Provide description of Externship:
The New York City jail system is the second largest
in the nation, with approximately 10,000 individuals aged 16 years and older
incarcerated at any given time in 12 the detention facilities (9 facilities on
Rikers Island and 3 borough jails). Approximately 55,000 patients move through
the system every year with 89% males and 11% females in the jail population
(NYC Health + Hospitals, 2016). The population is racially diverse with 54%
non-Hispanics blacks, 33% Hispanics, and 9% non-Hispanic white (NYC H+H). 43%
of the population receives mental health services, 11% are diagnosed with a
severe mental illness and 48% report substance abuse upon admission (2016).
In January 2016, the Division of Correctional Health Services (CHS) of the New York City Health and Hospitals (NYC H + H) assumed the inmates' healthcare services in Rikers Island Correctional Facilities. The psychiatric service strives to provide safe, holistic and evidence-based therapeutic interventions for the diverse range of mental health issues that face the population, from serious mental illness to the natural struggles that accompany incarceration. The service provides some of the most comprehensive and unique treatment modalities in the country, including specialty housing units for individuals with serious mental illness, a 24-hour on-call psychiatric service, robust creative arts programming, a strong DBT training program, clinics in each of the facilities, substance use treatment, integrated re-entry services, and relationships with multiple training institutions throughout the city.
The Psychology Externship Program through NYC H+H CHS offers different clinical tracks that provide opportunities to work on specialized units that serve male and female patients who present with a vast range of psychopathology and who are at different stages of justice involvement.
General information about externship site:
Director of the Program: Hung-Yi Cindy Ho, Psy.D.
URL for Externship Brochure: Please email the Director of Student Training above at firstname.lastname@example.org
Length of externship (in months): 10 months - 12 months
Start Date: Tuesday after Labor Day - 9/3/2019
End Date: 5/31/2020 - 8/31/2020
How many hours a week are expected of extern?: At least 2 days (14 hours)
# of externs to be accepted for 2019-20: 7. Please see description of each specialty tracks below
Minimum level of readiness (any prior experiences or level of training required for applicants: At least 2 years of completed course work and 1 practicum before the start of externship training
Do you provide a stipend? If so how much?: No stipend
When do you expect to begin interviews? (Applications can be submitted no earlier than Jan 22): 2/3/18
Interview process (provide information about interview process- time frame, how decisions are made) Also, do you conduct individual and/or group interviews; case presentation, other information?: Interviews are conducted individually with the panel consisting of the Director of Training and clinical supervisors for the tracks students apply to.
What application materials are required (i.e., cv, transcript, how many reference letters, case summary, test report, other?:
- Cover letter - To indicate the specific track(s) you are applying to, detail your clinical interests/experiences, goals for the externship year, and mutual fit between your goals/interests/experience and offerings of the training program. Please limit to 2 tracks per applicant.
- Updated curriculum vitae
- Graduate transcript (unofficial transcript is acceptable)
- 2 Letters of recommendation - At least one of which must be from an individual clinical supervisor closely familiar with your clinical skills, level of maturity, and personal qualities
- 1 Writing sample - Case conceptualization with identifying information redacted, except for AMKC PACE Assessment Track, please submit an integrated assessment report
Intervention and Assessment:
Intervention training experiences offered:
AMKC PACE Assessment
Unit (Adult Males 21+)
AMKC PAU Track is an 18-bed unit specifically for patients who are in need of psychological assessment. The purpose of the PACE program is to provide a robust, evidence-based therapeutic environment by offering a continuum of care to meet the diverse clinical needs of specific groups of mentally ill patients in the New York City jail system. Through the provision of intensive assessment and treatment in a tailored therapeutic milieu, the PACE unit is designed to encourage adherence to treatment and jail rules for patients who struggle to function adequately while incarcerated due to chronic mental illness, risk of acute psychiatric decompensation, and/or behavioral disruption. This specific PACE unit focuses on individualized and comprehensive mental health assessment in order to optimize treatment. Psychological testing includes personality, intellectual functioning, neurocognitive, and functional abilities. A team-based approach, that includes DOC and MH, is utilized in order to provide the best care for the patients. Interns/Externs placed at this unit are required to have psychological assessment experience and can expect to master their testing skills including tailoring assessment batteries, conducting clinical observations, analyzing assessment results, writing reports, and providing feedback to the patient and team.
