Access Institute | Program Overview
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Access Institute’s Psychoanalytic Community Mental Health Training Program is specifically designed to support psychoanalytic work in a community setting.

Individuals, couples, and children, and families are served in our Hayes Valley community clinic. Fellows spend 25 hours per week providing direct clinical services to children, adolescents, adults and seniors. The psychoanalytic approach allows for more intensive treatments and many patients are seen at the clinic two or three times per week. Most fellows also work off-site providing services at one of our partner programs.

Pre-doctoral Internship

Psychoanalytic Psychology Internship Program

PLEASE NOTE: We are not accepting applications for the 2019-2020 training year.  Please check back in Fall 2020 for new application dates.

Access Institute offers two-year, half-time psychoanalytically-oriented pre-doctoral internship. Interns participate in an intensive program where half of the 24 hour per week commitment is comprised of supervision and didactic training from some of the Bay Area’s top clinicians. This internship begins July 1 and ends June 30 and pays a yearly stipend of $12,500.  It is open to pre-doctoral interns who have completed their coursework and practica requirements. Interns in this program receive 1200 hours per year for a total of 2400 hours.

Interns spend up to 12 hours per week providing direct clinical services.  This can include individual therapy for adults, adolescents, and children, as well as therapy with couples and families.  The psychodynamic approach supports the use of more frequent sessions, and many patients are seen at the clinic two and three times per week. The 12 hours per week also includes the completion of at least three psychological assessment batteries over the course of the training year.

All trainees receive at least two hours of individual supervision per week for their psychotherapy work.  One of these hours is on-site at Access Institute, with a primary supervisor who is an Access Institute staff member.  The second hour of supervision is provided by an affiliate of Access Institute and takes place off-site in the delegated supervisor’s private office.  In addition, interns attend five one and a half hour seminars per week. Seminars are progressive throughout the two year period and are designed to facilitate the building of clinical thinking and skills. Interns also attend the weekly staff meeting where, in addition to covering general clinic business, they have the opportunity to consult on cases with the clinic’s prescribing psychiatrist and participate in “Care Team” where patients in need of adjunctive services are discussed.  When interns have been assigned an assessment battery, they are also assigned an external supervisor with whom they meet for the duration of the time that they are working on that battery up through the completion of the report and the feedback session.

Intern’s weekly time commitment will include:

  • Direct patient services, up to 12 hours per week (half-time).
  • Attending all required didactic training seminars. Attending a weekly staff meeting.
  • Meeting weekly with the primary on-site supervisor for one hour.
  • Meeting weekly with the adjunct supervisor(s) for one hour.
  • Maintaining all clinic paperwork.
  • Attending all in-house Grand Rounds presentations.
  • Attending and completing other assigned activities related to training and patient care.

Goals

The overall goal of the internship programs at Access Institute is to teach young clinicians how to flexibly integrate psychoanalytic approaches to be used with an underserved, inner city population. We train clinicians to be culturally competent and theoretically sound. Our graduates have a dedication to working with underserved populations and carry this commitment with them as part of their enduring professional identity.  More specifically, students can expect to gain experience working with a culturally and diagnostically diverse caseload, spanning the lifecycle. They will become proficient in diagnosis, case formulation, treatment planning and become well versed in contemporary psychoanalytic theory that flexibly integrates cultural and sociopolitical perspectives. Through this intensive training, they will find their own clinical voice among others in the psychoanalytic tradition.

In their psychotherapy work, after completing their internship at Access Institute, interns will be able to:

  • Use psychoanalytic concepts in case formulation
  • Accurately diagnose a broad range of patients
  • Understand how cultural forces interact with internal dynamics
  • Use psychoanalytic techniques flexibly
  • Intervene appropriately in a crisis situation
  • Self confidently assess their own strengths and weaknesses
  • Use supervision and consultation maturely and appropriately
  • Know ethical principles and legal mandates

In their assessment work, after completing their internship at Access Institute, interns will be able to:

  • Perform a clinical interview and Mental Status Exam
  • Administer Cognitive, Educational, Personality, Projective and Neuropsychological assessments
  • Write assessment reports
  • use assessment supervision efficiently and appropriately
  • communicate findings and give clinical feedback about assessment results
  • manage assessment cases in a timely and responsible manner

Curriculum overview

This sequence of courses follows a developmental trajectory, starting with basic principles, beginning treatment and formulation, and becoming more specific, with classes in working with special populations, like children and couples and ending with a course on termination.  The theoretical sequence begins with Freud and continues through Contemporary Object Relations. Additionally, courses include Substance Abuse and Trauma, as these are common problems in the community mental health population served in our clinic.  We place special emphasis on Sociocultural Processes in each and every class, in addition to having a designated course which addresses this topic alone.  The case conference is designed to follow a developmental process, whereby in the first semester, the students focus on case formulation and diagnosis and in the second semester, the focus is more on issues that arise once treatment is established. This sequence of courses continues the developmental trajectory that was started in their first year of training.  Human Development is taught, the sequence in psychoanalytic theory is completed and technique specific courses are included having to do with ending treatments.  The case conference continues the developmental process, and the students become more and more collegial and collaborative, with less structure provided by the instructor as the sequence goes on.  The assessment seminar meets weekly for the whole year.

