Orientation

Hospital based orientation provided by hospital staff
Departmental orientation provided by the Director of Training

Professional Ethics

Interns are expected to use professional codes of ethics in their decision-making and behavior. They are to maintain adherence to the standards of practice as established and published in the Ethical Principles of Psychologists and Code of Conduct; General Guidelines for Providers of Psychological Services; Standards for Educational and Psychological Testing; Guidelines for Providers of Psychological Services to Ethnic, Linguistic and Culturally Diverse Populations; Guidelines for Computer Based Tests and Interpretations; and the Specialty Guidelines for the Delivery of Services by Clinical Psychologists, Counseling Psychologists, Industrial/Organizational Psychologists and School Psychologists of the American Psychological Association. Guidelines as established in the Pennsylvania Licensing Law for Psychologists and other appropriate organizations and standards are also applicable.

Furthermore, students are expected to follow all guidelines and policies as established by the Lancaster General Hospital, the Department of Neuroscience and the Division of Behavioral Medicine and Neuropsychology.

Clinical Responsibilities

Consultation Service

Interns will provide consultations on patients hospitalized at the Lancaster General Hospital as well as the Lancaster Rehabilitation Hospital with feedback to the consulting physician, nursing staff and ancillary health professionals. Students will be trained to review hospital records, evaluate patients and write succinct consultation reports within specified time frames.

Bedside and Inpatient Psychometric Testing

Students will learn to administer, score and interpret neuropsychological/psychological tests given to hospitalized patients. Often this testing is of the screening variety, which allows for determining post-injury baselines or assessments of patients suspected of having a dementia or delirium. Occasionally, a comprehensive neuropsychological test battery is necessary but usually this type of assessment is performed on an outpatient basis. Psychological testing is typically in the form of an MMPI, MCMI or other psychometric instrument. We historically have not used projectives in our assessments of patients.

Inpatient Psychotherapy

Students will provide psychotherapy services to medical inpatients. Usually, this is in the form of aiding the patient in adjusting to an acute, chronic and/or unexpected medical problem; continuing treatment for an ongoing psychiatric problem, e.g. anxiety or depression; and assisting the family in understanding and coping with the patient’s medical problem. Inpatients typically respond best to a cognitive-behavioral/psycho-educational approach and it is this model that the intern is expected to practice. The interns also conduct group psychotherapy to stroke patients and their families.

Outpatient Neuropsychological Evaluations

Interns will learn to evaluate patients suspected of having a dementia using a dementia test battery. It is expected that interns will participate in evaluating patients at our Memory Disorders Program, to interface with neurologists, geriatricians and social workers in determining a diagnosis and treatment plan for their patients. Students will also have the opportunity to evaluate residents of our community during our annual memory screening day at the LGH Health Campus.

Interns will be introduced to the administration, scoring and interpretation of the Halstead-Reitan Neuropsychological Test Battery (HRB). Students will participate in scheduled case presentations using the HRB and are expected to develop a basic understanding of neuropsychological test data and clinical underpinnings.

Outpatient Psychotherapy

Interns are expected to see patients for psychotherapy. Often the outpatient caseload consists of follow-ups from the hospital; e.g. patients with head injury or post-stroke depression. Interns will also see patients with a variety of pain-related issues though the hospital’s Fibromyalgia Program and as referrals from the Central Pennsylvania Pain Center, which is located at our Health Campus. Our service does not accept referrals for patients with the need for intensive, long-term psychotherapy or patients with the primary problem being related to a specific personality disorder (other than that caused by acute cerebral pathology).

Didactic Training

Interns are required to participate in regularly scheduled didactic training seminars at the internship site. The intern must log an average of two (2) hours of didactic training per week. There will be ample opportunities to meet this requirement. Every month the medical staff offers multiple CME opportunities for clinical staff. While some of the presentations might be beyond the scope of the typical psychological practice e.g. “Current Tends in the Management of Atrial Fibrillation” other conferences are considered quite apropos for psychology interns. Recent conferences offered were “Current Topics in Neuroscience”, “Anxiety, Delirium & Depression/Whole Patient Assessment” and “Pregnancy and Depression”. Each week, the clinical staff leads seminars on relevant clinical topics. The didactic training schedule for the 2008-2009 internship year is available on the Intern Case Conference Schedule link.  In addition to didactic training, students will participate in weekly trauma and rehabilitation case review conferences.

Also, the Intern will review cases in face-to-face consultation with the supervising psychologists on a daily basis. Each day at the hospital there will be a review of cases seen on previous days and a review of each new patient the intern evaluates that day.

Supervision