Tag Archive for: RAMS Training Institute

Wellness Center Practicum

Wellness Center Practicum


High school site-based clinical training programs designed to provide Marriage Family Therapy and Clinical Social Work interns new skills by working in a school setting.




Program Overview

RAMS, inc. (Richmond Area Multi-Services) offers a high school site-based clinical training program designed to provide Marriage Family Therapy, and Clinical Social Work interns and trainees with the generalized professional practice skills of a behavioral health counselor in a high school setting. We are accepting clinicians-in-training into our program, giving preference to students who have an expressed interest in cultural competence and the vision of working long-term with adolescents in a school milieu.

Trainees/interns will have the opportunity to develop individual and group counseling skills, in both mental health and substance use issues through the high school Wellness Centers In addition, students will learn intake/assessment, case management, and crisis intervention skills as well as gain familiarity of the San Francisco Unified School District (SFUSD) system and youth services in San Francisco.

Located in 19 public high schools, the Wellness Center programs are a joint project between SFUSD, SFDPH, and RAMS. The Wellness program is responsible for serving, primarily non-academic needs of the students and is comprised of a core staff typically including a Wellness Coordinator, a school health nurse, a CHOW (Community Health Outreach Worker), and RAMS Behavioral Health Counselor. The Wellness Center team provides counseling and other health services, but also works to link students and their families to resources outside of school, and to bring community based organizations on campus. The vision of Wellness purports that a well supported student has the best chance for academic and personal success. For more information on the Wellness Initiative, please visit their website at www.sfwellness.org

Five teenage girls laughing together.

Training & Role

Our trainees/interns function as integral members of RAMS Behavioral Health Counseling team of the Wellness Centers Program. Because of the rich diversity of the client population and treatment team, trainees/interns have the opportunity to hone their clinical skills while developing professional sensitivity to issues of adolescents, culture, ethnic identity, religion, class, disability, gender, and sexual orientation. Trainees/Interns will also have both didactic and supervisory training. Our licensed clinical supervisors have extensive experience as high school-based therapists and each student will receive 1 hour of individual and 2 hour of group supervision weekly. They will also be mentored by RAMS senior behavioral health counselors, and provided administrative support by the Program Director.

As part of our commitment to maintaining and further enhancing the professional development and cultural competence of staff, interns, and trainees, RAMS coordinates various clinical trainings, presentations, case conferences, didactic seminars, and group discussions at which local, national, and internationally renowned experts present on various clinical and cultural topics. Interns/trainees have the opportunity to participate in such events as part of the Wellness internship/traineeship program.

Because RAMS employs over 400 employees in 30 programs, trainings at RAMS have a wide breadth. Trainees/Interns are invited to the majority of these trainings in addition to attending specific trainings geared toward the Wellness Trainee/Intern program. Examples of trainings in 2016 from both the Wellness Program and RAMS at large include:

  • “Short-Term Dynamic Psychotherapy,” Hannah Levenson, PhD
  • “ Reading Body Language in Youth, “ Gabriel Kram, Applied Mindfulness
  • “Trauma, Grief & Loss Issues in Adolescents,” Babe Kawaii-Bogue, PhD
  • “Clinical Boundaries in Schools,” Richard Zevin, LCSW
  • “Countertransference in a School-Based Setting,” Talia Korenbrot, MFT
  • “Brief Intervention System,” Kevin Gogin, MFT
  • “ “Motivational Interviewing & Stages of Change,” Cynthia Hoffman, MFT
  • “Using Alternative Therapies With Teens,” Caya Schaan, ASW
  • “Group Counseling with Teens”, Dennielle Kronenberg, LCSW
  • “Working with African American Youth,” David Shepard, PhD

Roles/Functions of the Behavioral Health Intern/Trainee

Individual Therapy

The RAMS Behavioral Health trainees/interns will generally provide ongoing weekly counseling to students who are unable or unwilling to go off site for counseling due to monetary, academic, or other support challenges. Caseloads range from 8 – 12. Some students are dealing with typical developmental adolescent issues such as concerns about school, friends and individuation. More often, however, students being seen on-going by RAMS have experienced multiple traumas related to issues such as immigration, family, community violence; sexual, physical abuse and/or substance abuse within their families. The length of time that a student is seen by a RAMS counselor varies depending on the presenting problem, the needs of the student, and the demands made on the time of the therapist.

Group Therapy

RAMS facilitates one or more prevention groups at each site every year to address substance abuse related topics. Clinicians are creative in what that group looks like -structure, theme, members, etc. and taper the group to the culture and need of the school. Groups are about 6 weeks in length, but can vary. Interns/trainees may have the option to run or co-facilitate a group during the 2nd semester depending on availability of space.

Assessments

Each Wellness Center receives referrals from teachers, counselors, parents and students about various concerns about students. Interns/trainees may be given referrals to provide a behavioral health assessment. In an assessment, we concentrate on building rapport with students and getting them comfortable with Wellness services. We look at a student’s risk-factors and gather history to assess for mental health and/or substance abuse issues. We help student’s figure out what their strengths are and what they need to succeed both in school and in their lives. We then determine with the student and their family what services best meet their needs and assist them in accessing those services. RAMS counselors know that every student and family has unique needs dependent on culture, socio-economic background, language, and learning style. We will utilize Wellness, school, family, or community support services to best match the needs of the student.

Crisis Intervention

There are many different kinds of crises that can arise in a school setting, such as suicidal/homicidal threats, child abuse, or community violence. An intern/trainee may run into such a crises on their caseload. RAMS and the other members of the Wellness Team at each site works closely with family, school administration and community resources, such as Child Crisis or CPS, to stabilize crises. Interns/trainees will not be expected to handle crises alone, but will be able to utilize our on-call crisis supervision, RAMS and Wellness staff as support.

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Application & Selection

For 2023-2024 our clinical practicum program will offer a total of 6 positions for students.

Each application package should include:

  • A letter of interest and intent (where applicants need to explain why they are interested in our training and point out their appropriate qualifications);
  • Curriculum vitae
  • Two letters of recommendation, preferably, from people who know the applicant’s clinical work.

The deadline for submission is Friday, February 17, 2023.  First and second interviews will be conducted between February 21 and March 24.  Offers made no later than March 31.  Acceptance required by April 14.

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National Asian American Psychology Training Center Doctoral Internship

National Asian American Psychology Training Center Doctoral Internship in Clinical Psychology


NAAPTC began operating in 1979 as the first program in the USA to focus on development of psychologists with expertise in working with Asian and Pacific Islander populations.





General Overview

NAAPTC began operating in 1979. It was originally funded by the National Institute of Mental Health as the first program in the USA to focus on development of psychologists with expertise in working with Asian and Pacific Islander populations. In 1980, our Doctoral Internship Program first received an APA accreditation, which it has consistently maintained ever since (the last APA re-accreditation site visit occurred in the summer of 2016; the internship has been re-accredited through 2023).

The clinical internship at RAMS is a full-time, year-long training program beginning the first week of September and ending the last week in August. The stipend for doctoral internship is $37,232. In addition, full health coverage, including medical, visual, dental benefits and life insurance are provided for the interns; spouses and domestic partners are eligible to purchase coverage through RAMS. RAMS also provides interns with access to its EAP, including psychological and legal counseling. The training year includes 192 hours of PTO and 10 paid holidays.

To verify the APA-accredited status of the NAAPTC Doctoral Psychology Internship, please check the American Psychological Association website: APA Accreditation or contact the APA Office of Program Consultation and Accreditation.

