Practicum Information Form

 

California Institute of Integral Studies

1453 Mission Street, San Francisco, CA 94103

(415) 575-6117 - Fax (415) 575-1264

 

 

Date: March 1, 2008

 

General Agency Information:

 

1)         Agency Name: Process Therapy Institute

            Address:          16573 Los Gatos-Almaden Rd., Los Gatos, CA 95032      Phone #:          408/358-2218, Fax 408/356-4728

            Email:              pti@processes.org

            Website:          http://www.processes.org.

2)         Training Coordinator: Don Hadlock, clinical co-director

                                    Carol Hadlock, clinical co-direcor

3)         Agency Director:         Don Hadlock, Executive Director

Training Opportunities:

 

4)                                                         # of Openings

 

MFT Trainee                                       5                      Hrs. p/Wk.      5-25

MFT Intern                                         5                      Hrs. p/Wk.      5-25

Psychology Trainee (Level I)              __________                Hrs. p/Wk.      __________

Psychology Trainee (Level II) __________                Hrs. p/Wk.      __________

 

5)    Please describe the major activities of the practicum:

Receiving weekly training behind one-way mirrors. Weekly video taped sessions with commentary. 
Providing counseling for individuals, couples, families and groups. 
Assessing, diagnosing and developing treatment plans for clients, and keeping progress notes.

 

6)  Please describe the minor activities of the practicum:

Handling crisis intervention. 
Coaching,

Presenting lectures, workshops and trainings

 

7)  Please list the current training cohort (i.e., MFT Trainee, School; MFT Intern, School; Psychology Trainee, School; Psychology Intern, School; MSW intern, School):

 

            Type of Trainee                       # of Trainees               School of Enrollment

 

1.  MFT                                               3                                  CIIS

2.  MFT                                               3                                  NOTRE DAME DEMUR

3.  MFT                                               2                                  SANTA CLARE

4.  MFT                                               3                                  JOHN F KENNEDY

5. MFT                                                2                                  UNIVERSITY SAN FRANCISCO

 

Agency Description

 

8)  Description of Agency:

PTI is a non-profit, non-discriminatory, charitable organization. We are a school and have been providing education and psychotherapy services to the community since1972.

The Institute is approved for continuing education courses for LMFTÕs and/or LCSWs as required by the California Board of Behavioral Sciences. Provider# PCE231.

We are a designated United Way Agency.

We are incorporated as a counseling center as well as an educational institution providing training for professionals.

 

9)  Mission Statement of Agency:

Our mission is to provide opportunities for people to enhance their awareness of self and the quality of their relationships with others. We provide these opportunities through personal and professional classes and trainings, as well as through counseling, psychotherapy and coaching services.

 

10)       a. Bi-lingual Services:

 

            b.  Special Services offered for Women or Girls:

 

            c.  Special Services offered for Men and Boys:

 

            d.  Is the agency wheelchair accessible?

 

 

11)       Population Served (give percentages of clients in each category):

         Spanish, Polish, German, And French.

 

 

 

a. Life Cycle

                        Adults-   65%                                      Families-   5%

                        Children-   15%                                   Elders-   5%

                        Adolescents-   10%

            b.  Gender

                        Women and Girls-       59%     Men and boys-              40%   Transgender- 1%

            c.  Ethnic/Cultural Identity

                        African American-      10%                             Latino/Latina   10%

                        Asian & Asian American-       10%                 Native American-   3%

                       

                        Euro-American-          64%                             Other (i.e., physically                                                                                                  challenged, international subsets)

d.    Severely Emotionally Disturbed

Please Describe:  Special Needs

12) Description of Agency Facilities

 

Office space available for trainees?   YES   _X___      NO   ____

 

            Office space conducive to:                                          __X__ art tx

                                                                                                ___X_ drama tx

__X__ somatic tx

___X_ family tx

__X__ group tx                                   __X__ sandplay

____ psychological testing

 

Office supplies and/or money available for:                __X_ art tx

                                                                                                ___X_ drama tx

__X__ somatic tx

__X__ family tx

__X__ group tx

                                                                                                __X__ sandplay

                                                                                                ____ psychological testing     

Supervision and Training Information

 

Please indicate by checking below the clinical and administration responsibilities of the student trainee/intern:

 

13)  Clinical Service:

Inpatient          _____  Outpatient        __X___                       Day Tx_X____

Crisis               __X___           Psychotic         _____              Chemical Dep._____

Psych. Testing _____              Research          _____              Outreach          _____

Case Mgmt.     __X___           Intake              _X_                 Individual Tx   ___X__           Family Tx        _X____           Couples Tx            _X____           Group  Tx        _X____

            Brief Tx           _X____           Long Tx          X_____           Transitional     _____

Drama Tx__X___                 Expressive Arts __X_            Somatic Tx___X__

Other   __X___  (please describe):PROCESS

14)  Theoretical Orientation:

            Psychodynamic   _X__                       Jungian            ___                  Gestalt             _X__

            Object Relations  _X__                       Systems           _X__              Humanistic       __X_

Self Psychology   _X__                      Cog.-Beh.        _X__               Transpersonal  _X__

Psychoanalytic    ___                          Existential        __X_             Other_PROCESS_

(please describe):

The Process Model of psychotherapy is taught as a universal model that incorporates all other theoretical orientations. Focused more on the therapist than the client, this model extensively explores how-to-be as well as what-to-do. We teach a wide variety of therapeutic interventions, how to work in various mediums, and how to integrate the numerous counseling models into a psychotherapy trainees and interns can understand, own, and use effectively. Inviting, following, and working with the clientÕs ongoing experience is taught and practiced. Our approach does not exclude any model or theory of therapy and, within the frame of respect both for the client and for Self, each student is encouraged to develop his/her own therapeutic style and to develop any mode of therapy in which he or she wishes to become proficient. At PTI we invite everyone to adopt a life direction of self-empowerment, and to invite his or her clients in that direction as well. There is a strong spiritual element taught at PTI based on the idea that it is our job to connect to our own center of well-being, then to extend that center to clients while we invite them to resolve or transcend their core issues.

