Download Long Term Outpatient Psychotherapy Experience

ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY
CLINICAL PSYCHOLOGY INTERNSHIP TRAINING PROGRAM
ADULT TRACK
GUIDELINES FOR LONG-TERM OUTPATIENT CASES AT BUTLER HOSPITAL
(REV. 5-2-16)
Maria Mancebo, PhD, Coordinator
As per APA guidelines, clinical psychology residents are required to carry long-term outpatient psychotherapy
cases throughout the training year. This work will be conducted under the supervision of a licensed clinical
psychologist who is also a member of the training faculty. Outpatients are seen through the Butler Hospital
Universal Treatment Program (UTP), and it is expected that you will carry 2 such cases at any given time. Longterm cases that do not last a full year, and terminate prior to April 30, should be replaced as they terminate.
Please note that the Adult Track Faculty has agreed to provide release time one afternoon per week from 2:30pm
on so that you may see your outpatients. If you rotate out of Butler Hospital to another training site, please be
mindful that you will have to travel to Butler to continue to see your patients. Given that schedules vary from site
to site (especially during the third, out-of-track placement), please discuss this requirement with your rotation
supervisors so that you obtain approved “release time” to see your outpatients at Butler one afternoon per week.
In the case that you encounter any scheduling conflicts, please discuss the issue with Dr. Mancebo and your
rotation supervisor. Such situations will be handled on a case by case basis, so that an equitable solution is
reached.
You will be matched with a clinical supervisor at the start of the year. You may carry 1 or 2 supervisors,
depending upon your case load characteristics. Clinical psychology residents are expected to meet with their
supervisors regularly (i.e., weekly) for clinical supervision. It is expected that 45-60 minutes be devoted to
supervision each week, which should provide ample time to review both outpatient cases. If you have more than 1
supervisor, it is expected that you will split this time evenly between the two (i.e., 30 minutes of weekly
supervision with each supervisor).
2. Familiarize yourself with the Universal Treatment Program (UTP) at Butler.
Orientation meetings will be at Butler Hospital. Dr. Mancebo will provide an orientation on Monday, July 11, at
4pm in the Outpatient Building, 2nd floor conference room, room W230 at Butler Hospital. There will be a
separate orientation to the electronic medical record on Tuesday, July 19, at 4pm in the Lippit Training Room,
Lippit Building, Lower Level.
3. Find a patient.
Typically, clinical psychology residents have: a) been referred cases from the UTP clinic, and/or b) taken referrals
from their supervisor or another Brown faculty member. Once you have received a referral, please confirm with
your supervisor that the presenting complaint is within their scope of practice. If not, please notify Dr. Mancebo
immediately, so that the case can be reassigned.
It is expected that once you are referred an outpatient, you will contact them within 48 hours to schedule their
intake. Given current demand for treatment, we anticipate that you will be referred at least one, and possibly two,
new cases at the beginning of the training year. If not, you will be responsible for arranging for your first case no
later than August 12 2016. You are expected to have two active cases by September 9, 2016. If not, Dr. Mancebo
will contact you with the name of the patient who is next on the UTP waitlist.
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4. Have patient entered into the system.
Have your patient complete the “New Patient Information” form, or call your patient and complete the form with
them over the phone. Drop off the new patient info form to Karleen so that the patient is entered into the system.
The patient will be mailed a packet.
5. Schedule the appointment.
Prior to the first session, please note to your patient that you will be seeing him/her through the UTP program, and
that: a) insurance will not be billed, b) there is a set, flat fee and proof of income is required to establish fee, and
c) (s)he will be required to bring proof of income (tax return, pay stubs, etc.) to the first visit and provide to
reception at check in. Schedule the first appointment with enough lead time for paperwork to be processed (the
paperwork that was mailed in advance by Karleen).
Prior to each subsequent session, you will schedule future sessions through Avatar, the electronic outpatient
medical record system.
6. Arrange for office space.
You may use your assigned office at Butler Hospital to see your outpatients. If you have rotated off site, and you
have a research placement at Butler, you may be able to use office space there. Alternatively, you may arrange
with a current Butler resident to use his/her office during your scheduled appointments. Talk to your fellow
clinical psychology residents or with Dr. Mancebo if you have any questions about office space.
8. Conduct the session.
Please meet your patient at outpatient reception at the scheduled time of your first appointment. The patient may
meet you at your office for all subsequent sessions.
After each session, you will reconcile the completed session within Avatar (at which point you can also schedule
the next session). The patient will need to go to the outpatient reception desk to remit payment. If your session
extends beyond regular business hours (e.g., any time after 5pm), you will need to collect payment and put the
payment in the drop box next to outpatient reception.
9. Complete required documentation.
Following the initial therapy session, you are required to complete the Outpatient Session Note -Initial Psychiatric
Evaluation in Avatar, which functions as an intake assessment. Please also specify in this document who will be
supervising the particular case. For all subsequent sessions, you are also required to complete the Outpatient
Session –Psychotherapy Note. Supervisors will provide guidance and supervision to clinical psychology residents
as to the content and structure of these notes. More detail re: note content will be provided during your Avatar
training. Clinical psychology residents must enter treatment notes immediately following clinical contact with a
patient. Supervisors must co-sign these notes through Avatar.
10. Other important information.
Activity log: Clinical psychology residents will submit via email a monthly log of their clinical and supervision
hours to Dr. Mancebo.
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Telephone messages/access: Clinical psychology residents are expected to provide their patients with up-to-date
business phone numbers so that patients can contact residents directly. Clinical psychology residents are also
expected to receive and respond directly to phone messages from their patients. Clinical psychology residents
have voicemail boxes assigned to them at Butler Hospital; the main line for residents is 401-455-6350, upon
which you will have a direct extension. The outgoing message on the voicemail should include instructions to call
911 or go to the nearest ER in the event of an emergency. Clinical psychology residents should check their
voicemail at least daily and should also inform their patients of emergency services at Butler Hospital (e.g., PAS)
and how to access them if patients cannot immediately get in touch with them. Clinical psychology residents are
expected to work closely with their supervisors to ensure that continuity of care is always maintained, regardless
of what rotation or hospital the clinical psychology resident is assigned to.
Terminating/transferring patients: Clinical psychology residents will either terminate treatment or transfer their
patients to another clinical provider at the end of the internship year, on June 30. This requires that clinical
psychology residents (1) work with their supervisors to determine whether termination or transfer is clinically
appropriate; and (2) inform their patients well in advance of the end date of internship and of treatment.
Regardless of whether the patient is terminated or transferred, you must complete an outpatient Discharge
Summary form for each patient.
11. Important telephone numbers.
Maria Mancebo, PhD, Coordinator of Outpatient Training for Butler Residents: 401-455-6216
Lauren Weinstock, PhD, Adult Track Coordinator: 401-455-6304.
Paul Malloy, PhD, Butler Hospital Director of Psychology: 401-455-6355
Sherrie Collins, Outpatient Operations Manager: 401-455-6536 (or x 21355). STAFF ONLY.
Karleen Coppola, Outpatient Intake Office: 401-455-6436 (or x 21354). STAFF ONLY.
Patient Assessment Service: 401-455-6266
Butler Hospital Security: 401-455-6200 (or x 26200) to be connected to the BH switchboard. They will page
security.
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