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Under the Rainbow: Clinical Training Program

 

HISTORY OF UNDER THE RAINBOW

The Under the Rainbow (UTR) program began in spring of 1992 as an inpatient pediatric ecology program that focused on comprehensive forensic assessments of children and adolescents that were referred for child abuse and/or neglect.  The multi-disciplinary assessment team included pediatricians, nurses, psychologists, social workers, specialized forensic interviewers, and child developmental specialists.  In the summer of 1998 the inpatient multi-disciplinary assessments were all shifted from inpatient to the current outpatient setting.  At that time, the Under the Rainbow program was shifted from the department of pediatrics to the department of psychiatry and merged with a small outpatient community mental health clinic.  In the years following, UTR continued specializing in assessing and treating youth with histories of neglect, abuse, and other traumas while expanding their services to include youth challenged with all mental and behavioral health issues.  The UTR multi-disciplinary team included child psychiatrists and added medication management and group psychotherapies to its range of psychiatric services.  UTR staff learned from their years of working with traumatized youth that early assessment of childhood trauma is key in addressing and treating the children.  As a result, since 1999 UTR has prioritized education and prevention in their work with children, adolescents, and their families.  UTR staff, since 1999, provides early educational and preventative awareness and assessment through UTR integrated services in the community (grade and high schools, WIC) and within Mount Sinai Hospital (inpatient pediatric unit, PICU, NICU, Mother-Baby, pediatric endocrinology, HIV).  Under the Rainbow staff has assured that quality “clinicians for the future” will be available to serve UTR clients and their families by maintaining a doctoral-level psychology externship program from 1992 till present, and recently added a social work internship program to also continue to foster a multidisciplinary environment.

SERVICES PROVIDED AND WHO WE SERVE

Intake                                 

Intake is an initial assessment in which demographic, administrative and clinical information is obtained. During this initial appointment, the presenting problem is identified, a risk assessment is completed, and an assessment of needs and appropriateness of service is determined. Guardians will leave this appointment with a preliminary diagnosis, recommendations for treatment, and/or referrals if needed, and a scheduled next appointment to continue services. Please call 773-257-4750 to schedule an intake.

“What is Therapy” Workshop

This workshop provides guardians/parents with crucial information about mental health services for children and what role they can play in helping their child benefit the most from services. The workshop is designed to help guardians understand mental health treatment and modalities, such as individual, group and family therapies. Guardians are required to attend this workshop prior to receiving services. Guardians will leave the workshop with a scheduled mental health assessment with a mental health professional.

Mental Health Assessments

This is a two hour appointment in which the mental health professional will complete a thorough assessment of the presenting problems and gather background history. The evaluator will provide treatment recommendations that may include the following services:

Individual Therapy/Play Therapy

This type of therapy involves the use of toys, blocks, dolls, puppets, sand-tray, drawings and games to help the child recognize, identify, and verbalize feelings.  The psychotherapist observes how the child uses play materials and identifies themes or patterns to understand the child's problems.  Through a combination of talk and play the child has an opportunity to better understand and manage their conflicts, feelings, and behavior (American Academy of Child and Adolescent Psychiatry, 2012).

Family Therapy

The participation of family members in the assessment and treatment of infants, children, and adolescents has been shown to be integral to positive clinical outcomes. Family therapy will incorporate family members and dynamics to utilize a family approach to the presenting problem. In the care of young children, work with parents is always necessary. Extended family members, foster parents, or guardians also participate in assessment and treatment when they are the primary caregivers or prominent figures in the child's life (American Academy of Child and Adolescent Psychiatry, 2012).

Group Therapy

Children and adolescents often benefit by receiving feedback from same-aged peers, as opposed to parents, teachers or therapists. Within a group setting, children can learn and practice new and more appropriate social skills, including problem solving, conflict resolution, giving/receiving feedback, sharing and cooperation. The group setting offers a safe, therapeutic space to learn or better develop healthy emotional and interpersonal skills. UTR offers a vast number of different group options for children, adolescents, parents and entire families.

Psychiatric Evaluation/Medication Management

UTR offers a variety of therapeutic services all on one floor, including psychiatry. UTR is staffed with child psychiatrists and nurse practitioners, all of whom have excellent training in the realm of psychotropic treatment for children. Psychiatry staff practices high collaboration with each other, psychology staff and guardians to assure best practice and high quality services. Psychiatry services are offered in both English and Spanish.

