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Internship Program in Clinical Psychology

 

 

INTRODUCTION AND PROGRAM´S MISSION

Ponce School of Medicine (PSM) is a freestanding, non-for-profit institution of higher learning accredited by the Middles States Commission on Higher Education and authorized by the Council on Higher Education of Puerto Rico to offer doctoral education in medicine (MD Program), Clinical Psychology (PsyD Program), Biomedical Sciences (PhD), Public Health (PH), and a Professional Post-graduate certificate degree in Family and Couples Therapy. Ponce School of Medicine began its Clinical Psychology Program in 1999. By the year 2004, the program had received APA accreditation and for the 2007 re-accreditation process, the program was re-accredited for seven years.

To address the training needs of the students of the Clinical Psychology Program and to address the psychological services needs of the neighboring community, a mental health clinic was created in 2000, the Center for Psychological Services (CSP). In 2002, an Internship program (PSM-IP) was developed to address the advanced training needs of the Clinical Psychology Program students. PSM-IP operates within the CSP facilities. These facilities include nine therapy offices, one administrative office, an interns’ office/lounge, a record room, office space for a receptionist, and a patient waiting / reception area. The mission that guided the development of the PSM internship program is:

To provide a solid clinical, professional and learning experience for the PSM Clinical Psychology students during their internship year by providing the necessary opportunities for the consolidation of prior knowledge, skills and attitudes, and for further development of the Clinical Psychologist professional role.

Consistent with the basic concepts of professional training in Clinical Psychology elaborated at the Boulder Conference (Raimy, 1950) on the role of internship programs in graduate training, PSM-IP provides its interns the opportunity for further development of the Clinical Psychologist role. The internship strives towards strengthening students’ identity as ethical and self-respecting psychologists. It provides an opportunity for integrating the extensive theoretical information received during the years of academic training, with the skills and ethical attitudes of the field. The Cube Model, with its emphasis on the development of foundational and functional competencies (Rodolfa, et.al., 2005) is used by PSM-IP for the elaboration of its goals, objectives and training activities.

By the end of the internship program the predoctoral intern has had the opportunity to become what the 1987 Gainesville Conference delegates described as “an individual who has demonstrated the capability to function autonomously and responsibly as a practicing psychologist" (Belar et al. 1987).


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PROGRAM VISION

Consistent with the training tradition in professional psychology and with the current trends in the field, the PSM IP holds as its guiding vision that:

PSM Clinical Psychology Internship Program will develop diversity-sensitive Clinical Psychologists who, within a 12 or 24 month period, will be prepared to assume multiple roles in diverse clinical, academic and professional settings, and who will be capable of setting a new standard of excellence in the practice of Clinical Psychology in Puerto Rico and abroad. The internship program will be known for providing opportunities for the development of the multiple skills and attitudes needed to practice Clinical Psychology based upon a biopsychosocial/systemic model.

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GOALS AND OBJECTIVES

The goals that guide this program are designed to help staff and students fulfill the program’s mission. Each goal is divided into objectives that solidify the assessment of the stated goals. Consistent with the Cube Model for competency development (Rodolfa, 2005) the objectives are constructed on the bases of functional and foundational competencies. The Internship goals and objectives are described below:

Goal I: To prepare clinical psychologists to be able to competently integrate the knowledge, skills, attitudes, and values that serve as the foundation of clinical practice through the provision of a broad-based training experience.

Objective 1: The intern will develop/consolidate reflective practice-self-assessment competencies as evidenced by his/her professional conduct, lifelong learning commitment, engagement in scholarly work, and critical thinking.

Objective2: The intern will develop/consolidate scientific mindedness and apply scientific and evidence-based methodology in their clinical practice.

Objective 3: The intern will develop/consolidate the personal and professional characteristics that enable the formation and maintenance of professional relationships with clients, colleagues, supervisors, faculty, multidisciplinary healthcare team professionals, and community members.

Objective 4: The intern will develop/consolidate the capacity to successfully manage complex ethical reasoning and decision making in their clinical practice.

Objective 5: The intern will develop/consolidate awareness, attitudes of respect, and appropriate responses regarding all dimensions of diversity (e.g. gender, socioeconomic status, affective orientation, ethnicity, physical and mental capacities, religion, spirituality, and age) in their clinical practice.

