Acceptance and Mindfulness-Based Partial Hospital Program – Rhode Island Hospital

Faculty Supervisor(s): Core Supervisors - Laura Fischer, PhD (Primary), Hannah Herc, PhD, Danielle Cohn, PhD, Shereen Khoo, PhD; Additional Supervisors - Joseph Donahue, PhD, Christina Mele, PsyD, Rachel Depner, PhD, Laura Fischer, PhD, Cazzie Steinzor, PhD, David Forman, PhD, Russ Marks, PhD, Alex Brake, PhD, Rachel Ojserkis, PhD, Helen Day, PhD, Sarah Schmidhofer, MD, Kristy Dalrymple, PhD

The Acceptance and Mindfulness-Based Partial Hospitalization Program at Rhode Island Hospital (RIH PHP) is a telehealth program that serves adults aged 18 years and older who present with a range of psychological problems, including mood, anxiety, PTSD, and personality disorders.  The primary treatment model is based in Acceptance and Commitment Therapy (ACT), although other empirically supported behavior therapies, including Dialectical Behavior Therapy (DBT) and ACT-enhanced exposure therapy, are also integrated as indicated.

The partial hospital runs from 8:00 AM to 2:00PM Monday through Friday, and the average length of stay for patients is 2-4 weeks.  Patients attend 3 groups per day, providing them with skills in: values and goals clarification; greater acceptance towards difficult feelings and thoughts while engaging in meaningful behaviors; improving interpersonal relationships; and increasing mindfulness and other coping behaviors.  Two of the three groups are 45-minute-long skills groups, and the third group (interpersonal therapy) is 90 minutes.  Patients also receive individual therapy and medication management sessions on an almost daily basis.  Individual therapy sessions are approximately 30 minutes each. The program includes four treatment tracks: (1) general track, (2) trauma/PTSD, (3) young adult issues, (4) borderline personality disorder/emotion regulation difficulties, and (5) co-occurring substance use issues. Residents rotate through the general track.

This rotation is focused on clinical psychology residents developing proficiency/mastery in delivering ACT within a generalist framework. Clinical psychology residents will only provide didactic skills groups in the general track but may have individual clients who are in the young adult or emotion regulation tracks. Residents will not have individual patients who are in the trauma track but may collaborate with trauma track providers on referrals or have patients with trauma related issues who are a better fit for the general track. Residents will have frequent opportunities to collaborate with staff psychiatrists and psychologists and will participate in weekly team meetings/case consultation.

Given the virtual nature of the PHP, residents are required to follow Brown’s tele-supervision policy such as working at the office at least 2 days a week and obtaining at least 1 hour of in-person supervision a week.
 

Alcohol and Drug Treatment Services Program - Butler Hospital

Faculty Supervisor(s): Deb Herman, PhD & Morganne Kraines, PhD

The Alcohol and Drug Partial Hospital Program (ADP) is a treatment program for people who have already completed detoxification.  It is located in the Day Hospital, staffed by a multidisciplinary team, and involves the treatment of a maximum of 25 patients.  Patients attend weekdays from approximately 9:00 a.m. to 2:30 p.m., during which they participate in a variety of group sessions, individual counseling, and pharmacology visits with a psychiatrist.  Group sessions combine psychoeducation and cognitive behavior approaches, and focus on a functional analysis of drinking, drug use and associated problem behaviors; implementation of self-control procedures; goal setting; relapse prevention strategies; and family education.  Patients meet with their individual counselors daily and their psychiatrist at least twice per week.  Discharge planning is individualized, and typically involves step-down care, use of 12-step programs, and individual counseling. The average patient stay is 5-10 days.  Clinical psychology residents are involved in all areas of the program, and lead groups, provide individual counseling, provide family meetings as applicable, complete intake evaluations and attend team meetings.