Our hope that trainees/interns will increase their clarity about who they are as a therapist, how they can practice with joy in their work, and how they can stay free and creative in their interactions with others.

15)  Administrative Services

            Process notes              __X___                       Staffings          _____             

            Community Ed.           __X___                       Other               _____

16)  Will the Trainee have the opportunity to follow a case for a minimum of 6 weeks?                    Yes      __X___                       No            _____

17)  Will the Trainee have an opportunity for assessment experience?

            Yes      __X___                       No       _____

            If yes, please describe the supervision and psychological instruments used:

Staff is trained to do assessments. This training includes gathering history, making assessments, determining and handling dangerousness, diagnosis, and making referrals. We teach how to develop a treatment plan based on 1) determining the assessment 2) developing the goals for that assessment, and 3) creating interventions that can invite the accomplishment of those goals.

18)  Length of training (number of hours/week; duration of training period).

a.     Hours per week: Between 5 and 25

b.     Starting date of training year:  Anytime

c.     Ending date of training year:  Anytime

d.     Application deadline:  Anytime

19)  Required days/times that trainees must be present in agency:

20) One supervision/training day. The rest of the schedule is set by trainee/intern.

21)  How many weeks of vacation are trainees permitted?

Negotiated between supervisor, trainee/intern and clients. Usually 4 weeks.

22)  Please describe the stipend and benefits if any:

PTI is a paid internship program. Trainees/interns are employed part-time.

Client fees for an internÕs/traineeÕs counseling services range from $35 to $100 per session. .

23)  Supervision:

            a.  Hours/Week--individual                 ____as needed______

            b.  Hours/Week--group                       _____2-6_____

c.  Are site supervisors available who have background/training in expressive arts therapy, drama therapy or somatic therapy?

yes.

 

24) The supervision of the trainee will be based on the following:

X Videotaped Sessions                                                 Audiotaped Sessions            

              Co-Therapy w/ Supervisor                X  Process Notes

X  One-Way Mirror Observation                      Other, Please Describe:

 

24)  Supervising Staff  (please attach copies of the most recent CVs)

Licensed Mental Health Professionals

  Name/Degree            Cal. Lic #         Mo/Yr of Lic         # Hrs/Wk              Orientation

1.     Don Hadlock, LMFT 15316         June 2008                    10   All models, Experiential

2.     Carol Hadlock, LMFT 15315       May 2008                    10   All models, Gestalt

25)  Training

Please describe the frequency and duration of the following:

Orientation Training

about 10 hours. A mentor is assigned to support the trainee/intern whenever necessary. Each staff member is issued a Policy and Procedure Manual

As needed and determined by the supervisor and trainee/intern.

 

Didactic Seminars:

 

Training on Minority/Multicultural Issues:

Incoportate in weekly Mirror Training sessions:

 

Staff Meetings (other than business)

None. Business is handled as needed, and meetings are scheduled when convenient to all parties.

 

Other Training (co-therapy, process group, grand rounds):

Occasionally, trainings are offered to all staff members at PTI. They allow us uninterrupted time to focus on a specific subject area, such as crisis intervention, imagery, psychodrama, play therapy, breathwork, working with groups, holdings, dreamwork, trauma recovery, etc.

 

26) Number of Placements available last year:

            20

27) If there is a difference between the number of placements available this year and last year please explain why:

 

 

28) Students should address applications and questions to:

Don Hadlock

 

29) Required for Application:

                        __x___a. curriculum vitae or resume (please specify) Either.

__x___b. letter of intent or cover letter (please specify)

                        _____  c. letters of recommendation (How many? _____)

                        _____  d.  application form (please attach)

                        _____  e. experiences (e.g. particular populations, testing, etc.)

                      ___x__ f.  other: _Initial interview

 

30) Please describe the interview process for your agency: individual or group interview, role playing required, case presentation required, etc.)

First Interview: Discussion between Placement Coordinator and applicant to determine if this seems to be a compatible site for the trainee/intern.

Visitation: To see our mirror trainings and agency operation ŌliveĶ and to discuss with other intern/trainees their experience at PTI.

Final Interview: To explore any reservations, set a series of goals during placement, and to set up any final details.

 

31)   Please describe what you are looking for in an applicant:

Availability to explore oneself, availability to take responsibility for oneÕs part in interactions, humor, a desire to place love and non-resistance as guiding concepts in their work, able to keep commitments, and a high spiritual commitment to oneself.

 

32)   Other information not covered above:

 

33)   Please attach training syllabus, brochures or other printed information concerning the services or training programs available at your agency.

 

34)   Please circle one setting that applies and attach appropriate documentation if needed:

a)     Governmental entity

b)    School, College, or University

c)     Nonprofit and charitable corporation – MUST attach copy of 501(c)(3).

d)    Licensed Heath Facility as defined by Health and Safety Code Sections 1250, 1250.2, 1250.3, social rehabilitation facility or community treatment facility 1502(a), pediatric day health and respite care facility 1706.2, and a licensed alcoholism or drug abuse recovery or treatment facility 1706.2.  – MUST attach copy of License that setting is operating under.

           

I verify that this information is current and accurate,

 

 

________________________________________________                  ___________       

            Signature of Agency Representative / Title                                         Date