Quotient

UTR takes pride in being a pioneer in using advanced technology in the diagnostic assessment and treatment of ADHD.  UTR has been using the Quotient system since 2009 in treating ADHD/ADD as well as a tool for the differential diagnosis in childhood disorders. The Quotient is an FDA-cleared assessment for the objective measurement of impulsivity, hyperactivity and inattention as an aid in the assessment of ADHD.

UTR Summer Program

The summer program at UTR is a six-week social skills program that provides a safe place for children to meet peers and learn to build and maintain healthy social relationships, practice skill-building in a therapeutic environment, resulting in a reduction of social isolation in marginalized communities.  Added benefits to the program include excursions outside of local communities to explore all of the benefits that the Chicago-land area has to offer, such as horseback riding, zoos, museums, and Millennium Park.  The program has multi-sensory, including arts and crafts, food experiments, gross motor development, and more.  We also offer support groups and workshops for parents.

UTR Special Programs

UTR also offers special programs and events to acknowledge holidays and model for families how to engage in cultural traditions. Emotional distress often hinders or challenges a families’ ability to experience joy and a sense of belonging. Therefore, UTR offers events, programs and opportunities to reduce social isolation. We offer programs at no direct cost to families throughout the year. We encourage parental participation in games and promote leadership in the older children when involved with activities with larger groups.

Case Management/Consultation

UTR staff strives toward integral care. Staff ensures professional communication between providers of care, including UTR staff, staff of other agencies, with other professionals, and systems that are involved providing services to a client. Likewise, clinicians make great efforts to coordinate, support and advocate for social, vocational, educational, child welfare, and other community services and resources.

SASS Services

SASS (Screening Assessment and Supportive Services) is a twenty-four (24) hour, seven days (7) a week community-based program.  The target population served is children and adolescents age 17 and younger who are severely emotionally disturbed and whose ability to function adequately at home, school, or in the community is greatly impaired.  These children may be at risk of being placed in a more restrictive setting, such as a psychiatric hospital or a residential treatment center.  The needs of the children and families are met through a variety of methodologies that include a written SASS assessment, recommendation for outpatient or inpatient services, individual, family, group therapy, school monitoring, and when necessary, hospital monitoring, etc..  Ancillary services include, but are not limited to the following:  individualized treatment planning, ensure psychiatric examination, clinical consultations.  Outreach services including telephone contacts, mailings, home visits, collateral contacts, and linkage with teachers, social workers, counselors and other appropriate agencies.

Children served in SASS reside on the Lower West Side (Pilsen-Little Village) or are at St. Anthony’s Hospital.  SASS children and adolescents are referred to other appropriate programs/agencies under the following conditions:  due to the SASS goals have been met, the crisis ameliorated relocation of the client, at the parent/guardian’s request or death of the client.  SASS services may be provided for 90 days.  An extension maybe requested for an additional 30 if needed.

Group Therapy at UTR

  • Social Skill Groups for all ages (5-18)
  • Play-Based Groups
  • Parent-Child Attachment Groups
  • Parent Support/Education Groups
  • Teen Groups
  • Healthy Relationships Group for Teens
  • Expressive Art Groups (ages 7 and up)
  • Multi-Family Groups
  • ADHD Groups

 

*most groups are 1x/week for 60 minutes*

*most groups are held during after-school hours*

* groups are offered on a variety of days/times

* some groups are held in English and/or Spanish*

 

Social Skill Groups for all ages (5-18)

These groups tend to focus on development of social and coping skills. The goals of these groups generally include building and maintaining appropriate peer relationships, identification and management of difficult emotions, and socially appropriate communication. Both directive and non-directive interventions are utilized to help children learn and practice new skills, including relaxation techniques, anger management, making friends, sharing, and cooperation.

Many members of these groups have significant social skills deficits. Many also have externalizing behavior disorders, and have been either the victims or perpetrators of bullying. The groups then help provide an emotionally and physically safe therapeutic environment where children can improve their social confidence.

Groups for teens offer a safe space to be able to explore and discuss various issues that may arise in the multiple environments in which they engage in. The teen groups are often process oriented, with an emphasis of the group being a place where members can seek and offer support, while improving social skills and communication.

Parent-Child Attachment Groups

A dyadic therapy group, in which parents attend with their children (ages of 3 to 6) to enhance a healthy parent/child attachment. This is achieved through play, as well as processing with parents the struggles they face in their role as caregivers.  Behavioral management skills for parents are also offered.

