Placement Description
Substance abuse assessment and treatment
Intern or Field Placement
Responsibilities/Opportunities
- Observe intensive outpatient treatment groups
- Learn to use breathalyzers to check sobriety
- Learn to check-in and orient clients
- Teach psycho-educational components
- Do background research for therapists
- Attend grand rounds
- Observe treatment group at the partial hospitalization program
- Attend team meetings
- Observe Consults
- Observe group at inpatient unit
Contact Information
- Contact Person: Robin Breeden
- Address: 644 University Boulevard, Harrisonburg, VA 22801
- Telephone: 540/564-5960
- E-Mail: RDBREED1@sentara.com
- Website: http://www.rmhonline.com/BehavioralHealth/BehavioralHealthAddictionServices.aspx
Read about students’ experiences at this site below:
Abigail Hanifen – Fall 2023
My field placement site has been the Sentara Life Recovery Program. The main goal of the program is to educate people struggling with substance abuse on the process of recovery and coping skills. My supervisor, Robin Breeden, has the philosophy that when you pull back the substance abuse, there is mental health problems underneath causing suffering. We work to not only educate about addiction, but about mental health struggles as well. While I mainly worked with life recovery, I also got to observe and help with the Partial Hospitalization Program, the Intensive Outpatient Program, and psychological testing. All of which is offered at Sentara Outpatient Behavioral Health. While I did not get to directly observe, I had the opportunities to speak with and learn from family and relationship, grieve and bereavement, and women and gender therapists as well. I was also able to shadow the PERS team at the Sentara Psych Emergency Department and learn what that setting entailed. Once settled in, I was able to help lead activities in group therapy, make lesson plans, watch intakes, write client progress notes, and even lead group therapy sessions myself under supervision. I truly got to try out working in many different types of psychological services and see which ones I most enjoyed.
My first impression of the site was how welcoming everyone in the office was. They each told me to ask if I ever needed help. They all communicated well with each other, and it felt like a very positive work environment. Everything was organized, clean, and it was obvious everyone respected the space. Robin is warm, very funny, and easy to work with. She made me feel very comfortable during the learning curve of being in a new place. She would give me constructive criticism, but never made me feel bad for not being perfect right away. She encouraged me to ask questions and speak out during group therapy. When the time came that I was comfortable, she pushed me to take on more leadership roles and had confidence in me even when I was nervous. With practice, I became more comfortable talking to clients and offering my insights during therapy. Working in the group therapy setting was extremely interesting. I got to know many different types of people, watch group dynamics, and help people connect with others going through the same hardships. Even though there are sad moments like when you want to help those that do not care to be helped, I got to watch some people change for the better over time. I got to see them improving their mood and coping better with their struggles. Those moments made everything worth it. It solidified my love for this field and helped me know that being a therapist is truly my dream job. Working here has given me an even stronger passion and let me know I am going down the correct path.
I most often pulled prior knowledge from abnormal psychology class. We talked a lot about mental health and what the clients could be struggling from. It also helped with catering treatment plans to client’s specific needs so we could get the best outcomes. Cultural psychology also prepared me well for this position. We would have many group dialogues on difficult topics such as race, gender, socioeconomic status, ability status, and much more. This prepared me to be an active listener, look from other’s perspectives, and provide my own insight without dominating a conversation. During group therapy, these topics were often brought up and I felt prepared to empathize and add insight. While specific classes did help me with understanding the process of therapy or how to communicate with others, almost all aspects of my life came up at one point. From studying abroad, working with horses, teaching children, my research, to my relationships with friends and families, it all gave me unique perspectives that I could share with others and offered different ways to either relate to clients, or think about the world in new ways.
My contribution project was a lesson plan book that detailed each lesson given in the Life Recovery program. Robin told me that she felt like she could never take off work, even in an emergency, because all her lesson plans were only in her head. No one else would know what to teach or how to run the class in a way the clients were used to. I decided to make a lesson plan book as a solution to this issue. I determined the 20 most important lessons someone in the substance abuse program would need to learn. I collected the handouts for all the lessons and made a section header in the beginning of each segment that explained what was included in the section and what materials are needed. In the beginning of the book, I gave examples of how the group check ins work and what materials need to be given to a client on their first day. Finally, I made a table of contents to aid in finding needed information easily. My goal was that if a new employee was hired, they could look at the book and begin teaching the classes with relative ease. We have already been using the finished book to streamline the morning process of picking out a lesson and they are planning on giving the book to a new employee to use as a basis for her lesson planning.