Address: 750 First Street, NE Washington, DC 20002-4242

Phone: 202-336-5979

Email: apaaccred@apa.org

Training Goals, Model and Philosophy

The National Asian American Psychology Training Center’s Doctoral Internship is an experience-based training program that provides socialization into the profession of psychology and development of generalist entry-level psychology practice skills: proficiency for the clinical assessment and conduct of psychotherapy (individual, family, group & couples) across the life span, with a variety of patient populations, and in a broad spectrum of clinical settings. The hallmark of our internship training is development of informed clinical sensitivity to diversity (particularly, in regard to Asian American and Russian-speaking minorities) and building a repertoire of assessment/ intervention skills applicable to a wide range of clients, including the more disturbed and chronically troubled patient.

While receiving didactic and supervisory training, doctoral interns function as integral members of RAMS clinical staff. Our multi-lingual, multi-cultural, and multi-disciplinary treatment team includes mental health peer specialists, vocational counselors, clinical social workers, marriage and family therapists, psychiatric nurses, psychiatrists, and psychologists. Because of the rich diversity of the client population and treatment team, doctoral interns have the opportunity to hone their clinical skills while consolidating their professional identity as a psychologist and developing advanced sensitivity to issues of race, culture, ethnic identity, religion, class, disability, gender, and sexual orientation.

The variety of clinical experiences offered through the RAMS Outpatient Community Mental Health Clinic, and the four available Clinical Rotation sites (CAAP Counseling and Pre-Vocational Services, Hire-Ability/Transitional Aged Youth Services, Peer Based Services, and Broderick Adult Residential Treatment Program) allows our program enough flexibility to accommodate specific learning needs of each intern. Interns have a chance to practice their skills with a wide spectrum of mental disorders, a broad range of clients (e.g. age, marital status, ethnicity, etc.), in various clinical modalities, and in an array of clinical and community settings. The formal training curriculum (didactic seminars, case conferences, individual and group supervision) is designed to parallel and complement this intense clinical exposure and to facilitate the interns’ growth as clinicians and professional psychologists.

The theoretical orientation of the NAAPTC internship is psychodynamic, with emphasis on the Object Relations, Interpersonal & Contemporary Relational Approaches. We train interns to function as participant observers: to avail themselves to input from clients (both verbal and communicated by impact) and to study it. The patient is viewed as a credible interpreter of the therapist’s experience in the “bi-personal filed” of clinical work. This helps interns to maximize learning from their patients and allows treatment to be conducted as a co-participant inquiry in order to better meet each client’s unique needs.

The model for training at the NAAPTC Doctoral Internship is that of the Scholar/Practitioner (the Vail model). Consistent with this approach, which underscores preparation for professional psychology practice that is informed by science, our internship emphasizes the development of clinical skills through provision of many diverse types of direct patient care that are rooted in a knowledge-based foundation of theory, empirical data, and informed sensitivity to issues of diversity. Interns’ learning from this intense experiential exposure is supported by focus on the ongoing evaluation of the efficacy of their interventions and continued treatment planning to improve their clinical services. We teach interns to bring their professional knowledge base and scientific attitudes to their clinical work and to deal with each individual treatment as a unique research project that occurs in the context of the consultation room: to explore their own clinical and cultural biases, to generate clinical hypotheses and to verify them by empirical observations, to select interventions on the basis of case formulations, and to track the outcomes of interventions to support/modify clinical hypotheses. Coupled with the recognition of the value of local observations and local solutions to problems, this attitude of informed curiosity and co-participant inquiry enables interns to go beyond the unquestioned use of technique-based or empirically validated approaches to develop treatment strategies that are both rooted in the accumulated body of scientific and clinical knowledge and respectful of clients’ cultural and personal diversity.

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Internship Core Training Activities

Training Program Overview

The variety of clinical experiences offered through the RAMS Outpatient Community Mental Health Clinic, and the four available Clinical Rotation sites (CAAP Counseling and Pre-Vocational Services, Hire-Ability/Transitional Aged Youth Services, Peer Based Services, and Broderick Adult Residential Treatment Program) allows our training program enough flexibility to accommodate specific interests and training needs of each intern. Accordingly, interns have a chance to develop and practice their skills with a wide spectrum of mental disorders, a broad range of clients (e.g. age, marital status, ethnicity, etc.), in various clinical modalities, and in an array of clinical and community settings. Additionally, all internship training placements provide rich exposure multidisciplinary collaboration, which affords interns the opportunity to consolidate their professional identity as a psychologist. The required Scholarly Projects/Presentation of Professional Work are devised to further promote interns socialization into the profession.

The formal training curriculum (didactic seminars, case conferences, individual and group supervision) is designed to parallel and complement this intense clinical exposure and to facilitate the interns’ growth as clinicians and professional psychologists.

Whereas predominantly psychodynamic/systems in approach, Clinical Supervision is provided in a number of different formats (individual, group, teamwork meetings, and hands-on mentorship) and with different foci (outpatient psychotherapy cases, psychological assessment, rotation clinical work, and cultural competency projects). These varied supervision experiences establish a venue for didactic instruction that meets the particular needs of the intern group as it faces the unique populations served at RAMS.

The training year starts with an intensive three-week-long Orientation Program. After that, interns participate in three mandatory ninety-minute long weekly training series: Psychological Assessment Seminar/Group Supervision, Intern and Trainee Seminar, and In-service Training. Additional didactic trainings are provided at the rotation sites.  Interns can also join one or both elective one-hour-long weekly consultation groups/seminars: Relational Work with Children and Families and Clinical Understanding and Sociocultural Considerations in Working with Community Mental Health Clients.

Both supervision and didactic seminars emphasize issues of comprehensive assessment and treatment for complex mental disorders and include a strong emphasis on cultural competency. This, coupled with the rich diversity of the client population and training staff, gives our interns the opportunity to build a repertoire of culturally competent assessment/ intervention skills applicable to a wide range of clients across the life span, including the more disturbed and chronically troubled patient. The hallmark of our internship training program is development of informed clinical sensitivity to and expertise in working with diversity (particularly, in regard to Asian American and Russian-speaking minorities).

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Orientation to the NAAPTC Internship Program, RAMS Outpatient and Rotation Clinical Work and the San Francisco Community Mental Health System. Three Weeks in the beginning of the year.

The Training Center is located at the site of the RAMS Outpatient Clinic, a free standing mental health facility contracted by the City and County of San Francisco to provide community-oriented mental health services to families and individuals throughout life span. This is where doctoral interns spent most of their year.

While receiving didactic and supervisory training, doctoral interns function as integral members of the Outpatient Clinic’s diverse multi-disciplinary treatment team. Our multi-lingual, multi-cultural, and multi-disciplinary treatment team includes certified mental health peer specialists, clinical social workers, marriage and family therapists, psychiatric nurses, psychiatrists, and psychologists. This intensive exposure to multidisciplinary collaboration affords interns close familiarity with the specific roles psychologists play in the community settings, and provides the opportunity to consolidate their professional identity as a psychologist.

Adult cases are assigned through the RAMS Adult Outpatient and Prevention (AOP) Services and child cases are assigned through the RAMS Children, Youth and Family (CYF) Services. Combined, these two outpatient programs cover the full range of diagnostic groups throughout the life span; a substantial percentage of these patients suffer from severe and persistent mental illnesses. Culturally, the client population is extremely diverse, which affords interns a rich exposure to clinical work with minority clients, particularly, with Asian Americans and Russian-speaking immigrants.

