Psychology Student Completes 14-Week Requirement at Concordia University St

Introduction

As part of my bachelor's degree studies in Psychology and per the requirement of Concordia University, St. Paul, I completed a 14-week internship beginning the 21st of January through the 22nd of April, 2019. My internship was completed at Aurora Products and Services, a Day Training and Habilitation (DT&H) day program for adults with developmental disabilities. Aurora provides home and community-based services and operates under 245D-HCBS Program License Number 1070559. Aurora is located at 4225 White Bear Pkwy #100, Vadnais Heights, MN 55110

Aurora provides many services including supervision, training and help in self-care, communication, socialization and behavior support.

They offer customized employment services, center and community-based work opportunities, and vocational rehabilitation services including job development, job tryouts, job placement, job supports and retention, vocational assessment, internships, job shadows, paid work trials. Aurora provides services to individuals who are 18 years and older that are diagnosed with a developmental disability or have a related condition ("Minnesota State Operated Community Services Day Training and Habilitation sites and services / Minnesota Department of Human Services", 2019).

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During my internship at Aurora, I have had the opportunity to see many of the psychological theories and concepts that I have studied over the past few years. The concrete experiences that I have had over the 14-weeks has allowed me to participate in active experimentation where I have been able to apply some of the new ideas I have learned. My internship has brought me closer to understanding some of these complex theories and concepts and has given me the opportunity to further analysis the different psychological perspectives, especially the behavioral and cognitive perspectives.

Explication and Integration

As I had stated above, Aurora Products and Services is a Day Training and Habilitation (DT&H) program that that provides services to adults ages 21 and older who live with developmental/intellectual disabilities and related conditions. Aurora is designed to enhance participants' skills and abilities through center-based and community employment, work services, vocational training, and recreational/leisure activities. Many of the participants that attend Aurora have lived with developmental/intellectual disabilities, mental illness and/or related conditions from a very young age; however, there are a few individuals that have suffered traumatic brain injury's (TBI). Aurora currently supports more than 60 participants both on-site and in the community.

Staff at Aurora hold one of five different professional job titles. We have one RTS (Rehabilitation Therapy Supervisor), four DC's (Designated Coordinator), two WTA's (Work Therapy Assistant), ten WTT's (Work Therapy Tech) and ten HST's (Human Service Tech). Aurora's RTS supervises and directs staff performance to ensure a high quality of care and establishes objectives to ensure the overall success of the program. The DC's are responsible for assessing Individuals' needs, developing and implementing habilitation and training plans and, in conjunction with RTS, enforce standards of care so that objectives are achieved. WTA's design integrated work therapy treatment plans and assist in the delivery of work activity and therapy programs. WTT's and HST's provide direct care to participants and implement overall treatment plans, prescribed care and behavior management programs. I am currently a Human Service Tech (HST) at Aurora and have been for the past 6.5 years.

All staff at Aurora are required to maintain significant amounts of yearly training to ensure that we are providing appropriate care to everyone we support. Each one of the individuals we serve have complex needs, some of which include DSM-5 categorized neurodevelopmental disorders, schizophrenia spectrum and other psychotic disorders, bipolar and related disorders, depressive disorders and personality disorders. Most of these individuals need continuous supervision and require high levels of behavioral modification to meet their individual needs. Because the population we serve is diverse, staff need to understand what approaches are most appropriate.

One model I referenced frequently while providing direct care is the Behavioral Model. Within this Model, the teachings of one individual, B.F. Skinner, stands out. Skinner's operant conditioning emphasizes a method of learning that occurs through rewards and punishments for behavior (Durand & Barlow, 2019). For instance, the individuals at Aurora don't always recognize how to behave appropriately in community or work settings. They may struggle to stay on task, use inappropriate language and may not understand or see the need to change their behavior. Not only do staff foster an understanding of appropriate workplace behaviors, they also apply the use of Skinner's psychological techniques like positive reinforcement to help them modify their behavior. One of most popular and effective ways I used positive reinforcement at Aurora is by giving praise. Telling someone that they are doing a good job can be powerful and often makes people feel good. An increase in feelings of self-esteem and pride are just a few reactions the people I support get from receiving positive feedback. I see a positive increase in the quality of their work, their confidence and in their social interactions. These reactions may be fostered due to the release of dopamine, a neurotransmitter that helps control the reward and pleasure of the brain, that can be triggered by receiving positive feedback (Durand & Barlow, 2019).

While we are focusing on B.F. Skinner and operant conditioning, I would also like to discuss the Stimulus-Response pattern and how this is incorporated into individual service plans. At Aurora we believe in habilitation, we teach by using positive support strategies. We do not use punishment and restrictive interventions because we do not believe they teach skills but rather teach a person what not to do. As B.F. Skinner pointed out, an individual's behavior is directed to some degree by reinforcement. "He believed that using punishment as a consequence is quite ineffective and that the primary way to develop new behavior is to positively reinforce desired behavior (Durand & Barlow, 2019)." Aurora never uses coercion or makes a job, community outing or any other occasion a requirement for any individual to participate. We use positive and/or negative reinforcement to encourage a desired response with the expectation that this will result in an increase in the frequency of that response. There are several methods we use to help capitalize on effects of the reinforcement including offering a tangible object or an edible reinforcer (weekly soda, DQ outing, printed color picture of choice, etc.), giving more opportunities to participate in paid jobs, and allowing for more control of scheduled activities.

Person-centered therapy, "a therapy method in which the client, rather than the counselor, primarily directs the course of discussion, seeking self-discovery and self-responsibility (Durand & Barlow, 2019)," is something that Aurora prides itself on. Person-centered planning (PCP) is a model that helps staff to get to know the individual they support and their "story". At Aurora we incorporate person-centeredness by finding out what the individuals that we support want out of their life. We listen and respond in a therapeutic manor while respecting everyone's history, dignity and cultural background. Aurora provides opportunities for personal development and encourages personal advocacy. As we have learned, there are many laws to protect people who are vulnerable and to protect members of society (Durand & Barlow, 2019). Aurora's believes in community participation and inclusion and attempts to provide their services in the most integrated setting with the least restrictive supports necessary.

While working at Aurora over the past few months, I have had the opportunity to enhance a diverse range of professional, emotional, and cognitive skills including high levels of critical thinking, self-awareness, empathy, and sensitivity to others. One thing that comes to mind as I discuss the The individuals I support often seek help for the problems they are facing in their lives. Having the ability to be sensitive to their needs while understanding boundaries has been key to my success. I have become a better active listener, making sure those I support feel that I see and understand them. My critical thinking has been strengthened due to having to act quickly while keeping a level-head when responding to unexpected situations. My mindset has become more flexible and fluid in order to adapt to frequent changes and challenges, and I have gained new perspectives and methods of doing things.  The professional skills that I need to continue to develop mainly include my interpersonal skills, specifically public speaking, assertiveness, and confrontation. I have a tendency to be introverted and at times I lack confidence in myself. I become overly stressed because I have a difficult time saying no and at times I let others take advantage of my willingness to help. I end up taking on more than I can handle and become resentful and overwhelmed.

References

1. Durand, V.M. & Barlow, D.H. (2019, 2016). Essentials of abnormal psychology (8th ed). Boston: Cengage Learning.
2. Goldstein, E. B. (2015). Cognitive psychology: Connecting mind, research, and everyday experience (4th ed.) Stamford, CT: Cengage Learning.