Objective 6: The intern will develop/consolidate the ability to recognize and engage in opportunities for effective collaboration with other professionals toward shared goals.


Goal II: To prepare clinical psychologists for the ethical delivery of evidence-based psychological services in diverse clinical situations through the provision of a wide variety of sequential, organized, and supervised training experiences.

Objective 1: The intern will develop/consolidate understanding and solid command of clinical assessment, diagnosis and case conceptualization adapted to particular populations and/or problems.

Objective 2: The intern will develop/consolidate the skills and knowledge to appropriately select and execute evidence-based psychological interventions as well as to document and evaluate therapeutic progress accurately.

Objective 3: The intern will develop/consolidate the knowledge to articulate, implement, and evaluate consultation services/ interventions applying a variety of intervention models.

Objective 4: The intern will develop/consolidate the ability to evaluate and apply current research to their clinical practice and exercise command of different methods of scientific inquiry in clinical settings
.
Objective 5: The intern will develop/consolidate the ability to utilize appropriate supervisory and teaching strategies/skills in enhancing the professional functioning of 1st and 2nd years Clinical Psychology graduate students who are beginning to acquire basic clinical skills.

Objective 6: The intern will be able to develop and/or consolidate administrative skills and will learn to apply a variety of models appropriate to lead the delivery of professional services.


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MAIN COMPONENTS OF THE PROGRAM

The PSM Internship program (PSM IP) is designed as a Generalist/Practitioner Internship program. However, students have the opportunity of exploring a number of areas including, Family Therapy, Health Psychology, Mental Health Administration, and Psychological, Psychoeducational and/or Neuropsychological Assessment. The internship is currently considered captive since it is only accepting students from the Clinical Psychology Program at Ponce School of Medicine. As stated in its vision and mission, the IP aims at providing the intern with the opportunity (in terms of setting, experience, and supervision) to begin assuming the professional role of a psychologist consistent with the Practitioner/ Scholar model of training.


Clinical

Students in the PSM IP are expected to invest a minimum of 13 hours per week in face-to-face patient contact hours. Such experience includes a wide range of clinical activities including:

  1. Psychotherapeutic interventions: Individual, marital, family and group modalities

  2. Psychological assessment: Intelligence, personality, psychoeducational, and neuropsychological testing along with psychodiagnostic report preparation.

  3. Consultation with collaterals: Relatives, schools, courts, medical staff and other relevant individuals.

Advanced Trainings for Interns

The program includes a sequence of didactic experiences designed to enhance the intern’s theoretical background and capacity to apply knowledge to specific clinical populations and situations. At this level, the intern is expected to integrate multiple sources of information into a coherent and readily accessible frame of reference. Therefore, a sequence of clinical workshops is provided to achieve this goal. Furthermore, the didactic component includes opportunities for interns to present cases and to obtain feedback from peers and supervisors on how he/she applies the knowledge and techniques acquired through the training program to specific clinical situations. The main focus of the didactic component is the acquisition and consolidation of theory and clinical models to guide specific interventions within the framework of Evidence-Based Practice (EBP). To this end, advanced trainings are divided in Modules and General Topics to allow flexibility for areas identified in need of reinforcement. The modules offered address the following areas:

Module I. Organization Skills for Interns
Module II. Evidence Based Practice in Psychology
Module III. Advanced Conceptualization and Treatment Planning
Module IV. Legal Aspects of Clinical Practice
Module V. Advanced Psychological Testing
Module VI. Cognitive Functioning in Old Age
Module VII. Evidence Based Interventions for Affective, Anxiety, and Personality Disorders
Module VIII. Interventions with Families and Couples
Module IX. Models of case consultation and management
Module X. Models of Clinical Supervision
Module XI. Development of Private Practice in Clinical Psychology

Family Team

Interns participate in bi-weekly family team interventions supervised by Dr. Nydia Ortiz. Family therapy sessions are conducted by interns, with Dr. Ortiz acting as “family consultant”. Interns not doing interventions with a family, participate in the training session as members of the Family Therapy Reflective Team who sit inside the therapy room with the family and the supervisor/consultant (Andersen, 1991) and reflect on the situations presented by the family. The other interns observe the sessions through the one way mirrors.