In this setting, interns have the opportunity to hone their clinical skills while exercising flexibility in the use of clinical theory and methodology to account for matters of diversity and to accommodate the needs of the more disturbed and chronically troubled patients. Interns are expected to build a repertoire of culturally competent psychotherapy, clinical evaluation, psychological assessment, and clinical case management skills applicable to broad variety of clients and situations across the lifespan. Because of the nature of the client population, interns also learn counseling related to trauma, mourning and adaptation to major life changes. Through close collaboration with other RAMS programs and a broad variety of San Francisco community mental health agencies, medical clinics, social services and educational organizations, interns gain knowledge of the place and function of the outpatient clinic-based treatment in the community mental health system and the overall system of care. At the Outpatient Clinic, doctoral interns are expected to provide about 12 hours of various direct clinical services per week, including: initial clinical intakes (1 hr on average); administration of psychological assessments (2 hrs on average); individual, family and dyadic psychotherapy with adult and child clients (8 hrs on average); collateral work, consultation to other providers, and clinical case management (1 hr on average). Non-direct casework (initial/ongoing clinical assessment & treatment plan development, multidisciplinary teamwork, etc.) and clinical documentation (charting, billing, utilization reviews, etc.) are conducted as required (2 hrs per week on average).

To diversify interns’ clinical training experience and to provide comprehensive exposure to the system of community-based mental health services, RAMS doctoral interns are assigned to two consecutive External Clinical Rotations. In addition to working with adult and child clients at the RAMS Outpatient Clinic, each intern spends one day a week at a rotation site delivering clinical services and receiving on-site training and supervision, which is provided both individually and in the form of a treatment team consultation. The two rotations are selected from four options that represent different levels of mental health treatment and prevention embedded into a “non-mental-health-focused” system:

Vocational Rehabilitation Support Services: CAAP Counseling and Pre-Vocational Services
Residential Services: Broderick Street Adult Residential Facility Services
Professional Development and Empowerment Services: Peer-Based Services and Hire-Ability Vocational- Transitional Aged Youth Services

Whereas predominantly psychodynamic/systems in approach, Clinical Supervision takes a number of different formats. For their work on outpatient therapy cases, interns receive two hours of weekly Individual Supervision with two different supervisors and one hour of group supervision with an external Delegated Supervisor. Their assessment work is supported by a weekly 2-hour–long Group Supervision/Seminar on assessment cases and weekly half hour of individual supervision on assessment cases with Assessment Supervisor (plus the ongoing support on report writing via phone/email as needed). Weekly hourlong group supervision with Director of Training focuses on interns’ work Cultural Competency Projects; in the last two months of the training year, after interns complete Cultural Competency Projects, the focus of this meeting shifts to Professional Issues: processing of various aspects on interns’ experience and professional development within the framework of legal, ethical and professional standards. At rotation sites, interns receive one hour of weekly individual/group supervision, supplemented by ongoing hands-on modeling and mentorship (formats differ at different rotations). Additionally, interns have a choice of joining one or both elective one-hour-long weekly consultation groups/seminars: Relational Work with Children and Families and Clinical Understanding and Sociocultural Considerations in Working with Community Mental Health Clients.

Monthly one-hour-long Training Group Meeting with the Director of Training (includes practicum trainees); monthly inter-program Clinical Grand Rounds at the Outpatient Clinic (includes clinical staff, interns and trainees from multiple RAMS programs); weekly multidisciplinary team meetings at Rotation Sites; quarterly All RAMS Meeting with the RAMS CEO and representatives from all RAMS programs.

Interns’ training year starts with an intensive three-week-long Orientation Program. After that, in addition to the didactic trainings provided at the external clinical rotation sites and the “interns-only” weekly Assessment Seminar and Cultural Competency/Professional Issues Seminar, there are two weekly mandatory ninety-minute training sessions where interns are exposed to clinical and diversity issues within the context of a multidisciplinary treatment team and training cohort. One, which is held on Tuesdays, is a Trainee and Intern Seminar, and the other is held on Wednesday as an In-service Training open to the entire RAMS staff.

The Intern and Trainee Seminar (Tuesday, 10:25 am-11:55 am) involves doctoral psychology interns, psychology practicum trainees, and interns from other mental health professions (i.e. Marriage & Family Therapy and Social Work). This seminar is structured and timed to parallel and facilitate trainees and doctoral interns’ progress and to follow the development of yearlong treatments they are conducting. Correspondingly, in the course of the training year the seminar goes through several distinct stages. The initial sessions, part of the orientation program, provide a historical overview of treatments for the poor mentally ill and an introduction to the specifics of conducting therapy in the Outpatient Clinic. They are followed by a series of trainings designed to lay the foundation for culturally informed psychodynamic therapy with the poor, minorities and severely mentally ill in the context of a community mental health center. The next training series is designed to help trainees and interns foster greater cultural self-awareness in the clinical context. At this stage, training is mainly experiential and consists of individual presentations and group discussions of cultural biases and predilections that influence how interns and trainees conceive of their work and how they experience their clients. (For a list of suggested questions to address in one’s cultural presentation, please click here.) Later in the training year, the Intern and Trainee Seminar becomes a four-months-long weekly Clinical Case Conference. Toward the end of the training year, the focus of this forum shifts again, this time toward emphasis on terminations with clients and the training program and on related professional development issues.

In addition to participating in this seminar alongside practicum trainees, Doctoral Interns are expected to act as co-facilitators of the case conference and peer-supervisors vis-a-vis their less experienced colleagues.

At the In-service Psychotherapy Seminar (Wednesday, 9:10 am-10:30 am) interns and trainees participate with RAMS staff in a training program of invited speakers, presenting on specific clinical, cultural, and professional development topics that are pertinent to work with RAMS client populations. This series also includes three yearlong monthly clinical case conferences: Clinical Grand Rounds, Adult Case Conference and Child Case Conference).

The didactic module of the in-service training feathures issues of comprehensive treatment for complex mental disorders, social and cultural factors that influence symptom manifestation and treatment course; biological symptom management and the use of medications; evidence-based treatment strategies for specific disorders; and culturally responsive approaches to working with minority populations. Being a psychodynamic program, most presentations emphasize contemporary psychoanalytic theories and psychodynamic treatment principles as they apply to severe mental illness and working with minorities.

As part of this series, Doctoral Interns are required to present at least one adult and one child case to the entire clinic’s staff and to an invited discussant (usually, a psychoanalyst or a psychodynamic therapist practicing in the community). This is also setting where the doctoral interns present their Cultural Competency Projects at the end of their internship year. In this way, interns have the opportunity to conduct a professional presentation to a group of colleagues with advanced experience and training, and it is our way of introducing them to the role that psychologists play in contributing to and advancing our understanding of the human experience.

Additionally, interns can choose one or both elective one-hour-long weekly consultation groups/seminars: Relational Work with Children & Families and Psychodynamic Conceptualization in Working with Severely Mentally Ill Adults (open to doctoral psychology interns, psychology practicum students, and postdoctoral psychology fellows).

To see the current Wednesday In-Service Schedule, please click here.

For previous RAMS Training Sessions, please click here.

Doctoral interns are expected to hone their proto-supervisory and consultation skills by providing feedback, guidance and advisement to psychology practicum trainees and masters-level interns. The Intern and Trainee Clinical Case Conference provides the formal setting for this practice. As the case conference progresses, interns are expected to take on more leadership (under the guidance from the Director of Training) and, during the second half of the case conference series, they are encouraged to independently facilitate one case conference session each.

