GBHWC is the sole state entity providing comprehensive public behavioral health services to the adults and children of Guam. Services are offered regardless of the person’s ability to pay. GBHWC offers high quality of care via its main facility in Tamuning, as well as satellite offices in the J&G Commercial Center in Hagatna, and an adult mental health transitional residential service in Asan. Services offered at the main facility in Tamuning include pharmacy services, day treatment, adult mental health case management, rape crisis intervention, medication clinic, adult inpatient, child inpatient, intake/emergency, child and adolescent division, nursing services, psychological services, and adult counseling. Services offered at the J&G Commercial Center in Hagatna include drug and alcohol, GBHWC-I’Famagu’on-ta (children’s outpatient), and prevention and training. Drug and alcohol support services are offered for children and adults (one program for adult males and another for adult females) contracted out for 5 of these group homes, clinical care for all homes is provided by Dr. Mary Fegurgur, GBHWC’s lead clinical psychologist and Guam-PICs Program Director. The intern works primarily from the main facility in Tamuning but travels to provide supports to other sites as needed.
At the end of FY 2020 (October 2019-September 2020), GBHWC had a total of 2,100 active consumers getting services from the different programs; 53% are males and 47% females. The top three races served by GBHWC include (1) Native Hawaiian and/or Pacific Islander (including Chamorro); (2) Asian; and, (3) White. Most consumers are uninsured. Majority of these consumers belong to the Adult Outpatient Mental Health Services (1,432 consumers), followed by GBHWC-New Beginnings Drug and Alcohol Program (284 consumers), and GBHWC-I’Famagu’onta, Child and Adolescent Division (282 consumers). Due to COVID-19 pandemic, GBHWC closed its offsite facilities and only operated on crisis mode. Thus, a significant drop in admissions from the previous years across all programs were noted.
Interns are expected to work Monday through Friday during standard business hours; no on-call services required. Interns gain experience in multiple areas of psychology which include, but are not limited to, individual and group psychotherapy, psychological testing, report writing, and consultation. Interns not only work with clients but also have opportunity to interact closely with other disciplines such as psychiatrists, psychiatric technicians, pharmacists, nurses, social workers, licensed counselors, community aides, care/WRAP coordinators, and others. Interns who complete an internship with GBHWC are expected to be well-rounded in the practice of psychology and leave with the skills necessary to treat and assess diverse populations as well as those who live with various mental health accommodations.
Interns provide psychotherapy among individuals, families, and groups. Further, they provide consultation to clients (inpatient and outpatient), medical providers, care coordinators, physicians, guardians, family members, and members of the client’s multidisciplinary team concerning the psychological dimensions of their patients. The training provided is designed to develop competencies in psychological assessment and diagnosis, psychological interventions, and crisis intervention. While acquiring these competencies, interns also develop sensitivity to issues of cultural diversity, awareness of professional ethics in the delivery of psychological and forensic services, and self-awareness as these relate to issues that affect professional functioning.
At GBHWC, interns develop competencies in psychological assessment and clinical interventions among a diverse panel of patients. GBWHC provides rotations that offer experience in working with adults, adolescents, families, elderly, outpatient population and those with Serious Mental Illness (SMI). Interns are given the opportunity to provide a variety of treatment modalities to help residents achieve their treatment goals. These include, but are not limited to, activities that are in consultation with treatment team members, as an individual therapist, or as a treatment team member within the unit milieu:
The GBHWC rotation prepares interns for doctoral-level independent practice in clinical psychology in a public mental health setting. During their GBHWC rotation, interns receive education and training across three focus areas – Adult Services Division (involving in and outpatient care), Drug and Alcohol (at GBHWC-New Beginnings), and children and adolescents (at GBHWC-I’Famagu’on-ta). Each area provides a unique learning experience that enhances the intern’s clinical, diagnostic, and assessment skills and knowledge.
During this rotation, the intern conducts psychological evaluations and assessments; delivers individual, group, and/or family therapy and/or other evidence-based interventions; and provides crisis intervention as needed. Interns also participate in daily rounds, treatment team meetings, individual supervision, and the Prevention and Training Branch of GBHWC by providing outreach and prevention to meet the needs of Guam’s rural and diverse population. Some of the prevention and outreach activities include psychoeducational workshops, committee work, mental health awareness month, and screening days.
The following are brief descriptions of the three focus areas.
The Adult Services Division (ASD) offers individual, family, and group behavioral health inpatient, outpatient, and residential treatment opportunities at several locations throughout Guam for individuals ages 18 and older experiencing a variety of life, emotional, and mental health issues from adjustment to life stressors to serious mental illness. Interns receive training to meet the needs of a smaller community by learning to practice as a generalist working with a wide array of clients using a continuum of care. Clients are seen via scheduled appointments or as walk-in if urgent/emergent. This focus area also supports eight group homes across Guam: two of which are for adults diagnosed with SMI; three of which are for adults diagnosed with a co-occurring SMI and Developmental Disability (DD); one of which is for those diagnosed with a SMI as well as designated as medically fragile and/or elderly; and two homes for those diagnosed with SMI as well as being homeless; there are about five to 12 beds at each of these group homes. While operations are contracted out for five of these group homes, clinical care for all homes is provided by Dr. Mary Fegurgur, GBHWC’s lead clinical psychologist and Guam-PICs Program Director. Interns additionally provide supports to the Crisis Stabilization Unit Program with ASD; which provide structured crisis stabilization services in a locked unit of 16-beds for those presenting as an imminent danger to self and/or others. Interns at the ASD focus area provide supports to clients with an array of needs.
GBHWC-New Beginnings, provides inpatient, outpatient, residential, and medically assisted substance-use treatment for individuals aged 18 and over in an individual and/or group setting for those who are at-risk or diagnosed with a Substance-Use Disorder (SUD). Among some of the skills interns learn at this focus area include conducting assessments using the American Society of Medicine (ASAM) patient placement criteria and make appropriate referrals, treating clients using Dialectical Behavioral Therapy for Substance Users (DBT-S), improving coping skills, and helping patients make positive lifestyle changes. Interns also provide supports to the Crisis Stabilization Unit Program with GBHWC-New Beginnings which provide structured crisis stabilization services in a locked unit of 16-beds for adults presenting as an imminent danger to self and/or others.
GBHWC-I’Famagu’on-ta, provides behavioral health services to children and adolescents experiencing a variety of life, emotional, and mental health issues from adjustment to life stressors to serious mental illness. GBHWC-I’Famagu’on-ta offers Individual, family, and group behavioral health inpatient, outpatient, and residential supports for those ages 5 and under age 18, or up to 21 if receiving special education services and attending school and diagnosable with an emotional, behavioral, or mental disorder, substance use disorder, or developmental disorder.
This focus area also supports two group homes across Guam: one of these group homes is designated for children and adolescents diagnosed with a Serious Emotional Disability (SED), and the other for those diagnosed with a co-occurring SED and DD. The first of these group homes accommodates 8 children and/or adolescents and is intended to provide temporary short-term placement of 6-12 months for youth whose needs are not able to be met at home and in the schools. The second of these group homes accommodates 4 clients and is intended to provide temporary short-term placement of 6-12 months to youth transitioning from the Therapeutic Group Home, Crisis Stabilization, and other restrictive level of care, needing help with daily living skills in a higher level of structure and supervision than what can be provided in the home. The children and youth admitted into this group home are usually wards of the courts and in the Child Protective Services (CPS) because their parents are unable to provide appropriate care for their well-being and safety. Interns also provide supports to the Crisis Stabilization Unit Program with GBHWC-I’Famagu’on-ta; which provide structured crisis stabilization services in a locked unit of 16-beds for those children and adolescents presenting as an imminent danger to self and/or others. Among some of the skills interns learn at this focus area include utilizing Trauma-Focused-Cognitive Behavioral Therapy (TF-CBT) and play therapy; and, working in coordination with families and other providers using the Wraparound Fidelity Model.
Site Director: Mary K. Fegurgur, M.S.W., Psy.D.
Email address: Mary.Fegurgur@gbhwc.guam.gov
Phone number: (671) 647-5731
Address: 790 Gov. Camacho Rd., Tamuning, Guam 96913