Academic

Interns have the opportunity to explore the academic world by utilizing their clinical and academic experience in the supervision of entry-level graduate students and serving as Teaching Assistant to professors. The internship program provides for such experiences and encourages interns to develop basic teaching and supervisory skills.

Dissertation Time

All interns are provided four hours per week of free time to work on their dissertation or to engage in one of the CPP´s research activities. These hours need to be authorized by the dissertation committee member or by the professor in charged of the research project.

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THEORETICAL APPROACH


The PSM IP subscribes to a biopsychosocial orientation with a systemic approach. Within this orientation, supervisors and professors emphasize a variety of treatment frameworks and modalities, mostly those that adhere to Evidence Based Practices. These modalities include; Cognitive and Cognitive-behavioral Therapy, Short term Psychodynamic, Systemic, and Postmodern approaches. The emphasis is on accurate diagnosis, conceptualization, and utilization of evidence-based techniques.

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APPLICATION PROCESS

The PSM IP utilizes the Association of Psychology postdoctoral and Internship Centers (APPIC) application process and format. The PSM Clinical Psychology students applying for the internship must submit a curriculum vitae, three letters of recommendation, an official transcript, copy of a complete clinical intervention or case write-up (without testing) and two psychological reports that include psychological tests. In order to apply for the internship program the student must have approved all academic courses and must have passed the Clinical Practice Examination. Additionally, the student must have a dissertation proposal approved before submitting the application.

The internship committee will review all the submitted documents and will invite qualified students for an interview. After all the interviews are conducted, the Internship Committee will select the students and submit the Rank Order List to APPIC.


The PSM IP utilizes the Association of Psychology postdoctoral and Internship Centers (APPIC) application process and format. The PSM Clinical Psychology students applying for the internship must submit a curriculum vitae, three letters of recommendation, an official transcript, copy of a complete clinical intervention or case write-up (without testing) and two psychological reports that include psychological tests. In order to apply for the internship program the student must have approved all academic courses and must have passed the Clinical Practice Examination. Additionally, the student must have a dissertation proposal approved before submitting the application.

The internship committee will review all the submitted documents and will invite qualified students for an interview. After all the interviews are conducted, the Internship Committee will select the students and submit the Rank Order List to APPIC.

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GENERAL PROCEDURES AND GUIDELINES

The following procedures and guidelines describe the responsibilities of the internship and of the interns. They are discussed at the beginning of each internship cycle and signed by the intern and the clinic director.

Program location: PSM IP takes place at the Center for Psychological Services which is an integral part of the institution’s Clinical Psychology Doctoral Program.

Program duration: The PSM IP has a duration of 12 months for full time students or 24 months for part time students.

Starting and ending dates: The program starts the first week of July and ends during the last week of June of the following year.

Work hours: Work hours are from 12:00 noon to 8:30pm, Monday through Friday.

Schedule changes: Any change to this schedule must be approved by the clinic’s director.

Signing in/out: The intern must sign his/her attendance sheet at the beginning and end of the work day. The intern must notify the chief intern and/or the clinic’s director before leaving the clinic during work hours. Every time the intern leaves the clinic he/she must sign out on the attendance sheet and sign back in when he/she returns.

Changes in internship schedule: The intern must notify the internship committee, in writing, of any change in his/her schedule.

Absences: The intern must provide a justification or doctor’s note for every absence exceeding 48 hours. Every absence must be notified to the chief intern, director, supervisor, and patients. Maternity days or hours must be replaced.

Timeliness: The intern is always expected to be timely. All delays must be notified to the chief intern, director, supervisor, and patients.

Vacation: The intern is entitled to 10 vacation days. Six (6) of these have been pre-determined by the PSM Christmas vacation closing period. The other 4 days would be programmed according to the intern’s petition to the chief intern and the approval of the clinic and internship director.

Holidays: The observed holidays during the internship year will be provided at the beginning of each internship cycle so that interns are able to plan accordingly.

Accountability and Report of Internship Hours:
 
  •  The intern is responsible to keep a precise account and report of his/her hours.
  • The intern is responsible for completing a monthly report of the work hours spent in each of the listed clinical activities
  • These reports (2 copies) are to be handed to the Chief Intern by the first of each month.
Internship documentation: The intern is responsible for maintaining all documentation related to his/her internship up to date (evaluations, hour reports, supervision notes, etc.).