Parent Support/Education Groups

This group is a bilingual relaxation group “Peaceful Oasis” / “Isla de Paz” for adults ages 18 and over (some older teens may also be appropriate). Relaxation exercises and activities include, but are not limited to, mindfulness exercises, movement activities, stretching, sensory activities, imagery exercises, progressive muscle relaxation, etc.

Healthy Relationships Group for Teens

The goal of this group is to encourage adolescent females to identify and engage in healthy dating relationships. Psychoeducational and experiential techniques are utilized to enhance members' awareness of factors that constitute healthy and unhealthy relationships. Members learn to identify harmful and abusive dating behaviors and understand the impact of these behaviors on emotional well-being. This group is also designed to teach members techniques that promote the development and maintenance of healthy relationships, including: positive communication, conflict-resolution, anger management, and problem-solving skills.

Expressive Art Groups (ages 7 and up)

The expressive arts bilingual art therapy group is designed for children and families ages 7 and above. The group is designed to be a primary or adjunct therapy that utilizes verbal and non-verbal forms of expression through a variety of materials, including drawing, painting, three dimensional design, sand, clay, and other materials. The goal is to address individuals’ identified goals for treatment, which may include improving self-esteem, exploring feelings and fostering self-awareness, reducing symptoms, addressing trauma history, managing behaviors, and developing skills. The group is beneficial for any client who gravitates towards creative forms of self expression, although experience is not required.

Multi-Family Groups

Multi-family group brings together five to eight families under the guidance of three therapists who help them navigate the acculturation process so that they may enjoy the fruits of their difficult immigration process and come to enjoy stability, friendship, and community in their chosen destination of Chicago. At first, the family members are strangers to each other and hold close to their hearts the stigma of having severe mental health problems. They feel isolated, broken, lost and suspicious. The group allows them to earn and gain the trust of their community neighbors who are facing similar challenges and, in sharing their past sorrows and future hopes, the stigma of mental health problems is turned into the pride of positive growth. The parents come to terms with the reality that they now belong to two cultures: Mexican-American, Mississippi-Chicago, South-North, rural-urban, football-soccer, English-Spanish, and parents learn to accept their children’s identity choices and celebrate their backgrounds. Through crafts and activities, families are encouraged to enjoy both cultures, rather than feel shame for one over the other. They might carve a Halloween pumpkin and trick-or-treat, and build an altar for Día de los Muertos filled with sugar skulls. Child psychopathology, gang involvement, domestic violence, and parent unemployment-imprisonment-deportation are themes constantly addressed in the group, but in a context of community and inclusion. Groups last 12-weeks and are formed with a uniformity of children’s ages in mind.

 

 

HOW TO GET STARTED

To make a referral or initiate services, please call 773-257-4750 and ask to speak to our intake coordinator, Yalut Salgado.

An intake appointment will be scheduled and the intake coordinator will guide you through the registration process.

UTR is located on the 5th floor of the Nurses Residence building, which can be accessed by using elevator ‘D’ of Mount Sinai Hospital.

 

LOCATION AND CONTACT INFORMATION

Mount Sinai Hospital

Under the Rainbow Program

1500 S. California Avenue

Nurses Residence, 5th Floor

Chicago, IL.  60608

Phone: 773-257-4750

Fax: 773-257-4753

 

CLINIC HOURS

Monday thru Thursday 9am – 7pm

Fridays 9am – 6pm

 

UTR TRAINING PROGRAM

Under the Rainbow (UTR) is an outpatient therapy program for children, adolescents and their families.  Direct services are provided by psychologists, social workers, child development specialists, psychiatrists, and psychology externs. UTR evaluates and treats most psychological disorders of children and adolescents and provides outpatient mental health services for children between the ages of 0 and 18. UTR has historically specialized in the treatment of the emotional effects of abuse and neglect. Services are also provided for the adult caretakers of these children who are dealing with issues related to those of the child. Services are provided in both English and Spanish to children and families who are on Medicaid.

UTR offers a range of services to children and their families, including: evaluation of the need for psychological services; individual therapy; play therapy; family therapy; group therapy; psychiatric evaluation; psychotropic medication management and consultation; ADHD assessment and treatment; case management; ongoing child advocacy; liaison with private and public child welfare agencies; and crisis intervention.  Since UTR is located within a community hospital, the clinic is able to provide both medical and community-based work. Within the community, UTR provides consultations and interventions within the public school system. Within the hospital setting, UTR provides consultations to a variety of clinics and programs, including the pediatric medical inpatient unit, pediatric weight management clinic, and the pediatric endocrinology clinic.

