Training Experiences

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

Training Requirements at-a-Glance

  1. Complete two, 6-month major and minor rotations. (The intern schedule is described at further length in the intern handbook.) Interns are to receive two hours of individual supervision per week (one hour for each rotation).
  2. Complete a minimum of 625 (30%) hours of direct client care mostly compromising of individual therapy, group therapy, and evaluations.
  3. Complete and "pass" 10 psychological evaluation reports covering multiple testing domains (i.e., intellectual/cognitive, personality, neuropsychological, malingering, functional behavior assessment, sex offender, and risk assessment).
  4. Present four case presentations throughout the training year, one per quarter. Two case presentations should pertain to an individual therapy case and two should pertain to a testing case.
  5. Attend weekly, two-hour didactic seminars. Seminars occur every Friday from 1:00pm-3:00pm in the Administration Building Conference Room. Interns are to complete evaluations of the seminar (anonymously) and return to the Training Director at MS 320. 2011-2012 Seminar Schedule.
  6. Attend weekly, one and one-half hour research meetings. Research meetings occur every Friday from 3:00pm-4:30pm in the Administration Building Conference Room.
  7. Attend monthly, one and one-half hour meeting of the Cultural Competence Council. The Council meets every third Wednesday from 1:30pm-3:00pm in the Administration Building Conference Room.

For additional information regarding internship training requirements, please see the Internship Handbook provided as link on this website.

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. Our internship utilizes a flexible approach to training, allowing interns to craft a training plan that best fits their needs.

Forensic Evaluation (Dr. Kline & Dr. Telander) - Major Rotation

The Forensic Examination team at FSH is responsible for completing outpatient and inpatient court-ordered mental evaluations. During this rotation, the intern will be exposed to forensic evaluations of defendants in the State of Missouri. The evaluation process will focus on several legal questions commonly asked by the Court. These common questions include the issue of competency to stand trial, mental state at the time of the alleged criminal conduct (or criminal responsibility), risk assessment for sexual violence, and risk assessment for physical violence. Other questions sometimes posed by the Courts include issues pertaining to Battered Spouse Syndrome, Diminished Capacity, and issues pertaining to sentencing recommendations. The intern will work with both supervisors in observing and performing forensic evaluations, though one supervisor will be assigned to oversee the completion of forensic reports. The intern will review hospital records, police reports, and collateral records and then participate in an evaluation interview and testing. As the rotation progresses, the intern will take on more responsibility for the interview and information gathering progress, culminating in the intern performing evaluations from beginning to end. Throughout the training experience the intern will write reports of the evaluation results; detailing the psychological and legal issues that are pertinent to the court. Also, the supervisor may co-sign and submit to the Court some of the intern’s completed evaluations. Finally, interns will have the opportunity to witness testimony of the Forensic Evaluation Examiners in a variety of cases. There are two tracks for this rotation. On track one, interns will be more involved in the competency restoration process and facilitate groups on the competency restoration ward.  Track two focuses mainly on forensic evaluations and psychological assessment.  Please see the 2011-2012 internship handbook for more details.

Intellectual/Developmental Disabilities (Dr. Robbins) - Major Rotation

Fulton State Hospitalservesa number of clients with intellectual and developmental disabilities, including Moderate Mental Retardation to Borderline Intellectual Functioning, and with additional diagnoses of Pervasive Developmental Disorders like Autism and Asperger‘s. These clients present with a wide array of other treatment concerns, including personality psychopathology, symptoms of mood disorder, and impulsive and problematic behaviors. The intern will learn the treatment program for New Outlook, a new approach that applies Dialectical Behavior Therapy and Positive Behavior Support. The intern will be supervised in providing group and individual therapy and comprehensive behavioral assessments by the primary rotation supervisor as well as the facility’s Board Certified Behavioral Analyst. The intern will also assist in the development of individualized treatment plans, emphasizing principles of Positive Behavior Support. Interns will be expected to participate in the treatment milieu as part of a multidisciplinary treatment team, which includes regular team meetings and team reports and ward activities with the clients. Additional training, treatment, or assessment opportunities may also be offered to supplement the intern’s learning experience, depending on his or her specific interests or learning objectives. The intern will meet with the rotation supervisor at least one hour per week.

