CMH MODEL: At Pathways Counseling Center, interns learn to use a Community Mental Health (CMH) model. A focus of the internship is to integrate training with the services we provide to best assist this population. Due to our CMH model, our scholar-practitioner orientation, our training integration, and the diverse populations we serve, our approach to therapy services is unique unto us. We strive to teach our interns how to provide mental health consultation within the schools we serve and within community. This CMH model assists our clinicians in helping school staff and teachers, as well as other individuals in the child’s mesosystem, to identify mental health issues and consultation allows us to help guide these individuals to the best means to promote success with these children. WEEKLY TRAINING: After the five week of orientation training, didactic seminars commence every Friday these consist of two hours of didactic training and two hours of seminars in either Clinical Documentation (CDS), Community Mental Health (CMH), and/or Trauma Focused-CBT (TF-CBT). SUPERVISION: We offer 1-2 hours of individual supervision (based on number of internship hours) per week and 2 hours of group supervision. ASSESSMENT/SCREENING: As part of our training, intern become certified in the Child and Adolescent Needs and Strengths (CANS) Assessment, a screening tool used currently in 50 states. The CANS was developed for children’s services to support decision making, including level of care and service planning to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of services. A portion of children we see have trauma histories, and we train interns in using Trauma-Focused CBT (TF-CBT) in working with these kids and families. TF-CBT is an evidence-based treatment for children and adolescents impacted by trauma and their parents or caregivers. DOCUMENTATION: Many of Pathways’ clients are from low-income families who utilize Medi-Cal insurance. Interns are comprehensively trained in all types of the Early and Periodic Screenings, Diagnostic, and Treatment (EPSDT) Medi-cal paperwork to meet county and legal and ethical requirements. SEMINARS: As previously stated, throughout the year we also host mental health trainings and seminars for the county through the Community Mental Health Consortium that interns are invited to attend free of charge through the agency.

Pre-doctoral interns provide 14-26 hours of direct service rather than the 10 that practicum students provide. Full-time interns receive two hours (not one) of individual supervision per week. Doctoral interns provide crisis intervention for incorrigible youth during the week and on a handful of Saturdays and holidays throughout the year. As part of this crisis work, interns assist the Delinquency Prevention Network in trying to reunite run-away youth with their caregivers and provide crisis services and referrals. This opportunity is not given to practicum students at our site. Doctoral interns are also allowed to provide in-home counseling to select clients, whereas practicum students must only see clients at the clinics. Part-time doctoral interns who complete a second year internship at our site , or interns who choose to complete both their pre- and post-doctoral experience with us, provide in-house trainings. During this second year there is a greater emphasis on professional development and organizational thinking and they provide mentoring to practicum trainees with less experience.

Interns work either 24 to 40 hours a week, delivering services approximately 12 to 24 hours depending on half-time or full-time status. Over the course of the year, interns should expect to earn at least 25%, and up to 50%, of direct face-to-face clinical hours (including: intake sessions; individual, child, group, and family counseling sessions; mental health workshop presenter; Malabar crisis sessions, mental health fair spokesperson, and consultation with school staff or other people in the multidisciplinary team). COORDINATED TRANSFER: While most interns are placed in mid-August, some interns are placed in the clinic in mid-June to allow for ease of client transfer from one intern cohort to the next. CLINCIAL INTAKE: Interns that start in June will have coordinated client transfer meetings with the outgoing intern then additional training for the transfer. In the clinic most of our referrals are for children and their families. Interns are assigned days to take intake calls and receive messages on their voicemail from potential clients. They are then asked to return these calls and complete an intake form with the caller’s presenting problem and possible billing type. Clients are screened by Pathways staff and then delegated to interns. ASSESSMENT: At the start of seeing a client, interns conduct a complete bio-psycho-social assessment of the case. They then determine therapeutic modality, frequency of treatment, and best treatment location site with their individual supervisor. DOCUMENTATION: Prior to services, interns are trained to screen, bill, and provide proper documentation for Medi-cal clients. Interns are required and must maintain clinical files, provide EPSDT documentation, and fill out various agency contract statistics. EPSDT documentation requires maintaining charts that follow county requirements which include the development and implementation of initial assessments, treatment plans, and progress reports within a scheduled time period. They will learn and develop clinical review skills for Medi-Cal documentation purposes. CLINICAL CONTINUITY: Regarding clinical client hours, to maximize the amount of time that clients and their families in the schools can benefit from therapy services, interns are expected to take time off when school is not in session or they take long weekends. Most of the referrals in the clinic are children and their families. These clients can often only come to therapy appointments late afternoon and evenings. To meet these out-patient appointment needs, interns work from 2 to 5 evenings a week depending on the number of hours placed in the clinic.

Training/Clinical Services Offered:

Comments Regarding Theoretical Orientation of Staff