Department of Psychiatry

Division of Clinical Psychology

Adult Developmental Disability Clinical Psychology
Community Centered Boards in Colorado
2009-2010:  The Resource Exchange (TRE)
This major rotation of the psychology internship program provides interns with an opportunity to learn to provide community-based clinical services to adults with developmental disabilities and their support networks.  Community Centered Boards (CCB’s) are private, non-governmental organizations that serve as single entry points for all State of Colorado services to children and adults with developmental disabilities (DD).  As defined in Colorado Revised Statute (See 27-10.5, C.R.S.), CCBs determine eligibility for DD services; establish individually determined need-based service arrays for enrolled individuals; provide case management and service coordination to all enrolled individuals; and, provide comprehensive quality assurance and control oversight of services and service providers. Several CCB’s could potentially participate in this training opportunity, with slightly different training opportunities at each site.  In 2008-09, a major rotation is offered at The Resource Exchange (TRE), the CCB in Colorado Springs.  TRE serves El Paso, Park and Teller counties of the Pikes Peak region, with nearly 2000persons, including approximately 1100 adults, enrolled.  Trainees in this rotation will learn to provide community based behavioral and psychological health services, including assessment, psychotherapy, behavioral interventions, family therapy, and support system integration. 

Goals of the Adult Developmental Disabilities Track at TRE in Colorado Springs

The overarching purpose of this major rotation is to develop psychologists who can provide a full range of clinical psychology services in a range of community-based settings to adults with developmental disabilities in collaboration with multi-disciplinary health, residential care, and social services teams. Interns will complete the internship identifying themselves as psychologists who are important members of the DD community resource network.  Secondarily, interns will develop an understanding of the process and some techniques of consultation within the DD network along with specific knowledge and skills related to delivering psychological and behavioral health services to adults with developmental disabilities.  They will become familiar with the roles that psychologists can have in multidisciplinary teams, and in serving a network that has rarely had access to psychological services other than IQ testing.  Specific training goals are to:

1. Teach trainees about the needs and strengths of persons with developmental disabilities and their families
2. Teach trainees a variety of specialized clinical skills for assisting persons with developmental disabilities, including psychological assessment, psychotherapy and consultation
3. Teach trainees to work in an integrated fashion with members of an interdisciplinary clinical team
4. Foster development of leadership skills and scholarly activities related to the field of developmental disabilities
5. Engage trainees in ongoing research examining the effectiveness of psychological and behavioral health services, and other research on developmental disabilities as appropriate to the agency and their own interests. 
6. Introduce trainees to values of inclusion, family and individually centered care, diversity, advocacy, and self-determination for persons with developmental disabilities

Objectives of the Adult Developmental Disabilities Track

• The psychology intern will learn to administer a variety of cognitive tests applicable for persons with developmental disabilities including, but not limited to, the Mullens Scales of Early Learning, Leiter-Revised, Stanford-Binet Intelligence Scale-Fifth Edition.  The intern will refine his/her use of more traditional cognitive tests, such as the WISC-IV, with children with developmental disabilities, and will learn and utilize inventories of adaptive skills such as the Vineland Scales of Adaptive Behavior, Supports Intensity Scale (SIS), and the Scales of Independent Behavior-Revised (SIB-R).
• The psychology intern will learn to administer one or more tests specifically designed for the diagnosis of autism (Autism Diagnostic Interview; Autism Diagnostic Observation Schedule).
• The psychology intern will learn the basic tenets of positive behavioral interventions and use these strategies (where appropriate) for persons with developmental disabilities to (1) design teaching and educational strategies to develop new skills and (2) to design positively based interventions to address problem behaviors, based on functional assessment.
• The psychology trainee will learn to conduct an assessment of socio-affective functioning and to design and carry out treatments (individual, group, family, and consultative) for persons with developmental disabilities.
• The psychology trainee will work together as a team member with members from other disciplines, including primary health care, social work, occupational therapy, speech/language pathology and psychiatry to evaluate and treat persons with developmental disabilities, and to impart information to family members and others interested in the diagnostic information.

