Internship in Clinical Social Work:

Transcription

1 Internship in Clinical Social Work: The Hamm Clinic Internship in Clinical Social Work is a 9-month, 16-hour per week commitment, beginning on September 4, The internship is structured according to guidelines below, and operates in collaboration with each intern s program s expectations. TRAINING MODEL and PHILOSOPHY: Social work interns develop foundational skills to provide comprehensive diagnostic assessment and individual psychotherapy. Opportunities to provide couples, family or group therapy are available, based on the intern s training goals. Interns experience and learn the multifaceted role of a clinical social worker in an outpatient clinic setting: completing diagnostic assessments, providing psychotherapy, attending staff meetings, preparing medical records, coordinating therapy with medication management, arranging referrals to other agencies and services, and learning the ethical and legal considerations involved in service delivery to a broad mental health population. The training philosophy for social work interns emphasizes an attachment and relational psychodynamic theoretical framework, within which trainees learn to utilize a range of therapeutic interventions (e.g. skills based, CBT, problem-solving, mindfulness). Trainees learn to use scholarly inquiry to understand and apply empirically-based approaches and relevant research findings to therapy practice. In addition, our training model strongly encourages consultation across mental health disciplines and recognizes the impact of collaborative care on client care. Social work interns are encouraged to develop their professional identity as a clinical social worker, and as a professional who can work effectively in collaboration other mental health professions. The board and all clinical staff at Hamm Clinic understand that training the next generation of mental health service providers a core mission of our organization. To support this mission, trainees receive intensive supervision, and supervisors and other staff clinicians are regularly available for consultations. Training Aims 1. Trainees will develop the foundational skills necessary for the provision of quality, culturally-responsive short-term and long-term psychotherapy to a diverse adult population. Focus is paid to examining therapeutic process, the fundamental importance of the therapeutic relationship, and value of utilizing transference/counter-transference to inform and enhance treatment.

2 2. Trainees will be competent at inter-disciplinary work. As a consultation team-member, trainees learn to navigate and facilitate productive collaboration with psychiatry (within a community mental health setting), for the benefit of the client. In addition, trainees will learn how to provide peer-consultation, and to elicit and integrate feedback from a consultation group to supplement, enhance, and diversify their treatment approach. 3. Trainees will further their development as a professional. Training model is strengths-based, and encourages and supports self-reflection to enhance all facets of therapeutic work. Trainees will gain greater skill and independence with organizing complex ethical issues, navigating complex interpersonal interactions, and making thoughtful decisions to guide clinical care.

3 Training Goals for Social Work Internship Training at Hamm Clinic Goal #1: Diagnostic assessment - trainees will develop a proficiency in diagnostic assessment. Goal #2: Psychotherapy - trainees will develop the foundational skills to provide individual psychotherapy. Goal #3: Scholarly Inquiry - trainees will recognize the importance of and become proficient at integrating scholarly inquiry and practice. Goal #4: Crisis Intervention - trainees will become proficient in recognizing and managing client crises. Goal #5: Individual and Cultural Diversity - trainees will be sensitive to the individual and cultural diversity of their clients, and will be able to effectively attend to diversity into the delivery of mental health services. Goal #6: Professional Ethics - trainees will act in a professional manner consistent with the professional and clinic s codes of ethics and applicable state laws, initially through the appropriate use of supervision, and over the course of the training year, assuming greater independence in doing so. Goal #7: Therapist Use of Self - trainees will demonstrate a commitment to understanding and attending to the use of the self in their work. Goal # 8: Consultation - trainees will become proficient in mental health consultation.

