Traumatic Stress Treatment Center (TSTC)

The Traumatic Stress Treatment Center (TSTC) is housed in the Sanford Health Professional Building in Fargo, ND. Co-located within this Sanford Health facility are the Child and Adolescent Behavioral Health Clinic and the Care Clinic (Child Abuse Referral and Evaluation). Both the Traumatic Stress Treatment Center and the Child and Adolescent Behavioral Health Clinic provide clinical psychotherapy, psychological assessment, psychiatric management, case management, and social support services to children, adolescents, adults, and families. These services offer families who travel from rural and frontier regions across the state to receive high-quality, evidence-based treatment following major stressors, traumatic events, or the onset of psychiatric symptoms. The team of psychologists include both trauma specialists and general child psychologists. Psychologists are co-located with the child and adolescent psychiatrists with whom regular consultation occurs. In the stress clinic, behavioral health providers offer specialized trauma services to help children, teens, and families navigate difficult situations, such as trauma grief, child abuse and neglect, and caregiver substance use. There is significant collaboration with many multidisciplinary partners, including pediatricians, nurse practitioners, psychiatrist, social workers, child protective services, law enforcement, and prosecutors. Additionally, the Care Clinic program uses a team approach to diagnose, treat and prevent abuse and evaluate injuries without a known accident or cause. This team is composed of a physician, family nurse practitioners, RN’s and social workers. They work closely with the Red River Children’s Advocacy Center (RRCAC) to provide medical evaluations, treatments, and recommendations. The staff work with childcare agencies, medical agencies, law enforcement officials and social service agencies to educate the public about abuse and its prevention.

The Internship Experience

At TSTC, interns will have an array of training opportunities related to the assessment and treatment of children, adolescents, and families. The larger team of psychologists at this site include both trauma specialists and general child psychologists and are co-located with the child and adolescent psychiatrists with whom regular consultation occurs. In the trauma clinic there is significant collaboration with many multidisciplinary partners, including pediatricians, nurse practitioners, psychiatrist, social workers, child protective services, law enforcement, and prosecutors. Interns are expected to work closely with primary care and pediatrics, social workers, and other professionals to support our patients. Interns who complete an internship with TSTC are expected to be well-rounded in the practice of psychology and leave with the skills necessary to treat and assess diverse populations as well as those who live with various mental health conditions and stressors.

Patients present at the Traumatic Stress Treatment Center (TSTC) from a variety of backgrounds for a range of behavioral health concerns. Patients treated include children (2-17 years old), young adults, and caregivers of children and young adults. Some patients travel from geographically remote regions as child behavioral health specialty services are scarce in this region. Many patients belong to racial and ethnical minority groups, identify as LGBTQAI+, are from economically disadvantaged backgrounds, and are in foster care or kinship care.

Presenting problems for children and families include child abuse, sexual assault, medical trauma, motor vehicle accidents, traumatic grief, involvement in the foster care system, caregiver substance use disorders, and homelessness. Common clinical conditions include PTSD, Major Depressive Disorder, Adjustment Disorder, Generalized Anxiety Disorder, and Phobias. Many patients present with co-morbid anxiety and depression. TSTC therapeutic services are delivered in traditional office-based and telehealth delivery models. Interns will conduct initial intake assessments and provide individual, family, and group therapy interventions.

Interns are given the opportunity to provide a variety of treatment modalities to help patients achieve their treatment goals. These include, but are not limited to, activities that are in consultation with treatment team members, as an individual therapist, or as a treatment team member within the unit milieu:

• Psychoeducation
• Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
• Child and Family Traumatic Stress Intervention (CFTSI)
• Cognitive Processing Therapy (CPT)
• Child Parent Psychotherapy
• Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT)
• Dialectical Behavioral Therapy (DBT)
• Parent-Child Interaction Therapy (PCIT)
• Cognitive Behavioral Therapy for Depression and Anxiety
• Exposure Therapy
• Other physician ordered interventions, as appropriate

At TSTC, interns will develop competencies in psychological assessment and clinical interventions among a diverse panel of patients. The training provided is designed to develop competencies in psychological assessment and diagnosis, psychological interventions, and interdisciplinary consultation. While acquiring these competencies, interns will also develop sensitivity to issues of cultural diversity, awareness of professional ethics in the delivery of clinical services, and self-awareness as these relate to issues that impact professional functioning.