Child/Adolescent Psychiatry Fellowship

PROGRAM DESCRIPTION

A major goal of the first year is to help residents integrate the special knowledge and skills relevant to child psychiatry into their general psychiatry knowledge base. Toward this end, knowledge of and experience with various stages of child and adolescent development (both normal and abnormal) will permeate the year’s clinical and didactic training. The Fellows will also interact with multiple spheres and systems surrounding the child, so as to get a well-rounded perspective on the environmental influences affecting development. They will learn how to function within a multi-disciplinary team to promote healthy child development. Finally, they will begin to learn when and how to appropriately intervene with pharmacological and psychosocial treatments in order to ameliorate child psychopathology.

The bulk of the first year clinical rotations involve evaluation and treatment of children and adolescents within the acute care settings of inpatient and residential treatment. Each Fellow will rotate for six months at West Hills Hospital, which is a private, free-standing acute psychiatric facility containing a 35-bed child and adolescent psychiatric unit. They will spend another six months treating children at the Willow Springs Center, which is a private, free-standing residential treatment center with a census of approximately seventy children and adolescents and an average length-of-stay of three months. In both of these highly supervised settings, Fellows will perform psychiatric evaluations, medication evaluations, medication management, individual and group psychotherapy, family therapy and participate in multi-disciplinary treatment settings.

In addition to the above core rotations, Fellows will also spend several half-days per week in the Washoe CountySchool District, the Washoe County Juvenile Services program, and the Reno-Sparks Tribal Health Services. These experiences are meant to expose residents to culturally and developmentally diverse populations of youth within different settings, and to help them develop their skills as child advocates and mental health consultants. Finally, the Fellows will each work for one half-day per week in a child psychiatry outpatient clinic to give them an introduction to long-term, continuous outpatient care.

Didactic seminars in the first year are geared toward teaching the essential knowledge, skills and attitudes of a child and adolescent psychiatrist. The first month of didactics consist of a “crash course” in essential topics such as child and adolescent evaluation techniques and management of the agitated child. Then in the second month, Fellows will participate in an experiential child development seminar which will allow them to observe young children in a variety of natural settings (such as daycares, Head Start preschools and kindergarten classes). After these observation sessions, Fellows will meet to discuss how the behaviors they witnessed reflect established developmental theories and principles. This second month is followed by a structured, year-long didactic seminar on child development, as well seminars on diagnostic formulation, school consultation, forensic consultation, substance abuse, family consultation, psychopharmacology and diagnostic interviewing.

The second year of the Child and Adolescent Fellowship builds on the basic knowledge and skills obtained in the first year. The core rotation of this second year is a continuity outpatient clinic at Child Behavioral Services (CBS), where the Fellows will work increasingly independently in caring for their own panel of outpatients. At CBS, which is a state of Nevada child and family services agency, they will also participate in early childhood intervention, active case management, outpatient family and individual psychotherapy and intensive family-oriented community based treatment homes for children and adolescents.

Other important rotational experiences in the second year will hone the Fellows’ skills in psychiatrically intervening with special needs children. This includes rotations at the Special Children’s Clinic (for developmental disorders and mental retardation), Briarwood Treatment Center (a group home for sexual offenders) and Renown Medical Center (pediatric consultation-liaison within a general medical hospital.) Didactic seminars for this second year of Fellowship will concentrate on advanced instruction in the major psychotherapeutic modalities for child and adolescents (individual psychodynamic therapy, play therapy, family therapy, cognitive-behavioral therapy, brief supportive therapy, and parent guidance), in the major developmental theories of child psychiatry, and in ethics and practice management strategies which will prepare the Fellows for practice after residency.