Bilingual Services

Access Institute provides therapy in both English and Spanish and strongly encourages applications from Spanish bilingual interns.

In addition to providing individual therapy at the Hayes Valley Clinic, fellows with this emphasis conduct comprehensive psychological assessment batteries of children, adolescents, and adults. Fellows gain specialized training and experience in addressing complex diagnostic referral questions around areas of personality / emotional functioning; neuropsychological & executive functioning; intelligence; cognitive functioning; and achievement. Fellows also gain experience conducting intakes for prospective psychological assessment referral clients, and providing psycho-education on the testing process and outcomes. During the training year fellows also gain skills researching and presenting on a specialized area of their assessment interests, as well as have the opportunity to present their work through assessment case presentations.

In addition to receiving individual weekly supervision for each assessment case, fellows receive weekly didactic training to gain skills in the following areas:

  • Rorschach Performance System (RPAS) administration, coding, and interpretation
  • Evidenced based practices for assessment of Attention Deficit Hyperactivity Disorder (ADHD) in children, adolescents, and adults
  • Evidenced based practices in the assessment of learning disorders
  • Differential diagnosis of emotional disturbance and ADHD or other neurocognitive issues
  • Structured professional judgement (SPG) approaches to the assessment of violence risk
  • Assessment of malingering or feigning symptoms
  • Cultural considerations as they relate to limitations of test validity
  • Therapeutic assessment and social justice based approaches to psychological assessment
  • Skills in providing psychoeducation to clients about test results and improved report writing
  • Considerations in the development of an assessment private practice

In all areas of assessment work, fellows are trained to employ a multicultural, social justice approach to psychological assessment. This approach supports fellows in accounting for cultural differences in the interpretation of measures and validity of test outcomes, as well as consider the current and historical cultural factors that impact their evaluations.

Postgraduate Fellowship

Access Institute’s postgraduate fellowship is comprised of 13 clinicians working toward licensure as psychologists, LCSWs, LMFTs, and LCPPs.  Our diverse group of fellows comes from reputable graduate schools from across the country, bringing with them a broad range of clinical and life experiences.  While they come from diverse backgrounds, they all share a passion for community mental health work, and a deep appreciation and curiosity for psychoanalytic thinking.

The fellowship is a one year, full-time commitment comprised of 4 major components:  clinical work, didactic training, supervision, and professional development.

Clinical Work: Fellows spend 25 hours providing clinical services to the community. All fellows see adults and couples in our community clinic for a portion of their clinical hours, the remaining hours are dedicated to their area of focus, one of four tracks:  Assessment, Intake, Elder, or School-Based.

Didactic Training: Fellows are placed in one of four tracks, which each meet weekly with one of Access Institute’s clinical staff members for didactic training, clinical discussion, and a chance to collaborate with colleagues.

In addition to track meetings, fellows attend two didactic seminars each week.  The first focuses on psychoanalytic theory and technique, while the second focuses on sociocultural processes.  These courses are taught by senior clinicians in the community who hold a deep understanding of psychoanalytic theory and practice, along with a commitment to supporting community work with marginalized populations.

Fellows also participate in weekly case conferences where they have an opportunity to bring theory to life in a collaborative group setting.

Supervision:  Each fellow works with 3 individual supervisors throughout the training year.  In addition to their Access Institute staff supervisor, fellows are thoughtfully paired with experienced clinicians in the community.  The diversity and high-quality of supervision at Access Institute, is one of our major training values.  Our supervisors work with fellows to hone their skills, find their clinical voice, and develop their professional identity, in order to become culturally competent, ethically minded mental health professionals.

Professional Development: Our program weaves professional development into many areas of our training, understanding that at the post-graduate level, clinicians need to develop autonomy, gain confidence in their clinical abilities, and begin to think about the ways they will uniquely contribute to the mental health field.

To apply to our postgraduate fellowship click here.

Program Tracks

Assessment Track

In addition to providing individual therapy at the Hayes Valley Clinic, fellows with this emphasis conduct comprehensive psychological assessment batteries of children, adolescents, and adults. Fellows gain specialized training and experience in addressing complex diagnostic referral questions around areas of personality / emotional functioning; neuropsychological & executive functioning; intelligence; cognitive functioning; and achievement. Fellows also gain experience conducting intakes for prospective psychological assessment referral clients, and providing psycho-education on the testing process and outcomes. During the training year fellows also gain skills researching and presenting on a specialized area of their assessment interests, as well as have the opportunity to present their work through assessment case presentations.

