James Holmes, James Holmes, Psy.DPsy.D..

June M. Stapleton, Ph.D.June M. Stapleton, Ph.D.

��Overview of AzSH

�Patients at AzSH

�Functions of Psychology Department

�Assessment

�Treatment

�Case example

Topics

��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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��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

Patients at AzSH

��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

Functions of Department

�

��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

Assessment

��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

Treatment

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Case Example