St. Louis Psychiatric Rehabilitation Center
SLPRC, under various names, has served the public since 1869. It is a JCAHO accredited, inpatient psychiatric facility operated by the Missouri Department of Mental Health. The facility currently has 196 beds divided into four 25-bed wards and twelve 8-bed residential cottages. We provide long-term inpatient psychiatric and psychosocial rehabilitation services to adults with severe and persistent mental illnesses and Axis II disorders from the urban, suburban, and rural areas of eastern Missouri. We also perform outpatient evaluations of criminal defendant’s competency to stand trial and probable mental state at the time of an alleged offense. Most of our clients were committed for treatment because they are Incompetent to Stand Trial or Not Guilty by Reason of Insanity.
The Psychology Department consists of nine psychologists who have varying interests and backgrounds. We are active participants in the ongoing development of treatment and treatment programs and have leadership roles in the units we serve. In general, interns rotating at SLPRC should expect to complete two or more assessments, participate in at least four weekly therapy groups, carry a caseload of three or four individual therapy clients, and participate in multidisciplinary treatment team meetings. These expectations are flexible based upon the needs and interests of the intern. The supervision available is intense and plentiful, with a minimum of one, but commonly two scheduled hours, along with frequent informal opportunities for supervision. Preferred rotations are selected from the programs detailed below.
Cognitive-Behavioral Program: You may choose this as a primary rotation. The two teams of this program provide services for one ward and five cottages. The clients have a broad range of functioning, although most are at a higher level. Most have a personality disorder (often Antisocial Personality or significant Antisocial features) in addition to a stable Axis I disorder (usually Schizophrenia). Many have problems with chemical dependency as well. A few are in the later stages of preparation for discharge. If you choose this rotation, you will spend much of your time gaining additional experience in providing individual and group therapy. You will gain experience completing risk-related summaries, working as part of a treatment team, and you will learn the role of a psychologist in an inpatient facility. You might have the opportunity to help develop release applications for committed clients. There will be a few opportunities for psychological assessment. In supervision, you can expect discussions on the management of reluctant and resistant clients, maintaining professional boundaries, and a psychologist’s role in this kind of setting.
Forensic Pretrial Program: You may choose this as a primary or secondary (i.e., add-on) rotation. The program has two functions: inpatient and outpatient forensic evaluations, and inpatient restoration of adjudicative competency.
Certified Forensic Examiners, who conduct pretrial evaluations of competency to stand trial, criminal responsibility, and other matters related to criminal defendants (e.g., Sexually Violent Predator commitment evaluations), staff the forensic evaluation service. Evaluations are usually on an outpatient basis.
The inpatient unit is comprised of a ward and a cottage. Nearly all the clients are Incompetent to Stand Trial and committed for competency restoration. The team provides medical and psychiatric treatment, psycho-educational competency restoration, group and individual therapy, and preparation for court.
If you choose this program as a primary rotation, you will spend two-thirds of your time on the inpatient unit participating in individual and group competency restoration and psychological assessment. You will spend the remaining time observing and participating in forensic evaluations. Specific expectations for the latter include observing and participating in at least one evaluation each week, reading extensively on the subject of forensic evaluation, observing court testimony, and developing forensic report writing skills. You should expect to complete three full reports before the end of the rotation. A primary rotation should prepare you for a forensic post-doc or other supervised forensic experience.
If you choose this as a secondary rotation (i.e., added to a primary rotation in CBP), you will observe several pretrial evaluations and do basic readings in forensic evaluation. If you are interested, you can also develop forensic report writing skills with the goal of completing one full pretrial report. A secondary rotation will give you good exposure, but will not prepare you well for a forensic post-doc.
Centralized Cognitive Rehabilitation Program: This is not offered as a rotation, but an intern may choose to participate in treatment offered by the adjunct supervisor in this program. This service provides a systematic, 12-month cognitive rehabilitation program to schizophrenic clients from across the hospital that have cognitive deficits.
Specialized Forensic Services: This is not offered as a rotation, but an intern may choose to participate in treatment offered by adjunct supervisors in this program. This service focuses on treatment and evaluation related to the risk of dangerousness. Psychologists serving clients throughout the hospital staff this program. Treatment is usually based on a cognitive-behavioral approach.
Freedom Bound Dual Diagnosis Program: This is not offered as a rotation, but an intern may choose to participate in treatment offered by the adjunct supervisor in this program. This service focuses on treatment of clients throughout the hospital who have co-morbid chemical abuse or dependency. Didactic introductory groups and treatment following relapse are offered. The service also hosts 12-step meetings.