Additionally, interns may choose to engage in several optional training activities:

  1. Under supervision, providing ongoing Peer Consultation to a (BA-level) paraprofessional clinical staff or to a less experienced trainee.
  2. Providing one Didactic Presentation to clinical or support staff of one of the RAMS programs; topic is determined by both interns’ interests and area of expertise and program training needs.
  3. Participating in outreach efforts raising mental health awareness in the communities RAMS serves (health fairs; translation of psychoeducational materials; parenting classes, etc.)

At the RAMS Outpatient Clinic, we have several ongoing Case Conferences, each with a different focus and a different audience:

The monthly Adult Clinical Case Conference is conducted as a Staff In-Service Training (10:30-12:00 on the first Wednesday of the month) and involves interns, trainees, and the staff of the Adult Outpatient Clinic. The Director of the Adult Outpatient Clinic and the Director of Training oversee this conference.

The monthly Child Youth and Family Clinical Case Conference is conducted during the Wednesday Staff In-Service Trainings (9:10-10:30 on the last Wednesday of each month) and includes interns, trainees, outpatient child therapists and school-based clinical staff. The Director of Children, Youth & Family Services and the Director of Training oversee this conference.

Both In-Service Case Conferences usually involve an external discussant who provides an in-depth analysis of the clinical case presented and moderates the discussion. Typically, the discussants represent psychodynamic approach to therapy, however, depending on the nature of the case and requests of the presenter, other arrangements can be made. RAMS clinicians take turn presenting their cases and each Doctoral intern is expected to present at least one adult and one child case in this format.

Another monthly in-service case conference is the Clinical Grand Rounds (9:00-10:25 on the first Wednesday of the month). This is a cross-program teamwork-oriented clinical forum: Staff, interns and trainees from multiple RAMS programs gather to take part in a free-flowing conversation on a pre-selected clinical topic relevant to their work or for a clinical discussion focusing on a particular client/family who receives services from multiple RAMS programs. The conversation is moderated by one of the program directors and is lead by a group of clinicians (both staff and interns) who are the clinical case presented or have a particular expertise with the clinical topic under consideration.

The Intern and Trainee Clinical Case Conference is held at 10:25-11:55 every Tuesday in the second half of the training year (during the first semester, the Intern and Trainee Seminar is run as a didactic clinical training and a seminar on cultural self-awareness in clinical settings).

This conference is overseen by the Director of Training and involves practicum trainees and Doctoral interns only. Each participant is expected to deliver one formal case presentation. This includes a comprehensive clinical case write-up (clinical work with a client of their own choice described from a knowledge-based perspective grounded in theory, empirical data, and informed sensitivity to diversity), an hour of process notes from a recent therapy session, and an oral presentation of a case to the group of peers. In addition to offering another opportunity for developing competency at professional presentation, Intern and Trainee Clinical Case Conference also gives doctoral interns a venue for trying their hand at peer-supervision and for practicing their proto-supervisory skills. Doctoral interns serve as co-facilitators of this case conference; towards the end of the training year, each intern has a chance to facilitate one session of this case conference on their own.

Intern and Trainee Case Conference Format

For completion of the internship, the program requires three types of scholarly products that integrate empirical clinical material with the body of professional literature.

  1. One individual Cultural Competency Project, including a written treatise and an in-service oral presentation to an audience of fellow interns, practicum trainees and clinical staff from multiple RAMS programs
  2. Three formal Clinical Case Presentations, including a comprehensive written case formulation; an hour of detailed process notes; oral presentation; and group discussion (one child or adult case is presented to the audience of peers at the Intern and Trainee Case Conference; one adult and one child case are presented to an outside expert discussant and a large audience of clinicians at the RAMS Adult and Child Clinical Case Conferences, respectively).
  3. Four Psychological Assessment Reports on a comprehensive battery of tests, each to include: integrative case write-up, recommendations, feedback letter to the client and referral source, as well as a debriefing/feedback session with a client.

For successful completion of the internship, interns need:

  • to be in attendance for a minimum of 1808 hours over a twelve month period;
  • to obtain the required supervised professional experience at the RAMS Outpatient Clinic and two successive one-day-per-week clinical rotations;
  • to submit satisfactory Assessment Reports on at least four comprehensive test batteries;
  • to successfully complete at least three formal Clinical Case Presentations;
  • to successfully complete, present, and submit a treatise for a Cultural Competency Project;
  • to complete all charting and paperwork required for termination or transfer of their clinical cases;
  • to receive a positive final program evaluation in every target area of competency

NAAPTC Doctoral Interns are entitled to 192 hours of PTO and ten paid holidays. However, any leave time is to be subtracted from the supervised professional experience hours that interns accumulate towards licensure.

Should an intern, due to an illness or for another medically verified reason, need to take time off beyond the allowed amount of leave time, the internship will be extended to allow any missed training to be made up (to be completed in no more than 24 months from the original internship starting day, without additional compensation).

Psychological Assessment Training

The psychological assessment training is an integral part of the NAAPTC doctoral internship. It consists of a weekly two hour Assessment Seminar/Group Supervision and a half-hour Individual Supervision on testing cases. This program involves both theoretical learning and practical application of assessment skills, with an emphasis in Cross-Cultural Assessment and Collaborative/Therapeutic Assessment. Each intern is required to complete four in depth testing batteries during the training year, and the core didactic curriculum is supplemented with didactic training covering issues that arise as students deal with their assigned assessment cases and/or issues related to students’ particular areas of interest.

Core Curriculum:

  1. Orientation to the Program
    1. Ethical and Legal Issues in Assessment
    2. Basic Test Psychometrics
    3. Introduction to theory and practice of Collaborative/Therapeutic Assessment
      (www.therapeuticassessment.com)
    4. Introduction to Cross-Cultural Assessment
    5. Developing assessment questions, initial interview & assessment
    6. Test administration and scoring of commonly used measures
    7. Written report and feedback letter
    8. Discussion of the interns’ background knowledge and interests in relation to assessment training at the NAAPTC
  2. Introduction to Neuropsychology/ Mental Status Exam and Basic Neurological Screening
  3. Developmental Assessment
  4. Cognitive Assessment
  5. Learning & Memory
  6. Executive Functioning
  7. Emotional Functioning and Personality Assessment
  8. Assessment of Specific Populations
    • Including assessment of children (rapport issues, working with parents and teachers, assessment of Mental Retardation, ADHD, learning disabilities, etc.); geriatric assessment (Dementias, Delirium, psychiatric illnesses, etc.), assessment of substance abusers; assessment of cultural minorities; assessment of severely mentally ill and fragile clients, and other populations of interest to interns.

Practical Testing Experience:

The practical part of the training consists of comprehensive collaborative/therapeutic assessment of at least four clients: clarifying the referral questions; collecting historical information; administering and scoring assessment measures; interpreting the data; writing reports and feedback letters; providing feedback to the clients and referral sources. At a minimum, each in-depth assessment battery includes a thorough Mental Status Exam, a basic neuropsychological screening, WAIS-IV/WISC-IV or Ravens’ Coloured Progressive Matrices, RAVLT, RCFT, D-KEFS Trail Making Test and Verbal Fluency, and the Rorschach (R-PAS system) or TAT and MMPI-2 or BAI/BDI. Typically, these assessment techniques are supplemented by other measures pertaining to specific referral questions. Given the diversity of the populations served by RAMS, the trainees have some latitude in selecting their testing cases, including the opportunity to test adults and children with a variety of diagnoses, cultural backgrounds and languages, and to provide consultations on assessment and treatment plan development within the outpatient and residential treatment settings.

