Elective Rotations

2012-13 Interns and Faculty at the First Day Orientation Meeting.

ACS Family Treatment and Rehabilitation Program

The Family Treatment and Rehabilitation Program (FT/R) is dedicated to providing comprehensive child-centered, family-focused and strengths based services designed to address the safety and well-being of children and families in the Bronx impacted by a range of challenging family situations, including mental health and/or substance abuse concerns, domestic violence, trauma and poverty. The ultimate goal of the FT/R program is to support families whose children are at-risk for foster care placement. This is accomplished by bringing together formal and informal networks of individuals and agencies that work to support and strengthen families own capacity to meet its needs and nurture and care for their children in their homes. All families accepted into our FT/R program will receive a comprehensive family assessment, intensive case management, ongoing monitoring, and supportive service referrals. This rotation offers a broad array of clinical training opportunities, including opportunities to conduct comprehensive clinical assessments with adults and children, to provide ongoing supportive services to families, and to serve as an integral part of an interdisciplinary FT/R team, committed to maintaining the safety and well-being of children and families in the Bronx.

Behavioral Sleep Medicine Program - Sleep-Wake Disorders Center

The Behavioral Sleep Medicine Program specializes in the diagnosis and treatment of patients that have severe or long standing problems associated with sleep and waking. Interns have the opportunity to participate in the evaluation and treatment of patients that have insomnia, circadian rhythm disorders, nightmares, nocturnal panic disorder, narcolepsy and CPAP compliance difficulties.

Though mostly focused on work with adults, child and adolescent patients are occasionally seen. Interns can also observe polysomnography sleep studies, and are given the opportunity to attend a weekly sleep-wake case conference.

Butler Child Advocacy Center (CAC) Mental Health Team

The Butler CAC 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 using 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 observation of forensic interviews, conducted by a multidisciplinary team of pediatricians and nurse practitioners, social workers, ACS workers, NYPD detectives (special victims unit) and Assistant District Attorneys. Interns will then be expected to carry cases in the mental health assessment and treatment phase. The model of intervention is Trauma-focused Cognitive Behavior Therapy. There will also be an opportunity to participate in leading adolescent or parent groups.

Children's Hospital at Montefiore (CHAM) Behavioral Consultation Team

The Behavioral Consultation Team at CHAM 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 create and co-lead outpatient groups for children with chronic illness, participate in individualized and group DBT interventions for patients struggling with adherence to their medical regimen, and liaison with the medical team and provide education about psychosocial issues in the pediatric population.

Interns also provide psychological consultation to children, families and medical teams in the inpatient 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.

Geropsychology

The Geropsychology 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 interested in working with older psychiatric patients will be assigned cases in the Geriatrics service of the AOPD. If interested, however, interns may also create a more intense elective experience that would include providing care at area nursing homes, conduct home visits, and participating in an array of inter-professional seminars and case conferences conducted in collaboration with the training program of the Division of Geriatric Medicine.

Interns choosing this elective would also have opportunities to work with Holocaust survivors and participate in National Institute of Aging-sponsored research. Supervision is provided by psychologists and psychiatrists with special expertise in this area.

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/or inpatient rotations. Interns may also have the opportunity to observe brain mapping and Wada (intracarotid sodium amobarbital procedures).

During this rotation, interns develop expertise in the assessment and diagnosis of the cognitive and behavioral effects of various neurological and psychiatric disorders, including traumatic brain injury, dementia, stroke, multiple sclerosis, brain tumors, lupus, epilepsy, learning disabilities and attention deficit disorder.

Psychiatry AIDS Connected Ambulatory Program (PACAP)

The PACAP outpatient treatment services individuals living with HIV/AIDS and comorbid psychiatric disorders. The program also provides services to family members of these patients. Cases involve a wide range of Axis I and II pathology not limited to health-related concerns, and are treated with a similarly wide range of therapeutic interventions.

Interns have the opportunity to conduct intake assessments, provide individual psychotherapy, and co-lead groups.

Substance Abuse Treatment Program (SATP)/New Directions Recovery Center (NDRC)

The SATP and NDRC are two off-site treatment programs. The SATP treats opioid-dependent patients in a comprehensive methadone maintenance program, and the NDRC treats adults with addictions to other substances in an outpatient setting. Most of these patients are polysubstance abusers, and have comorbid mood and/or anxiety disorders, personality disorders or adjustment difficulties. Many have chronic medical disorders.

During this rotation, interns may be involved in assessment, consultation, individual therapy and group treatment. Interns will 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. These psychotherapeutic approaches include motivational interviewing, acceptance and commitment therapy, cognitive behavioral therapy, and psychodynamic therapy.

Supporting Healthy Relationships Program

The Supporting Healthy Relationships Program is a unique opportunity to gain experience working on a federally-funded marriage education research program serving married couples in the South Bronx. This program is designed specifically to enhance relationship skills and strengthen marriages for low-income couples in the greater New York metropolitan area.

The curriculum utilized is John and Julie Gottman's Loving Couples Loving Children, which was shaped by the Gottmans' many years of research on marital functioning. Using a didactic, prevention-based approach, the program teaches relationship skills in a group format.

This rotation offers a broad array of clinical training opportunities, including opportunities to conduct clinical assessments with couples and individuals, co-lead relationship education groups, design and lead groups on topics of intern's choice, provide ongoing supportive services to couples, as well as contribute to marital research/program evaluation projects, as available.

Transplant Psychiatry Service

The Transplant Psychiatry Service 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 work with adult organ transplant patients and their multidisciplinary treatment team. Interns provide both general psychotherapy and behavioral medicine interventions to support the transplant candidate through this process.

University Behavioral Associates (UBA)

UBA is an innovative managed care company founded by the Department of Psychiatry at Montefiore, which delivers behavioral health services to a large population in the Bronx.

Interns in this elective learn about models of managed care, utilization review and reimbursement methodologies. Interns can also elect to rotate at UBA's comprehensive case management program for substance abusing welfare applicants.