Ben Taub Hospital - Adult Psychology Track
***Funding Update (10/3/13): We are pleased to report that funding is now confirmed for two positions in this track for the 2014-2015 internship year.
Location: Harris Health System - Ben Taub Hospital
Ben Taub Hospital is a public facility of the Harris Health System with 650 beds serving the medically indigent population of Harris County. Ben Taub offers mental health inpatient and outpatient care including day treatment programs and an intensive outpatient program (IOP) for individuals with personality disorders and complex mood and anxiety disorders. Ben Taub is the primary teaching facility for Baylor College of Medicine. The Mental Health Service is a training site for many health care professions, including clinical psychology, psychiatry, social work, nursing, occupational therapy and pharmacy, among others. This training track will be divided into two rotations: one six-month inpatient rotation and one six-month outpatient/consultation-liaison rotation.
Assessment and Consultation
Psychology interns will conduct psychological assessments and consultations on two primary rotations at Ben Taub Hospital (BTH). One rotation (6 months) will take place on the BTH Psychiatric Inpatient Unit (PIU). For the other rotation (6 months), the psychology intern will conduct assessments and consultations as a member of the BTH Consultation-Liaison Psychiatry Service and the BTH Psychiatry Outpatient Clinic.
Inpatient Psychiatry Service: the PIU is a 20-bed, adult, co-ed inpatient psychiatric/medical unit. The PIU is the only psychiatric unit in the greater Houston-area capable of providing care for indigent patients needing psychiatric hospitalization, who also have medical conditions that frequently render them ineligible for services at other local psychiatric inpatient facilities. The unit is divided into two multidisciplinary treatment teams, each responsible for the care of 10 patients. Psychology interns are expected to become active members of each treatment team which include an attending psychiatrist, psychiatry residents, medical students, occupational therapists, a social worker, a chaplain, a dietician, a substance abuse counselor, mental health workers, and nurses. With an average length of stay of eight days, the inpatient psychiatric service admits patients during acute disturbances or crises including mania, depression, psychoses, and characterological disturbances, as well as a variety of neurologic illnesses presenting with psychiatric symptoms.
During the inpatient rotation, the intern will attend inpatient rounds four mornings per week. The function of these teaching rounds is to help formulate a diagnosis and treatment plan for each patient and to discuss each patient's treatment, progress and discharge plans. The intern is encouraged to be an active participant by interviewing patients and providing feedback to the team regarding observations during intake interviews, interaction with patients on the unit, observations during group or individual therapy, and results of psychological testing. A primary goal for each intern is to learn the team member role and consultation role of a psychologist in a hospital setting.
Consultation-Liaison Psychiatry Service: Psychology is part of a multidisciplinary C & L Psychiatry Service providing consultations to patients throughout Ben Taub Hospital. During the Consultation & Liaison rotation, the intern attends morning rounds from 8:00 am until 10:00 am. The intern then works in conjunction with Dr. Flores, psychologist in the C & L service providing bed side psychotherapy, brief psychological assessments such as suicide, depression, anxiety and cognitive screeners. The intern also provides brief psychological interventions at the bedside. Patients referred to C & L services are referred to psychological services by either the psychiatric team and/or by the medical teams. Such medical patients referred for psychological services present with primary or secondary psychiatric/psychological issues (Axis I and II). The intern provides consultation services to inform diagnoses, treatment decisions, and discharge planning as part of a multidisciplinary team by working in direct contact with a team of medical students, medical residents, social workers, spirituality as well as nursing staff. The psychology intern serves as an independent consultant to services within the hospital.
Psychiatry Outpatient Clinic: During the outpatient/consultation-liaison rotation, the intern provides psychological and cognitive assessment services to outpatients through the Psychiatry Outpatient Clinic to help with diagnostic clarification. Referrals primarily come from psychiatry and may include assessments for determination of ADHD, learning disability, intellectual and memory functioning, and dementia. The intern may conduct between two to three outpatient assessments a month. The intern will continue to gain experience expanding their knowledge using various assessment measures and with interpretation of results.
Inpatient Psychiatry Service: During their 6 months on the inpatient psychiatry service, interns are expected to provide time-limited psychotherapy services to patients who have been identified by the treatment team as likely to benefit from short-term supportive-expressive or cognitive-behavioral treatment. The intern also co-leads a daily skills training group for inpatients.
Consultation-Liaison Psychiatry Service: The intern will also have opportunities to provide time-limited psychotherapy to patients with extended medical admissions. An intern may engage in using supportive, cognitive, and integrated brief therapies with patients to address psychological issues including coping with medical illness or injury. The intern often gains experience with brief interventions for risk reduction and safety enhancement, skills training, adjustment problems, grief, treatment non-adherence, and other health psychology issues.
