Psychology Internship Program - Training Experiences

Three primary training goals form a unifying basis for the program.  Graduates will:

1. Be prepared to enter into the professional practice of psychology.
2. Be skilled in the interface among the science, theory, and practice of professional psychology.
3. Be aware of and sensitive to individual differences and cultural diversity within areas of professional practice and scholarly inquiry.

Training Rotations

With these broad goals as a framework, the training director and other faculty assist interns to formulate individualized training plans and select from the range of training experiences listed below.  Interns and faculty collaborate to decide such issues as the duration and percentage of time that will be spent in various training experiences.

Social Learning (Dr. Coleman, Dr. Martin, Dr. Newbill)
The Social Learning Program (SLP) is an empirically-supported comprehensive psychosocial rehabilitation program designed to treat those individuals with the most severe and persistent mental disorders.  The majority of clients in the SLP have primary diagnoses in the schizophrenia spectrum.  Most are in their mid-30s or older, have never been married, and have limited educational backgrounds.  SLP rotations are available on all-male and co-ed wards in the hospital’s maximum security setting, on all-male and co-ed wards in the intermediate security setting, and on a co-ed ward in the minimum security unit.

Interns on the SLP rotation serve as a member of a multidisciplinary treatment team.  They receive supervised experience with psychological assessment and a range of clinical interventions, including individual and group psychotherapy, social skills training, cognitive rehabilitation, and case management.  They also receive training and experience in using observational assessment data to assist the treatment team with evidence-based clinical decisions and evaluation of client progress and outcomes. Other members of the treatment team work alongside the intern to enhance the learning experience.

Psychological Services Clinic, Dialectical Behavior Therapy Program (Dr. Trull, Dr. Skinner, Dr. Bell)
The Psychological Services Clinic (PSC) is an outpatient clinic that operates under the auspices of the Department of Psychological Sciences at the University of Missouri-Columbia. It is staffed by doctoral student clinicians and Ph.D. level psychologists affiliated with the Department’s clinical training program, as well as psychiatry residents and psychology interns from the University and other area training programs.  The PSC’s primary mission is to provide high quality training to doctoral students, interns, and residents, emphasizing a clinical science approach to clinical service delivery, and to provide affordable, empirically supported assessment and treatment to the community. 

Clinicians in training gain supervised experience in individual, couple, and family therapy with a wide variety of presenting concerns, as well as in various specialty groups (e.g., dialectical behavior therapy).  Interns in this rotation will participate in the PSC’s Dialectical Behavior Therapy program, which provides empirically-supported intensive outpatient services to adults with Borderline Personality Disorder and related issues (impulsivity, emotional dysregulation, etc.).  Interns will have the opportunity to co-lead groups, provide individual therapy, and participate in ongoing consultation and training with the DBT treatment team.  As interests and caseloads permit, interns may also carry cases outside of the DBT program.  This internship rotation is available as a year-long rotation, with the intern spending 8 to 12 hours per week during their internship year at the PSC.  Four to seven of these hours will be spent providing individual and group therapy.  The remaining time will be devoted to supervision, DBT consultation team meetings, and other administrative tasks. 

Psychiatric Rehabilitation (not currently available as a rotation)
The Psychiatric Rehabilitation Program (PRP) is a comprehensive psychosocial rehabilitation program based on the Boston Model developed by William Anthony, et al.  Originally developed as an outpatient treatment model, Fulton State Hospital has modified and implemented it for an inpatient treatment setting.  PRP is a client-centered approach to treatment for individuals with moderate to severe persisting mental illnesses that reconstitute relatively quickly with medication.  Diagnostically, most clients have a primary diagnosis of a thought disorder, with a significant functional psychosis.  In addition, many clients have a history of substance abuse. The client population is predominantly male, with one ward being a co-ed population.  In other ways, the population is quite diverse, with clients ranging in age from 19 to 70 years of age, and all levels of educational and vocational experience. 

Currently, this is not available as a rotation although interns may have more limited contact with clients receiving services on this program (e.g., assessment, program evaluation projects).  Information about this program is provided in order to provide a more comprehensive description of the psychosocial rehabilitation programming occurring at the hospital.

Program Evaluation (Dr. Beck)
The Program Evaluation and Research Service at FSH is charged with assisting treatment units and programs with evaluating the processes and outcomes of their treatment and rehabilitation programs, and conducting research in treatment/rehabilitation technologies and related areas.

In this rotation, interns will gain supervised experience in the selection, use, and development of appropriate program evaluation measures, and in appropriate data collection and analysis techniques.  They will assist treatment staff in developing goals, monitoring progress, and interpreting and using data as part of program-based and unit-wide program evaluation projects.  They will prepare reports of their findings. 

Much of this work requires collection of clinical data using a number of traditional psychological assessment techniques and tools (e.g., BPRS, PANSS, MMPI, Wechsler scales) as well as more recently developed observational assessments (e.g., TSBC, SRIC). 