4 Learning Elements: Overview: Social work interns clinical practice experience occurs within a community mental health outpatient setting. Interns provide individual therapy services for a diverse adult population; and have the option of providing group, family, and couples therapy. They collaborate with multi-disciplinary teams, to provide thoughtful and well-coordinated services. 1. Diagnostic Assessment: Diagnostic assessment is an important part of service delivery at Hamm Clinic. A thorough assessment is necessary for the clinician to be able to provide informed treatment. Training in diagnostic assessment takes a variety of forms, and occurs in a graded, cumulative, and sequential manner: Trainees are introduced, early on, to the idea of diagnostic assessment as an ongoing process in psychotherapy. Initial supervision and seminar training sessions focus on a given diagnostic assessment and the influence this will have on initial stages of therapy. Topics such as use of the DSM V, differential diagnoses, assessment of risk, case conceptualization, identification of appropriate treatment recommendations, clinical interviewing, mental status, gathering a developmental history, and treatment planning are discussed. As the trainee progress in their training, they are introduced to more sophisticated aspects of diagnostic assessment. Weekly seminars contribute to the focus on diagnostic assessment viewing personality structure from a variety of perspectives. Specifically, assessment as viewed through multiple professional and theoretical lenses, and trainees are encouraged to consider various ways of gathering and organizing information gleaned from therapy interactions. During the middle and later phases of the training, supervision parallels the trainee s development by focusing on more complex and nuanced issues in the diagnostic assessment process. Trainees are required to write an intake assessment, intake history, diagnostic summary, and treatment plan for each of their clients. This gives trainees repeated opportunities to develop their diagnostic and charting skills. Supervisors review this documentation and see it as an opportunity for training and teaching. 2. Psychotherapy: Psychotherapy is fundamental to the trainees clinical training at HMPC. Trainees receive a concentrated orientation throughout their first weeks at the clinic. This occurs via a severalday orientation, weekly two- to three-hour seminars, the trainee handbook, and meetings with their primary supervisor. During initial supervisory sessions, care is taken to cover critical aspects of delivering psychotherapy at the clinic. Trainees work closely with their individual supervisor to identify areas of growth, and to develop goals for the trainee s development as a therapist. Trainees are assigned a low

5 number of new client intakes during their second week at the clinic. The clients are carefully selected by the Hamm Clinic Triage Group in collaboration with the Director of Education and Training, in an effort to provide the trainees with clients that are appropriate for their capacities, and stage in their clinical training. From that point on, trainees make requests for new clients in collaboration with their supervisor. In order to address training in a sequential, graded, and cumulative manner, trainees (in collaboration with their supervisor) are encouraged to increase their caseload in an intentional, managed fashion, keeping in mind the need to conceptualize, diagnose, formulate a treatment plan, and provide timely completion of paper work for each client. As the training experience continues, trainees can request certain types of clients to balance their learning such as couples, certain presenting issues, etc. Within the constraints and limitations of the presenting patients, an attempt will be made to provide interns with a variety of clinical issues and concerns. 3. Multi-disciplinary Consultation: Trainees participate in a weekly, one-hour multidisciplinary Clinical Consultation Team of approximately 7 staff, which includes professionals and trainees in psychiatry, psychology, and social work. In this consultation team experience, trainees are exposed to a range of mental health issues that are managed in an outpatient psychotherapy setting. In addition, trainees are exposed to the work of a diverse range of professional and theoretical points of view. Trainees participate as a team member, support team members, and gain experience with seeking consultation in their role as a therapist. Clinical staff model case presentation skills. Trainees are expected to present their clinical work, and as the year progresses, they are encouraged to become familiar with seeking feedback from others to help navigate challenging clinical issues that arise, ethical concerns, transference/counter-transference, and individual and cultural diversity. Supervision: Individual Supervision (1-2 hours/week + open-door policy ): Depending on the specific training track, trainees meet 1-2 times/week for one- to two-hours total duration per week with their primary supervisor. The primary supervisor is the point person for the trainee, and available to consult with the trainee outside of scheduled supervision. The trainee s individual supervisor is responsible for supervising the majority of the intern s clinical activities. Hamm Clinic has an open-door policy, in which trainees are encouraged to seek out ongoing supervision and consultation with their individual supervisor as issues and concerns arise to aid in continuity of their training experience. In an attempt to support this, the individual supervisor makes efforts to coordinate schedules with the trainee, such that the trainee s schedule overlaps as much as possible with the times that the individual supervisor is onsite.