Collaborative Addiction Recovery Services - Providence VA Medical Center

Faculty Supervisor(s): Jayne Kurkjian, PhD (primary) & Corinne Bart, PhD 

The Collaborative Addiction Recovery Services (CARS) rotation at the Providence VA Medical Center is designed to allow the clinical psychology resident to develop skills in the psychological assessment and treatment of substance use disorders with a focus on acquisition of group therapy skills, taking into account the special needs for holistic, integrated care in this population. 

Organized within the Mental Health and Behavioral Sciences Service of the Providence VA Medical Center, CARS is a multifaceted program that provides, via its interdisciplinary treatment team, services that encompass the entire continuum of care in the treatment of addictive behaviors. CARS either directly provides or has access (via in-house referral, referral to other VAMCs in the region, or referral to private sector treatment resources) to the following services: comprehensive intake assessment, treatment planning and case disposition; CARS Consultation-Liaison Clinic (servicing the medical/surgical areas of the Medical Center); outpatient motivational drop-in group; inpatient detoxification; inpatient substance abuse rehabilitation; CARS Intensive Outpatient Treatment Program; evidence-based individual and cognitive behavioral group outpatient psychotherapy including CBT groups for Relapse Prevention, Anger Management Group, ACT Group, SUD/Depression Group and other groups focused on coping skills training; outpatient psychiatric and medication management services; Aftercare Group Program; and Opioid Treatment Program. Some services are offered via the VA's telehealth platform. 

Patients serviced by CARS present with a wide range of DSM-5 Substance-Related Disorders (usually severe and long-term in nature), often carry multiple DSM diagnoses, and typically have concomitant physical conditions that directly relate to their Substance-Related Disorder (e.g., chronic pain). CARS strives to provide addiction treatment that is well-integrated with patients' concurrent primary medical care (typically also provided in the Medical Center). 

Intensive Outpatient Program for OCD and Anxiety Disorders - Butler Hospital

Faculty Supervisor(s): Aaron Kaiser, PhD, Brandon Gaudiano, PhD, & Yael Schonbrun, PhD

The OCD and Anxiety Disorders Intensive Outpatient Program is a specialized program designed to help adults experiencing persistent obsessive compulsive disorder (OCD), intense fears (phobias), panic disorder, health anxiety, and social anxiety. Grounded in an exposure-based CBT model of treatment, the program is geared towards patients who have not responded to traditional outpatient treatment. Treatment takes place Monday through Thursday (1:45pm – 5pm), over an average 7 week period. Patients in this program receive individual therapy, daily group therapy, as well as home-based ERP, family consultations, and expert psychiatric medication consultation. Clinical psychology residents will participate and receive supervision in all aspects of program procedures. At the Inpatient Assessment Center (IAC; Psychiatric Emergency Room), residents will observe and conduct intake evaluations and discuss disposition decisions with IAC clinicians. Treatment services are delivered in-person.

Inpatient and Family Therapy Program – Rhode Island Hospital

Faculty Supervisor(s):   Rebecca Troeger, PhD, Tanya Tran, PhD, Alison Goldblatt, PhD,  & Gabor Keitner, MD

The Inpatient Unit & Family Therapy Program at Rhode Island Hospital provides intensive psychiatric treatment for outpatients and inpatients with a special emphasis on involving families in treatment and a biopsychosocial approach. Each inpatient is treated by a multidisciplinary team, which formulates a treatment plan that is tailored to the specific needs and problems of the patient. Treatment is multidimensional and may involve combinations of individual psychotherapy, group therapy, family therapy, and psychopharmacological treatments. Clinical psychology residents sit in on daily rounds with the treatment team, in addition to having their own caseload of individual patients and groups. On-site inpatient supervision is provided by Dr. Gabor Keitner, and individual and group therapy cases are supervised by Tanya Tran, PhD.  One afternoon a week, clinical psychology residents also participate in the outpatient family therapy clinic through the Family Therapy Program.  Supervised by Alison Goldblatt, PhD, and Rebecca Troeger, PhD, the clinic uses the McMaster approach to assess and treat families and couples using an observation and co-therapy model.  Residents sit in on sessions and become more active in co-therapy as the rotation progresses. As part of clinical psychology residents’
experience on the inpatient unit, it is possible that weekend coverage may be included, which provides an opportunity to see a much broader range of patient problems. The frequency of the weekend coverage varies depending on how many medical students and clinical psychology residents there are (e.g. one in three weeks to one in six weeks).