Specific Training Activities

Required Activities

Psychological assessments:  Each month, the intern will complete 1-3 (to be set with supervisor) comprehensive psychological assessments of adults referred by TRE staff.  A limited number of neuropsychological evaluations of persons with disabilities will be conducted as needed to complete the intern’s training.

Psychotherapy:  The intern will treat a number of adult therapy clients presenting with a variety of problems and generally including persons with mild to severe developmental disabilities.  The intern will also participate in group treatment and family treatment.

Scholarly activity:  Every intern has the opportunity to work with any faculty member or supervisor at JFK Partners on a research activity.  The intern also has the opportunity to develop his or her own individual research project.  All interns complete an individual health services project as part of the UCD internship requirements. 

Educational activities:  The intern is expected to attend clinic meetings, supervisory sessions, and may attend topic-related ongoing seminars, and lectures, courses, and special workshops at TRE, JFK Partners or the CU Aging Center.

Optional Activities

Developmental Disabilities Research:  The trainee may participate in research conducted collaboratively between TRE and the Gerontology Center at the University of Colorado at Colorado Springs.  

Additional Courses 

There are a variety of seminars, courses, and lectures provided by TRE, UCCS Gerontology Center, UCCS CU Aging Center, and JFK Partners that are available to trainees.

Theoretical Approaches

Interventions are conducted using behavioral analysis, cognitive-behavior therapy, and family systems therapy.  Individual and family developmental psychology form a framework for understanding adults with developmental disabilities and conceptualizing the challenges they face.  There is an emphasis on neuropsychological assessment that includes a focus on development of guidelines to functioning that are useful to families and providers as well as the traditional focus on diagnostics.

Types of Clinical Approaches

• Interdisciplinary and disciplinary diagnostic services
• Family, health care, and community consultation
• Applied behavioral analysis
• Positive behavioral methods for skill building and behavior management
• Cognitive/behavioral therapy groups
• Family-centered consultation and advocacy
• Child and adult individual psychotherapy

Population of Clients 

TRE serves persons of all ages, from infancy to old age, with a diagnosis (or a question of a diagnosis) of a developmental disability.  This major rotation focuses on services to their adult and geriatric populations. TRE serves people with disabilities throughout the Pikes Peak region, both urban and rural settings, from all ethnic groups and from all income levels.

Supervision 

The intern receives supervision for all clinical activities, including psychological assessment, psychotherapy and consultation. Supervisors must be licensed psychologists approved by the internship Director.  Additional training, case consultation, and clinical support are available from CCB staff related to the clients assigned to interns.

Assessment supervision is available from licensed psychologist supervisors at TRE (general psychological assessment) and CU Aging Center (neuropsychological assessment).  Depending upon the competencies the intern needs to gain during the internship year, the intern may be assigned to the CUAC for neuropsychological assessment experience or to TRE for general psychological assessment experience with persons with developmental disabilities.  On the neuropsychological assessment assignment, the intern will be supervised for 12 months in neuropsychological assessment by one supervisor within a team-training context at the CU Aging Center.  Diagnostic and functional assessments will be supervised by another clinical psychologist at TRE.  Supervision for assessments averages 1 ½ - 2 hours per evaluation, not including live supervision during the assessment itself.  Supervision covers preparation for the assessment, review and interpretation of data, written and oral reporting. 

Psychotherapy supervision is provided weekly for the entire year, at minimum for 1 hour per week. Multiple supervisors may be used at the discretion of TRE and the internship to provide expertise in both family and individual therapy as well as applied behavior analysis.  Live supervision and supervision by videotape are also important components of the supervision.  Each trainee may participate in a psychotherapy group supervision.

Supervisors

Michael A. Kenny, Psy.D. (University of Denver, 1990).  Neuropsychological assessment.  Major Areas:  Evaluation of functional cognitive abilities, neural networks, evaluation of capacity.

David Hatfield, Ph.D. (University of Colorado-Boulder, 1998).  Applied Behavior Analysis.  Major Areas:  ABA child and family interventions, developmental disabilities assessment and intervention.