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Child Psychiatry Curriculum

  • First Year Rotations

    The first year is divided into five blocks of ten weeks each. In addition, Wednesday and Thursday afternoons are devoted to a longitudinal outpatient experience throughout the year.

    I. Child Assessment Unit (CAU)

    • Child Psychiatry Inpatient (Cambridge Hospital)

    II. Adolescent Assessment Unit (AAU)

    • Adolescent Psychiatry Inpatient (Cambridge Hospital)

    III. Riverside, Evaluation Team, Elective, Development (REED)

    • Psychiatric Emergency Services (Cambridge Hospital ED)
    • Community Service Agency (Riverside Community Care)
    • Early Intervention Observation (Riverside Community Care)
    • Evaluation team (CHA Child/Adolescent Psychiatry Outpatient Department)
    • Complex ADHD Clinic (CHA Child/Adolescent Psychiatry Outpatient Department)
    • Neurodevelopmental Clinic (CHA Child/Adolescent Psychiatry Outpatient Department)
    • Integrated Neuropsychiatry (CHA Child/Adolescent Psychiatry Outpatient Department)

    IV. Consultation/Liaison & Substance Abuse (CLS)

    • Inpatient pediatrics consultation (Tufts Medical Center)
    • Consultation to State Agencies (Depts. of Mental Health and Children and Families, various locations)
    • Substance Abuse Rotation (Riverside Community Care; Boston Children’s Hospital Adolescent Substance Abuse Program)

    V. Elective, Walden, Integrated Care, Neurology, Global Infant-Parent Mental Health (E-WING) 

    • Residential Consultation (Walden Street School, Justice Resource Institute)
    • Independent Clinical and Scholarly Activity Time (8 hours/week for 10 weeks)
    • Pediatric Neurology (Lurie Center for Autism)
    • Global Parent-Infant Mental Health (Supporting Child Caregivers)
    • Outpatient Child & Adolescent Mental Health integration Service (CAMHI, CHA Cambridge Pediatrics))

    VI. Longitudinal Outpatient Experience (Cambridge Hospital, Macht Building)

    • Psychotherapy clinic (Cambridge Hospital, 3 hours/week for 52 weeks)
    • Precepted psychopharmacology clinic (Cambridge Hospital, 3 hours/week for 52 weeks)

    Rotations: First Year

    I. Child Assessment Unit (CAU), Cambridge Hospital - 10 weeks

    This clinical experience gives fellows the opportunity to work with multidisciplinary staff, gain experience negotiating with outside systems such as the Department of Children and Families, the Department of Mental Health, and the wrap-around services of the Children’s Behavioral Health Initiative. Fellows develop assessment and treatment skills with oversight and supervision from inpatient psychiatric attendings and other faculty.

    Patients range in age from 3 to 13 and represent a diverse socioeconomic, ethnic, and cultural mix. Patients present with a wide range of diagnostic problems, including post-traumatic, disruptive, mood, psychotic, and developmental disorders. Clinical focus is on accurate diagnostic assessment, including individual and family evaluations, and broad-based treatment, including psychopharmacology, family work and milieu therapy. The unit has received recognition for its development of strategies to reduce the use of restraint and seclusion. The unit has also developed a family-centered model of care.

    Educational activities include a biweekly interview and case formulations conference with consulting faculty, a biweekly family therapy case conference, weekly clinical supervision from outside faculty, daily supervision with an onsite attending supervisor and informal supervision from other psychiatric and psychology staff. Teaching opportunities include supervising medical students and general psychiatry residents. Fellows are also expected to present and implement evidence-based treatment plans in team meetings. The rotation supervisor is Linsey Koruthu, MD.
    .

    II. Adolescent Assessment Unit

    (AAU), Cahill 3, Cambridge Hospital - 10 weeks
    The AAU rotation provides a rich clinical experience with adolescents and their families involving close work with multidisciplinary staff in a team format, both as the primary clinician on cases and as the medication consultant. Fellows gain experience negotiating with outside systems and presenting evaluations in teams and to outside providers in systems meetings.

    This unit has 14 inpatient beds and the population ranges in age from 12 to 17. Like on the CAU, the patients represent a diverse socioeconomic, ethnic and cultural mix. CHA provides access to an award-winning interpreter service including ASL for deaf and hard-of-hearing patients. The AAU serves a wide range of adolescents with diagnoses including PTSD, mood disorders, psychotic disorders, substance abuse, ADHD and other disruptive disorders. Systems work includes school, social service and program (residential) consultation.

    Faculty on both inpatient units include child and adolescent psychiatrists, social workers, psychologists, nurse managers, staff nurses and milieu counselors. Faculty members are experienced in assessment, psychotherapy, play therapy, behavior modification, psychopharmacology, substance abuse and family therapy.

    Educational activities include a biweekly interview and case formulations conference with consulting faculty, a biweekly family therapy case conference, weekly clinical supervision from outside faculty, weekly supervision with an onsite attending supervisor and informal supervision as needed. Teaching opportunities include supervising medical students and general psychiatry residents. The supervisor for the rotation is Gloria Carrera, MD.

