This is a year-long primary rotation on the Adult Psychiatric Services (APS) unit at the Wyoming State Hospital. The supervisors for this rotation are Drs. Klotzbach and Kay (see above regarding assignment of supervision). Adult Psychiatric Services moved into the new WSH inpatient facility in March 2004. This facility consists of three wings and approximately 42 beds. Length of stay is typically 30-60 days although longer stays are possible when necessary. People admitted to APS carry a wide range of diagnoses on both Axis-I and Axis-II. Many have multiple diagnoses, presenting unique treatment challenges. As patients become more psychiatrically stable, they are discharged to community settings. Those who have difficulty stabilizing may be transitioned to a longer-term unit that is also part of APS, providing opportunities for longer-term therapy.
Part of the intern’s role is to serve on the multidisciplinary treatment team, providing diagnostic screening, psychological assessment, and consultation services. The interns provide individual and group treatment (process and psycho-educational groups), and may also develop behavioral treatment programs for individual patients. Interns also provide assessment services addressing a variety of referral questions (e.g., diagnostic clarification, cognitive functioning, independent functioning, psychological functioning, disability evaluation). The intern on APS will experience working with a wide range of psychiatric diagnoses and levels of functioning, severe psychopathology, and persons with multiple diagnoses. A significant number of patients seen on APS have co-occurring substance abuse problems in addition to other mental illness and/or personality disorder. Some patients have co-occurring intellectual or developmental disabilities or serious medical problems that must be addressed as part of their treatment. This rotation offers an opportunity to hone brief therapy skills, develop expertise in rapidly determining diagnoses, experience working with individuals who are acutely psychotic, manic, depressed, have cognitive limitations, and/or at risk for suicide, and work intensively with a multidisciplinary team.
On the Adult Acute Inpatient Unit, interns have the opportunity to provide substance abuse treatment and assessment, including group and individual therapy, and to practice Motivational Interviewing skills with this population. Interns may work with geriatric patients, including those with dementia due to various etiologies, providing assessment, therapy, and consultation to the treatment team for behavioral management and placement concerns.