Intensive Outpatient Program (IOP): During the outpatient/consultation-liaison rotation, the intern serves as a primary clinician for up to two patients enrolled in the IOP, a short-term (10 week), multi-disciplinary program geared towards patients with borderline personality disorder with chronic suicidal ideation and complex mood and anxiety disorders who have tried and failed standard outpatient care. Responsibilities include providing weekly individual psychotherapy, co-leading (with a psychiatry resident) an interpersonal process group twice weekly, and attending weekly multi-disciplinary staff meetings. The purpose of our staff meetings is to discuss each patient’s treatment progress as well as our team therapeutic approach; thus, the intern is an active and vital member of our staff meetings and provides feedback regarding observations during group and individual therapy as well as share any relevant empirical knowledge to help further inform treatment planning. All IOP activities occur Monday and Friday mornings.
Support, Treatment, and Rehabilitation (STAR) Program: During the inpatient psychiatry rotation, the intern serves as a group therapist in the STAR program, a group-based, multidisciplinary program for patients who experience psychoses as part of a primary psychotic disorder or as secondary symptoms of a primary mood disorder. The intern co-leads a weekly group focusing on social skills and other interpersonal issues.
Outpatient Psychotherapy Clinic: The intern may provide short-term individual psychotherapy and group therapy to adult outpatients presenting with a wide variety of concerns.
Access to Diverse Populations
Interns have the unique opportunity to work in both outpatient and inpatient hospital settings, with patients who have a variety of psychiatric illnesses that are frequently complicated by major health issues. Psychiatric problems addressed vary greatly in terms of severity and diagnoses; however, Ben Taub often treats some of the most treatment resistant patients in the greater Houston area.
Ben Taub provides excellent representation of the sociocultural diversity that exists within Houston, and patients receiving services often reflect underserved populations. Approximately 75% of patients served are racial/ethnic minorities, with approximately 40% receiving treatment under indigent or charity care and another 40% under Medicaid or Medicare. Spanish is the most spoken foreign language among patients. As Houston has one of the largest Vietnamese populations in the United States, Vietnamese is the second most spoken foreign language among patients. Among the psychology faculty at Ben Taub, two psychologists speak Spanish fluently and a third psychologist is fluent in Vietnamese. Interpreting services are also available in 150 different languages, offering interns the opportunity to develop skills working with interpreters.
Various faculty members at Baylor College of Medicine are engaged in research and publication. Current research interests of the faculty include: issues of diversity/multiculturalism, severe psychopathology in racial and ethnic groups, and positive psychological processes. Interns are encouraged to become involved in ongoing research projects at Ben Taub and are also expected to make use of the scientific literature on assessment, case conceptualization, and treatment planning in their clinical activities.
Supervision & Didactics
Araceli Flores, Ph.D. - Dr. Flores supervises the Consultation and Liaison Service activities, which include consultation, assessment, and brief therapy with medically-ill patients. She is also the Ben Taub Psychology Fellowship Training Director and serves an administrative role authorizing leave and addressing issues specific to the Ben Taub experience.
Phuong T. Nguyen, Ph.D. - Dr. Nguyen is the Internship Training Co-Site Director and the supervising psychologist for interns on the inpatient psychiatry rotation. He works primarily in the psychiatric inpatient service, teaching both a team member role and the consultation model for the intern. Dr. Nguyen also leads the Advanced DBT Group, is the DBT Consultation Team Leader, and is the Program Director for the STAR Program.
Jeannine Tamez, Ph.D. - Dr. Tamez is the Program Director for IOP and Internship Training Co-Site Director. She supervises interns during their rotation for outpatient services. Her supervision style allows for more of a developmental model for supervision. Thus, she helps the intern identify what stage of clinical development they are currently at and, with support and feedback, helps facilitate the intern’s progression to the next stage in their clinical development.
DBT Consultation Team - Members of the DBT Consultation Team meet once a week to provide peer supervision, to discuss and problem-solve difficult cases, and to provide validation and support to fellow clinicians. Interns are encouraged to be active members of this consultation team and to seek peer supervision whenever necessary.
Weekly Psychology Team Meeting - This time is used as a weekly check-in for psychology team members. Supervisors, Postdoctoral Fellows, and Interns are encouraged to utilize this supportive space to discuss and address issues that might arise during the training year. Topics of discussion have included patient risk assessment, treatment strategies, licensing process, and administrative issues. Additionally, a formal didactic component is integrated into the psychology team meetings. Team members periodically present on a variety of topics that are relevant to their clinical work or are of particular interests to team members.
Postdoctoral Fellows may also provide additional supervision for interns.