Adult Core Rotations
The Adult Services program at Larue Carter Memorial Hospital provides inpatient mental health services to those with severe and chronic mental illnesses, and includes 117 adult beds with an approximate nine months average length of stay. The program adheres to a bio-psycho-social approach to mental illness and serves a diverse clinical population from across the State of Indiana. About half of the patients are diagnosed with schizophrenia, about a quarter are diagnosed with mood disorders, and the rest hold a variety of diagnoses such as personality, eating, and anxiety disorders. Patients with such difficulties as deafness, substance abuse, and medical complications are also treated on this service. Adults of all ages are treated in the hospital, with a significant portion of them geriatric patients. A large number of the current patients are both experiencing chronic mental illness along with chronic and severe physical health issues and all such challenges are a part of the hospital’s treatment mission and assignment.
There are four units for adult patients at Carter Hospital, and each of these offer differing populations and treatment activities adapted to the needs of the particular patients on those units. Each unit has its own unique interdisciplinary treatment team as well, where psychology is always represented and important to its functioning. Diversity of experience as well as patient populations is well represented on each of the various units. Adult patients are typically drawn from urban setting and many of them come from stressed socio-economic living arrangements and some are experiencing homelessness. Carter Hospital is also the designated institution for the state of Indiana to provide mental health services to those with chronic and severe mental illness who also experience the range of communication barriers, including the deaf, those that speak Spanish or Vietnamese, as well as a variety of other non-English languages. Occasionally the hospital is also involved in providing care to those with visual deficiencies and blindness. Many patients come to Carter in need of inpatient services while experiencing cognitive challenges as well as a history of developmental difficulties. A good number of patients are forensic patients as well, both in the categories of outdate from correctional facilities or as needing to be restored to competency for legal procedures.
The intern will join a multidisciplinary treatment team on one of these units and assume a wide range of clinical activities focusing on participation in specialized patient education programs for those diagnosed with such chronic disorders as schizophrenia, mood disorders, or borderline personality disorder. The intern may also have the opportunity to supervise psychology graduate students and to initiate and/or collaborate with ongoing research projects. As all supervisory psychologists at Carter Hospital are IU School of Medicine faculty members, each of the supervisors are supportive and active in some type of research activities. Interns are welcome to participate with faculty in research and publication efforts. Most recent publications and research results have focused on the treatment of those who are deaf, those with Borderline Personality Disorder, and treatment outcomes. Several supervisors are available to be assigned as intern supervision. The Director of Training will make the assignment of the intern's unit and supervisor based on intern interests among a range of factors, so a wide variety of experience is available for trainees.
The psychology intern will work with the supervisory psychologist in the assessment of newly admitted patients, provide consultation to the treatment team regarding behavioral management, and function in the role of primary therapist for select patients. In the role of primary therapist, a psychology intern typically provides individual therapy and coordinates the efforts of other members of a multidisciplinary treatment team. The intern may also participate in and co-lead therapy groups and unit meetings. Psychology interns will be exposed to pharmacotherapy issues and assist the psychiatrists and the treatment team in the process of evaluating and potentially reducing the medical regimen of patients.
The adult outpatient rotation takes place at the Adult Psychiatry Clinic and Study Center at Indiana Neuroscience Center. The IU Neuroscience Center is a tertiary care facility with nationally and internationally recognized programs in specialized medical care. General psychiatry residents as well as psychology interns rotate through the clinic, located on the IU School of Medicine campus. The clinic offers psychiatric services, including consultation-liaison services, and outpatient psychological testing and treatment. The clinic is staffed by IU faculty physicians and psychologists, social workers, and trainees in each of these disciplines. Clinicians specialize in the treatment of mood disorders, anxiety disorders, personality disorders, geriatric disorders, somatoform disorders, behavioral health issues, and women's issues. Specialty training in areas of health psychology such as psycho-social oncology and behavioral sleep medicine is offered. Additionally, interns often have the opportunity to train in consult-liaison psychology.
Interns on this rotation may have the opportunity to conduct clinical interviews and diagnostic assessments, provide individual and group psychotherapy, receive individual and group supervision, and provide supervised supervision to doctoral students in clinical psychology.
Child and Adolescent Rotations
Child and Adolescent Inpatient
The Child and Adolescent Program at Larue D. Carter Memorial Hospital provides intensive multidisciplinary inpatient treatment to seriously disturbed boys and girls, ranging from eight to eighteen years of age. The program consists of a 13-bed adolescent boys unit, an 18-bed adolescent girls unit, and an 11-bed unit for elementary school and middle school age boys and girls. Patients admitted to the Child and Adolescent Program typically have complex diagnoses, family problems, and systems of care issues. Prior to their placement at Larue D. Carter Memorial Hospital, many of these children and adolescents have previously participated in residential treatment programs, acute inpatient and partial hospitalizations, and outpatient therapy. A broad range of disorders may be treated but, in general, these are children and adolescents with disruptive behavior and mood disorders. The average length of stay for patients in the Child and Adolescent Program is intended to be six months. Patients attend a fully accredited school located on the hospital grounds. Parents are expected to participate in adjunctive conjoint and family therapy. Social-learning, cognitive-behavioral, and family-systems are the predominant theoretical orientations.
