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James Holmes, James Holmes, Psy.DPsy.D..
June M. Stapleton, Ph.D.June M. Stapleton, Ph.D.
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��Overview of AzSH
�Patients at AzSH
�Functions of Psychology Department
�Assessment
�Treatment
�Case example
Topics
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��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
Overview of AzSH
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�
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�
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��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
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��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
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�
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��Program for SVP
�Sent for SVP evaluation
�If deemed SVP, civilly committed for treatment at ACPTC following prison sentence
Patients at AzSH
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��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
Patients at AzSH
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��Have masters and doctoral level staff, predoctoral interns, and students
�APA-accredited internship site
�Function as consultative department
Functions of Department
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��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
Functions of Department
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�
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��Neuropsychological assessment used to guide treatment of patients
�Most assessments include a comprehensive battery:
�Intelligence
�Sensorimotor
�Language
�Visuospatial
�Memory
�Personality
Assessment
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��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
Assessment
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��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
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��Development of lists
�Teaching elaborative rehearsal and memory strategies
�Tasks that target weaknesses, look for progress, and utilize compensatory strategies
Treatment
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��Help with personality/behavioral factors: Impulsivity, anger, and depression
�Educate patient on injury, strengths/weaknesses, and basic neuroanatomy
�Incorporate movies, books, and articles
Treatment
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�
Case Example