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TRAINING PROGRAM’S EXPECTATION OF TRAINEES

The expectations of interns are divided into three areas: (A) knowledge of and compliance with relevant professional standards, (B) acquisition of appropriate professional skills, and (C) appropriate management of personal attitudes as they relate to professional functioning.

Each of these areas is described below:
 
A. Professional Standards: In accordance to this area, interns are expected to:
  1. Be cognizant of and abide by the guidelines as stated in the APA Ethical Principles of Psychologists and Code of Conduct, Standards for Providers of Psychological Services, Specialty Guidelines, and the Code of Ethics of the Puerto Rico Psychological Association which address psychologists' ethical, personal and/or legal responsibilities. Be cognizant of and abide by the laws and regulations governing the practice of psychology as stated in the pertinent legal documents. Such documents include but are not necessarily limited to the Puerto Rico Board of Examiners in Psychologists (Law 96).

    The Internship program recognizes that mere knowledge of and exposure to the above guidelines and standards are not sufficient. Interns need to demonstrate the ability to integrate relevant professional standards into their own repertoire of professional and personal behavior. Examples of such integration include a demonstrated awareness of ethical issues when they arise in work with clients, appropriate decision making in other ethical situations, and awareness of ethical considerations in their own and other's professional work.
B. Professional Competency: By the time the internship is complete, interns are expected to:
  1. Demonstrate knowledge of psychopathology and of developmental, psychosocial and psychological problems.
  2. Demonstrate knowledge of the special issues related to clinical work with disadvantaged populations.
  3. Demonstrate knowledge and skills in conducting diagnostic procedures and diagnostic techniques including psychological assessment and psychodiagnostic interviewing with children, adolescents, and adults.
  4. Demonstrate knowledge and skills in providing therapeutic interventions including individual psychotherapy (various modalities), case management, family therapy, group psychotherapy, crisis intervention, and consultation with children, adolescents, and adults.

    Interns are expected to make steady progress throughout the year in the acquisition and mastery of these competencies. Interns are expected to achieve the expected levels of competency in each area by the end of the internship year.
C. Personal Functioning

The training program recognizes that there is a strong relationship between the level of personal functioning and effectiveness as a professional psychologist, most notably as it relates to the professional roles to be assumed in the delivery of mental health services to clients. Physical, emotional and/or educational problems may interfere with the quality of an intern's professional work. Such problems include but are not limited to a) educational or academic deficiencies, b) psychological adjustment problems and/or inappropriate emotional responses, c) poor management of personal stress, d) inadequate level of professional development, and e) inefficient use of and/or response to supervision.

When supervisors or other staff members detect that personal issues significantly interfere with an intern's professional functioning, such information will be communicated to the intern, initially through verbal communication and in the event the problem persists, through written communication. The training program, with the participation of the intern, will formulate strategies for ameliorating the difficulties or problems, and will implement the selected strategies and procedures. If such attempts do not restore the intern to an acceptable level of professional functioning within a reasonable period of time, consideration will be given to discontinuation from the program. The specific procedures employed for the acknowledgment and amelioration of intern deficiencies will be described later in this document (see evaluation and grievance procedures).


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TRAINING PROGRAM RESPONSIBILITIES

A major focus of the PSM-IP is assisting interns in integrating their personal values, attitudes and functioning as individuals with their professional identity and performance. The training program is committed to providing the type of learning environment that allows interns to meaningfully explore personal issues which relate to their professional functioning. To address these expectations, the training program assumes a number of responsibilities. The responsibilities correspond to the three general expectation areas (Professional Standards, Professional Competency, and Personal Functioning) and are described below:
 

A. The training program will provide interns with information regarding relevant professional standards and guidelines and will provide appropriate forums to discuss the implementations of such standards.

B. The training program will provide interns with information regarding relevant legal regulations that govern the practice of psychology and will provide opportunities for the analysis, discussion and appropriate implementation of these regulations.

C. The training program will provide written evaluations of the intern's progress with the timing and content of such evaluations designed to facilitate interns' change and growth as professionals. Evaluations will address the interns' knowledge of and adherence to professional standards, their professional skill competency, and their personal functioning as it relates to the delivery of professional services.

