Clinical Rotations
Major Adult Rotations
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| Graduates from 2005 & 2006 presenting at Association for Behavioral and Cognitive Therapies |
Adult Psychiatric Inpatient Unit
The Inpatient Psychiatric Unit is a locked 22-bed unit within the general hospital for adult, geriatric and adolescent psychiatric patients. This rotation provides an excellent opportunity for interns to be exposed to severe psychopathology, to work within a multi-disciplinary treatment team, and to hone their psychological assessment skills. Interns on this service serve as primary therapists for patients presenting with a range of affective, psychotic and neuropsychiatric disorders. Interns are responsible for conducting the initial diagnostic evaluation, providing individual and family psychotherapy, and working in close collaboration with the attending psychiatrist and social worker to monitor patients' response to treatment and formulate disposition plans. Interns also participate in the unit's group therapy program, as group leaders and peer supervisors. During this rotation, interns have the opportunity to perform brief psychological and neuropsychological assessments and to observe patients with unusual neurological and neuropsychiatric conditions. This service is also a training ward for psychiatrists, neurologists, social workers, medical students, nurses and art therapists.
Adult Outpatient Psychiatry Department (AOPD)
The AOPD is a heterogeneous catchment-area clinic serving over 1000 outpatients with a variety of psychiatric disorders. Disorders treated in this clinic include various mood and anxiety disorders, personality disorders, psychotic disorders, and psychiatric disorders associated with HIV disease. Interns are responsible for all phases of outpatient psychiatric care including structured assessment, diagnostic and treatment planning and provision of psychotherapy. Interns receive comprehensive supervision from psychodynamic, cognitive behavioral, and dialectical behavioral perspectives. Interns may elect to treat 1-2 patients for the entire year. Interns also co-lead therapy groups and work as part of a multidisciplinary treatment team.
Psychiatric Emergency Room
The Psychiatric Emergency Room, also known as the psychiatric observation suite, is a five-bed crisis intervention service within the general medical emergency room. This rotation introduces interns to patients who are in an acute state of decompensation and distress. Interns learn to quickly diagnose patients, make triage and referral decisions, perform suicide and violence potential assessments, and do crisis intervention. Interns work closely with psychiatrists, nurses, and social workers.
Addiction Psychiatry Service
The Addiction Psychiatry Service provides consultation services for medical inpatients regarding their substance abuse problems. During this rotation, interns participate as part of a multi-disciplinary team, under the supervision of a substance abuse psychologist, conducting substance abuse evaluations and making referrals to appropriate programs after the patient has been discharged from the hospital. Interns develop considerable expertise in substance abuse evaluation and treatment, using a variety of models and gain skills in motivational interventions.
Neuropsychology Assessment Service
The Neuropsychology Assessment Service provides assessment and treatment planning for individuals of all ages in both inpatient and outpatient settings. Interns may participate in assessments as part of their outpatient and inpatient rotations. Interns also have the opportunity to observe brain mapping and Wada (intracarotid sodium amobarbital procedures (intracarotid sodium amobarbital procedures). During this rotation, interns develop expertise in the neuropsychology of medical and psychiatric disorders.
Major Child/Adolescent Rotations
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| Dr. Rego and Psychology Intern Shelby Harris presenting at Association for Behavioral and Cognitive Therapies |
Child Outpatient Psychiatry Department (COPD)
The Child Outpatient Psychiatry Department treats a heterogeneous group of children and adolescents (ages 4-17) with diagnoses ranging from disruptive behavior disorders, anxiety and depressive disorders, psychotic disorders to adjustment disorders and learning disabilities. During this rotation, interns receive intensive training and supervision in psychodynamic psychotherapy, family therapy, cognitive behavior therapy, and group therapy. Interns have the opportunity to co-lead both the parenting and child components of the Incredible Years program for treating children with disruptive behavior disorders. Interns also learn how to liaison with schools, foster care agencies, the Committee on Special Education, and other relevant organizations.
Adolescent Depression and Suicide Program (ADSP)
The Adolescent Depression and Suicide Program is a specialty outpatient program serving depressed and suicidal teens (ages 12-19) and their families. Many of these adolescents have experienced significant abuse and have comorbid anxiety, substance related, personality and disruptive behavior disorders. During this rotation, interns learn to conduct semi-structured diagnostic interviews, and to intervene intensively using dialectical behavior, cognitive behavior, brief psychodynamic and family systems therapies as well as crisis intervention. Various group therapies are also employed, including parent training, and the CBT Coping with Depression course. Interns also have the opportunity to participate in academic activities, including authoring articles, presenting at conferences, conducting research, and leading workshops at local schools regarding adolescent suicide.
Child and Adolescent Assessment Service
The Child and Adolescent Assessment Service helps interns develop proficiency in child/adolescent psychological and neuropsychological testing. At a minimum, interns administer 5 comprehensive psychological evaluations during the year, with more available for those interested in developing special expertise. Referral questions typically include assessing for the presence and type of learning disabilities, assessing for the presence of a wide range of diagnoses and the potential need for medication, differential diagnosis, and evaluating the presence of neuropsychological deficits. Supervision highlights the impact of cultural differences and bilingualism, and employs a developmental framework. Exposure to more traditional instruments as well as newer, empirically-driven, and computerized instruments is offered. Training in the cross-battery approach to defining learning disabilities is integrated with more conventional theories.