6 Individual supervision at Hamm is comprehensive. Focus is paid to examining a range of issues on an ongoing basis. This includes: 1. Providing psychotherapy to a broad, community mental health population 2. Providing diagnostic assessment 3. Preparing documentation 4. Coordinating therapy with medication management 5. Managing crises 6. Arranging referrals to other agencies 7. Attending to both the content and process of therapy sessions 8. Examination of transference and counter-transference 9. Attention to client s intra-psychic and interpersonal dynamics 10. Attention to personality structure, as seen through various lenses 11. Evaluating the effectiveness of therapeutic interventions. 12. Reflection on individual and cultural diversity, in understanding a client s perspective and presenting concerns. 13. Integration of science and practice 14. Working within the ethical and legal guidelines involved in service delivery. 15. Professional development of the trainee 16. Navigating interpersonal relationships and communication with co-workers, supervisors, and teammates Of specific emphasis are issues of individual and cultural diversity and professional ethics. Hamm Clinic believes these issues are crucial to examine in any clinical and psychological work. By addressing these issues throughout the training curriculum and particularly in individual supervision, trainees learn to incorporate aspects of diversity and ethics in the formation of their professional identity and reflect it in their work as mental health care providers. Supervision increases in intensity and complexity as the trainee progresses with their caseload. Trainees are given ongoing formative feedback throughout their supervision experience, as it pertains to the above issues, and the training goals that are established at the onset of supervision. Summative feedback is provided in the form of biannual evaluations. Multi-disciplinary Team Consultation (1-hour/week): Trainees participate in weekly multidisciplinary team. Team allows trainees the opportunity to observe and integrate varying views and styles into their work. Trainees are expected to present cases at team as they feel ready to do so and staff provide modeling of case presentation skills before expecting trainees to present. As the year progresses, trainees are encouraged to freely share their work as well as their thoughts and ideas about others work thereby functioning in a consultative capacity. As the year progresses, they are encouraged to seek feedback from others to help navigate challenging clinical issues that arise, ethical concerns, transference/counter-transference, and individual and cultural diversity. Two-times per year, the trainees will receive formal written evaluations addressing their capacity to give and receive consultation in the team setting. The trainee is asked to choose a staff member of their team to conduct this evaluation.

7 Educational Activities: Training Seminar (2- to 3-hours/week, September-May): Trainees attend a weekly, 2- to 3- hour seminar to provide didactic training to all Hamm Clinic trainees (i.e. psychology, psychiatry, and social work). Approximately one seminar per month is open to mental health professionals from the public, and the remainder attend to the specific needs of the training cohort. They are taught by Hamm Clinic staff as well as external mental health experts. The seminars are both didactic and experiential, intended to help trainees to develop their skills in comprehensive assessment, case conceptualization, core components of psychotherapy, integration of theory and practice. Training incorporates a range of therapeutic techniques in therapy, with a concentrated focus on psychodynamic therapy. Cultural-responsiveness is emphasized in all areas of the training, and is the focus of specific seminars (e.g. Working with Latino/Latina Clients). PCOMS (embedded within Seminar Series and Orientation): Trainees receive initial and ongoing training in Partners for Change Outcomes Management System (PCOMS), which is a program that utilizes client feedback to inform and improve the treatment process. PCOMS training will provide a framework for therapeutic work that is informed by ongoing, cumulative research on treatment outcome, which identifies the therapeutic alliance as a central variable in client success in therapy. Trainees gain experience tracking clients session-by-session response to treatment, as a gauge to understand treatment effectiveness. They also monitor clients ratings of their therapy experience and therapeutic alliance, to encourage open discourse about the client s experiences of treatment. Case/Research Presentation: In the spring of the traineeship year, social work interns present a clinical case and applicable literature or present a research project they have conducted to their colleagues. Each trainee, in their presentation, is expected to integrate relevant clinical research into the practice of psychotherapy. Each trainee receives feedback from the staff via discussions at the presentation. In addition, the individual supervisor may complete a written evaluation form for the trainee as structured feedback regarding their integration of scholarly inquiry and practice as demonstrated in the presentation. Optional Training and Supervision (based on trainee interest and availability): Hamm Clinic recognizes and values that each trainee enters this training experience at their own level of development and will progress through the training at their own pace, while maintaining a clear minimum standard. Learning goals, skill development, and interests will individualize the training for each trainee. To facilitate the individual training needs of each trainee, Hamm Clinic offers various professional development opportunities for trainees. These activities are optional for trainees. It is recognized that time constraints, academic requirements, and/or training requirements also play a significant role in whether trainees can pursue any additional professional development opportunities.

