The mission of the CU Aging Center is to enhance the quality of life for older adults and their families through innovative mental health services and programs. In order to fulfill our mission, the CUAC provides comprehensive, psychological and neuropsychological assessment and treatment services to individuals 55 and above as well as their families, trains students in the ethical and competent practice of clinical geropsychology, and supports the study of psychological aging processes.
The CU Aging Center is unique as a training clinic and service agency. Embedded in the community, the CUAC links academic standards of excellence and innovative clinical training with the practical needs of the community. The comprehensive and progressive range of services is available to all seniors either on a low-fee sliding scale adapted from the Federal Poverty Guidelines (e.g., psychotherapy fees range from $5 to $75 per session, neuropsychological evaluations range from $250-$700) or at no cost, through grant-funded programs. All community members may receive services without regard to insurance or ability to pay.
- A detailed Policy, Procedure, and Training Manual developed by the CUAC staff guides the clinical services and training functions of the Center and ensures compliance with HIPAA regulations. The CUAC staff and students all complete HIPAA training and one staff psychologist is trained as the compliance and privacy officer. The CUAC maintains a web site with updates on our programs and resources for seniors (www.uccs.edu/agingcenter). The CU Aging Center functions as a 501(c)(3) in affiliation with the CU Foundation that serves as a pass-through organization for CU nonprofit training and research service activities. The CUAC operates according to the Administrative Guidelines for Psychology Training Clinics (available through the APTC).
UCCS faculty administers and supervises all clinical services and conducts pioneering research, each integral to graduate training experience. Faculty administrators from the Psychology department are all licensed psychologists and include Michael Kenny, Psy.D. (Director of the CU Aging Center) John Crumlin, Ph.D., (Assistant Director) and the Clinical Supervisors: Sara H. Qualls, Ph.D., Daniel L. Segal, Ph.D., Leilani Feliciano, Ph.D., and LeAnne Starr, Psy.D. Carrie Bartell, LCSW, a private-practice social worker, supervises a weekly women’s group psychotherapy. Brian DeSantis, Psy.D., Director of Behavioral Health Services at Peak Vista Community Health Centers, assists with supervision of graduate students providing integrated care services and offers consultation and training for integrated models of health care and service delivery. Two private practice psychologists, Karen Underwood, Ph.D., and Patricia Pirrello, Ph.D., supervise the Long Term Care service rotation and general clinic clients respectively. Lori Bryan, Ph.D., is in her seventh year as Project Director at the CUAC and is responsible for grant proposals and project administrative oversight. Lynette Van Eaton, also in her seventh year at the CUAC, is the Program Coordinator.
The CUAC provides approximately 12 training rotations that are organized into the following four service centers. Interns are required to complete six or 12 month training rotations in each of the service centers.
- The Memory and Cognitive Assessment Clinic: Comprehensive Neuropsychological Evaluations are conducted to help determine the etiology and functional implications of cognitive disturbances. Each evaluation requires approximately 6-10 hours of interview, testing, scoring, interpretation, and report writing time. In addition, feedback sessions are offered to individuals and families. Clinical findings are translated into practical language to aid mental health and medical professionals, and family caregivers, in making decisions about treatment and care. Referrals originate from a variety of sources including physicians, nursing homes, Silver Key Senior Services, Pikes Peak Area Agency on Aging, attorneys, probate court, and Adult Protective Services. The evaluations help identify difficulties in independent functioning that compromise safety and well-being, support behavioral health workers in treatment planning, and assist the courts in determining decision-making capacity. Psychological evaluations are also conducted to provide information on individual personality dynamics, presence of major mental illness, differential diagnosis, and treatment plan recommendations. A system is in development to seamlessly integrate assessment results with treatment plans and facilitate clinicians’ work with caregivers and older adults. This will also help guide necessary lifestyle adjustments and ease transitions.
- The Aging Family and Caregiver Services Program: This collaborative program with the Area Agency on Aging focuses on assessing and treating the factors contributing to distressed caregiver families and assists with referrals for other supportive services within the community. Primary services, all available at no cost to clients, include comprehensive caregiver assessments and up to six problem-solving oriented psychotherapy sessions to help implement caregiver treatment plans. In addition, the program offers consultation and resource information for the caregiver(s), a psycho-educational support group, and Men’s Caregiver Support group. Educational seminars and community presentations to increase public awareness are also offered through this service.
- Psychotherapy Service: CUAC staff psychologists and student clinicians offer individual, couples/marital, family, and group psychotherapy for older adults experiencing psychological disorders including depression and anxiety, adjustment to illness and loss or other life stress, and family conflicts. The CU Aging Center uses the International Classification of Diseases (ICD-9) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) to classify and diagnose psychological problems. Psychological evaluations (including the MMPI-2, MCMI-III, PAI, PAS, TAT, BDS-II, BAS-II, Incomplete Sentence Blank, and diagnostic interviews) are administered through this service center and the Clinicians in the Community service center.
- Clinicians in the Community: A comprehensive range of programs link clinicians at the CUAC with agencies serving older adults, whose shared goal is to improve the quality of care and quality of life through coordinated services.
