OSH-PIP Program Options

OSH-PIP offers two programs with four fulltime internship positions. The Treatment Program has three intern positions, and the Forensic Evaluation Program has one intern position. In each program, the interns rotate through two six-month major and two six-month minor rotations during the training year, with interns spending approximately three and half days per week in a major rotation and approximately one day per week in a minor rotation, with the remaining time spent in didactic training and additional training activities. Across programs, interns complete an average of 10-20 hours per week of face-to-face direct service delivery. OSH-PIP’s training is based in the Practitioner-Scholar model. OSH-PIP trains clinical psychologists who are effective consumers of research and who utilize scholarly inquiry to inform their practice.

Treatment Program Positions 

The OSH-PIP Treatment Program positions (three interns) focus on learning evidence-based treatment interventions across a range of clinical and didactic experiences representing the necessary depth and breadth required for the future professional practice of psychology. Interns will rotate through two major and two minor rotations throughout the training year, which are listed in the Rotation Options section below. The interns participating in the Treatment Program can select from a variety of treatment rotations (offered as major and minor rotations) as well as from several assessment-based minor rotations. The interns participating in the Treatment Program cannot rotate through the Forensic Evaluation Service as a major rotation but can rotate through as a minor rotation. Again, across rotations, interns will complete an average of 10-20 hours per week of face-to-face direct service delivery.

Forensic Evaluation Program Position

The OSH-PIP Forensic Evaluation Program position (one intern) focuses on learning to competently complete outpatient and inpatient court-ordered forensic evaluations (primarily competency to stand trial evaluations) within a state hospital system for counties across Oregon pursuant to Chapter 161 of the Oregon Revised Statutes. The intern participating in the Forensic Evaluation Program position will also learn evidence-based treatment interventions across clinical and didactic experiences representing the necessary depth and breadth required for the future professional practice of psychology. This intern is guaranteed a major Forensic Evaluation Service rotation and a minor Competency Restoration Program rotation (this minor rotation is optional). This intern cannot rotate through the Forensic Evaluation Service as an additional minor rotation or the Competency Restoration Program as a major rotation. Additionally, as alluded to above, to complete their training year, this intern will also rotate through a treatment-focused major rotation and can select from a variety of treatment rotations and from two assessment-based rotations for their minor rotation(s). Again, across rotations, interns will complete an average of 10-20 hours per week of face-to-face direct service delivery.

Rotation Options 

OSH-PIP offers the following rotation options (with the above noted specifications/exceptions).

Major and Minor Rotations

Specifically, interns rotate through two major six-month and two minor six-month rotations throughout the training year, with interns spending approximately three and half days per week in a major rotation and approximately one day per week in a minor rotation, with the remaining time spent in didactic training. Rotation options include the following:

Competency Restoration Program

*Interns may elect to work within the competency restoration program for a major rotation or for a minor rotation depending on the OSH-PIP program they are matched to (i.e., Treatment Program or Forensic Evaluation Program). Assigned direct client contact hours will vary depending on whether the rotation is a major or minor.

The competency restoration program serves patients (male and female) who have been committed to the hospital by a circuit court judge pursuant to Oregon Revised Statute 161.370 as incompetent to proceed to court (also referred to as unable to aid and assist). Services provided are focused on identifying patients’ barriers to competency and aiding in their restoration to competency. Once deemed competent to proceed (by a certified forensic evaluator from OSH’s Forensic Evaluation Service), patients return to their committing county jail in order to proceed with their legal case. Many of these patients present upon admission with acute symptoms of mental illness and many present with cognitive impairments that interfere with understanding of court proceedings and decision-making ability. Personality disorders, substance use disorders, and response style issues (e.g. overreporting, underreporting) are also common.

Interns who choose a rotation within the competency restoration program are provided with a strong focus on clinical interviewing and psychological assessment (e.g. testing for psychopathology, personality, cognition, response style). Additionally, interns attend daily nursing report meetings as well as regular Interdisciplinary Treatment Team meetings, develop and implement behavioral management plans, and carry out group and individual interventions with a focus on addressing barriers to competency. Opportunities may become available to attend court hearings and observe competency evaluations.