For more information about the Assessment Report Outline, click here.

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Cultural Competency Training

The development of clinical sensitivity to diversity is a hallmark feature of the NAAPTC internship. The NAAPTC understands diversity as all differences related to culture, ethnicity, race, national origin, class, religion, gender, sexual orientation, and physical condition. It is an aspect of clinical work and professional functioning that permeates the internship’s learning environment.

Through exposure to a diverse client population, training cohort, and clinical staff, interns are faced with their assumptions about various cultures. This creates an opportunity and demand to address one’s own cultural biases and limitations in tolerating diversity. In this environment, the interns’ cultural sensitivity is demonstrated in the overall context of their professional responsibilities. Clinical aspects of diversity are discussed in supervision, case conferences, and didactic seminars on an ongoing basis. The Intern and Trainee Seminar also includes a focused four-month-long Cultural Self-awareness Module. In addition, interns can utilize the experience and expertise of diverse training cohorts and staff who are not core training faculty. In this way, peers and staff act as cultural consultants to cases with particular diversity issues, and supervisors often encourage interns to seek consultation on those cases.

A structured part of the NAAPTC diversity training is the required Cultural Competency Project, which is designed to provide structural scaffolding for, and to facilitate the development of, clinical sensitivity to diversity. The project comprises a clinical study that explores an intersection of clinical and cultural/social issues in light of interns’ own cultural biases and predilections. It must be of sufficient scope and depth that four weekly hours allotted to this work over the course of nine months are needed to complete it.

The director of training supervises interns’ work on their projects during the weekly hour-long Cultural Competency Project Meeting. It is conducted as a combined psychodynamic group supervision/clinical seminar where interns discuss their work, process various aspects of their internship experience, and help each other consider a variety of clinical, systemic, and training phenomena through culturally-informed lenses.

With help from their peers and supervisor, each intern identifies a specific cultural bias that may be affecting his/her clinical work, and chooses a relevant aspect of psychological functioning in the selected group’s culture on which to focus. As interns plan their individual projects and consider how they want to test their biases, they present their nascent ideas at the meeting and collaboratively ponder relevant clinical, cultural, and professional examples.

Throughout the course of this work, exploration of cultural biases is informed and shaped not only by feedback from the other members of the group, but also by cultural aspects of the group process. Supervision is focused on enabling interns to draw their own experiential conclusions. The director of training helps interns reflect on their functioning in diverse professional environments; facilitates discussion of cultural issues present in their clinical work and in the group process; assigns readings to bridge interns’ own insights with the accumulated body of professional knowledge; and helps find “cultural consultants.” As such, this forum provides a working model for considering intersections between cultural and clinical issues.

Staff clinicians and therapists in the community are available to work formally as mentors to interns as well as informally as sources of advice and support. In the summer, interns present their Cultural Competency Projects to the entire staff at the In-service Clinical Training. A written version of their presentation is added to the training library  as a resource for staff and future interns.

For the list of Cultural Competency Projects conducted by the RAMS interns since 1997, please click here.

For a paper co-written by a cohort of RAMS internship graduate about their experience of working on Cultural Competency Projects, please click here.

Dr. Alla Volovich supervises the cultural competency projects during her weekly group meetings with the interns; she also has the responsibility for securing resources that interns need in order to fulfill their learning goal. Staff clinicians are available to work with interns formally as mentors as well as informally to advise and support them in completing their goal. Interns present their projects to the entire staff at our Wednesday In-service Seminar, and they submit a written version of their presentation to be used as a resource for staff and future interns.

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Application

NAAPTC Doctoral Internship in Clinical Psychology is accredited by the American Psychological Association and a member of the Association of Psychology Post-doctoral and Internship Centers (APPIC).

To verify the APA-accredited status of the NAAPTC Doctoral Psychology Internship, please check the American Psychological Association website: http://www.apa.org/ed/accreditation or contact the Office of Program Consultation and Accreditation.

Phone: 202-336-5979
Email: apaaccred@apa.org
Address: 750 First Street, NE Washington, DC 20002-4242

Students who are preparing for a Ph. D. or Psy. D. in clinical, counseling, or school psychology are eligible to apply.

APA accreditation of the applicant’s graduate program is not required, but is much preferred; clinical psychology training is preferred.

In order to be considered, applicants must have a minimum of three years of graduate training and meet all their school’s standards of internship readiness before application deadline. Additionally, by the start of the internship, applicants must possess an equivalent of master’s degree, have comprehensive exams passed and have their dissertation proposal defended and accepted.

The minimal previous clinical training requirement is 500 hours of Supervised Intervention Experience expected by the start of the internship. Applicants who have higher amount of practical training and those with especially pertinent clinical experiences (similar patient populations, modalities of treatment, theoretical approach, etc.) receive more favorable ratings.

All applicants are required to register for the APPIC Match and submit their applications online according to the procedures adopted by APPIC.

In order to be considered, each application should include the following:

  1. A letter of interest and intent (What applicant hopes to learn during internship and what qualifies him or her as a good fit)
  2. Curriculum vitae (Please provide detailed information about all supervised professional experiences, including types of settings, clinical services provided, clinical and cultural populations served, and theoretical orientation of supervision. Additionally, we are asking all applicants who speak languages other than English to provide information on their fluency in these languages – “receptive skills only”; “minor to intermediate conversation skills”; “intermediate to fluent”; “fluent to very fluent”; “native speaker”)
  3. AAPI;
  4. Official Transcript of Courses and Grades (Graduate Transcripts)
  5. Three recent letters of recommendation (Strong preference is given to recommendations from professionals who are familiar with applicants’ clinical work, as opposed to letters that highlight applicants’ academic achievements.)
  6. An integrated psychodiagnostic assessment report on a comprehensive clinical battery of tests. Any complete test battery must include both cognitive and personality tests; the report must include a case formulation of both cognitive and emotional functioning. Strong preference is given to reports conducted on a patient, not a volunteer, as well as to those reports that include projective measures in addition to standardized tests. If you do not have any reports that fit all the above criteria (i.e. you have only done testing of volunteers, cognitive tests only, etc.) please choose one report that showcases your assessment skills at their best. Please submit your report with all identifying data removed.

For more information on what we are looking for in an assessment report, feel free to consult the Assessment Report Outline at our website at Psychological Assessment Training

The application deadline is November 1

Interview Process

A typical interview is conducted by two internship faculty members. It takes about an hour, and is rather informal. Interviewers ask applicants about their past training and clinical work, as well as career goals. Experience of working with clients of diversity and applicants’ understanding of the role their own culture plays in the clinical encounter are often discussed. Other topics of the interview may include applicants’ experience in working with the underprivileged and with the severely disturbed as well as applicants’ theoretical orientation and their own ideas about how therapy works. Applicants are expected to be ready to present a clinical case to illustrate their style of work and to demonstrate clinical cultural and theoretical competency.

Selection of Applications

Please note that while we give some preference to applicants who have experience or demonstrated strong interest in working with minority clients and/or are bilingual, the National Asian American Psychology Training Center and RAMS, Inc. are Equal Opportunity Employers and do not discriminate on the basis of race, culture, religion, ethnicity, nationality, class, physical ability, age, gender, gender identity, or sexual orientation.

We abide by our agreement with APPIC for participation in the APPIC Match, including the APPIC policy that no person at this training will solicit, accept or use any ranking-related information from any intern participant.

The applicant is notified of acceptance or rejection according to the procedures adopted by the APPIC; the interview notification date is December 20.

Please note that we do not routinely notify applicants of the receipt and status of their applications and are unable to respond to any inquiries regarding this matter.

