Interns provide treatment and testing services throughout the year in the Ambulatory Behavioral Health Services and Child/Adolescent Outpatient Clinics. In addition, throughout the year, interns select and rotate through four 3-month major rotations, described below.
Ambulatory Behavioral Health Services
The Ambulatory Behavioral Health Services (ABHS) provides an array of outpatient psychiatric services and is comprised of several specialized clinics for the treatment of adults experiencing a wide range of mental health problems. The clinic also houses the Methadone Treatment and Chemical Dependency Program. Psychology interns work in ABHS on a part time basis for the entire training year. Their primary responsibilities include providing individual, group, and family therapy. They also conduct psychological testing cases in the outpatient clinic. They will be conducting therapy sessions in-person and/or via telehealth (video platforms or telephonically).
Staffing: ABHS is staffed by multi-disciplinary teams of mental health professionals including psychiatrists, psychologists, social workers, community liaison workers, caseworkers, activity therapists and nurses.
Chemical Dependency and Methadone Program in ABHS
Description of service: The Chemical Dependency and Methadone Program provide outpatient psychiatric services for individuals and families to help with recovery from opioid use disorders and other substance use disorders (OUD/SUD). Based on one of our federal grant’s funding, interns on the OUD/SUD track will provide treatment by co-facilitating Seeking Safety groups.
Staffing: The clinic is staffed with a psychiatrist, social workers, nurses, and Credentialed Alcoholism and Substance Abuse Counselors (CASACs).
Child/Adolescent Outpatient Clinic
The Child/Adolescent Outpatient Behavioral Health Clinic provides outpatient services to children and adolescents. Psychology Interns’ primary responsibilities include providing individual psychotherapy to patients ranging in age from 5-20. Some interns will have the opportunity to conduct family therapy and/or group therapy for appropriately referred patients. There are also opportunities to conduct psychological testing to help clarify diagnosis. Therapy sessions are conducted both on an in-person basis and virtually, depending on the needs and situation of the patient. Finally, interns may have the opportunity to take part in the Child and Adolescent Rapid Evaluation Services (CARES) program, which helps ensure that appropriate initial evaluations (intakes) are done for patients recently referred from the community, our CPEP or inpatient units.
Adult Inpatient Unit
Dual Diagnosis Inpatient Unit
Women’s Forensic Inpatient Unit including Court Clinic
Adolescent Inpatient Unit
Consultation Liaison Service (C/L)
Comprehensive Psychiatric Emergency Program (CPEP)
Child/Adolescent Partial Hospitalization Program
Outpatient Integrated Care (Adult Medical Primary Care and Infectious Diseases Clinic)
Adolescent Collaborative Health (Adolescent Medical Primary Care) including Child Abuse/Sexual Abuse (CASA) Clinic and Pediatric Consultation Liaison (Peds CL)
DESCRIPTION OF ROTATIONS
Elmhurst Hospital Center is a training hospital affiliated with the Mount Sinai School of Medicine; as such some of the units serve as a training rotation for psychiatric residents, child psychiatry fellows, clinical psychology interns, and medical students. Interns are provided with a rich learning experience in which teaching and training are an integral part of most units.
Inpatient Units (Adult Inpatient, Dual Diagnosis, Adolescent Inpatient, Women’s Forensic Inpatient):
Inpatient units serve a diverse patient population with respect to race, culture, ethnicity, age, gender and psychiatric diagnosis. Inpatient services provide assessment and treatment to patients on the inpatient psychiatric units with a broad range of psychiatric diagnoses.
The Adolescent Inpatient Unit serves a varied patient population, including patients presenting with suicidality and self-injurious behaviors, mood disorders, conduct disorders, personality disorders, psychotic disorders, and developmental disorders. There are a small number of court-remanded adolescents who require psychiatric evaluation before returning to court. This unit places an emphasis on the evaluation and psychotherapeutic treatment of trauma and attachment disorders.
The Adult Inpatient Unit is a 22 to 26-bed service serving a broad age range and variety of diagnoses. Interns collaborate closely with the interdisciplinary team and individual and group psychotherapy are emphasized on this rotation. There is also the opportunity to facilitate family meetings and learn more about the interface of the medical and legal systems.
The Dual Diagnosis Unit has a similar training experience to the Adult Inpatient Unit in many ways, but also provides individual and group treatment specific to substance use disorder, including addiction recovery groups, peer support groups, and individualized addiction treatment for inpatients suffering from both severe mental illness and substance use problems.
