Case Assignment and Caseload Requirement

Case Assignment

1. Trainees receive the majority of cases when new clients are scheduled into their open initial assessment (also called intake slots) by the Initial Consultation (IC) Team.

2. IC Team members determine the appropriateness of a case by taking into consideration variables such as presenting issues, diagnostic concerns, diversity of caseload, level of trainee experience, schedule, trainee interest and client's preferences.

3. It is understood that some students present in such a way that makes them appear appropriate for trainee assignment, but later during or after the initial assessment appointment, turn out not to be. At those times, senior staff should be consulted. The first person to consult with is the trainee's supervisor. If the supervisor is unavailable, the trainee then seeks out an available ICTeam member, then the OCC and MOD, an Associate Director, or any available senior staff member, in that order.

4. After the initial assessment appointment, if the best disposition is for the client to be seen at CAPS, the intention is that the trainee will pick up the case.  However, there are situations in which this may not be appropriate for instance if the client presents as more complicated than expected or needs more frequent sessions than a trainee can reasonably provide given scheduling constraints. In these circumstances the trainee needs to inform the client that they (the trainee) will consult with their supervisor regarding the best disposition for the client. The client should also be told that they will be contacted by the trainee as soon as possible, but within 24 hours, with the plan for ongoing treatment.

5. If during the initial assessment the client is in need of immediate evaluation by a psychiatrist, the senior staff member, accompanied by the trainee, will access psychiatric input (e.g. scheduling with MOD, open medication evaluation appointment slot, psychiatric emergency room).

6. Trainees can also receive new clients from senior staff who have done an initial assessment and think it is appropriate for a trainee. The staff member either offers it directly to the trainee or tells the Director of Training or the Coordinators of the Psychology Externship or Social Work Intern Programs, who then offer the case to a trainee. The trainee discusses the offered client with their supervisor, who approves or disapproves the case assignment.

7. If a trainee receives a case from a senior staff member, the trainee immediately contacts the student, typically via email, and sets up initial appointment.

Messages to students should not include any confidential information regarding the student's presenting concerns and should be as general as possible.  Using clinical judgment and consultation with supervisor, a determination is made regarding how to word an email and/or leave a voice mail as well as when to re-contact a student if no reply to the message is received.

8. No shows for initial appointments are also followed up with an email or phone call to attempt to reschedule the appointment. Using clinical judgment and consultation with supervisor, a determination is made regarding when to stop attempting to reschedule an appointment if the student does not reply to the initial attempt.

Long-Term Cases

Each trainee is afforded the opportunity to work with a few long-term cases. The determination as to which case(s) will become longer-term is discussed and decided within the supervisory relationship. No decisions about long-term status for clients continuing at CAPS will be made during the intake or assignment process.

As a general rule, trainees who are at CAPS two days a week can have one long term case and those who are at CAPS three days a week can have two long term cases if the cases meet the general criteria for longer term cases at CAPS (please see clinical policies and procedures). If, given a trainee's developmental level and other clinical or training considerations a different arrangement is desired, the trainee discusses the request with their supervisors.

For full-time trainees, the number of longer term cases carried will be determined by the supervisor(s).  Since full-time trainees have larger caseloads and acquire more clients in high levels of distress, this number may vary among full-time trainees.

Caseload Requirements

Psychology Fellows
Case assignment will be between 14-16 cases. However, during certain times of the year (e.g., November and April), Fellows' caseloads, like all full-time staff, may exceed 16.

Doctoral Psychology Interns
Case Assignment will be between 10-12 cases, or 12-14 if not co-leading a therapy group.

Psychology Externship  Students
Case Assignment will be between 7-14 cases.

Social Work Students
Case Assignment will be about 10.

Psychiatry Residents
Clinical assignments include 4-5 psychotherapy and 2-4 medication management cases.

Nurse Practictioner Students
Case assignments will include 2-3 psychotherapy and 2-4 medication management hours.