The Mental Health Service at CHLA serves a low-income, multicultural urban population. The great majority of these families are ethnic minorities, many of whom require services in languages other than English. Latino families are the largest group, representing over 65 percent of families referred. Although over 40 percent of referred Latino families identify Spanish as their primary language, only a minority of mental health service personnel and trainees are bilingual. The psychology internship at Childrens Hospital Los Angeles (CHLA) has been funded to enhance the training of mental health professionals to serve underserved children and families, with a special focus upon Latino families. The following training initiatives have been established and implemented with the goal of enhancing interdisciplinary training and service delivery for Spanish-speaking clients.
Initiatives Impacting Supervision and Training
Master Clinician Supervisor
The first step in developing training enhancements was the recruitment of a "Master Clinician/Consultant" to mentor faculty and trainees. A nationally recognized researcher, educator and "master-clinician" was recruited to serve as a consultant the faculty and administration of the internship and its clinical programs.
Latino Professional Group
One of the first efforts of the Master Clinician was the establishment of a supervisory process for Spanish-speaking staff and trainees. Childrens Hospital Interdisciplinary Supervision and Training en Espanol (CHRISTE) is an interdisciplinary group of trainees and staff that has evolved to provide an opportunity for bilingual trainees to obtain supervision in Spanish language from the project's Master Clinician Consultant and Bilingual faculty.
Spanish-Language Instruction for Non-Spanish-Speaking Interns
Spanish-language instruction was introduced to the training environment with the goal of enhancing the ability of all interns to interact positively with Spanish-speaking clients and staff. Spanish-language instructors implement a curriculum focused upon "work-place" Spanish.
Cultural Proficiency Seminar The GPE project's Master Clinician/Consultant paired with a Bicultural faculty member to develop a Cultural Proficiency Seminar, the goal of which is to improve cultural competence skills by broadening conceptualization of culture, identifying the role that culture plays in one's life and in clinical work.
Case-Based Learning Module
A move was made from a traditional lecture series to a case based learning model (CBL). CBL provides several benefits to both interns and faculty members. CBL helps to expand an intern's knowledge and exposure regarding specific cases. CBL provides a safe environment for interns to actively increase their participation in learning by exploring systems of care and ethical dilemmas in "real life" situations. Interns also benefit from the knowledge of colleagues, gain new perspectives on clinical issues, and validate their learning.
Initiatives Impacting the Service System
Bilingual Consultation Project
Bilingual interns receive specialized training in assessment of Spanish-speaking children, and serve as consultants to non-bilingual staff, providing critical information regarding the specific language needs of referred patients.
Cultural/Language Facilitators
Case managers have been hired and trained to provide language and cultural assistance to non-Spanish-speaking intern psychologists serving Spanish-speaking families. These bilingual, bicultural case managers partner with the intern providing both translation and implementation of services.
Access Project
A primary aim of the Access Project has been to reduce time Spanish-speaking families' time await assessment for mental health services. Cultural/Language Facilitators partner with staff and intern clinicians to quickly assess and triage Spanish-speaking families for services.
Empirically-Validated Treatments in Spanish
Two empirically validated interventions for use with Spanish-speaking families have been implemented for use with Spanish-speaking clients. A certified bilingual, bicultural clinician and her trainees provide Parent Child International Therapy (PCIT). The Incredible Years/Anos Incredibles Parent Training program is available in both Spanish and English.
Diversification Committee
Recommendations from interns and fellows regarding increasing diversity and cultural sensitivity at all levels of the interdisciplinary training and clinical program at CHLA has led to the formation of the Diversification Committee. This committee represents staff, trainee and faculty issues and reports the organizations management team.
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