The Women’s Forensic Unit is similar in its mission as the other inpatient units, but is specialized in regards to the patient population who are women and come to EHC either pre-arraignment (in NYPD custody) or from the Rikers Island jail facility. The interaction between mental health issues and the legal system is a constant consideration. Collaboration with attorneys, diversion programs, and Rikers Island staff occur regularly. Malingering assessment tools are utilized to diagnose malingering and factitious disorders. Competency evaluations are also conducted. Monthly multidisciplinary team meetings are held at Rikers Island. This rotation includes a sub-rotation through the Brooklyn Forensic Psychiatric Evaluation Court Clinic (FPECC). Interns will observe and conduct court-ordered psychiatric evaluations of adult criminal defendants related to competence to stand trial or pre-sentencing investigation. Interns collaborate with lawyers, psychiatrists and psychologists.
Staffing: All inpatient units have a multi-disciplinary staff and clinical team, including behavioral health associates, nurses, nurse practitioners, creative arts/activity therapists, social workers, psychiatrists, and psychologists. Staffing also often includes psychiatry resident and fellows, clinical psychology interns, social work interns, medical students, and physician assistant students.
The Consultation Liaison service provides psychiatric consultation, assessment and treatment to patients on inpatient medical units. Evaluations conducted include capacity to make medical decisions. Interns evaluate patients with primary Axis I and II psychiatric disorders, as well as psychological problems secondary to a medical illness or situational stressor. Interns provide bedside psychotherapy to patients who may benefit from this service.
Staffing: Two psychiatrists run the service along with psychiatric residents and psychology interns. The interns on this service are supervised by the psychiatrist on the service as well as a psychologist on the faculty.
Comprehensive Psychiatric Emergency Program (CPEP)
The Psychiatric Emergency Room serves a diverse patient population with respect to race, culture, ethnicity, age, gender and psychiatric diagnosis. The Psychiatric Emergency Room provides consultation to patients in need of acute psychiatric evaluation. After initial triage by nursing staff the patient is evaluated by the clinician, as well as by the staff psychiatrist. After a diagnosis is arrived at, a treatment plan and disposition are determined. The patient may be discharged, hospitalized or continue to be observed in the emergency room for a maximum of 72 hours.
Staffing: The Psychiatric Emergency Room is staffed by psychiatrists (adult and child), a psychologist, social workers, nurse practitioners, nursing staff, as well as assistant coordinating managers. Staffing also includes at times psychiatry residents, clinical psychology interns, and medical students.
Child/Adolescent Partial Hospitalization Program
Outpatient Integrated Care (Medical Primary Care and Infectious Diseases Clinics)
Psychiatrists and social workers are located within the primary care setting to improve medical outcomes, reduce admissions to the hospital, and to identify patients in need of therapeutic intervention. Psychology interns will see patients within primary care settings including internal medicine and the Infectious Diseases Clinic for screening, assessment and short term psychotherapy.
Staffing: This rotation is run by an attending psychiatrist. A psychologist in will provide supervision. Primary care physicians, nurses, and social workers will also be providing patient care and collaborative training for interns.
Adolescent Collaborative Health (including CASA Clinic and Peds CL)
This rotation includes three hospital based services including Collaborative Care, CASA Clinic, and Pediatric Consultation-Liaison services: Patients seen for collaborative care are screened in the clinic for depression and anxiety by their primary care physician. Psychology interns on this rotation provide referred patients with brief psychotherapy once a week. Interns meet regularly with a staff of medical doctors and social workers to review cases in need of treatment. The treatment primarily focuses on skills-based intervention to improve coping strategies and interpersonal effectiveness. Psychology interns will also work in the CASA Clinic which serves an advocacy role with legal, child welfare, and law enforcement agencies and includes a parental education component for the prevention of child abuse. Interns are trained in Child Abuse/Sexual Abuse assessment and interviewing on an interdisciplinary team of social workers, medical providers, and case workers or patient advocates. Interns develop their skills for trauma-specific assessment and conceptualization of cases through a trauma informed lens, as well as psychoeducation for families and caregivers related to prevention of childhood trauma and abuse. Additionally, interns will gain experience on with Pediatric Consultation Liaison services. Working alongside a resident and supervised by an attending, interns gain experience in assessment of pediatric patients in medicine who require psychiatry consults. Interns are also able to provide bed-side therapy services for the length of the patients medical stay. Assessments will seek to determine if the patient requires psychiatric inpatient hospitalization.
Staffing: This rotation is run by a pediatricians as well as the supervising social worker and additional social worker. Therapy is done by the psychology intern and a staff social worker. A psychologist in ABHS will provide supervision. Pediatricians, nurses, and social workers will also be providing patient care and collaborative training for interns.
Staffing: This rotation is supervised by the Healthy Steps Specialist/Psychologist. Psychology interns will work closely with the pediatric providers as part of the treatment team.