Overall, I couldn’t be happier with my experience at the Sentara Life Recovery Program. I have learned so much and my confidence moving forward into this field has increased greatly. I feel even more passionate about helping others and have started gaining irreplaceable experiences to be a foundation for my future. The Life Recovery Program has given me far more opportunities than I imagined going into field placement. I was able to work on my writing skills, knowledge of ethics, communication, as well as leadership. I loved the work environment and all the people, and I am extremely sad to be leaving after only a semester.
Fall 2022 - Claire Peterson
This semester, I had the pleasure of being an intern at Sentara RMH Behavioral Health under the supervision of Robin Breeden. Their mission statement explains that “Sentara provides a comprehensive approach to mental health, offering a variety of treatment options and both inpatient and outpatient care. We put patients first. Drawing on the wealth of experts and resources throughout the Sentara network, we treat the unique and complex medical and psychological needs of patients. Patients and their families are included in the process of treatment and recovery. Our experts help patients realize that although they may not have full control over their symptoms, they do have control over their lives.” Sentara RMH Behavioral Health offers a variety of outpatient services, including substance abuse treatment, assessment and counseling services, group therapy, bereavement services, seminars, and training, as well as the Partial Hospitalization Program. During my time as an intern at Sentara, I had the opportunity to observe and co-lead groups in the LIFE Recovery Program, Intensive Outpatient Program, and occasionally the Partial Hospitalization Program.
The LIFE Recovery Program and Intensive Outpatient Program are both outpatient treatment services designed to assess and treat substance abuse. The LIFE Recovery Program’s philosophy states that “alcohol/drug dependency is a chronic and progressive, but highly treatable, disease.” The LIFE Recovery Program is a substance abuse treatment service that takes place on Tuesdays and Thursdays from 9:00 am - 10:30 am and is designed for individuals with substance abuse who are in early remission. For the Intensive Outpatient Program, Sentara states that this program is “designed for patients with chemical dependency and substance addiction who are beginning recovery. The program allows patients to receive the help and therapy they need with minimal disruption to their lives.” Like the LIFE Recovery Program, the Intensive Outpatient Program is a substance abuse treatment service. This program is designed for individuals with substance abuse who are early in their recovery and takes place from 4:00 pm - 7:00 pm on Mondays, Tuesdays, and Thursdays.
Before attending the group, Robin, Alison (another counselor at Sentara), the other undergraduate interns, and I would spend about an hour discussing what topics we would discuss during the group for that day and for groups that I had to miss (due to my schedule) what I had missed. For both the LIFE Recovery Program and Intensive Outpatient Program, groups would typically begin with check-in, where clients would state their names, whether they were sober, any triggers or stress they were experiencing, and coping skills used in their recovery. After check-in, Robin would teach clients psychoeducational components (such as radical acceptance, mindfulness, stress management, shame vs. guilt, and coping skills) and would hold a group discussion about these topics and how they related to the client's recovery. At the end of the group, clients would discuss how they planned to maintain their sobriety. Following the group, Robin, Alison, the other interns, and I would discuss what we observed during the group that day and ask any questions regarding the information discussed. After our debrief of the group, one of the interns would document information from the group into an electronic healthcare record system called EPIC (we would switch off doing this depending on our schedules). As an intern, I had the opportunity to observe and co-lead groups under the supervision of Robin. During my first few weeks at my site, I would mainly observe how Robin interacted with clients during group and as the semester progressed, I began to interact with clients more. Observing how Robin interacted with clients and hearing about client’s recovery during group helped to give me more confidence in my interactions with clients, and by the end of the semester, I found myself speaking more often during group. An experience that further increased my confidence in interacting and facilitating discussion with clients was implementing my contribution project, which was nerve-racking but rewarding.
My contribution project focused on relapse prevention for individuals with substance use disorder, specifically by utilizing skills used in Mindfulness-Based Relapse Prevention. Mindfulness-Based Relapse Prevention focuses on integrating mindfulness practices into the treatment of substance use disorder and research suggests that this treatment modality is associated with positive results and may be effective in preventing relapse. After examining the literature regarding implementing mindfulness for relapse prevention, I analyzed what common topics were for sessions discussed in the studies and translated these themes into topics I could integrate into group discussions during the Intensive Outpatient Program. Throughout 4-sessions, I was able to co-lead the group by introducing a topic related to mindfulness and facilitating a group discussion about how this topic related to relapse prevention. The primary topics that I incorporated into group discussions included mindfulness meditation, urge surfing, and automatic thoughts. Typically, I would find a worksheet online related to whatever topic I was presenting in that session and use that worksheet to facilitate group discussion. In addition, I would supplement the group discussions by integrating mindfulness-based activities related to the topic discussed during the group.