GRVC PACE Acute Care Unit (Adult Males 21+)
GRVC PACE ACU is a 25-bed unit for patients who are severely mentally ill and at risk for psychiatric decompensation. PACE ACU was developed in order to provide the most effective and clinically appropriate method of deterring individuals with mental illness from Bellevue Hospital and placing them in an intensive treatment setting. The therapeutic environment is housed with an interdisciplinary clinical team, which offers tailored treatment to each individual. All members of the team, including the patient, are active participants in the creation of each treatment plan. This unit utilizes the Illness Management and Recovery (IMR) curriculum for daily groups, weekly individual psychotherapy sessions, and art therapy groups. Externs placed at this unit can expect to learn how a structured token economy can assist in medication compliance, develop individual treatment plans, conduct individual therapy, conduct groups, learn to assess danger to self and others, as well as learn the steps to hospitalize a patient, and be an active participant in team meetings.
GRVC Mental Observation Unit (MOU) (Adult Males 21+)
GRVC MOUs are two 35-bed units (70 beds in total) that provide enhanced mental health services for patients with serious mental illness. Treatment includes daily clinical rounds and group therapy, art therapy 2-3 times per week, and weekly individual therapy. Patients who require suicide watch are housed on the MO units and seen twice a day to assess risk and need for suicide watch. A Level System is utilized to reinforce treatment compliance. Various treatment modalities are utilized, including, DBT, CBT for Psychosis, Motivational Enhancement Therapy, and trauma informed treatment. The MO team engages in daily case conferences. The MO team works closely with the Bellevue Hospital Prison Ward clinical team to refer patients for inpatient hospitalization when a higher level of care is indicated, as well as providing continuity of care when patients are discharged from the hospital to Rikers Island. Externs are an integral part of the MO team and are expected to have a caseload of individual patients, assist in crisis intervention, conduct group therapy, and complete psychological assessment for differential diagnosis.
GRVC RHU (Restrictive Housing Unit) (Adult Males 21+)
GRVC RHU is a 35-bed punitive segregation unit for patients who have committed an infraction with a history of suicidal and/or self-injurious behaviors. RHU practices Dialectical Behavior Therapy (DBT) and uses this treatment modality to teach patients more effective coping skills. RHU employs a level incentive system, with level three being the highest level that corresponds to time outside of cell for daily skills-training groups, weekly individual psychotherapy sessions, milieu skills-coaching, and art therapy. The weekly DBT consultation team meeting aims to support team members and ensures fidelity to DBT principles. The weekly joint Level's Meeting with DOC and MH provides an opportunity to support consistency within the staff on the unit and group coherence. Externs placed at this unit are required to have al training in DBT or/and prior experiences with DBT and can expect to learn application of DBT in short-term individual treatment modality, conduct DBT skill-training groups, develop individual behavioral treatment plans for challenging patients and assess treatment progress, conduct risk assessment, be an active participant in the treatment team, weekly DBT consultation team meeting as well as the weekly Level's Meeting with DOC.
OBCC General Population (Adults Males 18-21)
OBCC GP is a very dynamic and fast paced track. The extern will be responsible for initial assessments, diagnostics and initial clinical interviews, as a result, ability to diagnose pathology and assess malingering will advance greatly. The greatest outcome and advantage in working in the GP unit is in the development of clinical interviewing skills, the integration of social, cognitive, cultural and legal issues in your repertoire of assessment tools needed in assessment. In addition, the extern will be able to work with a wide range of psychopathologies on a daily basis. The opportunity to carry a small caseload is available as well.
RMSC Mental Observation Unit (MOU) (Female Adults 21+)
RMSC MOUs are two 45-bed (90 beds in total) units that provide enhanced mental health services for female patients with serious mental illness. Treatment includes daily clinical rounds and group therapy, art therapy 2-3 times per week, and weekly individual therapy. Patients who require suicide watch are housed on the MO units and seen twice a day to assess risk and need for suicide watch. A Level System is utilized to reinforce treatment compliance. Various treatment modalities are utilized, including, DBT, CBT for Psychosis, Motivational Enhancement Therapy, and trauma informed treatment. The MO team engages in daily case conferences. The MO team works closely with the Elmhurst Hospital Prison Ward clinical team to refer patients for inpatient hospitalization when a higher level of care is indicated, as well as providing continuity of care when patients are discharged from the hospital to Rikers Island. Externs are an integral part of the MO team and are expected to have a caseload of individual patients, assist in crisis intervention, conduct group therapy, and complete psychological assessment for differential diagnosis.