In addition to receiving individual weekly supervision for each assessment case, fellows receive weekly didactic training to gain skills in the following areas:

  • Rorschach Performance System (RPAS) administration, coding, and interpretation
  • Evidenced based practices for assessment of Attention Deficit Hyperactivity Disorder (ADHD) in children, adolescents, and adults
  • Evidenced based practices in the assessment of learning disorders
  • Differential diagnosis of emotional disturbance and ADHD or other neurocognitive issues
  • Structured professional judgement (SPG) approaches to the assessment of violence risk
  • Assessment of malingering or feigning symptoms
  • Cultural considerations as they relate to limitations of test validity
  • Therapeutic assessment and social justice based approaches to psychological assessment
  • Skills in providing psychoeducation to clients about test results and improved report writing
  • Considerations in the development of an assessment private practice

In all areas of assessment work, fellows are trained to employ a multicultural, social justice approach to psychological assessment. This approach supports fellows in accounting for cultural differences in the interpretation of measures and validity of test outcomes, as well as consider the current and historical cultural factors that impact their evaluations.

Intake Track

Fellows with this focus are integrally involved with the flow of patient referrals to the clinic. Intake Fellows each have two weekly Intake shifts where they answer telephone and email inquiries about the Hayes Valley clinic and services offered here. They also attend a weekly Intake Team meeting, where the week’s intakes are discussed, and the team works together to make determinations about patient appropriateness and case assignments. These Fellows are often the first contact a potential patient makes with the clinic, thus they work to develop the skills to complete a thorough, though brief, intake evaluation, while also being respectful of patient safety, privacy, and emotional concerns. Intake Fellows develop a knowledge base about Bay Area Mental Health referrals, along with an expert sense of a potential patient’s appropriateness for services with Access or elsewhere in the community.

Elder Track

Bringing psychoanalytically informed psychotherapy to marginalized communities is the hallmark of this track.  By immersing ourselves in the neighborhoods and cultures of the populations we serve, Access Institute ensures its best chance at scaling barriers to mental health care by providing culturally sensitive psychotherapy to elders who would otherwise remain isolated due to problems of access and stigma associated with psychotherapy.

 

In addition to working with a more general population at the Hayes Valley clinic, fellows in the Elder Emphasis work either at the Bayview Hunters Point Adult Day Health Center, where they offer individual, group, and milieu therapy to primarily African-American seniors or at Openhouse, where they offer individual and group therapy to LGBT seniors in the Castro.  Fellows will receive training on collaboration and consultation in multidisciplinary settings (nurses, social workers, physical therapists, etc.) in addition to supervision and didactics in psychodynamic and person-centered elder care.

 

Fellows can expect to wrestle with the question of how to hold an internal frame while adapting traditional features of the frame to the complex needs of their clients.  Also worth noting, these elders are marginalized not only by virtue of their race, gender, sexuality, and socioeconomic status, but also by virtue of simply being old in a culture that devalues and disavows aging.  Fellows will examine how this ethos impacts their clients as well as their work with elders.

 

Trainees interested in cultivating an internal psychodynamic frame in tandem with creative and agile technique adapted to complex factors (non-traditional setting, wide range of functional levels and capacities) are encouraged to apply to the Elder Track.

School-Based Track

Providing psychotherapy at a school is a complex undertaking and a unique opportunity for treatment. We provide care for children at school and by doing that we become part of the school environment. We talk to teachers, social workers and principals. We walk the halls, visit the cafeteria, and encounter our clients’ classmates and peers. Our impact on our clients is not simply during the clinical hour, but throughout our time on campus. This requires thoughtful consideration of our multiple roles at the school, and the development of an internal frame that supports our clinical thinking.

 

Fellows in the In-School Mental Health Program receive training in consultation and collaboration, as well as didactics in psychodynamic play therapy. Fellows receive individual supervision and attend a child case conference and a group supervision focused on school-based work. Fellows also provide therapy to adults, couples, children, adolescents, and families at the Hayes Valley Clinic.

Didactic Training

Theory and Technique Courses

Infant Development

Contemporary Understandings of Freud

Transference/Countertransference

Theories of Therapeutic Action

Relational Theories

Primitive Mental States

Deepening a Treatment

Working with Dreams

Termination

Courses on Socio-cultural Processes

Work, Class, and Money

Genders and Sexualities

Psychoanalysis and Social Justice

Disability

Race

Impacts of Trauma on the Self

Psychoanalysis and Culture

Case Conference

Our case conferences are run by the same facilitator for 22 weeks, allowing the collaborative, clinical thinking of the group to develop.  Fellows will have the opportunity to present a single case for several weeks in a row.

Grand Rounds

Access Institute holds monthly Grand Rounds in which cutting edge ideas in the field of mental health are presented to staff, fellows, and the public.

Professional Development

Faculty Presentations

The Business of Private Practice

Building a Sustainable Career

Working analytically in community mental health settings