Department of Pediatric Behavioral Health
The interns in the Department of Pediatric Behavioral Health will be involved in two concurrent part-time rotations or two successive 6-month rotations (Consultation / Liaison and Pediatric Behavioral Health Clinic). The goal of this program is to graduate interns able to function independently as a consultant and care provider to pediatric inpatient and outpatient medical populations
On the Consultation / Liaison (C/L) service, the intern will provide psychiatric and psychological consultations and services to children hospitalized on medical-surgical services. Interns will learn to communicate effectively with patients, families, and the interdisciplinary team working with that child. When necessary, interns will provide ongoing consultation and therapy services to children and their families throughout their hospital stay.
As part of the Pediatric Behavioral Health Clinic, interns will provide a range of outpatient services to children with chronic medical illnesses. Services include psychological and neuropsychological evaluations, diagnostic assessments, and individual and family psychotherapy. Training opportunities also include consultation within specific medical clinics and educational consultation.
On both services, typical child/adolescent patients experience mental health difficulties as a consequence of -- or that influence -- a medical condition (e.g., adapting to acute and chronic medical conditions; complying with medical regimens; problems with separation from family, home, and friends; chronic pain management). Patients have a variety of conditions, including orthopedic anomalies and injuries, brain injuries and other neurological conditions, diabetes, asthma and other pulmonary conditions, cardiac problems, and feeding or other GI disorders.
Supervision is provided by pediatric psychology and psychiatry faculty. One intern will be placed at this site for the entire training year.
Adolescent Residential and Day Treatment Program
Located on Wasatch Canyons Campus, these programs provide psychiatric care to adolescents between 13 and 18 years of age who require a more structured and milieu-based treatment, and include two levels of care (residential and day treatment) and two program tracks (psychiatric and chemical dependency). Our residential unit includes 28 beds, while the day treatment program averages 20-30 additional patients. The Residential and Day Treatment Programs are positioned in the middle of a continuum-of-care model of mental health care delivery. Patients are typically referred into these programs from an outpatient provider or Primary Children's inpatient unit also located on Wasatch Canyons Campus.
Patients coming into the psychiatric program present with a wide range of concerns, including: severe depression, suicidal behavior, bipolar spectrum disorders, anxiety disorders, self-injurious behavior, PTSD, and autism spectrum disorders. Patients entering the chemical dependency program present with substance abuse or dependence disorders, although co-morbid psychiatric problems are frequent; we offer a dual-track treatment focus for such patients. Treatment provided in these programs is multifaceted and comprehensive, and includes psychotherapeutic, pharmacological, and milieu-based treatments. Although various therapeutic modalities are represented, the program's philosophical approach is grounded in cognitive-behavioral therapy.
Our staff includes masters-level therapists (primarily LCSWs), psychologists, advanced practice registered nurses, a psychiatrist, licensed substance abuse counselors, recreational therapists, teachers, psychiatric technicians, and others. The medical team (including a board-certified child psychiatrist) provides medication management.
Patients attend a fully-accredited (Northwest Association of Schools) classroom each morning, followed by a daily process group run by one of the therapists (including the psychology intern). Afternoons include recreational therapy, art therapy, or similar activities.
The psychology intern is viewed as a professional staff member, working primarily with psychiatric track patients, and is supervised by licensed psychologists. Depending on the intern's experience and interests, opportunities to work with chemical dependency patients are available. The psychology intern carries three patients on his/her caseload, providing individual and family therapy for these patients, as well as case management and consultation. The intern also conducts a daily process group, and can be involved in one of the specialty groups (e.g., Mood Group, Sexual Issues Group). As a member of the psychology team, the psychology intern's duties also include: completing one new patient assessment per week, attending rounds, participating in peer supervision, and consulting with other treatment team members.
One intern will be placed in this training site for six months, then rotating with Intermountain Psychiatry and Counseling Services (see below) for the second 6 months of the training year.
Primary Children's Center for Counseling
Primary Children's Center for Counseling is an outpatient psychiatric clinic located on Wasatch Canyons Campus, serving clients ages 3-18 with a wide range of developmental (e.g., autism spectrum disorder), mental health (anxiety, depression, ADHD, behavioral disturbance, eating disorders) and/or chemical dependency problems that do not require more intensive treatment. Available services at PCCC include: medication management; individual, family and group therapy; and didactic, skills-based groups (e.g., parenting). The medical director is a board-certified child psychiatrist, providing direct clinical care as well as direction for the multi-disciplinary team. A business manager and clinical director also share administrative duties. The treatment team consists of psychiatrists, psychologists, social workers and advanced practice registered nurses, for a total of approximately 25-30 staff and trainees at any one time.
The psychology intern provides approximately 16-18 hours of weekly service, including: intake evaluation, psychological/psychoeducational evaluation, psychotherapeutic intervention (individual, family, group), and consultation with schools and pediatricians. If desired, interns are able to co-lead one of several available treatment groups, or develop and lead a group according to clinic need and intern interest. PCCC parenting classes include a behaviorally-based approach for parents of younger to latency age children, and a Love and Logic course for parents of children or adolescents. PCCC also offers an intensive Dialectical Behavior Therapy (DBT) program for adolescents and their parents, including weekly individual/family therapy and skills training group.
