James Holmes, Psy.D. Psy.D. June M. Stapleton, Ph.D. Topics Overview of AzSH Patients at AzSH Functions of Psychology Department Assessment Treatment Case example Overview of AzSH Only state-funded psychiatric hospital in AZ Three basic programs: Forensic Civil Sexually Violent Person (SVP) Program at Arizona Community Protection and Treatment Center (ACPTC) Multidisciplinary approach Approximately 340 patients/residents at AzSH Patients at AzSH Program for civil patients Court-ordered treatment Gravely disabled (GD) Persistently and acutely disabled (PAD) Danger to self/others Not competent to stand trial Not Guilty by Reason of Insanity (NGRI) Patients at AzSH Program for forensic patients Guilty Except Insane (GEI) NGRI Restoration to Competency (RTC) Patients also sent for evaluations (e.g. GEI Evaluation) Patients at AzSH Program for SVP Sent for SVP evaluation If deemed SVP, civilly committed for treatment at ACPTC following prison sentence Patients at AzSH Patients are ethnically/culturally diverse Age range: 18-90 Most patients have multiple issues: Psychiatric, neuropsychological, personality, and substance abuse/addictive disorders Have had cases of Capgras Syndrome, rare congenital disorders, Dementia of the Alzheimer’s type, traumatic brain injury (TBI), and stroke Functions of Department Have masters and doctoral level staff, predoctoral interns, and students APA-accredited internship site Function as consultative department Functions of Department Roles include assessment, individual/group/family therapy, consultation with behavioral issues, and training Types of evaluations: Psychological, Psychoeducational, Neuropsychological, Competency, GEI, Violence Risk Assessments, and Psychosexual Assessment Neuropsychological assessment used to guide treatment of patients Most assessments include a comprehensive battery: Intelligence Sensorimotor Language Visuospatial Memory Personality Assessment Add tests for specific issues Clarify deficit Symptom validity Achievement Assessment helps clarify strengths/weaknesses for patient Staff can approach patient with strengths Clarify if functions due to psychiatric or neuropsychological issues May have implications for pharmacotherapy Treatment Provide individual and group cognitive rehabilitation Most patients well beyond initial injury Increase awareness Process losses associated with injury/disorder Focus on strengths, compensatory strategies Assistance with using a planner Treatment Development of lists Teaching elaborative rehearsal and memory strategies Tasks that target weaknesses, look for progress, and utilize compensatory strategies Treatment Help with personality/behavioral factors: Impulsivity, anger, and depression Educate patient on injury, strengths/weaknesses, and basic neuroanatomy Incorporate movies, books, and articles Case Example