More specifically, interns can be assigned to the following treatment units:

  1. Lighthouse 2: Admissions unit serving male patients deemed incompetent to proceed.
  2. Lighthouse 3: Admissions unit serving female patients deemed incompetent to proceed.

Dialectical Behavior Therapy (DBT) Program

*Interns may elect to work within the DBT program for a major rotation or for a minor rotation. Assigned direct client contact hours will vary depending on whether the rotation is a major or minor.

The focus in the DBT program is on assessment and provision of treatment for individuals diagnosed with Borderline Personality Disorder. People with other diagnoses may also participate in the program if they experience difficulty with emotion regulation, interpersonal effectiveness, non-suicidal self-injurious behavior, or suicidal ideation and attempts. Members of the Interdisciplinary Treatment Team have typically been intensively trained by Behavioral Tech clinicians (founded by Dr. Linehan) or by Portland DBT (Directed by Linda Dimeff). Direct-service aide-level staff receive four hours of formal didactic training monthly and interns can lead some parts of this training. In addition, interns participate in co-leading skills groups, individual therapy, and treatment team meetings focused on individual clinical and programmatic issues.

Interns working within the DBT program are assigned to the following treatment unit:

Anchor 1: All male admissions unit serving primarily GEI patients, though a small number of Incompetent to Proceed patients are sometimes housed on this unit as well.

Forensic Evaluation Service (FES)

*Interns may elect to work within the forensic evaluation service for a major rotation or for a minor rotation depending on the OSH-PIP program they are matched to (i.e., Treatment Program or Forensic Evaluation Program). Assigned direct client contact hours will vary depending on whether the rotation is a major or minor.

The Forensic Evaluation Service (FES) completes outpatient and inpatient court-ordered evaluations for counties across Oregon pursuant to Chapter 161 of the Oregon Revised Statute. Orders primarily involve initial competency to stand trial (CST) evaluations pursuant to ORS 161.365 for patients residing in county custody for one-day evaluations at the hospital or evaluations pursuant to ORS 161.370 for patients residing at the hospital and already determined incompetent to proceed by the court. Additional orders involve criminal responsibility and diminished capacity evaluations. Interns who choose this rotation will have the opportunity to participate in the evaluation process including and not necessarily limited to record review (hospital records, police reports, collateral records), contacting collateral sources, interviewing, administering and interpreting psychological testing, and report writing (with co-signed reports) as well as the possibility of witnessing and/or offering testimony.

Geropsychology Program

*Interns may elect to work within the Geropsychology program for a major rotation or for a minor rotation. Assigned direct client contact hours will vary depending on whether the rotation is a major or minor.

The Geropsychology program provides care and treatment to older adults with severe and persistent mental illness, traumatic brain injuries, and disease processes known to affect the central nervous system. Patients in this program demonstrate a wide range of neurocognitive disorders along with chronic medical problems that require substantial nursing care needs and/or medical monitoring. Due to the complexity of this patient population, there is a heavy emphasis on understanding the relationship between physical and mental health. Interns who choose a rotation within this program have opportunity for individual and group therapy, neuropsychological assessment, and interdisciplinary consultation. Interns also participate in the development of treatment plans that addresses each individual’s very specific biopsychosocial needs through an integrative, interdisciplinary approach with a goal of helping them return to a less restrictive environment.

Interns working within the Geropsychology program are assigned to the following treatment unit:

  1. Butterfly 3: Co-ed unit serving older adults committed pursuant to all four commitment types.

Guilty Except for Insanity (GEI) Program

*Interns may elect to work within the GEI program for a major rotation or for a minor rotation. Assigned direct client contact hours will vary depending on whether the rotation is a major or minor.

