Psychiatry and Behavioral Sciences
Major Clinical Rotations
|Program graduates Drs. Colleen Jacobsen and Jennifer Muehlenkamp presenting at Association for Behavioral and Cognitive Therapies.|
Major Adult Rotations
Adult Outpatient Psychiatry Department (AOPD)
The AOPD is a heterogeneous catchment-area clinic serving over 1,000 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. Patients are seen in individual, group or family therapy, and many receive psychopharmacologic treatment as well.
Interns are responsible for all phases of outpatient psychiatric care, including structured assessment, diagnostic and treatment planning, and provision of psychotherapy. All interns are assigned to a treatment team led by an attending psychiatrist, attending psychologist, social workers and psychiatric residents, and receive comprehensive, one-on-one supervision from licensed psychologists with psychodynamic, cognitive behavioral and dialectical behavioral perspectives.
Interns may request supervisors with expertise in a specific theoretical orientation. Otherwise, interns are assigned to a variety of supervisors so that they may be exposed to a range of therapeutic approaches. Interns in the AOPD rotation see patients on a short-term basis but may elect to treat one or two patients for the entire year. Interns also co-lead therapy groups and work as part of a multidisciplinary treatment team.
Adult Psychiatric Inpatient Unit
The Inpatient Psychiatric Unit is a locked 22-bed unit within the general hospital for adult 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.
Psychology Interns 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' responses 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 unit for psychiatrists, neurologists, social workers, medical students, nurses and art therapists.
Psychiatric Observation Suite (POS) - Psychiatric Emergency Room
The POS—also known as the Psychiatric Emergency Room—is a five-bed crisis intervention service within the general Emergency Department, which is the busiest of all the city's hospitals, and the second-busiest emergency room in the nation!
This rotation introduces interns to patients that 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 Consultation Service in Psychosomatic Medicine
The Addiction Psychiatry Consultation Service in Psychosomatic Medicine provides consultation liaison services to medically complex patients with admixtures of physical, mental, social and health problems admitted to the general hospital with substance use related-co-morbidity.
During this rotation, interns learn how to screen for addiction problems, differential diagnosis (e.g., delirium versus toxicity), withdrawal management, use of appropriate psychotropic medications, pain management in the addicted patient, and how to formulate and implement an appropriate treatment plan for patients with co-occurring medical and substance use problems.
Specific evidence-based interventions that are modeled and taught include Motivational Interviewing, Harm Reduction and Relapse Prevention. Interns are part of a busy and visible teaching service team, including Psychiatry Residents, Addiction and Psychosomatic Fellows, and first year medical students and psychology externs, and interact with a range of other disciplines and treatment teams throughout the hospital.
The service averages 80-100 patients per month, and interns typically conduct 10-15 written consultation reports and two-to-three follow-up visits with each patient during the hospital stay.
|Training Director Dr. Simon Rego with program graduate and current faculty member, Dr. Shelby Harris, presenting at Association for Behavioral and Cognitive Therapies.|
Major Child and Adolescent Rotations
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, and 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 ADSP 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 five 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.