Clinical Training Rotations
There are two six-month rotations, with Interns alternating these experiences. One rotation is in Dialectical Behavior Therapy (DBT) program and the other is in Applied Behavior Analysis. Interns spend 4-6 hours per week in activities for their rotation. Interns are assigned to a rotation at the beginning of the training year, in a random manner. Completion of both rotations enhances the overall “generalist” experience, by providing some exposure to these more specialized areas.
Rotation 1: Dialectical Behavior Therapy (DBT)
Interns receive didactic training in DBT at the beginning of the year. Solutions’ DBT program uses Marsha Linehan’s model (2nd edition materials), and the DBT program is designed to meet state requirements for certification in this specialized area. Andrew Hoerauf, MSW, LICSW is the clinical supervisor of this 6 month internship rotation. Clinical training activities for this rotation include:
a) Serving as co-facilitator for the DBT adult and/or adolescent groups (3 hours/week)
b) Providing individual therapy to at least one DBT client (1-2 hours/week)
c) Participating in weekly to bi-weekly DBT group supervision (1 hour/week)
The objective of the DBT rotation is for Interns to effectively co-lead a DBT group using the Linehan model.
Interns are given a list of the specific expected outcomes at the start of the rotation. Midway through, Interns are provided informal feedback as to their progress on these areas, as discussed in the Intern Evaluation section. They are again evaluated at the end of the rotation. The expected outcomes for this rotation include:
1. Shows an understanding of the paradigms of DBT, including: a) Acceptance paradigm and strategies; b) Dialectics paradigm and strategies; c) Change paradigm and strategies; and d) Can discuss DBT using “House of Hell” metaphor
2. Can understand and identify the hierarchy of target behaviors and secondary behaviors
3. Can identify and conduct steps in a chain analysis
4. Shows an understanding of the four group skills training modules and the core skills within each area (Mindfulness, Interpersonal Effectiveness, Distress Tolerance, Emotion Regulation)
5. Identifies core skills within each module
6. Demonstrates an understanding of the diary card and its purpose in the individual therapy session
7. Effective in teaching DBT skills in a group setting
8. Uses DBT protocols, including the suicide protocol
9. Provides effective supervision to the Adult Rehabilitative Mental Health Services staff
10. Provides effective consultation to the residential treatment team
Rotation 2: Applied Behavior Analysis (ABA)
Interns will receive didactic training in Applied Behavior Analysis (ABA) and autism at the start of the rotation. Dr. Jan Witte is the clinical supervisor of this rotation. Clinical training activities for this rotation will include:
a) Providing individual and group intervention (1-2 hours/week)
b) Developing assessments and treatment plans (2-3 hour/week)
c) Participating in group supervision (1 hour/week)
The intern will be given a list of the training objectives for this rotation at the start of the rotation. At the three month point the intern will be given feedback about as to his or her progress. He or she will again be evaluated at the end of the rotation.
The objective for the ABA program rotation is for Interns to develop a general understanding of Applied Behavior Analysis.
Interns are given a list of specific expected outcomes at the start of the rotation. Midway through, Interns are given feedback about their progress relative to these outcomes, as discussed in the Intern Evaluation section. They are again evaluated at the end of the rotation. These outcomes include:
1. Demonstration of ABA interventions, including: a) Discrete trial training; b) Prompting/reinforcement and proper timing; and c) Shaping and chaining procedures
2. Demonstration of knowledge of ABA assessment, including: a) Preference assessment; b) Functional Behavior Assessment
3. Demonstration of collateral assessment procedures, including: a) Vineland Adaptive Behavior Assessment interview; and b) Verbal Behavior-Milestones Assessment and Placement Program (VB-MAPP)
4. Demonstrates knowledge of the Promoting the Emergence of Advanced Knowledge (PEAK) Relational Training System assessment and curriculum
5. Develops and uses data systems in making treatment decisions
6. Develops comprehensive assessment review summaries
7. Develops treatment plans in collaboration with the child’s family
8. Demonstrates the ability to provide parent training
9. Provides effective supervision and direction to direct care staff in their implementation of ABA
10. Provides effective consultation to the autism services treatment team
Additional Training Opportunities
Additional training experiences may be available, as well as to nurture special interest areas Interns may have, through elective options, such as receiving extra on-call experience, being involved in Parent-Child Interactional Therapy (PCIT), adult psychosocial rehabilitation, Children’s Therapeutic Services and Supports, and infant mental health. These optional activities allow Interns to explore areas of interest. While none of these are required to accomplish the core competencies, they can be good supplemental experiences. To make a request to participate in these training opportunities the Intern should speak with a supervisor.