Psychology interns will participate with other treatment team members in the assessment of newly admitted patients and their parents, provide consultation to the treatment team regarding behavioral management, and function in the role of primary therapist for select patients. In the role of primary therapists, psychology interns typically provide individual therapy, participate in family therapy and coordinate the efforts of other members of a multidisciplinary treatment team including direct care and nursing staff, child psychiatrists and child psychiatry residents, social workers, activity therapists, and special education teachers. Psychology interns may also participate in and co-lead therapy groups and unit meetings. Psychology interns will also be exposed to pharmacotherapy issues and assist the psychiatrists and the treatment team in the process of evaluating and potentially reducing the medical regimen of patients in the Child and Adolescent Program.
Child and Adolescent Outpatient
The Riley Child and Adolescent Psychiatry Clinic offers outpatient mental health services to families with children and adolescents under the age of 19. Families present to the clinic with a wide range of psychiatric and co-morbid medical conditions and often with complex social situations. The child outpatient rotation is divided among a number of the specialty clinics that exist under the larger umbrella of this general clinic. Interns on this rotation will typically spend a full day in the headache clinic, a half day in the pain clinic, a full day in an intensive testing clinic, a half day in the mood disorders clinic, and one and a half days seeing general psychiatry outpatients. In all components of this rotation, the intern may have the opportunity to supervise a practicum student.
In the headache and pain clinics, interns will gain experience working as part of a multidisciplinary medical team. The headache clinic is a joint venture with Pediatric Neurology; interns will learn assessment of patients with headache, CBT intervention for headache as well as basic and advanced biofeedback skills. The pain clinic involves collaboration with anesthesiology, and provides interns with experience assessing patients with chronic pain, providing CBT and biofeedback interventions.
The pediatric testing clinic provides interns with experience providing intensive, full-day assessments to children and adolescents with complex issues involving cognitive abilities (approximately 90% of cases) and at times, issues involving personality/symptom assessment (approximately 10% of cases) . The intern is responsible for some test administration, behavior observation and test interpretation.
The pediatric mood clinic provides therapy services to children and adolescents with Depressive Disorders, Mood Disorder, NOS and occasionally, Bipolar Disorder. Co-morbidity is the rule rather than the exception; common comorbid diagnoses include ADHD, ODD/Conduct Disorder, Anxiety Disorders and Autism Spectrum Disorder. Co-occurring medical conditions are also common, and families often present with complex social situations. Treatment is conducted based on the Evidence Based Practice guidelines; individualized treatment plans are developed that incorporate, as appropriate, CBT, IPT, Behavioral Parent Training, and Family Systems interventions.
In their general psychiatry clinic time, interns will see patients from the general clinic population. Diagnoses include a wide range of typical (e.g. ADHD, ODD, Separation Anxiety) and less commonly seen (e.g. selective mutism, conversion disorder) psychiatric conditions. Co-occurring medical conditions are common.
Autism Spectrum Disorders Outpatient
The Christian Sarkine Autism Treatment Center (CSATC) is a comprehensive, hospital-based and university-affiliated treatment center engaging in clinical care, research, education and outreach activities in the state of Indiana. We are actively serving over 2,000 individuals with Autism Spectrum Disorders (ASD) of all ages, abilities, and developmental levels. The CSATC is one of only five sites in the country involved in a research study funded by the National Institute of Mental Health that is focused on parent management training for individuals with autism. Additionally, the CSATC has received government funding for a study on the relationship between social skills training and medication management for high functioning children with ASD.
Psychology interns have the opportunity to participate in a variety of clinical opportunities that include both assessment and treatment of individuals with ASD. Assessment experience will include diagnostic interviews and standardized testing experiences. The treatment focus of the CSATC is behavioral in nature with a specific emphasis on the science of Applied Behavior Analysis (ABA). Interns will carry therapy caseloads that will include multiple modalities (e.g., individual therapy, parent training), as well as a variety of presenting problems (e.g., aggression, self-injury, social skills deficits, adaptive skills training). In addition to treatment experience, interns can pursue opportunities to expand their research skills on several ongoing studies based on time and interest.
Child Consultation and Liaison
The Riley Pediatric Consultation and Liaison services offers inpatient mental health services hospital-wide. Consultation requests are received from various services including Hematology/Oncology, Rehabilitation, Gastroenterology, Neurology, Pulmonology, Neurosurgery, General Surgery, Developmental Pediatrics, Critical Care, Endocrinology, Emergency Medicine, Hospitalist and Adolescent services, and the burn unit. Our service also consults for various acute psychiatric emergencies in the outpatient pediatric specialty clinics. Psychology interns will be involved in consultation requests involving diagnostic assessment, pain management, behavioral interventions, family conflict, biofeedback, coping with chronic or terminal illness, feeding issues, pre- and post-transplant evaluations, Somatoform disorders, altered mental status and psychosis, and overdose/ingestion cases. Interns will carry an average of 4-6 cases per day, including new initial assessments and follow-up therapeutic interventions. The Pediatric Consultation and Liaison team is a multidisciplinary team which includes a full-time psychologist, psychiatrist, and two social workers. In addition, the intern will have the opportunity to work with psychiatry and triple board residents and medical students. Opportunities for supervision of graduate students and medical students are available.
The following is a list of specialty rotations that have been currently approved. Others are currently in development.
Pediatric Psychology Testing
Child and Adolescent Mood Clinic
Pain Center Specialty Clinic
Outpatient Pediatric Psychology
Child and Adolescent Inpatient
Pediatric Consult and Liaison
Adult Outpatient Psychiatry Clinic
Site Contacts for Questions
For questions about the listed core rotations, you may contact the following:
Larue Carter Memorial Hospital Rotations
Riley Child and Adolescent Psychiatry Clinic Rotations
Adult Outpatient Rotations
Autism Spectrum Disorders Rotations