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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 were adjudicated Not Guilty by Reason of Insanity.

The Psychology Department consists of six 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: 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 and learning the effect of the client's forensic status on their hospital stay and discharge. You will gain experience completing dangerousness risk 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 treatment of reluctant and resistant clients, maintaining professional boundaries, and a psychologist's role in this setting.

General Wellness Program: This is a new program that provides services to those with severe and persistent mental illnesses. They might also have chronic neurological and physical illnesses. If you choose this rotation, you will learn treatment approaches for moderately to severely impaired clients, as well as the treatment of PTSD (including clients from other hospital programs). Experience with the MMPI-2-RF is planned. Since this program started only recently, interns will also experience the planning and development of a new treatment program.

New Outlook Program (NOP): The program provides inpatient services to adults with severe emotion dysregulation. The majority of clients who take part in this program have developmental disabilities and Axis II diagnoses, primarily Borderline Personality Disorder. Although personality dysfunction is the primary problem for the majority of these clients, a wide spectrum of Axis I diagnoses are also represented. The primary treatment modality is Dialectical Behavior Therapy (DBT), yet other adjunctive treatments are also provided (e.g., groups to address mental illness). Interns who chose this program will be considered members of the DBT consultation team and the New Outlook multidisciplinary treatment team. Interns will also gain experience in delivering group and individual therapy, as well as in completing integrated risk assessments. Personality, intellectual, and other types of assessment experiences can be provided at the intern's request. There may also be opportunities for writing behavior management plans if so desired. Because the New Outlook Program is a new program, interns will also gain experience in program development.

Transitional 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. The multidisciplinary team of this program provides psychosocial rehabilitation services to four cottages. Most clients have been adjudicated NGRI and committed by the court for treatment. They usually function at a high level, with stable psychiatric symptoms.