Rotations at Eastern State Hospital:
- Acute Admissions & Pretrial Forensics (6 months)
- NGRI Forensics & Risk Management (6 months)
ESH Director of Psychology and Pretrial Forensic Services: Kristen A. Hudacek, PsyD, CSOTP
Supervisors: Maria Burke, PsyD, Alexandra Price, PsyD, ABPP, and Melissa Bennett, PhD
Eastern State Hospital (ESH) is the largest state psychiatric hospital in Virginia and is situated on 500 acres, consisting of two patient care buildings with 300 patients and a highly skilled staff of over 900. The current hospital population includes adult and geriatric patients who have either a civil or forensic commitment. ESH is part of the Department of Behavioral Health and Developmental Services (DBHDS) system, and is accredited by the Joint Commission. In addition to providing training to psychology interns, the ESH Psychology Department offers a robust tiered model of metasupervision, including practicum-level psychology students and a postdoctoral fellow.
In general, clinical activities at the Eastern State Hospital can be summarized as follows: Each intern at ESH will have opportunities to engage in inpatient treatment with acute and chronic severe psychiatric disorders across both civil and forensic populations, with particular focus on individual and group psychotherapy and psychoeducation, psychological assessment, treatment planning, principles of recovery and trauma-informed care, team building, milieu intervention, risk management, crisis management and behavior modification, and program development.
Treatment at ESH is provided in partnership with the patient and a multidisciplinary team comprised of a physician, psychologist, nurse, social worker, dietician and activities therapist. Discharge or release planning begins at admission, and interns will be able to experience collaboration and aftercare planning with community services as well. Interns will have the opportunity to be part of a treatment team during their internship and learn how a psychologist functions as a multidisciplinary team member. Within the various clinical roles, interns will also learn about the larger system of care in Virginia and may collaborate with team members for appropriate aftercare planning as patients return to the community.
During the Eastern State Hospital Internship Rotation in Inpatient Psychology, each intern completes two, six-month rotations including Acute Admissions & Pretrial Forensics, and NGRI Forensics & Risk Management. This format provides a wide range of clinical and training experiences as well as supervisory experiences.
During the Acute Admissions & Pretrial Forensics Rotation, interns have the experience of assessing and treating individuals under voluntary or involuntary civil commitment, individuals who have been transferred from a jail for emergency psychiatric treatment and individuals who have been court-ordered for evaluation of competency to stand trial (CST) and/or mental status at the time of offense (MSO).
During the NGRI Forensics & Risk Management Rotation, interns have the experience of assessing level of risk and treating individuals who have been adjudicated as Not Guilty By Reason of Insanity (NGRI), remanded to the hospital for treatment, and are moving through the privileging and release process under Virginia law.
In addition to serving in clinical roles, interns may have the opportunity to participate in research or program development efforts throughout the hospital. This may be especially relevant for those individuals with interests in public policy and systemic intervention.
In recent years, our interns have been able to participate in Basic Forensic Evaluation: Principles and Practice, a five-day course offered by the Institute of Law, Psychiatry and Public Policy at the University of Virginia. The course is designed to provide foundational, evidence-based training in the principles and practice of forensic evaluation generally and specific to the Code of Virginia. In addition to their regular rotation duties, as part of the forensic training at ESH, interns will be placed on a forensic assessment rotation and gain skills and experience in forensic assessment, specifically assessing competency to stand trial and sanity at the time of the offense under the supervision of a licensed clinical psychologist. Interns will also be excepted to participate in pre-trial group supervision and will occur over the duration of their training year.
Interns receive supervision during each six-month rotation from a licensed clinical psychologist with primary responsibilities on the specified unit. Additionally, interns may have the opportunity to supervise doctoral-level practicum students from local graduate programs, under the supervision of a licensed clinical psychologist. Other projects and assignments may evolve as warranted and will aim to address each intern's personal interests whenever possible, to include exposure to geriatric populations, behavioral treatment planning, gender-responsive strategies and trauma informed care approaches.