Elective Rotations
Behavioral Sleep Medicine Program, Sleep-Wake Disorders Center
The Behavioral Sleep Medicine Program specializes in the diagnoses and treatment of patients who have severe or long standing problems associated with sleep and waking. The first accredited sleep disorders center in the USA, the SWDC is staffed by neurologists and a supervising clinical psychologist. Interns will have the opportunity to participate in the evaluation and treatment of patients who have insomnia, circadian rhythm disorders, nightmares and CPAP compliance difficulties. The SWDC also offers overnight polysomnography, and interns will be given the opportunity to observe sleep studies.
Child Advocacy Center
The Butler Child Advocacy Center Mental Health team offers interns the opportunity to develop an essential awareness of the field of child abuse prevention and treatment, as well as familiarity with the functioning of child protective services. Interns will learn about trauma-focused cognitive behavior therapy, an evidence-based model of sexual abuse treatment, as well as therapeutic interventions for traumatic grief and the impact of physical abuse. Interns will work with children, adolescents and their families with a model that makes the non-offending parent or caregiver an integral part of the therapy. Interns will learn about cases during the fact finding phase, through the observation of forensic interviews, conducted by a multidisciplinary team of pediatricians and nurse practitioners, social workers, ACS liaison workers, NYPD detectives (special victims unit) and Assistant District Attorneys. Interns will be expected to carry 2 cases in the mental health assessment and treatment phase. There will also be an opportunity to participate in leading adolescent or parent groups. Two licensed psychologists will provide individual supervision for at least one hour a week.
Children's Hospital at Montefiore (CHAM) Behavioral Consultation Team
The Behavioral Consultation Team at The Children's Hospital at Montefiore gives interns the opportunity to develop an understanding of the ways in which acute and chronic medical illness affect the lives of children and their families, using an ecological developmental model. Interns will develop skills in the differential diagnosis of psychopathology in medically ill children. Interns will also provide psychological intervention to children and their families in the inpatient and outpatient setting. Interns will work in the department of pediatrics and have the choice to work in an interdisciplinary manner with members of the divisions of nephrology, adolescent medicine, obesity, endocrinology, rheumatology, transplant medicine, infectious disease, hematology, and oncology. The rotation will be one day per week for one semester. Interns will be expected to carry a caseload of 2 individual/family outpatient cases. They will also co-lead one outpatient group targeting co-morbid medical and psychiatric diagnoses. Individual supervision will be conducted by a licensed clinical psychologist for at least 1 hour per week. Finally, interns will have the opportunity to participate in a variety of weekly interdisciplinary patient care meetings.
Geriatric Psychiatry Program
The Geriatric Psychiatry Program elective offers interns the opportunity to learn about the special needs and challenges of geriatric patients. The geriatric population is faced with mounting health problems, issues relating to death and dying, and a decrease in ability for independent living. Interns will be assigned geriatric outpatient cases, and, if interested, may also provide care at area nursing homes. Supervision is provided by psychologists and psychiatrists with special expertise in this area.
Psychiatry AIDS Connected Ambulatory Program (PACAP)
The Psychiatry AIDS Connected Ambulatory program provides outpatient treatment services to individuals living with HIV/AIDS and comorbid psychiatric disorders. The program also provides services to family members of these patients. Interns have the opportunity to conduct intake assessments, provide individual psychotherapy, and co-lead groups.
Transplant Psychosocial Service
The Psychosocial Service to the Transplant Programs provides consultations to all the solid organ transplant teams at the medical center. Psychiatrists, consultation liaison fellows, social workers and psychologists are key participants in the multidisciplinary team that evaluates patients with congestive heart failure, liver diseases and kidney failure. Psychology interns have the opportunity to utilize a variety of behavioral treatment modalities to support the transplant candidate through this process.
School-Based Mental Health Program
The School-Based Mental Health Program is located at a nearby elementary school. Students are referred by pediatricians based at the school health clinic, teachers, school administrators, and guidance counselors. Interns learn to liaison with school representatives and to provide psychotherapeutic treatment in a setting where it is easy to access mental health services.
Substance Abuse Treatment Program
The substance abuse treatment program includes three separate off-site clinics for opiate-dependent patients. Most of these patients are polysubstance abusers, and have co-morbid mood and/or anxiety disorders, personality disorders, or adjustment difficulties and many have chronic medical disorders. During this rotation, interns learn psychotherapeutic approaches for substance abuse patients in various phases of recovery from patients who have newly entered treatment to patients who have been abstinent for many years.
Supporting Healthy Marriages Program
The Supporting Healthy Marriages Program is a new marriage education program for low income couples in the Bronx. Using a didactic, prevention-based approach, the program teaches relationship skills in a group format. Since these couples are under considerable stress, the program also provides case management to help them access important employment and treatment services. Interns learn to deliver the marriage education curriculum and have an opportunity to participate in a multi-site research study of the effectiveness of this intervention.
University Behavioral Associates (UBA)
UBA is an innovative managed care company founded by the Department of Psychiatry at MMC which delivers behavioral health services to a large population in the Bronx. Interns learn about models of managed care, utilization review, case management, and reimbursement methodologies.
