AGENCY DESCRIPTIONNature of Agency
Heritage Clinic (A.K.A. The Center for Aging Resources) is a gero-psychological center for older adults and their families. Services include in-home psychotherapy for homebound seniors; individual and group psychotherapy for older adults in the clinic; and psychological assessment.
Heritage Clinic’s services focus on reducing risk of premature institutionalization and on reducing barriers to service often experienced by older adults. Thus, services are offered in nontraditional manners, including providing services in clients’ homes, extending services when clients may be hesitant to receive services (clinical mental health outreach), assisting those who have limited cognitive ability (service to persons with dementia), have a wide range of ethnicities, and have low incomes..
Heritage Clinic’s mission is “to promote psychological healing and improve the quality of life of older adults who experience emotional or mental difficulties,” which is accomplished through the “provision of excellent direct services based on sound research and contributing to the development and training of mental health professionals.”
The Center’s services focus on reducing risk of premature institutionalization and on reducing barriers to service often experienced by older adults. Thus, services are offered in nontraditional manners, including providing services in clients’ homes, extending services when clients may be hesitant to receive services (clinical mental health outreach), have limited cognitive ability (service to dementia patients), serving multi-ethnic clients, and serving low income individuals. Heritage Clinic (the Center for Aging Resources) began operations in 1979 in the county of Los Angeles. For 22 years, it was a department of, and a training clinic for, Fuller Seminary’s Graduate School of Psychology. The Center amicably separated from Fuller in 2001 in order to expand its service mission for the older adult community. Heritage Clinic in Pasadena was a CAPIC approved pre-doctoral psychology internship site and is currently an APA accredited pre-doctoral psychology internship site. Heritage Clinic in Mission Gorge, San Diego started to accept MSW interns from San Diego State University from 2009 and psychological interns from Alliant International University from 2010. Population Served Heritage clinic focuses on serving disenfranchised older adults for whom financial, cultural, linguistic, physical and/or other barriers prevent access to traditional mental health services. It serves older adults. Many are of low income and varied ethnicity. Clients are eligible for services regardless of race, ethnicity, sexual orientation or religious affiliation. Services are offered in varied languages, including Spanish. Many clients are homebound. Clinical issues include: physical disability, chronic illness, crime victimization, elder abuse, domestic violence victims/perpetrators, and a broad range of psychopathology (depression, anxiety, PTSD, personality disorders, psychosis, psychosomatic disorders, delirium, dementia, etc.). Occasionally younger family members of the client are seen. Clients are referred to the program mainly through social workers, medical providers, law enforcement and Adult Protective Services. Over 500 elders are served directly each year. Hundreds more are served indirectly through community lectures, mutli-disciplinary consultation and workshops. Location of the Agency The Center for Aging Resources/ Heritage Clinic is headquartered in Pasadena, California. The Center also operates three adult daycare centers in surrounding areas (West Covina, Pasadena and Burbank) and five additional Heritage Clinic offices in Inglewood, Palmdale area, and 3 in San Diego. The interns in the San Diego office operate from the Mission Gorge office. GOALS AND OBJECTIVES OF TRAININGThe internship model at Heritage Clinic follows the guidelines set forth in and subsequent to the 1981 and 1992 “Older Boulder” Conferences on Training Psychologists for Work in Aging (Santos & VandenBos, 1982; Knight et al., 1995). The model is one of strengthening interns’ general psychological skills and their knowledge in areas needed to serve older adults. Interns with no previous experience working with older adults will be introduced to gero-psychology and those with previous gero-psychological experience will receive further training with older adults, as well as strengthening of general skills.
The training goals of Heritage Clinic are, in order of importance, to: 1) train interns in high quality, general skills in psychological assessment and diagnosis, intervention, supervision, consultation, research and inquiry, consumer protection and professional development; 2) develop interns’ understanding and skill in gero-psychology; and 3) help clinicians understand community psychology, with particular focus on methods of reaching underserved populations. We train interns to be prepared for entry-level positions as general psychologists and have skills to work with older adults who may present in their general work, or to secure postdoctoral positions in gero-psychology. Our model of training also follows a practitioner-scholar model. We train interns to be practitioners who apply scholarly knowledge and methods of scientific inquiry to the clinical and community situations in which they are asked to intervene.
Heritage Clinic provides training with emphases in 7 competency areas: Assessment and Diagnosis, Intervention, Supervision, Consultation, Research and Inquiry, Consumer Protection and Professional Development. Within the realm of Assessment and Diagnosis, intern graduates are expected to be able to: 1) Interview and accurately diagnose adults in general and older; 2) Choose appropriate assessment procedures; 3) Take into account medical condition of clients; 4) Administer dementia-screening tools; 5) Understand the necessity of using age, culture, and education-appropriate norms for assessment; and 6) Evaluate the appropriateness of the person’s environment to his/her functional abilities.