One of the biggest advantages of interning at my site was the opportunity to observe and help facilitate group discussions under supervision of Robin. Having the opportunity to observe how she would interact with clients and respond to them provided me with valuable insight into what it’s like to be a counselor and reaffirmed my desire to pursue a career in counseling. In addition, another advantage of being an intern at Sentara was Robin’s enthusiasm for the intern’s growth and development of skills. Robin would encourage the interns to contribute and integrate relevant information during group discussions, which I enjoyed having the opportunity to do. One limitation that I experienced was being unable to observe individual counseling, but this is not a limitation unique to Sentara and applies to most interns at the undergraduate level. Courses in Counseling Psychology and Abnormal Psychology were extremely helpful to me during my time at Sentara. During Counseling Psychology, we were given the opportunity to role-play a scenario with our professor where our professor was the counselor and one of the students was a client struggling with substance abuse issues. During this unit, my professor described helpful techniques for approaching topics specific to substance use disorder, which I found myself utilizing at Sentara during group discussions. In addition, Abnormal Psychology helped for me to better understand psychological disorders and their relation to substance use. Knowledge of symptoms that are associated with certain psychological disorders and how they could manifest in terms of substance use helped me to have a more comprehensive understanding of the client’s recovery and insight into how different approaches can be essential depending on the client.
In terms of lessons that I learned at my site, there are too many for me to begin to describe. Still, one of the most important ones I have learned so far is that many individuals, regardless of whether they have been diagnosed with a substance use disorder, could benefit from the skills taught during the LIFE Recovery Program and Intensive Outpatient Program. Developing skills and increasing education about psychoeducational components (such as self- esteem, anxiety, depression, guilt, acceptance, and communication) can help us cope with life’s challenges regardless of whether someone is struggling with substance use. This has affirmed my desire to become a licensed professional counselor and I feel more confident in my ability to help clients in my future work as a counselor. While I am still unsure of what exactly I plan to specialize in as a counselor, I am very interested in working with individuals who have substance use disorder after my experience at Sentara.
I truly enjoyed my experience at Sentara, and I will miss being an intern here. I am so happy that I had this opportunity to not only gain insight into the field of mental health and substance abuse but also into myself as a person. I am incredibly grateful for this experience and all that I have learned.
Fall 2022 - Jenny Olcott
For my field placement site I had the opportunity to intern at Sentara RMH Behavioral Health in downtown Harrisonburg. At Sentara RMH I worked alongside Robin Breeden, LCSW, in the Life Recovery program. The mission of the Life Recovery program is that “Alcohol/drug dependency is a chronic and progressive but highly treatable disease”. The Life Recovery Program is one of the many services offered at Sentara. This program works specifically with individuals who are in recovery for substance abuse whether that be alcohol, prescription medication, methamphetamine, etc. The Life Recovery group meets twice a week and is a 16 session program. Sentara RMH also offers other group therapy services, which includes the Partial Hospitalization Program and Intensive Outpatient Program.
During my time at Sentara RMH I was primarily working in the Life Recovery Program, however I was able to observe some of the other services that were offered at my site. I was not only able to observe the other group therapy services, however I was also able to observe a Psychological Assessment with one of the clinicians at Sentara RMH. The Intensive Outpatient Program was another service that I took part in and was very passionate about attending. The Intensive Outpatient Program is designed for individuals who have chemical dependency and are in early recovery. The Life Recovery is a program that most individuals will attend when they are finished with the Intensive Outpatient Program as a way to stay active in their recovery. The experience of being able to attend the Intensive Outpatient Program, I believe helped me when co-facilitating the Life Recovery group because I had a better understanding about the process of addiction and what the early stages of recovery looks like. This program is longer than Life Recovery, as it meets 3 times a week and is a total of 21 sessions. This program is also 3 hours long while Life Recovery is 1 ½ hours long. During my time in Life Recovery I would cofacilitate the group with Robin Breeden by helping lead the check in process and lead group discussion on a psychoeducational topic related to recovery. These topics ranged from the process of addiction, the neuroscience of addiction, Cognitive Behavioral Therapy/Dialectical Behavioral Therapy, Radical Acceptance, Mindfulness, Stress/Anxiety Management and much more. During check in everyone is asked to state their names, how long they have been sober, any stress/triggers they have been experiencing, and what coping skills they use to manage their stress or triggers. The Intensive Outpatient Program also uses the same check in process, however it goes more in depth with the psychoeducational topics.