Should you have any questions, please email Dr. Flora Chan at florachan@ramsinc.org or Dr. Shlomit Gorin at shlomitgorin@ramsinc.org.

NAAPTC Doctoral Internship Selection Criteria

The criteria listed below are those that are typically used for rating applicants during the interview and considered in our ranking of the applicants. This information is provided to you in hope that it will help reduce the interview stress. It is not necessary that all areas apply to each applicant.

Application Review:

Previous Training
  • Clinical, Counseling or School Psychology Doctoral Program
  • School’s APA Accreditation
  • Previous Practical Experience (relevance; # of intervention hours, # of assessment reports)
  • Relevant extra-training experiences
  • Interest & skills relevant to our training
  • Experience of psychodynamic supervision/training
Application Essays
  • Evidence of self-awareness in the essays
  • Evidence of cultural sensitivity in the essays
  • Writing Style and Organization of Essays
Recommendation Letters
  • Quality of recommendations
  • Relevance in terms of settings, populations, services, & training
Psychological Assessment Report
  • Case Formulation
  • Writing Style
  • Level of Organization of Material
  • Type of Formulation
  • Test Data Interpretation Accuracy
  • Justification of Diagnostic Impressions
  • Cultural Factors Taken into Account

Interview

Case Presentation
  • Presentation of relevant history & assessment information
  • Ability to diagnose according to the DSM-V
  • Case formulation’s relevance to history and clinical data
  • Integration of cultural factors into case formulation
  • Case formulation’s consistency with theoretical approach
  • Treatment plan’s consistency with case formulation
  • Emotional sensitivity/use of self in clinical work
  • Working knowledge of psychodynamic approach
  • Knowledge of medications and relevant biological issues
Cultural Sensitivity
  • Awareness of own cultural identity
  • Sensitivity to issues of diversity
  • Knowledge regarding diversity issues
  • Dedication to culturally competent clinical work
  • Commitment to working with Asians & immigrant populations
  • Relevant bilingual skills
Personal Characteristics
  • Ability to express self and to be direct, self-assertive, candid
  • Self-awareness (including ability to discuss countertransference)
  • Commitment to own personal growth
  • Capacity to tolerate stress and work pressure
  • Commitment to Community Mental Health
  • Unique interests that could be met at a placement here
  • Unique skills that would benefit a placement here

You can find information about APPIC Match Policies and Schedule as well as the APPI form at https://www.appic.org/Internships/Match/Match-Policies

A training year at RAMS should be stimulating and exciting, and we look forward to receiving your application.

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NAAPTC Doctoral Internship Handbook Trainee Admissions, Support, and Outcome Data

Outpatient Clinical Practicum

Outpatient Clinical Practicum


RAMS Outpatient Clinical Practicum is opened to students in professional mental health training programs: psychology, social work, and marriage & family therapy.




General Information

RAMS Outpatient Clinical Practicum is opened to students in professional mental health training programs: psychology, social work, and marriage & family therapy.

The Training Center is located at the site of the RAMS Outpatient Clinic, a free standing mental health facility contracted by the City and County of San Francisco to provide community-oriented mental health services to families and individuals throughout their life span. While receiving didactic and supervisory training, practicum trainees function as integral members of the Outpatient Clinic’s diverse multidisciplinary and multicultural treatment team.

Our clinical practicum is designed to provide trainees with the generalized foundational professional practice skills, and the expectation is that proficiency will be established for the clinical evaluation and assessment, conduct of psychotherapy (individual, family, dyadic & couples) across the lifespan, as well as intervention with the more disturbed and chronically troubled patient. Trainees will learn to search for clients’ strengths and liabilities and make the evaluation data relevant to functional life skills. Because of the nature of the client population, in addition to developing their general clinical acumen, trainees will also learn to work with trauma, grief, and adaptation to major life changes. Thanks to the rich cultural diversity of both clients and staff, trainees have the opportunity to hone their skills while developing keen clinical sensitivity to issues of diversity: cultural, religious, ethnic, disability, sexual orientation, gender and class.

We seek students who have an expressed interest in cultural competency training and the vision of working with minority populations.

Two women having a conversation at a table while taking notes.

Training Program

RAMS Clinical Practicum Program offers 12-14 positions for doctoral-level psychology practicum students and masters-level counseling and social work interns.

This clinical training requires a 20-hour per week time commitment for twelve months: from the beginning of September until the end of August. There is no stipend; each trainee is entitled to 80 hours of time off (combined vacation and sick leave).

Work schedule is flexible. However, all trainees need to attend weekly seminars and team meetings on Tuesday and Wednesday mornings and mandatory group supervision on either Thursday morning or Tuesday afternoon. There are also two elective training experiences: Group Consultation on Working with Children and Families (Monday afternoon) and Clinical Understanding and Sociocultural Considerations in Working with Community Mental Health Clients (Wednesday afternoon).

Trainees work with a caseload of approximately 8-10 clients, including children, families, couples, and adults (the exact percentage of each is based on the actual cases referred to RAMS and varies from year to year) . There is an expectation of 10 hours of direct client contact per week, including a clinical intake hour.

Every week, trainees receive one hour of individual supervision with a licensed mental health professional (for brief Supervisor Bios, click here). Additionally, all trainees attend at least one 1.5 hour group supervision session per week (up to three and a half hours of group supervision including electives).

Training is predominantly psychodynamic in approach and emphasizes object relations and contemporary relational perspectives on working with severely disturbed clients. It also features a strong emphasis on cultural competency, especially in regard to Asian, Pacific Islander, and Russian-speaking ethnicities. Students can expect to receive considerable didactic and experiential training in these areas and cultural competency in general.

The training year starts with an intensive three-week-long Orientation Program. During these three weeks trainees are expected to attend orientation trainings 9am through 5pm on Tuesdays and Wednesdays. After that, there are two weekly Didactic Training Seminars. One, which is held on Tuesdays, is for practicum students and doctoral psychology interns only. During the second half of the training year, a case conference format is utilized for this seminar. The other seminar is our Wednesday In-service Training for the entire Outpatient Services staff. Additionally, trainees are welcome to attend agency-wide “feature trainings” such as the RAMS Psychoanalytic Scholar Series held throughout the year (for RAMS Training Sessions, click here).

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Practicum Core Training Activities

Weekly Practicum Schedule

RAMS Clinical Practicum Program offers 12-14 positions for doctoral-level psychology practicum students and masters-level counseling and social work interns.

This clinical training requires a 20-hour per week time commitment for twelve months: from the beginning of September until the end of August. There is no stipend; each trainee is entitled to 80 hours of time off (combined vacation and sick leave).

Work schedule is flexible. However, all trainees need to attend weekly seminars and team meetings on Tuesday and Wednesday mornings and mandatory group supervision on either Thursday morning or Tuesday afternoon. There are also two elective training experiences: Group Consultation on Working with Children and Families (Monday afternoon) and Psychodynamic Conceptualization in Working with the Severely Mentally Ill Adults (Wednesday afternoon).

Orientation to the NAAPTC Internship Program, RAMS Outpatient and Rotation Clinical Work, and the San Francisco Community Mental Health System. Three Weeks at the beginning of the year.

Half-time practicum trainees can expect to have about 10 hours of various direct clinical services per week, including: initial clinical intakes for new clients (1 hr on average); individual, family and dyadic psychotherapy with adult and child clients (8 hrs on average); collateral work, consultation to other providers, and clinical case management (2 hrs on average). Non-direct casework (initial/ongoing clinical assessment & treatment plan development, multidisciplinary teamwork, etc.) and clinical documentation (charting, billing, utilization reviews, etc.) are conducted as required (2 hrs per week on average).