RMSC Clinical Alternative to Punitive Segregation (CAPS)/PACE (Adult Females 21+)
RMSC CAPS is an 18-bed treatment unit for the most acute and challenging female patients who have been served an infraction by the Department of Corrections (DOC). The program is designed to encourage adherence to mental health treatment and jail rules by those who have had difficulty doing so because of serious mental illness. Through the provision of intensive treatment in a tailored therapeutic milieu, the CAPS/PACE units are designed to encourage adherence to treatment and jail rules for patients who struggle to function adequately while incarcerated due to chronic mental illness, risk of acute psychiatric decompensation, and/or behavioral disruption. RMSC CAPS/PACE patients are afforded the same mental health programming, inclusive of the points structure, individual and group therapies, and crisis management responses. The program strives to maintain or restore a patient to her highest possible level of functioning via clinical interventions. The interdisciplinary CAPS/PACE team addresses the patients' complex behaviors in a therapeutic milieu with a progressive treatment paradigm. The program strives to maintain or restore a patient to his/her highest possible level of functioning via clinical interventions. Major goals include building enhanced coping skills, improving communication, and promoting insight and competency in managing one's mental illness and emotional/behavioral dysregulation. Continuity of care and a team-based approach in laboration with DOC as appropriate is emphasized on these units. Externs placed at this unit would have training opportunities that include: individual therapy, groups, development of treatment plans, development of behavioral treatment planning, and being an active participant in the weekly treatment team meetings. Additionally, depending on the development of the RHU programming, there would possibly be training opportunities for more ally trained DBT practitioners including short-term individual treatment modality, to conduct DBT skill-training groups, to develop individual behavioral treatment plans for challenging patients and assess treatment progress.
Estimate hours/week of individual supervision: At least 1 hour/week
Estimated hours/week of group supervision: At least 1 hour/week
Estimated hour/week of didactics: 2-3 hours/week
Estimated co-therapy hours with supervisors: At last 1 hour/week
Estimated informal open door "curbside" supervision: At least 1 hour/week
Specify if observation occurs during intervention, assessment, consultation (audio, video, live in person (in treatment room, one-way mirror, live video stream): Live in-person or co-leadership in group therapy
Context of didactics (seminars, Grand Rounds): 2018-2019 sample schedule below
Orientation Workshops(2018 -2019 Academic Year)
Rikers Island & Services, Overview of Criminal Justice System, Documentation Requirements on eCW, Review of Mandatory Reporting Policies, Department of Correction, Young Adult Services, Gang Intelligence and Safety, Dual loyalty, Confidentiality, lateral Information & Communication in Correctional Setting, Creative Arts Therapy Program, KEEP and SURE Services, CIRT Program & Alternative to Incarceration (ATI), Discharge Planning & AOT, LGBTQ Issues in Correctional Setting
Didactics and Seminars (2018-2019 Academic Year)
Clinical interviewing, Diagnosis, Clinical Documentation, Psychopharmacology, Hospitalization Assessment & BHPW, Suicidal Risk Assessment, Verbal de-escalation, Violence Risk Assessment, 730 evaluation, Trauma, ASPD, DBT, DBT in correctional setting and Tx of NSSI, Malingering, Dual diagnosis/Co-occurring disorders, Self-care, Mindfulness-Based Stress Reduction (MBSR), Supervision
Testing and Diversity Seminars
Testing (monthly) and diversity seminar (bi-weekly) throughout the
Is the agency readily accessible through public transportation?: Yes
Directions to Rikers Island by Car:
- Enter "Rikers Island Bridge" in Google map or navigation system of your choice. When you are near, you will see the blue and orange Rikers Island sign on your left and a parking lot on your right on Hazen street. Please park your car in this lot, leave your cellphone in the car and board the Q100 Limited Rikers Island - Long Island City bus at the bus stop in front of the parking lot to Sam Perry Control Building ("Perry Building.")
- Perry Building will be your first stop on the island where you will exchange for a visitor's with a government issued and your school . Proceed through the security clearance and board Route Bus to your assigned facility.
Directions to Rikers Island by Public Transportation:
- Q100 Limited Rikers Island - Long Island City is the only bus to Rikers Island. It will take you across the Rikers Island bridge to Sam Perry Control Building ("Perry Building.")
- Perry Building will be your first stop on the island where you will exchange for a visitors with a government issued and your school . Proceed through the security clearance and board Route Bus to your assigned facility.
Wheelchair accessible: No
Are home visits required as part of the trainee's duties?: No
Is a transportation stipend provided?: No