Within Intervention, intern graduates will be trained to 1) Form empathic relations with a range of clients; 2) Provide clinically beneficial psychotherapeutic interventions in a variety of modalities, such as behavioral, cognitive-behavioral, psychodynamic, interpersonal and existential approaches; 3) Develop appropriate treatment goals and treatment plans within one or more theoretical frameworks; 4) Provide psychological services to older adults with dementia; 5) Be familiar with community based interventions specifically appropriate to older adults including grief therapy and life review techniques; 6) Be familiar with intervention approaches appropriate to other underserved populations; and 7) Maintain appropriate boundaries and awareness of transference and counter transference.
In the area of Supervision, intern graduates will have 1) Received supervision from at least 3 supervisory perspectives; 2) Responsibly learned from and carried out supervisory guidance; and 3) Learned principles of providing supervision.
In Consultation, intern graduates will have 1) Gained experience and skill communicating with multi-disciplinary professionals, including social workers, physicians and nurses; and 2) Gained exposure to the use of psychological consultative skills in a multi-disciplinary geropsychological community.
Research and Inquiry: Intern graduates are expected to 1) Understand the need to base assessments on appropriately researched and normed assessment tools; 2) Base interventions on the available foundation of scientific knowledge, outcome studies and accumulation of documented knowledge; and 3) Gain knowledge of life span development.
Consumer protection: Intern graduates are expected to be trained to 1) Demonstrate clear and consistent adherence to legal and ethical principles; 2) Provide appropriate responses to emergencies; and 3) Complete necessary clinical documentation in a timely manner.
Professional Development: Intern graduates are expected to be able to 1) Reliably and responsibly meet the needs of the clients and agency; 2) Work as a team; 3) Communicate effectively orally and in writing; and 4) Receive mentoring in preparing for future roles and careers.
Interns are expected to achieve at least average-for-interns performance in each of the seven competency areas. Supervision, guidance and feedback are provided to interns throughout the training year to facilitate interns achieving and maintaining this level of performance.
SERVICES PROVIDED BY INTERNSIn order to develop these skills, pre-doctoral interns will become involved in many diverse clinical services of Heritage Clinic. These services include: in-home psychotherapy with homebound seniors; individual, collateral and group psychotherapy in the clinic; psychological assessment, cognitive screening for older adults concerned with memory changes, clinical case management, and consultation with multi-disciplinary professionals. Interns may provide group therapy, possibly including a caregivers’ support group, dementia support group, at-risk older parents group or parenting grandparents group. Psychological assessment batteries include a range of assessment procedures relevant to older adults.
Therapy is offered largely in a longer-term model, although some clients are seen short-term. Most clients are seen throughout the training year. Interns will primarily provide services to clients in their homes; some are seen at the clinic. Interns will conduct intakes, offer limited case managemes
snt services, and are on call with supervisory backup for urgent calls. Interns participate in multi-disciplinary team consultation with social workers, psychiatrists, nurses, physicians, etc., and multi-agency outreach and networking. Additional services provided can include community outreach, referral, trauma debriefings, community psycho-educational presentations and consultation. SUPERVISIONInterns will receive a total of three hours of supervision per week. Interns will receive two individual supervision sessions (one with Dr. Uchino, another with Dr. Hemmings). Interns will attend one group supervision session per week, which is supervised by Dr. Uchino. (In addition, interns will receive two hours of training per week. See “Training” section below). Heritage Clinic does not adhere to one particular theoretical orientation. Perspectives of the supervisors include Recovery Model, Object Relations, Psychodynamic, Client-centered, Humanistic/Existential, Integrative, Psychosocial Rehabilitation and Cognitive-behavioral. Interventions are planned with regard to both the longer-term conceptualization and the short-term, imminent needs of the clients.
TRAININGThe internship begins with orientation in mid August. Interns will attend training on Documentation, Social Security Benefits and Insurance, Housing Resources, Case Management, and Initial Assessment (See Internship Training Syllabus). Interns will attend a weekly meeting from 9:45 am on Tuesday. In this training, interns will give and receive clinical feedback through case presentations. In addition, interns will attend training seminars on topics including: Psychotherapy with Seniors, In-Home Therapy Boundary and Safety Issues, Dealing with Challenging Client Behaviors, Loss and Grief, Grief Therapy, Death and Dying, Dementia, Substance Abuse, Therapy with the Cognitively Impaired, Depression and Suicide in Older Adults, Healthy Aging, Working with Latino Seniors, Working with Asian American Seniors, Working with African-American Seniors, Life Review and Reminiscence, Religion and Spirituality, Family Therapy with Seniors, Supervision, Sexuality, Motivational Interviewing, Psychodynamic Interview Techniques, Geriatric Neuropsychology and Dementia Screening, Geriatric Psychopharmacology, and Elder Abuse Recognition and Reporting (See Internship Training Syllabus). Interns will receive two hours of training per week on average. Internship training seminars are intended to improve intern’s cultural competence on 1) aging as well as 2) other cultural backgrounds such as ethnicity and religion. In addition, interns will be provided with E-learning classes, which are on-line multicultural courses offered by Heritage Clinic. Supervisors will provide ongoing training as a part of group and individual supervision.