Fall 2020 – Kristin Manz
For my field placement capstone course, I interned at Sentara RMH Behavioral Health. Sentara RMH Behavioral Health offers a multitude of services such as 24-hour crisis care, addiction services, bereavement services, child and adolescent services, counseling services, inpatient treatment, intensive outpatient treatment (IOP), and outpatient services. Throughout all of the services listed, I was an active individual working in their addiction services, more specifically, working with the LIFE Recovery Program. The philosophy of this program is “that alcohol/drug dependency is a chronic and progressive but highly treatable disease. Dependency is an illness that results in pain, grief, guilt, shame and turmoil in all areas of life for the individuals and families involved. Those affected often feel trapped, helpless and isolated.” Despite all the devasting consequences that addiction holds, the mission of the Sentara RMH LIFE Recovery Program is to cure this highly treatable disease physically, mentally, and emotionally. This program provides outpatient substance abuse treatment for individuals age thirteen and older who are suffering from problems due to drug and/or alcohol use. Sentara RMH LIFE Recovery Program allows clients to attend the program while still maintaining their everyday lives by living at home, continuing to interact with their family members, and attending their regular school or work schedules. The LIFE Recovery Program occurs on Tuesday and Thursday evenings for an hour and a half, from 5pm to roughly 6:30pm.
In regard to my personal experiences and opportunities at Sentara RMH Behavioral Health, I mainly worked under the supervision of Robin Breeden, LCSW. Each week I arrived at my site thirty minutes to an hour prior to help prepare program materials and aid in faxing and/or filing papers. Each session began with patients following “check-in” guidelines. These guidelines included stating their name, stating if they are sober, if they experienced any triggers or cravings, and if so, how did the individual go about handling them. During this process, I took notes on what each patient addressed in order to submit progress notes afterwards. Although there were some patients that weren’t completely truthful about their recovery progress, I took this situation and made it into a learning experience. Oftentimes, the individual is experiencing guilt, shame, and embarrassment; but their effort to attend group and learn about our educational topics, shows initiative. After the “check-in” procedure, the psychoeducational topics began to be discussed. This was a time where patients were encouraged to participate and share their own experiences throughout their recovery. During this time, I helped lead specific worksheets, give advice and my own knowledge regarding these topics. Once the programming came to an end, I penned progress notes that included stating each patient’s session number, diagnosis, chief complaint, and other essential notes insurance companies and clinicians need to see and keep up with. After group ended for the night, my supervisor and I discussed take-aways from the group process. I came in the next day to complete the progress notes and get them signed before submitting them. Following the completion of submitting notes, I helped my supervisor with anything that would benefit her. I was able to gain experience contacting insurance companies to gain authorization for patient’s treatment, organize folders consisting of program worksheets, completing outside research for my supervisor, and assist in the process of intakes for new patients. After taking notes during these intakes, I completed an integrated assessment that provided the patient with a diagnosis, listed their family history and previous psychiatric treatment, and noted any additional key information. Assisting with intakes became one of my favorite responsibilities that I was involved in at my site other than our LIFE Recovery group. To be allowed to sit in on these intakes was very rewarding because the patient showed trust in both Robin and myself to listen to their story and be an active part of their journey.
Sentara RMH Behavioral Health holds many advantages throughout their organization. One advantage is that it treats a variety of patients, with a multitude of disorders. I was exposed to a very diverse population that varied in age, gender, race, socioeconomic status, disorder, just to name a few. Throughout this exposure to such a diverse population, I was able to learn how to effectively communicate with all of the individuals I came into contact with. I learned more about the dynamics of group therapy, the techniques, and coping skills that are taught to individuals suffering from both substance abuse and mental health issues. I benefited greatly from being able to observe and engage with patients in both group and individual sessions.
