(Intern)al Update

So, I’ve been working at the hospital and mental health facility for just over a month and a half now. My first rotation on the Partial Hospitalization unit has been very good. Everyday is a bit like working in a triage. I’ve worked as a therapist and case manager from intake to discharge for seven full cases thus far and each one is definitely unique in itself. I’ve had a few challenging cases of polysubstance dependent adolescents with comorbid Axis I and II disorders that left me on the unit in continual bewilderment. The amount of deceit and manipulation certainly elevates with drug and alcohol cases.

As I approach my second rotation in Inpatient Assessment and Consultation, I’m brushing up on my personality testing, particularly the Rorshach and the Thematic Apperception Test, both of which I will be giving somewhat regularly for 10 weeks. I’m looking forward to the experience since I didn’t get to run projectives to this degree as a school psychologist. The validity scales and reliability coefficients are fairly low for personality projective testing, but there is still some value in obtaining scores for severely mentally ill and disassociative patients.

I’ve also been brushing up on my child and adolescent developmental theorists, particularly Jean Piaget and Erik Erikson. I’ve also been reading more about clinicians work with Dialectical Behavioral Therapy and Rational Emotive Therapy in addition to my already more pronounced clinical work with Cognitive Behavioral Therapy. I’m coming across so many more severely mentally ill individuals that I’m having to tighten up on my conceptualization and clinical skills. I’m also getting to see a broader spectrum of mental illness from outpatient adjustment and family systems issues to severe adolescent mental illnesses like emerging schizophrenia, bipolar individuals with hypomanic psychotic features, and occasional juvenile justice cases.

So, I’ll try and give further updates about my work on the unit. I’m enjoying the challenge for now and hope to make some real changes in the lives of my cases. I find that everyday and actually every minute is profoundly different. I hope to keep up my energy and continue to work on my own conceptualizations and theories in child and adolescent psychopathology. There’s a vast area of clinical research out there and seemingly limited time.