Hispanic Behavioral Health Services / The Hispanic Clinic

Placement at the Hispanic Clinic provides the fellow intensive clinical training and preparation for working with an under-served and growing Latine community. Specific skill development opportunities including intake evaluations, intervention (group and individual), consultation, case management/care coordination, and assessment are offered throughout the course of the training year. Implementing a culturally and linguistically informed approach to care, the fellow is encouraged to integrate recognized cultural constructs in their interactions with clients, community partners, and family members. Beyond the provision of direct services, the fellow gains experience 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, community organizations, and area hospitals.

Primary Placement - A full year, 30 hour per week primary placement, which is combined with one of the following secondary placements:

• Child & Adolescent Services / West Haven Mental Health Clinic
• The Consultation Center
• Substance Abuse Services/Substance Abuse Treatment Unit

Secondary Placement - The Hispanic Behavioral Health Service is not offered as a secondary placement.

Primary Placement: 1

The Hispanic Clinic of the Connecticut Mental Health Center is an outpatient behavioral health service provider that offers clinical evaluation and treatment to the Latine 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/care coordination and community linkage, pharmacotherapy, and individual and group psychotherapy for persons with acute and chronic mental health, substance use, 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, socio economic status, 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 the LBHS are to improve access to behavioral health care to the monolingual Latine community, and to support workforce development efforts that will build regional capacity to deliver culturally informed treatments.

The fellow is expected to gain proficiency in the conceptualization of clinical presentations 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 through individual and group treatment modalities; and 3) assessment administration and interpretation of 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 10-12 clients. Clients present with a variety of behavioral health concerns, including: depression, anxiety, psychosis, substance use, PTSD, complex trauma, 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, the fellow can also expect to integrate case management into their clinical responsibilities and facilitate coordination of care in the community. Consistent with a team-based approach to care, the fellow works closely with the psychiatrist assigned to their caseload and participates in the medication management and periodic psychiatric assessments. Additionally, the fellow will facilitate the Ambulatory Specific Adjunctive Program (ASAP), which is designed to provide intensive clinical care within a group format. Clients referred to this group are typically stepping down from a higher level of care or in need of additional support. As part of this experience, the fellow may also provide peer consultation to third year medical students rotating through the Clinic. Due to the ever-changing dynamics in healthcare delivery stemming from the COVID-19 pandemic, the fellow may engage in tele-health sessions and tele-supervision.

The following evidence-based practices (EBPs) are used in this placement setting: motivational interviewing and cognitive behavioral therapy. The fellow will receive training and supervision in both modalities, in addition to other modalities based on clinical presentation. The fellow will receive training on how to culturally and linguistically adapt and integrate interventions in the provision of individual and group treatment. Additionally, the fellow has the option to receive training throughout the year in the use of motivational interviewing via tape rating and individualized performance-based feedback with the goal of attaining advanced proficiency.

The fellow will gain assessment experience through conducting clinical intake evaluations for newly referred clients at the Hispanic Clinic, and comprehensive psychological assessments. A core clinical training activity will be conducting diagnostic evaluations for purposes of admission to outpatient treatment. The fellow will conduct and prepare the initial evaluation, develop an initial treatment plan with the client, and present the case for disposition planning in the weekly clinical rounds at the Hispanic Clinic. The fellow will also conduct psychological assessments in Spanish as clinically indicated during the course of the training year. This type of assessment can include measures of cognitive abilities, executive functioning, and/or personality functioning. It can also include case and diagnostic formulation, report writing, and treatment planning. In order to facilitate the process of comprehensive assessments, the fellow will meet with a testing supervisor well versed in the assessment, application, and interpretation of psychological tests within a cultural context. Collaboratively, the fellow and supervisor will engage in reviewing the referral, selecting the appropriate instruments, interpreting the results, report writing, and the development of recommendations. Additionally, the fellow has the opportunity to lead feedback sessions with the client, family members, and/or referring clinicians. The fellow will also gain experience in conducting brief diagnostic assessments. Depending on availability, the fellow may be invited to observe psychological evaluations of asylum seekers conducted in Spanish.

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 and ethnicity, sexual orientation, gender identity, socio-economic status, culture, geography, country of origin, immigration status, ability status, and spiritual beliefs.

The fellow will have the opportunity to participate in ongoing projects (varies from year to year) or develop one based on interest, clinical relevance, and availability of resources to ensure a quality learning experience. 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.

Manuel Paris, Psy.D., Primary Advisor, Supervisor

Luis Añez, Psy.D., Supervisor

Michelle Silva, Psy.D., Supervisor

Oscar Rojas Perez, Ph.D., Supervisor

Francisco Lopez, Ph.D., Supervisor

Eric Frazer, Psy.D., Testing Supervisor

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, strengths-based, and multicultural approach that focuses on skill acquisition and retention, quality of care, use of best practices, professional development, and mentorship. Exposure to a variety of therapeutic modalities including motivational interviewing, cognitive-behavioral therapy, psychodynamic psychotherapy, and interpersonal approaches are offered. The fellow will also 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.

The fellow will participate in seminars focused on cross-cultural issues, substance use disorders, co-occurring disorders, community-based intervention, and prevention. In addition to the Core Seminar, the fellow in this placement participates in two site specific case conferences. The first is a monthly multidisciplinary case conference offered through the LBHS that covers areas such as assessment and intervention approaches to support the Latine community. The second is a once weekly Hispanic Clinic seminar focused on understanding recovery-oriented care practices for acute and chronic mental health concerns from a cultural perspective.

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.

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