Adult cases are assigned through the RAMS Adult Outpatient and Prevention (AOP) Services and child cases are assigned through the RAMS Children, Youth and Family (CYF) Services. The low-fee counseling center of the Asian Family Institute also refers some clients to the trainees. Combined, these three outpatient programs (with over 1200 open cases) cover the full range of diagnostic groups throughout the lifespan; a substantial percentage of these patients suffer from severe and persistent mental illnesses. Culturally, the client population is extremely diverse, which affords trainees a rich exposure to clinical work with minorities, particularly with Asian Americans and Russian-speaking immigrants.

In this setting, trainees have the opportunity to hone their clinical skills (psychotherapy, clinical evaluation,  and clinical case management) while exercising flexibility in the use of clinical theory and methodology to account for matters of diversity and to accommodate the needs of the more disturbed and chronically troubled patients.

Through close collaboration with other RAMS programs and a broad variety of San Francisco community mental health agencies, medical clinics, social services and educational organizations, trainees gain knowledge of the place and function of the outpatient clinic-based treatment in the community mental health system and the overall system of care.

Half-time practicum trainees receive one hour of individual clinical supervision and 1.5 hours of group supervision weekly. All psychology trainees are supervised by licensed psychologists; students from other mental health disciplines receive supervision from psychologists or other licensed clinicians.

Additionally, trainees have a choice of joining one or both elective one-hour-long weekly consultation groups/seminars: Group Consultation on Working with Children and Families and and Clinical Understanding and Sociocultural Considerations in Working with Community Mental Health Clients.

All supervision is predominantly psychodynamic/systems in approach and includes a strong emphasis on cultural competency, particularly with Asian American and Russian-speaking clients. Supervision especially targets trainees’ understanding of the ways in which their own culture manifests in the consulting room. Students receive considerable didactic and experiential training in these areas and clinical sensitivity to diversity in general.

Monthly one-hour-long Training Group Meeting with the Director of Training (includes practicum trainees and doctoral interns) and Monthly Clinical Grand Rounds (includes practicum trainees, doctoral interns, postdoctoral fellows, clinical staff from the Adult Outpatient Services, and clinical staff from Outpatient Child, Youth, & Family Services).  Clinical Grand Rounds meeting is described in more detail under Clinical Case Conferences.

The training year starts with an intensive three-week-long Orientation Program. After that, there are two weekly mandatory ninety-minute training sessions where trainees and interns are exposed to clinical and diversity issues within the context of a multidisciplinary treatment team and training cohort. One, which is held on Tuesdays, is a Trainee and Intern Seminar; the other is held on Wednesday as an In-service Psychotherapy Training and is open to the entire RAMS clinical staff.

The Intern and Trainee Seminar (Tuesday, 10:25 am-11:55 am) involves practicum trainees and doctoral psychology interns. In the course of the training year, this seminar goes through several distinct stages.

The first module is designed to lay the foundation for culturally informed psychodynamic therapy with the poor, minorities, and severely mentally ill in the context of a community mental health center. It starts with a series of lectures on the history of treatments for the “insane” and  gradually transitions to a group discussion of clinical papers on ways to maximize learning from patients in order to better meet each client’s unique needs.

The next training series is designed to help trainees and interns foster greater cultural self-awareness in the clinical context. At this stage, training is mainly experiential and consists of individual presentations and group discussions of cultural biases and predilections that influence how interns and trainees conceive of their work and how they experience their clients. (For a list of suggested questions to address in one’s cultural presentation, please click here.)

Later in the training year, the Intern and Trainee Seminar becomes a four month-long weekly Clinical Case Conference (for details, see Intern and Trainee Case Conference).

Toward the end of the training year, the focus of this forum shifts again, this time toward emphasis on terminations with clients and the training program and on related professional development issues.

At the In-service Psychotherapy Training (Wednesday, 9:10 am-10:30 am) interns and trainees participate with RAMS staff in classes on specific clinical, cultural, and professional development topics that are pertinent to work with RAMS client populations. To see the current Wednesday In-Service Schedule, please click here.

This series also includes monthly Clinical Grand Rounds and two year-long monthly clinical case conferences: Adult Case Conference and Child Case Conference.

Being a psychodynamic program, most presentations emphasize contemporary psychoanalytic theories and psychodynamic treatment principles as they apply to severe mental illness and working with minorities.

Additionally, trainees can choose one or both elective one-hour-long weekly consultation groups/seminars: Croup Consultation on Working with Children & Families and Psychodynamic Conceptualization in Working with Severely Mentally Ill Adults (both open to doctoral psychology interns, psychology practicum students, and postdoctoral psychology fellows).

Development of cultural competency and clinical sensitivity to diversity is a hallmark feature of the RAMS Training Program, and this is an aspect of professional development that permeates all facets of the learning environment and clinical work at RAMS.

Our understanding of diversity encompasses all differences related to culture, ethnicity, language, race, class, religion, gender, sexual orientation, and physical condition. RAMS is committed to providing clinical services by a clinician who is fluent in the client’s language of preference and has appropriate bicultural life experiences. RAMS extraordinarily diverse staff speak over 30 languages and come from a wide variety of backgrounds: White, Asian, Pacific Islander, African American, Latino, and Biracial; men and women; gay and straight; religious and atheists; American-born and immigrant… The Practicum Supervision Team is also very diverse: 90 % of our supervisors identify as cultural and/or sexual minorities and are native speakers of languages other than English.

The exposure to a diverse client population, training cohort, and clinical staff provides rich experiential learning about cultural differences. It also faces trainees with their own assumptions held about various cultures and creates an opportunity and demand to address one’s own biases and limitations in tolerating diversity. In this environment, the trainees’ sensitivity to diversity is demonstrated in the overall context of their handling of their professional responsibilities. Clinical aspects of diversity are addressed in supervision, case conferences, presentations of trainees’ own clinical work, and didactic seminars throughout the year.

In addition, trainees have the opportunity to utilize the experience and expertise of diverse training cohorts and staff who are not core training faculty. In this way, peers and staff act as cultural consultants to cases with particular diversity issues, and supervisors often encourage trainees to seek cultural consultation.

A structured part of the diversity training is the Cultural Awareness Training module of the weekly Intern and Trainee Seminar (four months in the first half of the year). The objective of this training is to help interns and trainees increase awareness of their own cultural biases, predilections, and countertransferential tendencies with diverse populations in order to develop a level of self-awareness that permits optimal use of one’s own emotional reactions and behavioral responses in a therapeutic relationship with clients of diverse backgrounds. In the course of this training, group members take turns to present their reflections on how their own cultural background(s) and experiences affect them as clinicians. Each presentation is followed by a group discussion facilitated by the instructor and informed by assigned readings. In an exceedingly diverse training cohort, this leads to more than learning about other people’s cultures: Such intensive exposure to difference also faces trainees with their own pre-existing assumptions about various cultural groups and helps them to become more cognizant of their limitations in acknowledging, tolerating, and addressing diversity.

Clinically, grappling with one’s own biases creates an opportunity for fine-tuning of the use of self in a therapeutic encounter; while trying to understand the reaction to differences in oneself and others helps to foster development of ability to explore differences with clients. In addition, learning from the cultural expertise of their peers teaches trainees to competently utilize others as cultural consultants to cases with particular diversity issues.