In addition to being able to work with a multitude of individuals, an advantage of this placement site is the staff. They truly care about everyone they work with and all of the patients that they come encounter with and see. From the beginning, I never felt like “just an intern”, I was welcomed with open arms and treated like one of the staff. Each staff member that I had the pleasure to meet, was extremely friendly, personable, and compassionate. In addition to each staff member being so kind and compassionate, they had one another’s back. Whether someone was having a hard day, experienced a challenging patient, or just needed some time to catch up on progress notes or assessments; each staff member was their standing behind them for support. Experiencing such a great aurora at RMH Sentara Behavioral Health, has upped my standards for what I’m looking for in a future employer environment.
My supervisor, Robin, was a big reason that my field placement felt like such an adequate fit. She was encouraging, hard-working, and overall, a positive influence on my time at Sentara RMH Behavioral Health and more specifically, while working with her through the LIFE Recovery Program. Robin exceeded my expectations in what a supervisor could be, and I’m very grateful to her for her guidance, patience, and positive outlook. Throughout my time working with Robin, she was very supportive in my ideas and encouraging when I felt defeated in the group setting at the initial start of my field placement. I give Robin a lot of credit, when I first started my field placement, she was tackling individual counseling sessions on top of being the LIFE Recovery coordinator for our substance addiction group. Being the only clinician in charge of this group, can be extremely overwhelming with keeping up with notes, court letters, breathalyzers and drug screenings, and more. Robin handled each day with grace and motivation to make it a great day. She is truly dedicated to her job and shows up for herself, which betters her services to her patients every day.
One particular piece that I thoroughly enjoyed was working with Robin at her part-time job with Sentara’s Psychiatric Emergency Team (PET). I was on-call with my supervisor on a Saturday from 8am-4pm. Robin called me and went into the hospital to respond to the services needed. Throughout the day several patients came to the hospital with issues regarding psychological services. Robin and I went to each patient’s room and evaluated their current state and decided on imperative next steps that were appropriate for each individuals’ unique circumstances. The patients that we did evaluate, were held for hospitalization, but Robin explained to me that others are oftentimes recommended to attend the Intensive Outpatient Program (IOP), and few were sent home with recommendations for individual counseling. While shadowing Robin in that environment, we always had to be on our toes as you never know what could potentially happen with a patient; whether they get aggressive, agitated, or completely shut-down, we had to be prepared for circumstance. During my time, there was an altercation with one of the individuals after we had evaluated them. The psychiatric nurses and Robin were extremely diligent and quick to respond to help keep this individual safe for their overall wellbeing. The constant fast-paced and active environment was particularly interesting to me as I never have been interested in a slow, stagnant environment. This specific opportunity greatly influenced my future career plans because I hope to be a part of something very similar as an additional form of practice, for both the experience and to aid this community.
The only limitation I noticed while completing my field placement at Sentara RMH Behavioral Health, was that the interns are unable to observe individual counseling sessions, after the initial counseling session with a patient. This disadvantage unfortunately limits our knowledge and understanding of the dynamic of a true and raw individual counseling session. However, I was able to address this with my supervisor and learned that this is due to confidentiality restrictions and HIPPA laws. After learning this new piece of information, I was more aware about the reasoning behind this. Other than that, there was really no other limitations that came to my concern throughout my field placement experience. Everything was so interesting, and interns were able to experience many new things.
Overall, I appreciated and enjoyed my time at Sentara RMH Behavioral Health. I learned several aspects of this field that spark my interest such as Psychiatric Emergency Team (PET), individual counseling, and substance abuse groups in general. This community tends to be so underserved due to the stereotypes and individual biases held by individuals who aren’t affected. Working with this community and forming interpersonal bonds with each patient, I will continue to advocate for these individuals because they truly deserve clinicians who care about their wellbeing and treat them like human beings in society. Unfortunately, I also witnessed the hardships and troubles that surround working with insurance companies. At times, insurance companies would no longer cover treatment for a patient. This can be extremely difficult because if a patient was doing exceptionally well, ending their coverage could be detrimental to both their physical and mental health. In addition to these obstacles, contacting and speaking with a representative who work for these companies can be dreadful and tedious. My future career goals were impacted by this because my experience gave me reassurance that I want to provide individual counseling to those struggling with psychological problems. In addition, the opportunity this site provided me with further solidified my passion to work with those struggling with substance abuse and I hope to further my experiences working with substance abuse groups by offering this service at my private practice as well.
