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Department of Psychiatry

Psychiatry Academics - Main

 

 
 
 

 

OUTPATIENT CLINIC

  • Evaluation team (3.5 hours/week for 26 weeks), Cambridge Hospital Campus
  • Psychotherapy (individual, group and family, 10 hours/week for 52 weeks), Cambridge Hospital Campus
  • Precepted psychopharmacology clinic
    (3 hours/week for 52 weeks), Cambridge Hospital Campus

CONSULTATION/LIAISON

  • School consultation, Cambridge/Somerville public schools
    (3 hours/week for 40 weeks)
  • Forensic consultation, Middlesex Probate/Family Court and Middlesex Juvenile Court Clinic, Cambridge (4 hours/week for 26 weeks)

FORENSIC CONSULTATION

PEDIATRIC NEUROLOGY

  • Neurological evaluation, LADDERS, Lexington, MA
    (4 hours/week for 10 weeks)

ELECTIVE/SCHOLARLY ACTIVITY

  • Independent Clinical/Scholarly Activity Time
    (1 day/week for 52 weeks)

 

I. OUTPATIENT CLINIC

The CHA Child and Adolescent Outpatient Service provides evaluation and treatment to children from ages 3 to 18, 60% of whom are male and 40% of whom are female. Half the children are 12 or under, half are 13 or older.

These children are most commonly diagnosed with conduct disorders, Depression, Post-Traumatic Stress Disorder, Oppositional Defiant Disorder, Attention Deficit Disorder, and Adjustment Disorders. School behavioral problems, learning disabilities, physical or sexual abuse, and family disorganization are frequently part of the clinical picture. The cultural and ethnic mix of patients includes Latino, Haitian, and Portuguese.

The Child Ambulatory Service handles approximately 8,500 visits per year. Among the components of the service are a psychotherapy clinic, a psychopharmacology clinic, and a small clinic for deaf and hard-of-hearing children. In addition, services are provided within both school and neighborhood health centers.

Team Evaluation Clinic. Second-year fellows spend 3 1/2 hours weekly for 20 weeks as senior members of the Evaluation Team providing outpatient evaluations. The clinic provides an opportunity for fellows to consolidate their skills in diagnostic interviewing, treatment planning, and working within a team setting. It also provides increased opportunity for fellows to teach and mentor first-year fellows, general psychiatry residents, and medical students.

  • Outpatient Clinic. Second-year fellows continue their work in evaluating and treating children and families. The emphasis is on a flexible approach and increasing fellows' breadth and depth of treatment modalities. The fellows are expected to have a minimum of eight clinical hours of outpatient psychotherapy, including co-leading a weekly outpatient group.

    Second-year fellows have 3-4 hours of weekly outpatient supervision, This includes 2 hours of individual supervision for psychotherapy in addition to group CBT supervision, group supervision for groups, and group supervision for school consultation.

  • Precepted Psychopharmacology Clinic. As in the first year, second-year fellows spend approximately 3 hours a week all year in a clinic for patients seeking psychopharmacology evaluations and medication management. Dr. Debra Rosenblum and Dr. Nick Carson are the clinic preceptors, and are available to see patients, answer any questions, and discuss cases with the fellows.

    Preceptors provide feedback on interviewing skills and documentation.

II. CONSULTATION/LIAISON1

The Cambridge and Somerville Public School systems serve a diverse ethnic and socioeconomic community from kindergarten through grade 12. Elementary to high school students, faculty, and families are offered the benefit of psychiatric input from consultations geared to support and enhance academic performance. This rotation provides a unique opportunity for the child psychiatry fellows to spend three hours per week for 9 months in consultation to a diverse ethnic and cultural public student population.

Fellows consult at either an elementary school or high school location. Their rotation consists of exposure to a variety of educational experiences, potentially including: individual education meetings for students receiving special education services; meeting on a weekly basis with the teacher assistance team; co-leading a group with school personnel; providing safety evaluations to the school system; and providing consultation to the school administration. The fellows will become more familiar with the barriers to learning and how to translate psychiatric concepts into useful concrete strategies for teachers.

This rotation is supervised by Nancy Rappaport, MD, Director of School Programs.

III. FORENSIC CONSULTATION

  • Probate and Family Court. The Family Service Clinic is a department of the Middlesex Probate and Family Court. It has offices located one mile from the Cambridge Hospital campus. The clinic staff performs comprehensive evaluations of families following parental separation in which custody and visitation of minor children are disputed issues. These evaluations focus on the needs, interests, and welfare of the child in the context of parental conflict. Children evaluated range in age from under one year to 18 and come from diverse socioeconomic and ethnic backgrounds. The rotation supervisor is Rebecca Pries, CAGS, LMHC.

    Educational activities include:Introduction to the Probate and Family Court, including observation of court proceedings and the provision of testimony during these proceedings; multiple diagnostic interview sessions with the referred children and their parents; review of collateral documents; and completion of a comprehensive report for the court, concluding with recommendations.

  • Juvenile Court. Adolescent Consultation Services (ACS) is a private non-profit agency, which operates the Juvenile Court Clinics for the Middlesex County Juvenile Courts.

Educational activities include: Multiple diagnostic interview sessions with the entire family and the referred youth;
Review of collateral documents; Completion of comprehensive report (delinquency, Child in Need of Services, or Care and Protection case) for the court, concluding with realistic recommendations; introduction to the juvenile court setting and staff including judges and probation officers; observation of juvenile court; and, opportunity to give testimony.

The rotation supervisor is Barbara Hauser, LICSW.

IV. PEDIATRIC NEUROLOGY

Fellows spend one morning a week for 10 weeks at the Learning and Developmental Disorder Evaluation and Referral Service (LADDERS) in Lexington, MA. They learn to take a pediatric and neurological history with a particular emphasis on birth and early development. School histories are also detailed. Areas addressed include the subtleties of abnormalities in processing and modulating sensory input (auditory, visual, tactile), and difficulties in perception which could potentially be confused or mistaken for psychiatric or behavioral disorders. Fellows review and perform a neurological evaluation, including cranial nerves, motor (fine motor, gross motor, balance), sensory, and mental status assessments. Pencil and paper tasks include reading, writing, spelling, and math. Fellows are taught and expected to dictate a complete report on the patients they have evaluated which are then reviewed by the supervising neurologists, Dr. Margaret Bauman and Dr. Ann Neumeyer.

V. INDEPENDENT CLINICAL/SCHOLARLY ACTIVITY

Fellows have approximately one day a week in the second year to pursue clinical activities according to their particular interests, and to complete a scholarly project. Fellows are expected to put together an elective proposal and identify a mentor for their elective time and scholarly project. The elective may or may not pertain to the same material as the scholarly project. In the past, fellows have chosen a wide range of projects, including a making video about toddler and preschool development, conducting a pilot research project of treatment for weight gain in adolescents on neuroleptics, and developing a school-based curriculum on cyberbullying. Projects are due by June 1st.

 



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