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SUCCESSFUL COMPLETION REQUIREMENTS

To complete this internship program the interns must satisfy the following requirements:
 
  1. Satisfy the minimum requirement of 13 hours per week of face to face interventions with patients and their collaterals for a minimum of 500 hours for the internship cycle.
  2. Write a minimum of ten psychological assessment (testing) reports.
  3. Participate in all required training programs, staff meetings and case conferences.
  4. Demonstrate a commitment towards professional and personal growth
  5. Demonstrate ethical behavior in all endeavors related to professional and personal behavior while at their training sites and in the community
  6. Comply with all supervision requirements
  7. Utilize prescribed remedies (described in pages 11-15) in the due process section of this manual) to address conflicts or difficult issues with patients, staff or with supervisors
  8. Satisfy the time requirement of 2000 hours of documented internship activities.

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INTERNSHIP STAFF AND AREAS OF INTEREST

Internship Interim Director

Rank

Areas of Interest and Expertise

José Pons Madera, Ph.D.

Full Professor Clinical Psychology

Psychological Testing, Clinical Neuropsychology, Mental Health and Academic Administration, Rorschach & Personality Psychology, Addictions Psychology, Consultation.

 

 

 

Supervisor and Professors

Rank

Areas of Interest and Expertise

Pura Dedós López, Psy.D.

Assistant Professor -Director of Center for Psychological Services

HIV/AIDS, Group processes, Health Psychology.

Nydia Ortiz-Pons, Ph.D.

Associate Professor – Director of Family Therapy Certificate

Family Therapy and Systemic Interventions, Postmodern and Narrative Therapies, Addictions in Adolescents, Organizational Issues, Team Building and Academic Administration, Teaching of Psychology.

Axel Santos, Ph.D.

Assistant Professor

Psychological research, Depression and Mood disorders, Socio-historic Models of Intervention.

Luisa Ferder, M.D.

Associate Professor

Psychoanalysis, Child Analysis and Play Therapy, Pediatrics, Short-Term Dynamic Therapy,

Leida Matías, Ph.D.

Assistant Professor

Psychological Assessment and cultural adaptation of tests, School psychology, research in mental health service utilization.

Nanet López, Ph.D.

Assistant Professor

Health Psychology, Psycho-oncology, psychological testing

Beatriz Cintrón, Psy.D.

Assistant Professor

Psychotherapy, Projective Personality Assessment, Neuropsychological assessment, Clinical Neuropsychology.

Maria Garrido, Psy.D.

Associate Professor

Objective Personality Evaluation, Forensic Psychology, CT and CBT therapy, Evidence-based treatments

Nydia M. Cappas, Psy.D.

Assistant Professor

Psychotherapy, Trauma, Poverty and Diversity, Recovery from severe mental illness, Brain-Based Psychotherapy

Giselle Medina, Psy.D.

Assistant Professor

Child development, assessment of pre-schoolers, psychological and psychoeducational testing, individual, family and couples psychotherapy.

Walter Rodríguez, Psy.D

Assistant Professor

Neuropsychological Assessment and peri-surgical assessment of neurological patients, Neuropsychological Rehabilitation, Cognitive Psychology.


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CULTURAL AND SOCIOECONOMIC DIVERSITY

The PSM Internship program intends to prepare psychologists for practice in different cultural contexts. In the context of Puerto Rico, diversity is reflected on the many ethnic backgrounds that compose our culture, the varied manifestations of affection and love, and the difference in access to resources in our community. Exposure to patients from different socio-economic backgrounds is expected from all interns. However, exposure to patients from different ethnic backgrounds might not be a frequent experience during a particular year due to the ethnic homogeneity of the community the program serves. Nonetheless, most interns will work with persons who have had migratory experiences and who have multiple experiences of oppression and disenfranchisement.

Discrimination and oppression manifest in the context of Puerto Rico in ways that are both, similar and different from USA. A predominant manifestation of oppression is the variations in access to fundamental resources such as education and health. Discrimination also manifests through racism, sexism, ableism, and heterosexism. PSM IP is committed to promote culturally competent services respectful of all manifestations of diversity in our students, clients, and staff.

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SUPERVISION


Interns obtain two hours of individual supervision per week and two hours of group supervision. Interns are expected to be fully prepared for supervision. They are expected to explore the literature to address particular issues they confront while in clinical practice. Supervisors are to serve as mentors but are also to expect compliance with recommendations and assignments. Supervisors are knowledgeable of the competencies required by interns and are prepared to assist in their development.

