5
Figure 2. A complete diagram of the 2014 Inpatient Psychiatry Flowchart according to the model by Bancroft, Donaway, Freiberger, and Lyons. Of note, in this figure, the professional figure of Inpatient Psychiatry Group Therapist/Psychotherapist is still listed as Activity Therapist.
1 Direct Description available at: https://medcenterblog.uvmhealth.org/innovat ions/fletcher-allen-named-best-regional-hospital-4th-year-means-quality-patien t-care/
2 Direct Description available at: https://medcenterblog.uvmhealth.org/innovati ons/fletcher-allen-named-best-regional-hospital-4th-year-means-quality-patien t-care/ and https://www.uvmhealth.org/medcenter/news/Fletcher-Allen-Ran ks-in-Top-Ten-Among-Leading-University-Hospitals
3 The psychotherapist is directly responsible for supervising psychiatrists, social workers, and nurses during the completion of morning clinical rounds-related tasks, such as completing assessments/evaluations, updating the multidisciplinary treatment team notes and signatures, and spending a pre-determined average time-per-patient vs. new-admit description times during rounds. Furthermore, Master or Doctoral level psychotherapists also supervise students from the University of Vermont Department of Rehabilitation and Movement Science, UVM College of Nursing and Health Science, UVM Larner College of Medicine, UVM Healthcare Programs/Continuing and Distance Education, UVM Human Development and Family Studies Program/Department of Leadership & Developmental Sciences, and related programs. In some cases, psychotherapists also supervise students from other universities/departments (for instance the Albany College of Pharmacy and Health Sciences), who work or are completing their clinical rotations/internships/practicums in Inpatient psychiatry as MHTs/LNAs/USs etc. and meet with psychotherapists upon request (usually from Nursing Management or Nursing Education, as part of their training).
4 According to the International/Bologna process descriptors for Higher Education degrees (Framework for Qualifications of the European Higher Education Area and ECTS—European Credit Transfer and Accumulation System): First cycle (level): 180–240 ECTS credits (a minimum of 60 credits per academic year), usually awarding a bachelor’s degree. Second cycle (level): 90–120 ECTS credits (a minimum of 60 ECTS per academic year), usually awarding a master’s degree. Third cycle (doctoral degree): at least 180 ECTS after the completion of a master’s degree.
5 In this context, as defined by the highest academic degree and level achieved. Working on the Inpatient psychiatry unit there are also physicians, psychotherapists, etc. with a doctoral degree, thus both (in the aforementioned example) “Doctors-physicians” (PhD + MD/MBBS), “Doctors-psychotherapists” (PhD + MA/MS), etc. For the purpose of this description we omitted higher qualifications or doctorates such as Доктор наук, Habilitation, HDR, Abilitazione scientifica nazionale, Priv.-Doz., and similar.
6 There are four professional figures within the Multidisciplinary Treatment Team: physicians/psychiatrists, psychotherapists/psychologists, registered nurses, and social workers. The pharmacist is the newest addendum to the team and works interdisciplinarily, at the interface between psychiatry and psychotherapy, often with the support of pharmacy students from the Albany College of Pharmacy and Health Sciences.
7 Third Cycle Degree (Doctorate-level clinicians), i.e. PhD-MA, PhD-MD, PhD-MS, etc.
8 Second Cycle Degree, i.e. MA, MD, MEd, MS, MSW, etc. (in some cases, depending on the laws of each country/state awarding the degree, certain professional figures in this category can access the profession for licensing purposes, also with a Bachelor’s level degree, as in MBBS)
9 These are listed as example-degrees. Clinicians with a Level 2-degree might also have first-level professional degrees such as PharmD and similar. For professional (clinical) psychology, the State of Vermont recognizes two levels (Doctoral and Master’s) of degrees, although a doctorate-level licensed psychologist is not required to have a PhD, as a Psy.D. (a “Doctor of Psychology”, as opposed to the Level 3-degree “Doctor of Philosophy in Psychology”) is also recognized to sit for a doctorate-level EPPP examination for licensure.
10 First Cycle Degree, i.e. BA, BS, BSN, BSW, etc. Of note, although the professional medical degree awarded in countries following the UK/Commonwealth academic tradition is a bachelor’s level degree (MBBS—Bachelor of Medicine, Bachelor of Surgery) for the purpose of identifying professions in a clinical sense, we have included this degree in the Second Cycle. Of note, in the aforementioned countries, the MD is only awarded after the degree required to practice medicine. Therefore, this type of MD (often called MD Sci, Dr.Med.Sci., D.Sc.Med., etc.) is a real doctorate, contrary to the U.S.-awarded, second-level (not requiring a previously completed master’s level degree), MD.
11 These staff members are usually Mental Health Technicians (MHTs), Licensed Nurse Assistants (LNAs), Licensed Practical Nurse (LPNs), or Unit Secretaries (UTs). Their level of education varies (High School diploma/GED, Associate’s degree). Of note, while many RNs on the Unit do hold bachelor’s degrees (not necessarily in nursing), this is not a requirement in the State of Vermont.
12 As in the previous description, even in this case the level of education varies from High School diploma/GED, to Associate’s or Bachelor’s degrees.
13 Although management is not technically part of the Multidisciplinary Treatment Team, often a member of administrative staff (with an appropriate degree and/or licensure) can substitute a regular staff member, for instance during morning clinical rounds or other patient-related tasks.