Forensic Evaluation (Dr. Kline , Dr. Kempker, Dr. Telander)
The Forensic Examination team at FSH is responsible for outpatient and inpatient court-ordered mental evaluations, generally in connection with criminal trial proceedings.  The most common evaluations concern the client’s fitness to stand trial and/or the impact of the client’s mental disorder on his/her criminal offense. 

Interns in this rotation will begin by observing a number of evaluations as they are performed by experienced examiners, and they will gradually take responsibility for performing evaluations under the direct supervision of the primary supervisor.  This will include interviewing clients, administering and interpreting psychological tests, reviewing case history information, determining appropriate diagnoses, and formulating opinions on forensic issues such as competence and criminal responsibility.  Interns will also likely have the opportunity to observe testimony in cases depending on availability and scheduling.

Sex Offender Treatment (Dr. Maddox, Dr.Stinson)
The Sex Offender Treatment program provides group and individual treatment to clients who have a documented history of illegal or inappropriate sexual behaviors in community and residential settings. Many of these clients have corresponding diagnoses of paraphilias and involvement with the criminal justice system, as well as co-occurring intellectual and developmental disabilities, substance abuse, personality disorders, and a rnage of other Axis I psychopathology. This rotation is available across a variety of treatment programs and security levels. Assessment opportunities involving sexual history evaluations, standardized assessment of sexual interests (e.g., MSI-II), functional behavior analysis, and risk assessment for potential Sexually Violent Predators are also available.

Interns assigned to this rotation will be involved in co-facilitating sex offender treatment groups using a new manualized treatment approach.  These groups follow a model emphasizing the development of adaptive and appropriate regulatory strategies, focusing on such arreas as client motivation, self-regulatory deficits which may have contributed to a variety of problematic behaviors, skill replacement, and self-monitoring. Interns would receive training in manualized treatment, engage in related clinical activities such as providing input to assigned treatment teams and examining records for pertinent clinical information, and have the opportunity to participate in empirical validation of treatment efforts and assessment techniques used at the facility.

New Outlook Program (Dr. Robbins)
The New Outlook Program was developed to treat people with severe mood and behavioral dysregulation. Many of the people that we treat have intellectual and developmental disabilities. The primary reasons for placement in our program include severe aggression and/or self-harm behaviors. The treatment modalities in this program include Dialectical Behavior Therapy (DBT) and Positive Behavior Support. Interns interested in this rotation may choose from three training experiences. The first choice is a full Dialectical Behavior Therapy rotation which will include supervised experience in individual and group training modalities of DBT. The second choice is a primarily functional behavioral assessment rotation. This experience will include supervised training in functional behavioral assessment, behavioral support program design and implementation, and behavioral analysis groups. The third choice is a combination of DBT and behavioral assessment. All interns choosing a rotation in the New Outlook Program will be required to read Cognitive-Behavioral Treatment of Borderline Personality Disorder (Linehan, 1993) and Skills Training Manual for Treating Borderline Personality Disorder (Linehan, 1993). Interns are expected to participate in a DBT consultation team and will be assigned individual therapy cases. This program rotation will primarily occur in the intermediate security unit.

Burrell Outpatient Clinic (Dr. Beck; available as a Minor rotation only)
The Burrell Outpatient Clinic is located near a complex of clinics and hospitals run by the University of Missouri Health Sciences Center, located a five minute drive north of the Medical School and main University Hospital in the city of Columbia, Missouri. Several full and part time psychiatrists practice at the clinic, as well as a number of psychiatric social workers and a doctoral-level psychologist.

The client population is quite heterogeneous both with regard to client demographics as well as client referral and problem behavior characteristics, although most fit the severely mentally ill profile. Many clients are referred to Burrell from Department of Mental Health treatment facilities.

This rotation is available as a minor rotation only, and will comprise four to eight hours per week of the intern's time for the entire internship year. Two to six of these hours will be spent delivering individual and group psychotherapy. The rest of the time will be spent in intake screening, individual supervision, team meetings and various other administrative duties.

Seminars & Workshops
 

The internship provides a full calendar of regularly scheduled didactic experiences, with presentation responsibilities shared among the core and adjunct internship faculty.  Interns are also expected to make two to three presentations over the course of the internship year.

Research Seminar
The weekly Research Seminar is ongoing throughout the internship year and focuses on research and program evaluation projects conducted by the clinical research team (including hospital faculty members, research assistants and interns) and affiliated persons and agencies. Interns will be expected to participate in ongoing research either by collaborating in existing projects or by generating their own projects. Although we strongly advise interns to have at least proposed a dissertation project prior to the internship year, this seminar can be useful in providing assistance with the dissertation project.

Advanced Issues in Psychological Practice Treatment Seminar
Advanced issues in assessment, treatment, cultural competence & diversity, ethics, and professional issues are addressed in seminar occurring several times per month.  Seminars are designed to complement the experiential training that occurs on various rotations.  Particular emphasis is placed on empirically supported approaches to psychological practice.

Additional Opportunities

Other didactic or workshop experiences are available to interns throughout the years, including invited speakers presenting to FSH professional staff and Grand Rounds at the University of Missouri.