Patients within this program have been adjudicated GEI and committed to the hospital due to the ongoing risk they pose to themselves or others.  In addition to those who have recently been found GEI, this population also includes those who have had their conditional release revoked due to their level of dangerousness in the community.  Most individuals are admitted to one of the two acute stabilization units (Anchor 1 and Lighthouse 1), where the focus is on initial assessment, treatment care plan development, psychiatric and behavioral stabilization, and treatment engagement in preparation to move forward within the hospital setting.  Individuals who demonstrate stable behavior, who refrain from verbal and physical aggression, and who engage in treatment may transfer to one of several step-down units (including Bridge 3) focused on preparing individuals to request and use privileges and eventually move forward to community placement.  Some individuals who have shown psychiatric and behavioral stability in the community or in a jail setting may be admitted directly to one of these units. The goal of these units is to help patients achieve their highest level of health, safety, and independence as they prepare for discharge or conditional release to a community-based setting.  Often at this point in treatment, mental illness is stable and the focus is on personality and substance use problems and relapse prevention planning.

Interns who choose a rotation within the GEI program on Anchor 1 or Lighthouse 1 participate in a variety of direct care services, including assessment with regard to various diagnostic and treatment questions, co-leading group treatment focused on the development of skills to help regulate emotional and cognitive functioning, and individual treatment to help strengthen coping skills and help patients deal with their circumstances.  In addition, interns attend daily nursing report meetings as well as regular Interdisciplinary Treatment Team meetings.  Opportunities are sometimes available for didactic and practical experience in specific areas such as violence risk assessment and functional assessments of behavior.  Opportunities may be available to attend court hearings and other meetings regarding patient privileges as well as readiness for conditional release planning.

Interns who choose a rotation within the GEI program on Bridge 3 provide individual and group therapy to patients in the program, and conduct assessments necessary for the patients to leave the hospital, with a focus on mitigation of risk.  Additionally, interns attend daily nursing report meetings and participate in ongoing Interdisciplinary Treatment Team meetings with a focus on discharge planning. Opportunities may become available to attend court hearings and other meetings regarding patient privileges as well as readiness for conditional release planning.

More specifically, interns can be assigned to the following treatment units:

  1. Lighthouse 1: All male admissions unit serving primarily GEI patients, though a small number of Incompetent to Proceed patients are sometimes housed on this unit as well.
  2. Anchor 1: Co-ed admissions unit serving primarily GEI patients, though a small number of Incompetent to Proceed patients are sometimes housed on this unit as well.
  3. Bridge 3: All-male step-down unit serving GEI patients.

Neuropsychology Assessment Program

*Interns may only work within the Neuropsychology Assessment program for a minor rotation.

The Neuropsychology Assessment program offers neuropsychological consultative services to units and Interdisciplinary Treatment Teams across the hospital, including those serving patients of various commitment types. Interns who select a Neuropsychological Assessment rotation gain experience in the practice of clinical neuropsychology in a forensic inpatient psychiatric setting. In addition to developing the intern’s understanding of the practice standards in clinical neuropsychology, this rotation focuses on increasing the intern’s familiarity with brain-behavior relationships and the methods and measurements utilized to assess brain functioning, from the initial neurobehavioral exam to more advanced assessment instruments. Additional attention is given to the role of the neuropsychological consultant within the hospital setting, appreciation for the complex utilization of the literature to advance knowledge and analysis of assessment and behavioral data, the development of skills in the communication of results and recommendations through the report, and providing feedback to staff and patients. This rotation can be adapted for interns with only beginning experience in neuropsychological assessment who are interested in obtaining preliminary training to augment a more generalist orientation or tailored to more advanced students who may be pursuing future training and practice in neuropsychology. *Neuropsychological Assessment is a non-unit-based rotation.

Risk Assessment Program

*Interns may only work within the Risk Assessment program for a minor rotation.

Following GEI adjudication, patients are placed under the jurisdiction of either the Oregon Health Authority or Psychiatric Security Review Board; the primary mission of both being protection of the public. As such, assessment of risk for violence, formulation of violence risk factors, and risk management strategies is an important role filled by psychologists. Assessment of risk is provided throughout various programs, but several psychologists with advanced interest and training in risk assessment conduct specialty assessments across the hospital due to the nature of the offense, complexity of case, or other unique factors. Interns who select a rotation in Risk Assessment learn more about risk, risk assessment, and associated issues such as psychopathy. Interns are exposed to more severe and complex cases under supervision of one of the risk psychologists.  Additionally, there may be opportunities to provide testimony in hearings and to shadow members of the OSH Risk Review. *Risk Assessment is a non-unit-based rotation.