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THE EVALUATION PROCESS

D. Evaluation of student by supervisor - Formal evaluations are conducted three times in the internship year. The first evaluation is performed at the beginning of the internship to develop a baseline of the intern’s competencies. The other two evaluations are conducted at the end of each internship semester. During the process of evaluation, supervisors will discuss the areas of strength and the areas in need of further improvement. The evaluation form is completed and signed by both parties. Although the formal process of evaluation is conducted twice a year, students will frequently receive feedback during weekly supervision sessions. To address areas identified in need of improvement, a corrective plan will be developed between the student and the supervisor. If discrepancies in the assessment process occur and these are not solved through informal negotiations, the grievance procedures (page 11-15 of this manual) should be followed.


E. Evaluation of supervisor by student – Students evaluate their supervisors and the supervision experience semi-annually through a written evaluation. The evaluation is analyzed by the Internship Coordinator who will be in charge of integrating the feedback and discussing any concerns with internship supervisors. Any mayor concern that cannot be solved through this process should be channeled through the process described in PSM Faculty Manual and page 11-15 of this manual.


F. Evaluation of internship experience by student – Students also evaluate the internship experience. This process serves as feedback to the program and provides the Internship Committee an opportunity to identify the program’s strengths and the areas in need of improvement. The Internship committee is in charge of evaluating the information provided by students and implementing appropriate suggestions.


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DUE PROCESS GUIDELINES

Definition of Problem
For purposes of this document trainees’ problem is defined broadly as an interference in professional functioning which is reflected in one or more of the following ways:
  1. An inability and/or unwillingness to acquire and integrate professional standards into one's repertoire of professional behavior,
  2. An inability to acquire professional skills in order to reach an acceptable level of competency, and/or
  3. An inability to control personal stress, psychological dysfunctions, and/or excessive emotional reactions which interfere with professional functioning.


While it is a professional judgment as to when an trainee's behavior becomes more serious (i.e., problematic) rather than just of concern, for purposes of this document a concern refers to a trainees' behaviors, attitudes, or characteristics which, while of concern and which may require remediation, are perceived to be not unexpected or excessive for professionals in training. Problems typically become identified as problems when they include one or more of the following characteristics:

  1. The trainee does not acknowledge, understand, or address the problem when it is identified,
  2. The problem is not merely a reflection of a skill deficit which can be rectified by academic or didactic training,
  3. The quality of services delivered by the trainee is sufficiently negatively affected,
  4. The problem is not restricted to one area of professional functioning
  5. A disproportionate amount of attention by training personnel is required,
  6. The trainee's behavior does not change as a function of feedback, remediation efforts, and/or time,
  7. The problematic behavior has potential for ethical or legal ramifications if not addressed,
  8. The trainee’s behavior negatively impacts the public view of the agency,
  9. The problematic behavior negatively impacts the trainee’s class.
     

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Grievance Procedure General Guidelines

The guidelines described in this section are designed to ensure that decisions made by programs about interns are not arbitrary or personally based. When grievance procedures are considered or initiated, the following guidelines should be employed:

  1. All actions taken by the program and its rationale process must be documented, in writing and to all relevant parties.
  2. The program's expectations related to professional functioning must be presented to the intern, supervisor and/or staff in writing.
  3. All procedures and actions involved in making decisions regarding the problem will be available to the intern, supervisor and/or staff and parties involved.
  4. The graduate program should be informed early and often, about any suspected difficulties with interns, seeking input from the graduate program about how to address such difficulties.
  5. A remediation plan for identified inadequacies, including a time frame for expected remediation and consequences of not rectifying the inadequacies must be communicated in writing to the intern, supervisor and/or staff and all parties involved.
  6. The intern, supervisor and/or staff must be provided with a written procedure which describes how to appeal the program's action.
  7. Interns, supervisors and/or staff must have sufficient time to respond to any action taken by the program.
  8. Using input from multiple professional sources when making decisions or recommendations regarding the intern, supervisor and/or staff performance is encouraged.
  9. Whenever possible, the least restrictive/punitive alternative should be considered.
  10. Grievance procedures should be considered only after other alternatives (direct communication, mediation) are exhausted or when it is not possible to engage in this action because of the nature of the problem.
     