Mount Sinai Hospital Medical Center is a large treatment, training and research center located on the near west side of the City of Chicago, just southwest of Chicago's loop area.  In accordance with the hospital's mission to develop future generations of health care professionals, we provide clinical therapy externships in child and adolescent mental health for clinical psychologists-in-training.  A total of eight psychology doctorate and two social work positions are typically available each year.

These externships begin in July and end one year later. Clinical psychology externs spend approximately 22 hours per week addressing their clinical responsibilities.  Time off is provided during this period and it is expected that externs will arrange this time off with their supervisors, taking into account patient and service needs.  Training evaluations will be coordinated with the extern's graduate program.

The therapy practicum emphasizes the psychotherapeutic treatment of children, adolescents and their families.  Careful intake screenings, psychodiagnostic interviewing and treatment planning are expected.  Treatment plans typically include, but are not limited to, individual and systemic interventions including play therapy, verbal therapy, family therapy, group therapy, and parental guidance modalities.  Supervision is provided for each therapy case.  Externs will be expected to coordinate treatment planning with other health care professionals, schools and community programs.  Sensitivity to culture, gender and social class issues is highly valued and is viewed as fundamental to establishing the therapeutic alliance.  Externs are expected to attend team meetings, weekly supervision (both individual and group supervision), didactic seminars and case conferences. Externs are also required to videotape their sessions and then review a specific number of tapes both with their individual and case conference supervisors. All externs also receive live supervision of their therapy cases and mental health assessments.

The training program has developed into a competitive site, receiving approximately one hundred applications yearly for eight positions. Externs have come from a variety of different schools and disciplines (Psy.D. and Ph.D.), including:

Illinois School of Professional Psychology (Chicago and Northwest campus)

Chicago School of Professional Psychology

Wheaton College

Loyola University (Clinical and Counseling programs)

DePaul University

Adler University

Midwestern University

Illinois Institute of Technology

University of Illinois at Chicago

Roosevelt University

 

ROTATIONS

A total of seven rotations are available. Each rotation is designated as either 5- or 10- months. Each extern is expected to participate in a rotation or multiple rotations throughout the entire training year. Placement of externs into rotations is ultimately decided by the director of training, but relies on information about extern's goals and preferences. The rotations are as follows:

  • Pediatric Endocrinology Clinic
  • Pediatric Medical Inpatient Unit
  • SASS
  • Elementary School Program
  • Family Therapy
  • Art Therapy Group
  • Administrative

EXTENSIVE SUPERVISION

         Individual Supervision (1 hr weekly)

         Case Conference (1 hr weekly)

         Group Supervision (1.5 hrs weekly)

         On-Site Rotation Supervision (1-4 hrs weekly)

Time On

  • mid July through mid June each year
  • 22 hours per week (average)
  • Fridays are the only mandatory days; externs choose 2 other days

Time Spent

  • 8 individual or family therapy hours per week
  • 1 group therapy hour per week

Rotation

  • Year-long (about 1-4 hours per week)

 


Individual Supervision

  • 1 hour per week – More as needed

Case Conference

  • 1 hour per week

Group Supervision of Group Therapy

  • 1.5 hours per week

Didactic Seminars*

  • 1.5 hours per week

"Business Meeting"

  • 1/2 hour every week

*Externs will present/facilitate one didactic seminar during the training year.

Supervision

Externs will be assigned to doctoral level staff clinicians for supervision.  Additional supervision will be provided when the staff and extern determine it is advisable.  One supervisor will serve as the extern’s primary supervisor.  S/he will be responsible both for integrating the extern into their respective training program and for coordinating his/her experience at Mount Sinai with their respective graduate program. Supervisors will be responsible for assessing the extern’s learning needs and will facilitate learning experiences appropriate to those needs in the areas of clinical theory, clinical practice, ethics, and professional development.  The primary supervisor will also provide mentoring for the extern in establishing a schedule that allows for participation in required clinical and training activities.  Further, supervisors will monitor the timeliness of completion of charting, assessments, treatment plans, and treatment summaries.  In addition to individual supervision, externs receive supervision of the groups they co-lead. This supervision is in a group setting and is facilitated by two staff members and our postdoctoral fellow.

