occur in two primary modalities. The fellow will provide individual treatment to a caseload of approximately 8-10 clients. Clients present with a variety of behavioral health issues, including: depression, anxiety, psychosis, substance use, PTSD, and personality disorders. As clients often present with concurrent psychosocial issues, such as homelessness, parole/probation involvement, inadequate access to medical services, and extreme poverty and hardship, fellows can also expect to integrate case management into their clinical responsibilities and facilitate coordination of care in the community. Additionally, the fellow will facilitate the Ambulatory Specific Adjunctive Program (ASAP), which is designed to provide intensive clinical care within a group format. As part of this experience, the fellow may also provide peer consultation to third year medical students rotating through the Clinic.

Evidence-Based Practices

The following evidence-based practices (EBPs) are used in this placement setting: motivational interviewing and cognitive behavioral therapy. The fellow will receive ample training and supervision in both of these modalities. Specifically, the fellow will receive training on how to culturally and linguistically adapt and integrate these modalities in the provision of individual and group treatment.

Psychological Assessment

The fellow will conduct at least two comprehensive psychological assessments in Spanish during the course of the training year. This type of assessment will include measures of cognitive abilities, executive functioning, and/or personality functioning. It will also include case and diagnostic formulation, and treatment planning. In order to facilitate the process, the fellow will meet with a testing supervisor well versed in the assessment, application, and interpretation of psychological tests within a Latina/o context. Collaboratively, the fellow and supervisor will engage in reviewing the referral, selecting the appropriate battery, interpreting the results, report writing, and the development of recommendations. The fellow also has the opportunity to lead feedback sessions with the client, family members, and/or referring clinicians. In addition to the comprehensive assessments, fellows will also gain experience in conducting brief assessments in this placement.

Diversity

The training program is committed to providing the fellow with a culturally and linguistically appropriate training experience. The fellow is immersed in an environment in which Spanish is the dominant language spoken among staff and clients alike. This shared language is juxtaposed with the rich diversity the fellow will also experience in relation to gender, race, sexual orientation, gender identity, socio-economic status, culture, geography, country of origin, disability status, and spiritual beliefs.

Scholarly Activity

The fellow will have the opportunity to participate in original and/or ongoing research projects based within the Clinic. Additional mentoring and supervision related to the development of culturally competent clinical research skills can also be arranged based on the fellow’s interests and training goals.

Faculty

Manuel Paris, Psy.D., Primary Advisor, Supervisor
Luis Añez, Psy.D., Supervisor
Michelle Silva, Psy.D., Supervisor
Eric Frazer, Psy.D., Testing Supervisor

Supervision

Supervision is a cornerstone of the internship experience, and as such, is provided for all aspects of the fellow's work. A unique aspect of the supervision experience is that it can be conducted in Spanish, at the fellow’s request. The supervision provided at the Clinic utilizes a collaborative and strengths-based model that focuses on skill acquisition and retention, quality of care, use of best practices, and professional development. Exposure to a variety of therapeutic modalities including motivational interviewing, cognitive and cognitive-behavioral therapy, psychodynamic psychotherapy, and interpersonal approaches are offered. The fellow will also have the unique opportunity to learn about the diverse roles psychologists play in community settings and issues pertaining to the development of a broader system of care and community collaboration through the LBHS. Additionally, the fellow receives ongoing feedback during the internship from their advisor and supervisors. Quarterly formal evaluations are also completed and serve as opportunities to review progress on training goals and address progress toward core competency areas.

Seminar(s) & Specialized Training

The fellow will have opportunities to participate in seminars focusing on cross-cultural issues, addictions treatment, co-occurring disorders, community-based intervention, and prevention. In addition to the Core Seminar, fellows in this placement participate in a monthly multidisciplinary case conference specific to assessment and intervention with the Latina/o community.

Applicant Qualifications

Strong applicants for this placement have experience working with Spanish speaking adults with serious mental illness and substance use issues in an outpatient setting. Fellows who match with this placement 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 and substance use issues. Professional fluency and mastery of Spanish is a requirement for working within this multi-service, specialty clinic.

Applicants selected for this placement must successfully pass background checks conducted by Yale University and the State of Connecticut. Since this placement potentially requires travel between different training sites, previous fellows have considered it essential to have access to their own car.

For Further Information

Contact Dr. Manuel Paris at manuel.paris@yale.edu.

Hispanic Clinic

Connecticut Latino Behavioral Health System (LBHS) collaborators, from left, Robert Cole, MHSA; Esperanza Diaz, MD; Luis Añez, PsyD; Michelle Silva, PsyD. Not pictured: Manuel Paris, PsyD, and Luis Bedregal, PhD. An article that outlines the history and success of LBHS was recognized as the 2017 Best Paper in Psychological Services by the Division 18 Psychologists in Public Service. Read more.