Children’s Behavioral Health Services
The Devereux Children’s Behavioral Health Services (CBHS) is comprised of two main campuses, Brandywine and Mapleton. The Brandywine Programs serve approximately 120 boys between the ages of 7-18 while the Mapleton Programs serve approximately 40 girls and 18 boys between the ages of 11-18. Clinical diagnoses vary widely, but generally are encompassed in one of the following categories: Post Traumatic Stress Disorder, Mood Disorders, Disruptive Behavior Disorders, and Autism Spectrum Disorders.
Treatment Program Overview
Interns who match with Devereux CBHS will have the opportunity to work at the Mapleton Programs which offers Devereux Positive Behavior Interventions and Supports, a multi-tied system of supports. At the foundation of the system of supports is a positive behavioral support environment Training and technical assistance activities are focused on developing program-wide interventions for both the residence and school programs that teaches and reinforces appropriate, communicative, pro-social, and other adaptive behaviors. Given that many of our admitted youth have significant histories of personal trauma, our milieus and classrooms are developed to also support trauma informed care. Further, each client is surrounded by a team of interdisciplinary professionals working to provide individualized assessments and interventions that build on client strengths and assist with remediating client needs.
Psychological interventions are grounded in behavioral and cognitive-behavioral theory, and the psychology staff works closely with medical, psychiatric, residential, and educational staff to provide a comprehensive and integrated system of care. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) interventions are employed as a module-based approach to help clients understand their behaviors and beliefs as responses to trauma, learn skills in relaxation, increase affect tolerance, and learn connections between thoughts, feelings, and actions. Gradual exposure is used to facilitate processing of the traumatic experiences and installation of more adaptive beliefs. Family therapy features an emphasis on parent management training and dealing with resistance to consultation on parenting practices.
Assessment. Interns are required to demonstrate competency in assessment during the training year. Interns are expected to have developed competence in administration of psychological tests prior to internship. Assessment assignments provide an opportunity for the intern to develop competency in:
Assessment opportunities include assessment of cognitive functioning, academic skills, functional skills, diagnostic evaluations, functional behavioral assessments, intake evaluations and personality functioning.
Intervention. Clinical interventions can take an individual, group, or family focus. Interventions can include trauma-focused CBT, self-regulatory training, other cognitive behavior therapies, positive behavior support planning, and parent training and therapy. Supervision is provided in intervention delivery, clinical formulation, treatment planning, and progress monitoring. Interns will also have opportunities to observe supervisors or senior clinical staff as they conduct interventions. Further, all Devereux interns will participate in treatment methods seminars on alternate Fridays.
Consultation. Consultation may include assessment, observation, and/or interviews to formulate hypotheses. From the hypotheses, interns will formulate both informal and formal recommendations. Interns provide consultation during team meetings and on an individual basis with all disciplines within the therapeutic milieu, including teachers, direct care professionals, and program managers, among others. In cases where a specific training or a behavior support plan may be recommended, interns will provide training and follow-up to ensure treatment integrity. Interns will be provided with training in D-PBIS and can assist with staff training and integrity checks on model implementation.
Systems Management. Interns are responsible for the systems management activities associated with clients. Systems management typically involves collaboration with delinquency and dependency court systems, managed care organizations, resource coordinators and educational settings. Systems management includes planning for visitation and securing aftercare services.
Research/Program Evaluation. Each intern is expected to complete one research or treatment outcome study during the training year. The projects may be part of an existing research project or the intern may develop his or her own research initiative. As an alternative to an experimental design, interns may choose to participate in a treatment outcome study on a topic that is relevant to the center and will aid Devereux’s treatment outcome initiatives. Interns present their research/treatment outcome findings at a formal presentation to peers and other clinical staff. Interns are supported in their research by the Devereux Behavioral HealthCare Library, staff at ICPTR, and the intern supervisory staff at CBHS.
Diversity/Cultural Competence. Interns are provided training and supervision surrounding issues of cultural and individual diversity. Diversity dynamics are integrated in all parts of training, including assessment, intervention, consultation, case management, research, and supervision. These dynamics are crucial to the understanding of the individual, and in planning and delivery of treatment. The interns have the opportunity to work with culturally and individually diverse clients as well as staff. CBHS recruits staff internationally and supports cultural and individual diversity in the workplace. English-only speaking interns and psychology staff have access to an interpretation service for working with clients and families whose primary language is not English.
Supervision. Interns have the opportunity to learn about the process of the supervision of others during the training year. In their role as consultants, interns may need to supervise direct support staff in carrying out treatment recommendations and treatment protocols. Goal-setting, coaching, mentoring, and providing performance feedback are all skills that the interns develop to improve their competence as supervisors. During some training years, interns may have opportunities to also supervise practicum students.
Professional Skills and Development. Professional skills and development begin during the first week of the internship and are continuously evaluated throughout the year. After an initial self-assessment is completed, specific goals and objectives will be established. These targeted areas will be reviewed and discussed during individual supervision.
Interns are supervised by a team of three licensed, doctoral level psychologists. One of the supervisors is also a Board Certified Behavior Analyst (BCBA). The supervisory team provides four hours of individual, face-to-face supervision each week. Interns also participate in a weekly clinical meeting with the other clinical staff. Live supervision is provided by supervisors participating in meetings, assessment and intervention sessions, and consultation sessions with the intern. Additional mentoring may be provided by senior clinicians and consultants who have specialized clinical expertise. Supervision hours for obtaining behavior analysis board certification (BCBA) is also available for the internship year.
Desired Intern Qualifications and Competencies
The ideal intern candidate will have experience in providing evidenced-based practices to children and adolescents, the ability to conceptualize a case from a CBT framework, and experience in administering a variety of assessments to children and adolescents. The ideal candidate will be trained in behavioral principles and have the ability to apply behavioral interventions. Intern candidates should have strong consultation skills and be able to work collaboratively with a multidisciplinary team. Additionally, intern candidates will be able to conduct independent research (e.g., conceptualization, methodology, and analysis).
Outcomes of Training
Over the course of the training year, the intern will develop competencies and independence in providing clinical services using a best practices model where clinical assessment, formulation, intervention, and analysis are supported by relevant clinical data. After completing the internship, interns most commonly continue their training in formal post-doctoral fellowship placements in clinical settings such as hospitals and residential treatment facilities. Past interns have also taken positions in clinical settings that provide them with the necessary post-doctoral supervision to obtain professional licenses. Additionally, some interns have also accepted academic and research based appointments upon completion of internship.