8 Couple s and Family Therapy Group Supervision: Interns have the option to participate in Couple s and Family Group Supervision. This begins in the late fall with initial didactic training, and is followed by ongoing group supervision. To engage in the Couple s and Family Therapy group supervision, the intern, their individual supervisor, and the Director of Education and Training will meet to determine that this training will help to meet the intern s training goals, that the intern is progressing successfully within the training program, and is able to accommodate this in their schedule. Group Therapy Supervision: Interns have the option to co-facilitate a group with a staff clinician. The tasks of therapy groups range from exploring interpersonal relationships to providing psycho-education. Groups meet weekly. Interns meet regularly for at least one halfhour per week with their group co-facilitator. The co-facilitator serves as the intern s group therapy supervisor. Annual Conferences: Hamm Clinic sponsors an annual day-long conference during the year featuring a nationally recognized speaker. Topics presented are relevant to the work as a therapist, and frequently address cultural responsiveness. HMPC Staff In-service (1.5-hours/month): Once per month the Clinic sponsors monthly inservices for the staff and trainees on issues related to psychotherapy. The speaker for the inservice is usually a professional from outside the clinic and presents on his/her area of interest and expertise. Journal Club (1-hour/month): Trainees have the option to attend a monthly 1-hour journal club. The purpose is to engage trainees and staff in the collaborative process of examining and evaluating evidence-based literature/research. Journal articles and readings pertaining to client care are distributed and discussed. Past readings have included readings related to treatment and research of various clinical diagnoses, ethics, clinical and professional boundaries, multicultural therapy, and supervision. Articles often compliment the topics covered in the weekly didactic seminars. Cultural Responsiveness Committee: Interns are invited to participate in Hamm Clinic s version of a diversity and inclusion effort which is called the Cultural Responsiveness Committee (CRC). This committee used to be called the Cultural Competency Committee but was changed to Cultural Responsiveness Committee in an effort to stay current with the multicultural movement that one is never fully competent in multicultural issues, as it is a constant, life-long journey. Hamm Clinic s vision for cultural inclusion is to value and respect every person s culture and life story by being a healing space that is culturally responsive, inclusive, reflective and constantly evolving.

9 The CRC committee is charged to provide leadership and support as Hamm Clinic embraces culture in all facets of our work. This committee meets periodically throughout the training year, and sponsors events and trainings for staff. Psychoanalytic Case Formulation: Interns are encouraged to engage in a monthly reading group that studies Nancy McWilliams book, Psychoanalytic Case Formulation. The group runs throughout the course of the training year. It is intended to enrich and broaden interns capacity to conceptualize their work with clients, and to assist with treatment planning. TRAINING STAFF: Su Sethna, MSW, LICSW Acting Director of Clinical Services University of Minnesota, Twin Cities Campus Rachael Richardson, MSW, LICSW Clinical Social Worker University of Saint Thomas Kyle Murray, MSW, LICSW Clinical Social Worker University of Saint Thomas Toni Magnuson, MD Medical Director University of Minnesota Nicole Wolf, Ph.D., L.P. Director of Education and Training University of Tennessee, Clinical Psychology, Knoxville, TN Michael Wilke, MA, LP Staff Psychologist University of St. Thomas

10 Inquiry Inquiries regarding the Psychiatry Residency Program should be addressed to: Nicole Wolf, Ph.D., L.P. Director of Education and Training Hamm Memorial Psychiatric Clinic 408 St. Peter Street, Suite 429 St. Paul, Minnesota, Hamm Clinic is committed to fully utilizing our human resources through a policy of equal employment opportunity. We will not knowingly discriminate on the basis of any legally protected category, including race, age, color, religion, creed, sex, marital status, national origin, handicap / disability, veteran status, sexual orientation or public assistance.