Clinical supervision can be an illuminating, yet at times, anxiety-provoking experience.  One aspect of the learning experience is the processing and understanding of the trainee's interactions with patients and staff.  In a training setting such as ours, which often focuses on exploring issues of trauma and abuse, powerful feelings may be evoked in all members of the clinical team.  Your supervisors are here to facilitate your understanding of patients, theory, and in addition, your reactions to your training experiences.

Evaluation

The extern's performance with respect to clinical functioning, clinical skill, professionalism and openness to learning will be evaluated primarily by their individual supervisor with collaboration and integration from the entire training team. Careful attention to the strengths and weaknesses of each trainee is an integral part of focusing training experiences that are attuned to individual needs.  Supervision is viewed as involving an ongoing feedback and learning process.  Formal written or oral evaluations will be conducted two times during the training year.  Graduate program evaluations will be completed as per the requirements of the trainee's particular program.  Any questions or concerns about the evaluation procedure should be directed to the supervisor.  Every effort will be made for these evaluations to be fair, substantive and in the interest of the trainee's continued personal and professional development.

Externs will also have an opportunity to evaluate the training program and the degree to which it meets the externs' needs during the year.  We do encourage externs to provide us with ongoing informal feedback as well.

LONG TERM THERAPY/EXTENSIVE WORK WITH CHILDHOOD TRAUMA

Externs provide long-term outpatient therapy with children, adolescents and their families who present with a wide range of problems and diagnoses, including significant histories of abuse/neglect/trauma.

WHAT MAKES THE UTR TRAINING PROGRAM UNIQUE?

UTR’s dedication and commitment toward training psychology externs is exceptional. The training program is designed to provide externs with a wide range of experiences to enhance their clinical and professional skills. UTR training program utilizes an ‘open door’ policy in which externs are provided the support and guidance they need while given the opportunity and independence needed to find their clinical voice and identity.  Externs benefit from a collaborative, supportive, and team-approach within a community mental health center. Externs also receive live supervision with their therapy and assessment cases. This type of supervision, while intensive in nature, is a highly beneficial and rewarding experience.

Post-Doc Position

In addition to the psychology externship, UTR also offers a post-doctoral fellowship. The job responsibilities of the post-doc position include completing weekly mental health assessments, providing therapy for clients and their families, training and supervision of doctoral-level psychology externs and social work interns, and providing psycho-education and consultations in multiple hospital clinics and departments as well as neighborhood schools.

Mount Sinai compensates the post doc with a competitive salary and benefits package.  The post doc receives weekly clinical supervision from a licensed clinical psychologist and meets all the state's requirement for the post-doc’s licensure eligibility. The position will be filled by a clinician who has completed all the requirements (by September start date) for their Ph.D. or Psy.D. degree in psychology and who has at least 3 years of experience with providing mental health services to children, adolescents, and their families.

Post-doc applications are to be submitted by January 27th, as our program will make every attempt to abide by the new APPIC guidelines, which includes a February 27th 'match day.' Interviews will therefore take place in February with a start date of first week in September.

Interested applicants should forward all application materials to the UTR Director of Clinical Training, Dr. Bob Hirsch at bob.hirsch@sinai.org. All applications must include the following:

Cover Letter, Curriculum Vitae, Two (2) Letters of Recommendation (letters may be submitted directly from the writer or from applicant)

Only electronic applications are accepted

How to Apply: Psychology Therapy Practicum

Our training program abides by the Practicum Application and Notification Guidelines put forth by some Chicagoland schools.

In order to apply for a psychotherapy practicum, the following information is needed:

  • Cover Letter
  • Curriculum Vitae
  • 2 Letters of Recommendation
  • Writing Sample
  • Transcripts

UTR accepts only electronic applications. No paper applications are accepted. Please keep in mind that UTR is a therapy practicum and not a diagnostic site.

Interested applicants should email the training director, Dr. Bob Hirsch at Bob.Hirsch@Sinai.org, simply indicating their interest in applying. Applicants will then be forwarded instructions on how to upload their application materials.

All applications should be uploaded within 5 business days of the day that ACEPT permits students to send their materials. Applications received after this date may not be considered.  Applications must include all materials (limit to 2 letters of recommendation, Cover Letter, CV, Writing Sample, Transcripts).  Applications that are missing materials may not be considered.