Training Experience

Across the training year, Guam-PIC interns work primarily in the Adult Services Division with some training opportunities with Child and Adolescent Services, 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.

Adult Services Division

The Adult Services Division (ASD) offers individual, family, and group behavioral health inpatient, outpatient, and residential treatment across several locations throughout Guam for individuals ages 18 and older experiencing a variety of life, emotional, and mental health issues ranging from adjustment to life stressors to serious mental illness. In this rotation, interns learn to practice as generalist psychologists across the continuum of care, addressing the needs of a rural and diverse community. Adult consumers are seen via scheduled appointments (face to face or telehealth) or as walk-in if urgent/emergent. As noted above, the Adult Services Division rotation also includes clinical training for adults residing in group homes. GBHWC has five group homes, three for adults living with serious mental illness (SMI) and two for adults living with a co-occurring serious mental illness and developmental disability (DD). Additionally, interns assist the Adult Inpatient Unit, a structured crisis stabilization program for individuals who present an imminent threat to themselves or others or are gravely disabled.

Drug and Alcohol Services

Drug and Alcohol Services (New Beginnings) provides inpatient, outpatient, residential, and medically assisted substance-use treatment for adults aged 18 and older in an individual and/or group setting who are at-risk for or living with a substance use disorder. During this rotation, interns learn to conduct assessments using the American Society of Medicine (ASAM) placement criteria and make appropriate referrals, administer psychological assessments to identify co-occurring disorders, and apply evidenced-based practices like motivational interviewing and Dialectical Behavioral Therapy for Substance Users (DBT-S). Interns also provide support to the GBHWC-Medically Assisted Unit, which provides structured detoxification, or detox, services. The MAT unit provides 24-hour medical, psychiatric, psychological, and counseling services. Across related experiences, interns assist consumers improve coping skills and make positive lifestyle changes.

Children and Adolescent Services

Children and Adolescent Services provides behavioral health services to children and adolescents aged 5 to 18 years, or up to 21 if receiving special education services and attending school, experiencing a variety of life, emotional, and mental health issues ranging from adjustment to life stressors to serious mental illness. Typical diagnoses include childhood onset emotional, behavioral, or mental disorders, substance use disorders, or developmental disorders. On this rotation, interns provide comprehensive cognitive, achievement and behavioral testing services as well as individual, family, and group therapies for inpatient, outpatient, and residential care placements. Working collaboratively with multiple agencies (e.g., Child Protective Services, Guam Department of Education, Guam Superior Courts), interns incorporate a System of Care philosophy and adhere to the Wraparound Fidelity Model. Interns also provide support to the Child Inpatient Unit, which provides structured crisis stabilization services to children and adolescents presenting an imminent danger to themselves and/or others. Interns receive specific training in play therapy and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Finally, interns provide support to two group homes across Guam, one designated for children and adolescents diagnosed with a serious emotional disability, and the other for those diagnosed with a co-occurring serious emotional disability and developmental disability.

Guam Department of Corrections

Interns work primarily from the main facility’s Mental Health Unit in Mangilao but may also travel to Hagatna Detention Facility to provide support as needed. Interns at DOC enhance their skills in diagnostic assessment, risk assessment, consultation, and treatment for a diverse, rural population in the correctional setting. Interns will develop psychological skills and competencies in assessment and treatment of individuals living with serious mental illness, malingering, personality disorders, and crisis intervention. Interns work closely with a multidisciplinary team, which includes psychiatrists, psychiatric technicians, psychologists, nurses, social workers, program managers, and others. Interns will enhance their skills in professional development and clinical consultation. Consultation is regularly provided to clients, family members, medical providers, correction officers, program coordinators, and members of the client’s multidisciplinary team concerning the psychological functioning of the consumer. Interns additionally provide supports to the Crisis Stabilization Unit Program, which provide structured crisis stabilization services in a locked unit for inmates and/or detainees presenting as an imminent danger to self and/or others.

Required Major Training Emphases

All sites offer the following major training emphases.

Behavioral Health Intervention

Interns across training sites spend approximately 10-15 hours per week in activities related to behavioral health intervention. All sites provide interns the chance to work with a diverse range of underserved consumers within a variety of therapeutic modalities. Individual, group, family, and/or couples therapy treatments are available at some sites. Consumers served range widely in age, race, ethnicity, and diagnostic presentation.

Psychological Assessment

Interns across training sites spend approximately 5-15 hours per week in activities related to assessment. Interns at every site administer, interpret, and provide written synthesis of psychological test batteries. Assessments may include record reviews, clinical interviews, intellectual, achievement, personality, risk assessment, drug assessments, and/or competency-based measures. Interns have opportunities to write reports and make recommendations that convey meaningful information to prescribers, treatment teams, consumers, and families. Assessment opportunities and requirements vary by site.

Consultation and Systems Collaboration

Interns spend approximately 6-8 hours per week in activities related to consultation and systems collaboration, learning to consult with a variety of other providers and stakeholders. Collaborative opportunities include working within an interdisciplinary treatment team, providing psychological consultation to other disciplines, and partnering with community social service, medical and legal services. Opportunities for consultation and systems collaboration vary by site.