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Supervisor’s or staff grievance with a student

The following guidelines govern the process of a supervisor’s or staff grievance with a student. There are two principal situations in which a supervisor or staff member is compelled to present a grievance with a student: (1) Inadequate performance is consistent and has not improved after completion of the initial remedial plan; (2) Unethical or legal violation of professional standards or laws, professional incompetence, or infringement on the rights, privileges or responsibilities of others. Every step should be evidenced by written documents that explain the actions taken, decisions made, agreements and outcomes:

Step I: The supervisor or staff person will bring the issue with the Internship Coordinator.

Step II: The Internship Coordinator will inform the issue in writing to the Internship Committee and the student. The student should have time (at least 10 days) to react to the letter with the Internship coordinator.

Step III: The Internship Committee will meet along with the Internship Coordinator, the Clinic Director and a faculty of the student’s choosing. The Committee can recommend, but is not limited to one of the following actions:
  1.  Increased supervision with one or more supervisors
  2. Change in format, emphasis and/or focus of supervision or training
  3. Recommendation/requirement of personal therapy when the problems are psychological in nature
  4. Reduction of the intern's clinical or other professional duties
  5. Addition of special academic coursework or other remedial activity
  6. Recommendation, when appropriate, of a leave of absence and/or a second internship at another setting.


Step IV: When a combination of the above interventions does not, after a reasonable time period, rectify the impairment, or when the trainee seems unable or unwilling to alter her/his behavior, or improve his/her skills, Step II will be repeated. The Internship Committee may need to take more formal action, including:

  1. Giving the intern a limited endorsement for employment or letters of reference, specifying those settings in which she/he could function adequately.
  2. Communicating to the intern and academic department/program that the intern has not successfully completed the internship
  3. Recommending and assisting in implementing a career shift for the intern
  4. Terminating the intern from the internship training program.
     

All the above steps need to be adequately and appropriately documented in ways that are consistent with due process procedures.
 

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Student’s grievance with a supervisor or staff member

The following guidelines state the process of a student’s grievance with a supervisor or staff member. Every step should be evidenced by written documents that explain the actions taken, decisions made, agreements and outcomes:

Step I : Student should discuss the issue with the supervisor or staff member and attempt to resolve the problem. If the matter is not resolved, proceed to Step II.

Step II: Discuss the issue with the Internship Coordinator. If the matter cannot be resolved, or if the Coordinator of Internship is the object of the grievance, or is unavailable, the issue should be raised with the Program Director. The Internship coordinator and or the Program Director will attempt to resolve the issue through mediation or taking appropriate actions. If this attempt at solving the problem is not successful, proceed to step III

Step III: If mediation fails, the Internship Coordinator will raise the matter with the Internship Committee. The committee will review all written materials and will interview the parties involved if needed. The student can request that a faculty member of his/her choosing participate in the review. The internship committee will have an opportunity at its discretion to interview the parties or other individuals with relevant information The Internship Committee will recommend the appropriate course of action to the Internship Director. The Internship Committee along with the Internship Director have final discretion regarding outcome.

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Appeal

The intern can appeal the Internship Committee decision within 10 days of receipt of the decision. The student has to inform the Internship Coordinator, in writing, of such a challenge.

  1. Internship Coordinator will convene a Review Panel consisting of two faculty members selected by the Internship Coordinator and two faculty members selected by the intern, supervisor and/or staff. The intern, supervisor and/or staff retain the right to hear all facts with the opportunity to dispute or explain his or her behavior.
  2. A review hearing will be conducted, chaired by the Internship Coordinator, in which the challenge is heard and the evidence presented. Within 15 days of the completion of the review hearing, the Review Panel submits a written report to the Program Director, and Internship Coordinator including any recommendations for further action. Decisions made by the Review Panel will be made by majority vote. The intern, supervisor and/or staff are informed of the recommendations.
  3. Within 5 days of receipt of the recommendations, the Program Director will accept the Review Panel's action, reject the Review Panel's action and provide an alternative, or refer the matter back to the Review Panel for further deliberation. The Panel then reports back to the Program Director within 10 days of the receipt of the Program Director's request for further deliberation. The Program Director makes a decision regarding what action is to be taken and that decision is final.
  4. Once a decision has been made, intern, supervisor and/or staff, sponsoring university and other involved parties are informed in writing of the action taken.

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