- At-Home Mental Health Service Program. The CUAC continues to collaborate with Silver Key Senior Services, a provider of non-medical essential services to home-bound older adults. This grant-funded project is helping to both identify and treat frail, home-bound elderly who are at risk for physical and/or emotional decline. Silver Key Senior Services funds a half-time liaison to assist with coordinating referrals from the Silver Key staff to the CUAC. The first 20 visits are provided at no cost to community seniors. This collaboration also involves an educational inservice program for the Silver Key staff to better equip them to identify older adults at risk and to appropriately facilitate a referral for CUAC in-home mental health evaluation and care. As community ‘gatekeepers’, these staff members who see homebound older adults regularly in the course of providing Silver Key services are in the best position to identify concerning circumstances and possible decline in their clients. Twice monthly meetings with the clinical team, including the Silver Key liaison, ensures that vulnerable older adults identified by Silver Key staff members are referred for the in-home mental health services they need to remain independent for as long as is safely possible.
- Integrating Mental Health Services with Primary Care. In August 2005, we initiated an integrated behavioral health and primary care program at Peak Vista Community Health Clinics, developed by CUAC staff and Dr. Brian DeSantis to increase access to mental health care. The CU Aging Center clinicians developed brief depression and anxiety screenings for older adults seen in Peak Vista Senior Health Clinics that are administered as a routine part of the primary care appointment. The intern and CUAC Geropsychology Ph.D. student clinicians based at the two Senior Health Clinics give older adults immediate access to mental health services when their initial depression screen indicates a need for further evaluation.
This program offers opportunities for the physician to consult with an on-site geropsychologist and advanced clinical student to assist with complicated differential diagnoses and coordinating geriatric medical and mental health care. This integrated program has also afforded trainees the opportunity to participate in a progressive approach to mental health care that is reaching a greater number of older adults in need of services, but who might not otherwise access them. An integrated approach to the early detection of mental health disorders naturally extends to the early detection of cognitive impairments which was integrated into the Peak Vista Senior Center North in November, 2007, via a CUAC developed self-administered computerized memory and psychological screen.
- In June, 2009, the CUAC partnered with the Rocky Mountain Program of All-Inclusive Care for the Elderly (PACE) to launch a multidisciplinary training rotation. The interns and advanced doctoral students provide behavioral health services (10 hours per week) to PACE clients as part of a comprehensive program that includes medical, nursing, physical and occupational therapy, social work, recreational and milieu therapy, and family consultation all in a day program to help elders maintain independence in the community.
- The CUAC partners with Sunny Vista Living Center to offer a training rotation in a long-term care setting. The training offers experience in multi-disciplinary team case assessment, case consultation, individual and group psychotherapy, cognitive assessment, and on-site supervision by a licensed psychologist who specializes in long-term care psychology. The rotation is 8-10 hours per week.
- Advanced skill development in the assessment and treatment of older adults.
- Appropriate competencies in formal cognitive assessment, diagnostic interviewing, treatment planning, and case dispositions with referral sources.
- Continued development of professional identity as a psychologist in-training through clinical supervision, team leadership roles, required community in-service and educational presentations, and interagency collaborative work.
- Increased knowledge base of community mental health resources, interagency relationships, and multi-disciplinary relationships involved in provision of comprehensive services to community elders.
- Promoting sound clinical judgment, appreciation for cultural diversity, and leadership development through adherence to the Ethical Principles of Psychologists and the Competency Review Guidelines (APTC).
- Our core requirements can be tailored to satisfy the varied training needs of interns. During the course of the training, the intern will provide advanced psychological services to agency clients, with approximately 50% direct service. Hours include primarily individual psychotherapy but also include group, couples, and family therapy depending on the particular case. Interns conduct clinical intakes, develop diagnostic formulations, and prepare narrative reports. All services are supervised by licensed psychologists and the intern will receive a minimum of two hours of weekly face-to-face supervision, and an additional two hours of individual and group supervision depending on their rotations. Typically, the intern will have supervision with at least three different CUAC staff psychologists during their training year. This maximizes exposure to different models of supervision, therapeutic orientations, and assessment techniques. A formal, written supervision contract is signed by both the intern and supervisor. Supervisors are responsible for reviewing DVD and audio tape recordings of therapy sessions in the supervision sessions in order to maximize learning opportunities. Neuropsychological evaluations are directly observed by supervisors via either “bug-in-the-ear” or in-room supervision.
- The intern completes a year-long rotation in neuropsychological assessment. Depending on referrals, the intern completes a neuropsychological evaluation approximately every four to six weeks. Responsibilities include conducting clinical interviews, collateral interviews, comprehensive neuropsychological testing, narrative reports, and feedback sessions with clients, family, and/or professionals involved with the case.
- Indirect services include case management, client file and records management, and the development of treatment plans. The intern may provide supervision to Master’s students, while being supervised by the Licensed Psychologist. The intern prepares two clinical case presentations that are formally reviewed by all peers and staff in monthly staff meetings. The intern is also responsible for presenting a Practice-and Evidence-based scholarly presentation from the field of clinical psychology including the clinical issue, treatment paradigms, and supporting research with outcome information.
- Increased knowledge will be gained in understanding the considerable network of senior services available in order to make appropriate community referrals for clients. The intern prepares educational presentations for local senior service agencies, assisted living and long-term care facilities. The intern intern will submit a written, researched article for publication by a local monthly senior newspaper.