Perinatal Mental Health Rotation – Women & Infants Hospital

Faculty Supervisor(s):  Maggie Allen, PhD & Gina Erato Garza, PhD 

The Perinatal Mental Health rotation at Women and Infants Hospital offers clinical psychology residents a unique opportunity to develop expertise in the assessment and treatment of psychiatric disorders during pregnancy and the postpartum period. The rotation includes two innovative services that were among the first of their kind in the country: the Perinatal Day Hospital, which provides partial hospital treatment for a broad range of perinatal psychiatric disorders, and a specialized Perinatal OCD and Anxiety Disorders Intensive Outpatient Program. A defining feature of both programs is the opportunity for caregivers to remain with their infants throughout treatment, supporting the caregiver-infant bond while allowing clinicians to directly observe and address the ways in which mental health symptoms may affect parent-child interactions. In this dynamic, fast-paced setting, residents will be involved in all aspects of treatment, including providing group therapy, carrying an individual psychotherapy caseload, conducting intake evaluations and family meetings, and participating in collaborative treatment planning. The rotation provides residents with rich exposure to perinatal psychopathology, evidence-based interventions, multidisciplinary care, and the unique clinical considerations involved in treating psychiatric illness during pregnancy and the postpartum period.

Trauma Recovery Services (Post Traumatic Stress Disorder) Rotation - Providence VA Medical Center

Faculty Supervisor(s): Lauren Reeves, PhD, Julia Paulson, PhD, & Jerin Lee, PhD

In the Trauma Recovery Services (TRS) rotation, the clinical psychology resident learns, through direct participation, how to manage individuals suffering from trauma-related disorders, including PTSD, as well as other acute psychiatric and substance abuse problems. The TRS clinic at the Providence VA Medical Center is an outpatient treatment program for Veterans suffering from PTSD symptoms related to their military service as well as non-military traumas. Veterans receive a comprehensive diagnostic assessment and then engage in a treatment program with an emphasis on evidence-based interventions. Clinical psychology residents will participate and receive supervision in all aspects of program procedures. We primarily offer individual psychotherapy, with occasional groups being offered. Veterans in the program also present with many difficulties that co-occur with PTSD such as substance abuse, depression, and sleep disturbance. Some of the TRS staff participate in research projects and clinical psychology residents may have an opportunity to learn about ongoing research protocols during team meetings.

Acute Psychiatric Care (APC) Program Rotation - Butler Hospital

Faculty Supervisor(s): Christopher Hughes, PhD, Madeline Benz, PhD, Yael Schonbrun, PhD, Patrick Schule, MD, & Raja Akhtar, MD

The Acute Psychiatric Care (APC) rotation is comprised of multiple settings at Butler Hospital.  The APC rotation is focused on short-term psychological and psychiatric treatment of adults with significant mental health concerns. On the psychiatric inpatient unit, clinical psychology residents will attend team meetings and rounds, lead groups, conduct individual psychotherapy, conduct the Safety Planning Intervention (SPI) with patients, and attend family meetings as applicable. At the inpatient assessment center (IAC; psychiatric emergency room), residents will observe and conduct intake evaluations and discuss disposition considerations with the attending physician and IEC clinicians. If interested, the clinical psychology resident may have the opportunity to observe Transcranial Magnetic Stimulation (TMS) sessions and intakes at Butler Hospital’s TMS Clinic.