New Outlook Program (Dr. Robbins)- Major Rotation

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, sex offending behavior, and/or self-harm behaviors. The treatment modalities in this program include Dialectical Behavior Therapy (DBT) and Positive Behavior Support. Interns on this rotation will receive training and supervision in providing DBT in an inpatient forensic setting. Interns will provide individual DBT therapy, group DBT skills, participate in DBT consultation team, and provide coaching. Additional experiences include case management, multidisciplinary treatment team, program development, functional behavioral assessment, and writing behavioral support plans. 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).

Psychiatric Rehabilitation (Dr. Bucklew) - Major 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 (FSH) has modified and implemented it for an inpatient treatment setting. The PRP at FSH uses client-centered methods of interaction to move clients through the rehabilitation phases of Engagement, Readiness, and Choosing and Achieving. This is an evidence-based approach that has been found successful in a variety of settings for individuals with moderate to severe persisting mental illnesses that reconstitute relatively quickly with medication. In this rotation, interns will serve as a member of a multidisciplinary treatment team providing services to adult clients residing on the Psychiatric Rehabilitation Program. Interns will gain supervised experience with a range of clinical interventions, including psychological assessment, individual and group psychotherapy, social skills training, cognitive rehabilitation, and case management. Other members of the treatment team work alongside the intern to enhance the learning experience.

Sex Offender Treatment (Dr. Stinson) - Major Rotation

The Sex Offender Treatment program provides group and individual treatment to clients who have a history of illegal or inappropriate sexual behaviors in community and residential care 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 range of other Axis I psychopathology. This rotation is available across a variety of treatment programs and security levels. 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 areas as client motivation, self-regulatory deficits which may have contributed to a variety of problematic behaviors, skill replacement, and self-monitoring. Interns will also have the opportunity to provide individual therapy services to sex offending clients, conduct risk assessment evaluations to determine readiness for transfer to a less restrictive placement, and collaborate with treatment teams to assess client progress and treatment needs.

Social Learning (Dr. Martin & Dr. Johnson) - Major Rotation

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. The SLP is modeled after the evidence-based approach developed by Dr. Gordon Paul. 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.

Assessment - Minor rotation

The ability to formulate and answer important questions regarding psychopathology, cognitive functioning, behavior, and treatment needs are a crucial component of intern training at Fulton State Hospital. Interns will complete a minor rotation focusing on assessment techniques and strategies to accomplish this training goal. Interns are expected to complete 10 psychological assessment reports as part of this rotation, utilizing instruments from a variety of domains. This rotation is supervised by an assigned member of the internship faculty and is designed to expose the intern to diverse assessment needs facility-wide.

Program Evaluation (Dr. Beck) - Minor rotation

The Program Evaluation and Research Service at FSH is charged with assisting the executive leadership team at FSH with assessing the cost and effectiveness of facility treatment and rehabilitation programs, as well as evaluating and developing new treatment/rehabilitation technologies and related techniques. 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 to the executive management team. Co-authorship of resulting manuscripts and conference presentations is available for interested interns.

Didactic Training & Research Seminars

The internship provides a full calendar of didactic experiences that occur two hours each week. Presentations are offered by members of the Internship Training Committee as well as special guests from the Department of Mental Health and the community. Seminar topics include advanced issues in assessment, treatment, cultural competence, diversity, and ethics as well as professional issues. Seminars are specifically designed to complement the experiential training that occurs on various rotations. Particular emphasis is placed on empirically supported approaches to psychological practice. Other didactic or workshop experiences are available to interns throughout the year, including invited speakers presenting to FSH professional staff and Grand Rounds at the University of Missouri.

Cultural Competence Council

Fulton State Hospital’s workforce is comprised of a diverse population not dominated by one gender, race, or even culture. Our hospital and its leadership embrace this diversity and strive to create a safe workplace environment attractive to staff of all backgrounds. The leadership wants everyone to work together in a climate of respect and appreciation for the uniqueness that every individual brings. This includes employees, visitors, and especially the individuals we serve. Interns are strongly encouraged to participate in FSH’s Cultural Competence Council. The Council meets once per month and is involved in a variety of activities and projects throughout the campus. The Council is charged with implementing this philosophy and supporting the belief that all people must be valued because of their humanity, unique abilities, perspectives, and skills. The mission statement of the Cultural Competency Council reads as follows: This council is to make available continuous education for staff and patients related to Cultural, Ethnic and Spiritual needs, relevant to the facility’s Mission, Vision and Values statement. The responsibilities of the Cultural Competency Council include: