Program Structure

Across the training year, Guam-PIC interns gain training experiences within the Adult Services and Child and Adolescent Services with additional training exposure to the Drug and Alcohol Services and Guam – Department of Corrections (DOC). Adult Services Division is located at the main facility in Tamuning. Outpatient drug and alcohol services and outpatient children and adolescent services is located in the J&G Commercial Center in Hagatna. The primary training site for DOC is the Adult Correctional Facility in Mangilao.

Case Presentations

Interns are expected to complete three (3) 90-minute case presentations during their training year. Interns present at least one therapy and one assessment case (with the third either a therapy or assessment case). The presentation should be 60 minutes, leaving up to 30 minutes for discussion of consultation questions. Feedback is given to interns by members of the Guam-PIC Training Committee using the Intern Case Presentation Rating Form. The format involves providing Identifying information, psychosocial history, history of presenting problem, course of treatment/hospital course, mental status at time of interview, assessment or treatment data (depending on type of case), diagnoses and formulation, and recommendations.

Didactic Series

Guam-PIC faculty strive to embody the spirit of life-long learners and view professional development as a continuous process with no fixed endpoint. The didactic series is one way the value on education is put into practice. Interns are exposed to a variety of speakers through a comprehensive didactic series throughout the training year. Didactics focus on a range of relevant topics, designed to build upon and enhance prior knowledge and experiences, as well as compliment the direct service/experiential training provided during internship. Didactics prepare interns to face a wide variety of professional issues and circumstances they are likely to encounter throughout their careers. All didactics are expected to be professional grade presentations with evidence-based citations and references. Didactics are also expected to attend to individual and cultural diversity factors.

Didactics are held in person weekly for two hours. A didactic calendar is distributed during orientation and may be updated throughout the year. Didactic trainings are delivered by Guam-PIC psychologist faculty as well as by other behavioral health professionals who are experts in the topic areas. Many topic areas consist of a two-to-three-part series of didactic trainings to allow for sufficient depth in those areas. Didactic topics may include, but aren’t limited to:

1. Ethics and Adult Mandatory Reporting
2. Adult Assessment and Testing
3. Overview of Psychosis, Early Intervention and Family Treatments
4. Psychological Assessment/Evaluation Report Writing
5. Adults, SMI and Sequential Intercept Model
6. Assisted Outpatient Treatment
7. SMI and Medications
8. Adult Attention Deficit Disorder: Assessment and Treatment
9. Critical Incident Debriefing: Mitchell Model
10. Drug Assessment/Testing
11. Substance Use and Suicide: Assessment and Treatment
12. Overview of Substance Induced Psychosis, Early Intervention and Family Treatments
13. Substance Use Psychological Assessment/Evaluation
14. Juvenile and Adult Substance Abuse
15. Medications and Substance Use

Direct Client Contact

Across the training year, at least 25% (about 500 hours) of the interns’ time is spent in direct service delivery (e.g., delivering clinical interventions, conducting assessments). This equates to approximately 10 hours per week (for 52 weeks). To meet this requirement and account for paid time off, interns should aim to complete 15 hours of direct client contact per week.

Group Supervision

Interns receive two (2) hours of scheduled group supervision each week. Group supervision is led by one of the supervising psychologists and is conducted with all interns across consortium sites in person, with the option of video conferencing if needed. Group supervision may focus on clinical concerns, case presentation, the provision of supervision, topic-focused discussion, intern-led didactics, legal/ethical issues, and/or professional development topics.

Individual Supervision

Interns will receive supervision from at least two licensed psychologists throughout the training year – one supervisor per each six months and then alternating group supervisors. Interns receive a minimum of two (2) hours of individual supervision each week from their primary supervisor. Individual supervision focuses on direct client services and professional development. Supervisors hold primary responsibility for all cases/individuals the intern is involved with. Supplemental weekly individual supervision is provided as needed. This supplemental supervision may be provided by their primary supervisor or other adjunct faculty/site consultants. All training sites and supervisors subscribe to an informal “open door” policy. Interns are encouraged and welcomed to seek consultation and supervision as needed.

Peer Process Group

Interns meet one hour per month for peer process group. The purpose of peer process group is to encourage interns to support one another through shared experience, knowledge, and the feedback necessary for growth and success through a reciprocal process. The Guam-PIC process group will be facilitated by GBHWC staff.

Project ECHO

When encountering complex cases and the need for additional consultation occurs, interns, through their supervisors, can contact Project ECHO, present the case details (de-identified), and receive consultation from subject matter experts. This service is made available through the University of New Mexico Psychiatry Residency Program, Rural Focus Area, which has a rotation on Guam at Guam Behavioral Health and Wellness Center. In short, the ECHO Model provides medical rounds with a virtual community for support and guidance and for discussion, feedback, and recommendations consistent with best practices.

Research

All Guam-PIC interns are trained to be effective consumers, interpreters, and appliers of scientific information. Interns are expected to integrate current research literature and findings into case presentations and clinical practice.

Supervision

Interns participate in at least four (4) hours of supervision per week, including two (2) hours of individual supervision and two (2) hours of group supervision.

Other Training Opportunities

Interns participate in 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, screening days, and other activities. They also participate in intern cohesion activities (e.g., brown bag lunches, quarterly cultural retreats). Additional training opportunities may be offered throughout the year.