At the RAMS Outpatient Clinic, we have several ongoing Case Conferences, each with a different focus and a different audience:

The monthly Adult Clinical Case Conference is conducted as a Staff In-Service Training (10:30-12:00 on the first Wednesday of the month) and involves interns, trainees, and the staff of the Adult Outpatient Clinic. The Director of the Adult Outpatient Clinic and the Director of Training oversee this conference.

The monthly Child Youth and Family Clinical Case Conference is also conducted during the Wednesday Staff In-Service Trainings (9:10-10:30 on the last Wednesday of each month) and includes interns, trainees, outpatient child therapists and school-based clinical staff. The Director of Children, Youth & Family Services and the Director of Training oversee this conference.

Both In-Service Case Conferences usually involve an external discussant who provides an in-depth analysis of the clinical case presented and moderates the discussion. Typically, the discussants represent psychodynamic approach to therapy, however, depending on the nature of the case and requests of the presenter, other arrangements can be made. RAMS staff clinicians, postdoctoral fellows, and doctoral psychology internstake turn presenting their cases in this format; practicum trainees who stay with RAMS for a second training year are afforded this opportunity as well.

Another monthly in-service conference is the Clinical Grand Rounds (9:00-10:25 on the first Wednesday of the month). This is a cross-program teamwork-oriented clinical forum: Staff, interns and trainees from multiple RAMS programs gather to take part in a free-flowing conversation on a pre-selected clinical topic relevant to their work or for a clinical discussion focusing on a particular client/family who receives services from multiple RAMS programs. The conversation is moderated by one of the program directors and is lead by a group of clinicians (both staff and trainees) who work with the clinical case presented or have a particular expertise with the topic under consideration.

The Intern and Trainee Clinical Case Conference is held at 10:25-11:55 every Tuesday in the second half of the training year (during the first semester, the Intern and Trainee Seminar is run as a didactic clinical training and a seminar on cultural self-awareness in clinical settings).

This conference is overseen by the Director of Training and involves practicum trainees and doctoral interns only. Each participant is expected to deliver one formal case presentation. This includes a comprehensive clinical case write-up (grounded in theory, empirical data, and informed sensitivity to diversity), an hour of process notes from a recent therapy session, and an oral presentation of a case to the group of peers. In addition to offering an opportunity for developing competency at professional presentation, the Intern and Trainee Clinical Case Conference also gives trainees a venue for trying their hand at peer-supervision and for practicing their proto-supervisory skills.

Intern and Trainee Case Conference Format

Case Writeup Outline

Application

Our clinical training program offers 10 to 12 positions for doctoral-level psychology practicum students and masters-level clinicians-in-training (counseling, social work, and marriage and family therapy trainees and interns).

Each application should include the following:

  1. Letter of interest and intent (What applicant hopes to learn at our training program and what qualifies him or her as a good fit)
  2. Curriculum vitae (Please provide detailed information about all supervised professional experiences, including types of settings,
    clinical services provided, clinical and cultural populations served, and theoretical orientation of supervision. Additionally, we are
    asking all applicants who speak languages other than English to provide information on their fluency in these languages –
    “receptive skills only”; “minor to intermediate conversation skills”; “intermediate to fluent”; “fluent to very fluent”; “native speaker”)
  3. Three recent letters of recommendation (Strong preference is given to recommendations from professionals who are familiar with
    applicants’ clinical work, as opposed to letters that highlight applicants’ academic achievements.)
  4. A brief clinical case write-up, with all identifying data removed. Select any clinical case that showcases your clinical skills at their best; we have no preference regarding clinical settings and/or types of client (age, cultural identity, diagnosis, etc.). Please do not send extended clinical intakes, assessment reports, and other write-ups that showcase mainly your diagnostic and
    treatment-planning skills: We also want to see your acumen for understanding of and dealing with clinical dynamics in therapy. If you would like to see an example of a clinical write-up structure, you may refer to our Case Presentation Format.)

All documents must be emailed to florachan@ramsinc.org. Please make sure to put your full name both in the email subject line (e.g., “John Doe – RAMS Practicum Application”) and in the title of each document (e.g., “John Doe – Letter of Intent”, “John Doe – CV”, etc.) and send all application materials at the same time, attached to the same email.

For doctoral-level psychology practicum trainees who are applying through the Bay Area Practicum Information Collaborative (BAPIC), please refer to their website (https://bapic.info/) for application due date.

Applications from masters-level interns and doctoral-level psychology practicum trainees who are not applying through the BAPIC (supplemental practicums and non-BAPIC-affiliated programs) are accepted until all placement positions are filled (typically, end of April – early May).

Interview Process

Due to the COVID-19 pandemic, all selection interviews for 2022-23 training year will likely be conducted via teleconferencing.

A typical interview takes about an hour and is conducted as a rather informal conversation between an applicant and two supervisors from the RAMS Outpatient Clinical Practicum Program.

Applicants are asked about their past training and clinical experience, as well as training goals for the next year and overall career goals. Other topics of the interview may include applicants’ experience in working in the community mental health, with severely disturbed patients, and clients of diversity. All applicants are expected to be ready to present clinical cases and to discuss their understanding of their own cultural identity.

Selection of Applications

RAMS, Inc. is an Equal Opportunity Employer and does not discriminate on the basis of race, culture, religion, ethnicity, national origin, physical ability, gender, or sexual orientation. While some preference is given to bilingual/bicultural applicants, we are always happy to accept monolingual/monocultural English-speaking students who are genuinely interested in working with diversity. We also consider extra-training qualities that point to an applicant’s “good fit” for our program: relevant professional presentations and publications, teaching, awards, prior degrees in related fields or pertinent life experiences.

The criteria listed below are those we typically use for rating applicants during the interview. This information is provided to you in hope that it will help reduce the interview stress. It is not necessary that all areas apply to each applicant.

Selection Criteria for Practicum

Cultural/Diversity Sensitivity
  • Sense of own ethnocultural identity
  • Sensitivity to diversity issues (Emotional/Countertransference Skills)
  • Knowledge regarding cultural diversity (Cognitive Skills)
  • Commitment to culturally competent professional work
  • Commitment to professional working with Asians, Asian-Americans and Immigrants
  • Bilingual skills
Case Formulation:
  • Presentation of relevant history and background
  • Presentation of MSE and relevant assessment information
  • Ability to diagnose according to DSM-V criteria
  • Case formulation is relevant to history, MSE, clinical data, and diagnosis
  • Case formulation is coherent and consistent with theoretical approach
  • Cultural factors are considered in case formulation and understanding of clinical dynamics
  • Treatment plan matches case formulation
  • Working knowledge of psychodynamic approach
  • Awareness of transference and its impact on his/her functioning as therapist
  • Awareness of countertransference and its impact on the client
  • Knowledge of medications and relevant biological factors
Personal Characteristics
  • Ability to express self, understand questions and communicate effectively
  • Emotional sensitivity as evidence of use of self in clinical work
  • Capacity to be direct, self-assertive, candid
  • Capacity to tolerate stress and work demands
  • Commitment to own personal growth as an aspect of professional development
  • Awareness of countertransference as impacting clinical work and ability to talk about it
  • Unique skills that would benefit a placement here
  • Unique interests that could be met at a placement here
Previous Experience
  • Previous practicum experience
  • Previous clinical experience with similar clinical populations (severely and chronically mentally ill, trauma, minorities, immigrants, urban poverty)
Recommendations:
  • Settings (populations served, services provided, and approach to training – similarity to RAMS)
  • Recommendations

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Orientation Schedule Weekly Practicum Schedule