AGENCY AND TRAINING STAFFThe Center for Aging Resources is staffed by a number of mental health professionals including licensed psychologists, registered psychologists, masters in social work (MSWs), Psychological Assistants, psychology interns, MFT interns, social work interns, support staff, and volunteers. As Director of Training, Dr. Janet Anderson Yang oversees the training. The training is provided by a few psychologists including Dr. Yang and Dr. Uchino as well as other clinicians. Dr. Uchino is the primary supervisor. Dr. Michelle Hemmings, Psy.D. , Dr. Michael Carroll, Psy.D. ,, and Dr. Jim Bazzetta, Ph.D. are the delegated supervisors. All psychologists are trained in geropsychology. The Heritage Clinic is a current member of the California Psychology Internship Council.
SAMPLE INTERN SCHEDULEThe Mission Gorge Office of Heritage Clinic offers a one-year half-time internship. Interns will participate in the following activities and responsibilities. 1. Provide 10 hours per week of billable clinical work (individual or group psychotherapy in person or on the phone, assessment, case management, collateral contact, composing progress notes, driving to and from client’s place of residence, etc). Mileage reimbursement is provided.
2. Complete Initial Assessments with all new cases.
3. Use assessment instruments that screen for dementia, depression, and substance abuse. Complete one to two reports using such screening tools during the internship year.
4. Meet supervision and training requirements (two hours of individual supervision, one hour of group supervision, and two hours of training).
5. Attend clinical staff and training seminar meetings. Tuesdays from 9 am to 11 am and Wednesdays from 9 am to 11am are required for clinical meetings and training seminars. Intern, supervisors, and Training Director arrange other hours as mutually agreed upon. No evening or weekend hours. Total hours per week are 22 hours.
LENGTH OF TRAINING AND STIPENDFull-time positions are stipended at $50 per month starting in September. Mileage reimbursement will be provided. Interns will have one week of orientation in mid-August. Then interns will have one year of training from the beginning of September to the end of August of the following year. Interns receive three weeks of vacation and five days of sick leave. Vacation scheduling is negotiable, but not to be taken during the 1st, 2nd, 3rd, and 13th month of training or all at once. Interns will be assigned to a desk, a desk phone, a cell phone, and a laptop computer. Most therapy is conducted in client homes. Mileage reimbursement is provided. Therapy rooms are available in the clinic, by reservation for appointment time. Parking is street parking.
QUALIFICATIONSThe Heritage Clinic recruits applicants for the Psychology Internship Program who are students of advanced standing from a Clinical or Counseling Psychology doctoral program. Students from APA approved programs are strongly preferred. Applicants will have completed the following requirements:
Clinical preparation: At least 800 hours of clinical training as well as completion of the required doctoral courses referenced above are necessary to be considered for acceptance into Heritage Clinic training program. Academic preparation: Completion of doctoral course work, including courses in psychopathology, psychotherapy, life span development, practicum, ethics, psychological assessment is required. Completion of courses including multicultural competency development and psychopharmacology is preferred. Additional preparation: Expressed interest in working with older adults, expressed openness to a community-based service provision model, a valid driver’s license and active automobile insurance. Upon entry into the program, interns are expected to successfully pass finger-printing and drug screens. When all the above eligibility requirements are met, priority is placed on professional geriatric experience, additional psychotherapy experience and/or bilingual ability.
APPLICATION AND SELECTION PROCESSTo apply, send vita, cover letter with personal statement, CAPIC application, and 3 letters of reference to Dr. Taeko Uchino at Heritage Clinic in accordance with the CAPIC procedures. In the personal statement, please address degree of interest in working with older adults. Interviews will be offered to the top candidates and will be held in February and March. Applicants are offered an interview based on the Center’s evaluation of depth and strength of clinical experience, doctoral course completion and geropsychology interest, in their written materials. Interviews consist of meeting with 2 psychology staff Applicants are ranked for selection based on: a) degree of clinical experience; b) clinical acumen/ability to identify key clinical issues in interview case discussion; c) expressed eagerness to learn about geropsychology; d) openness to working in a community service provision model; and e) professionalism and responsibility. Additional value is placed on geriatric experience, additional psychotherapy experience and bilingual abilities. Further information is available on the Heritage Clinic’s website at www.heritageclinic.org and from Dr. Uchino by email at tuchino@heritageclinic.org; or by mail from Heritage Clinic; 6160 Mission Gorge Rd, Suite 120, San Diego, CA. 92120.
The Heritage Clinic is a current member of the California Association of Internship Council. For more information, please contact Taeko Uchino, Psy. D. at tuchino@heritageclinic.org or call 619-282-2232 x221. |