The psychology intern will attend weekly staff meetings that include case presentation/consultation, and weekly individual supervision from licensed psychologists. Two psychology interns will be placed at PCCC throughout the training year, one splitting time with Center for Safe and Healthy Families (see below), essentially being half time at both clinics throughout the training year. The other psychology intern, although with PCCC throughout the training year, will also provide some services to the acute care (inpatient) and latency and adolescent residential/day treatment programs (largely evaluations).
Intermountain Psychiatry and Counseling Services (IPCS)
ICPS is an outpatient mental health clinic serving children, adolescents, and adults through psychotherapy and medication management. ICPS staff includes psychologists, social workers, psychiatrists, and advanced practice registered nurses. The intern and supervisor work exclusively with children and adolescents. Services include individual therapy, family therapy, parent training, psychological and psychoeducational assessment, and consultation with schools.
In addition to weekly supervision, the intern attends staff meetings and participates in multidisciplinary case consultations. The typical intern caseload ranges from 16 to 20 patient hours per week. Interns will gain experience with a wide range of psychological disorders, including: depression, anxiety, OCD, eating disorders, behavioral disorders, and learning problems.
One psychology intern will stay at this site for 6 months, then rotating to the adolescent residential and day treatment programs for the second 6 months of the training year.
Center for Safe and Healthy Families
The Center for Safe and Healthy Families (CSHF) placement emphasizes training and career development for psychologists who can assume leadership roles in clinical service, continuous quality improvement, and research in child maltreatment. Clinical training focuses on assessment and treatment of abused children and their families on an outpatient basis, using Trauma-Focused Cognitive Behavioral Therapy and Parent-Child Interaction Therapy as well as other approaches. An opportunity for some experience with forensic psychology services as related to this population is also an available training option.
The core curriculum will include training and experience in evidence-based practice in child maltreatment and trauma. It is preferred that the intern will have his/her dissertation completed prior to the scheduled start of internship. One psychology intern is at this site is half time, while the other half of the week is at Primary Children’s Center for Counseling (see above).
The CSHF training program operates at the interface of clinical/developmental psychology, pediatrics, and the law. The Center for Safe and Healthy Families staff includes two psychologists, and three experienced master’s level therapists as well as pediatricians and nurse-practitioners (who largely complete all medical assessments on abused children in Utah). It is a good setting for developing skills and experience working within a multidisciplinary team specializing in services for abused children.
Our center was an initial site selected by the Substance Abuse and Mental Health Services Administration at the outset of the National Child Traumatic Stress Network. We emphasize a culture of continuous quality improvement and Intermountain Healthcare, the non-profit parent corporation, is recognized internationally as a leader in continuous quality improvement through the Institute for Health Care Delivery Research. Close collaboration occurs with the Intermountain Injury Control Research Center in the Department of Pediatrics at the University of Utah Medical School, the Utah Division of Child and Family Services, the Utah Office of the Guardian ad Litem, and other organizations in Utah and across the United States.
During a typical week, the psychology intern at CSHF would have approximately 8-10 hours of clinical appointments with children and their parents, including initial assessment (following a standard assessment protocol), therapeutic intervention, routine brief psychological testing on all incoming CSHF clients to help clarify treatment needs, and periodic in-depth testing to address specific clinical questions or as part of a forensic evaluation. Additional activities may include training practicum students, medical students, attorneys, or child protection caseworkers, as well as a possible presentation at a local conference or other didactic training event. Some time may, upon agreement with the primary supervisor, be devoted to research-oriented activities.
In addition to case discussion during weekly staff meetings, the intern receives one hour of individual supervision each week. Early in the internship year, time will be spent observing other clinical staff providing services, and learning about the larger child protection system (e.g., juvenile court shelter hearings, children's advocacy centers, forensic medical examinations.)
Program Location / Campus Information
Interns are involved in activities or placements on three campuses, all located within a 15-mile radius of the Salt Lake City metro area:
5th South offices -- Located in Salt Lake City, approximately three miles from the hospital, includes the Pediatric Behavioral Health and Center for Safe and Healthy Families programs.
Wasatch Canyons campus -- Located in Taylorsville, 12 miles south and west of the main hospital. This campus houses Primary Children's Center for Counseling, acute (inpatient) unit, and the adolescent residential and day treatment programs. The latency age residential and day treatment programs, currently located closer to the main hospital, will be moving to Wasatch Canyons campus during early 2012, allowing the entire child/adolescent behavioral health continuum (excepting the Pediatric Behavioral Health and Center for Safe and Healthy Families clinics) to be at one location.
Intermountain Psychiatry and Counseling Services -- Located in Cottonwood Heights, 15 miles south of the main hospital.