    III. Riverside, Evaluation Team, Elective, Development (REED)

    • Cambridge Hospital Psychiatric Emergency Service (PES)
      The PES is a consultation service based in the medical emergency room. It is the entry point for all acute psychiatric services, and provides evaluation and urgent treatment to children, adolescents, adults, and families. As part of the PES team, fellows see children and adolescent patients under age 18. The Rotation Supervisor of the PES experience is Scott Yapo, MD. Emergency assessments are directed at determining patient needs for acute stabilization and appropriate/least restrictive level of care.
    • The Community Service Agency (CSA) rotation at Riverside Community Care
      This rotation introduces fellows to wrap-around services offered in the setting of a community mental health center. These services are offered through the Massachusetts’ Children’s Behavioral Health Initiative (CBHI), an innovative statewide reform of public child mental health care emphasizing strengths-based, wrap-around community supports. Fellows participate in team evaluations of children and families, join the staff on home visits, and develop a comprehensive treatment plan. Fellows also become more familiar with community-based resources, work within a multidisciplinary treatment team, and act as a psychiatric consultant to CBHI service providers. The rotation supervisor is Allison Clark, LICSW.
    • Early Intervention Observation
      Fellows spend six mornings during their 10-week REED block with the Early Intervention program at Riverside Community Care. This experience involves observation of Early Intervention groups and home based assessments under the supervision of Kathy Kelts, LICSW. Fellows learn how preventive strategies are practiced in a state-supported program. Fellows also deepen their theoretical and practical understanding of typical development at this stage of life and learn to distinguish it from clinical pathology.
    • Team Evaluation Clinic
      First-year fellows spend 10 weeks during their REED Block on a weekly 3.5-hour Evaluation Team. The team is multidisciplinary (psychiatry, psychology, social work, nursing, medical students) and provides in-depth initial assessments of children and families over two sessions. This setting provides an excellent opportunity for fellows to observe senior faculty interview patients, receive direct feedback on their own interviewing skills, practice in-depth bio-psycho-social-cultural formulation skills (both written and in presentation to the team), learn about local resources and systems available for families, and to work together in a team setting to think through diagnostic formulations and treatment plans. The rotation supervisor is Nicholas Carson, MD.
    • Complex ADHD Clinic
      On Monday Afternoons, for 10-weeks, during the REED Block, first year fellows will rotate with child psychiatrist supervisor Margaret Weiss, MD, PhD evaluating children in the Attention Deficit Hyperactivity (ADHD Clinic) in the Child/Adolescent Psychiatry Outpatient Department. Fellows will conduct evaluations and follow-up visits, as well as associated clinical tasks, in a progressively autonomous way throughout the rotation. Fellows learn how psychoeducation, behavioral and parent training interventions are integrated into medication management.
    • Neurodevelopmental Clinic
      First year fellows spend 10 weeks rotating with child psychiatrist supervisor Scott Yapo, MD, evaluating children in the Neurodevelopmental Clinic.. This clinic is a service within the Division of Child Psychiatry that provides evaluation, consultation, and treatment for children referred for concern of serious neurodevelopmental disorders such as Autism Spectrum Disorder (ASD) and Intellectual Disability (ID). Evaluations include extensive review of developmental history, developmental assessment, review of neuro/psychological, academic, and Early Intervention evaluations, collateral from families and outside supports, and often a developmental assessment scale.
    • Integrated Neuropsych Rotation
      During the REED block, the fellow will meet with Laura Gaugh, PsyD, weekly on Wednesdays from 9-10am to discuss assessment of neurodevelopmental disorders with a focus on psychological and neuropsychological testing. Throughout the rotation, fellows will review testing results offered by Dr. Gaugh, or from the fellow’s outpatient caseload, with the goal of familiarizing the fellows with the types of tests they may encounter, and how best to interpret the testing results in the context of the greater cultural and linguistic clinical picture. Types of testing may include tests of cognitive functioning, academic performance, adaptive functioning, language, executive functioning, visuospatial and visuomotor functioning, learning and memory, and social communication.

    IV. Consultation/Liaison & Substance Abuse Block (CLS)

    • Inpatient Consultation-Liaison
      The Floating Hospital for Children at Tufts Medical Center in downtown Boston is a 100-bed pediatric tertiary care hospital within Tufts Medical Center. CHA fellows rotate at the hospital performing inpatient consultations with children and adolescents who have a wide range of concerns including psychological difficulties associated with pediatric illness, unexplained somatic symptoms, child abuse and neglect, pain management and problems managing chronic illness. In addition, fellows participate in more specialized inpatient consultation experiences on both the Pediatric Intensive Care Unit and the Bone Marrow Transplant Unit at the Floating Hospital. Fellows spend approximately 16 hours per week over a 10-week period at Tufts performing clinical consultations, presenting cases, attending a teaching conference, and receiving supervision. The rotation supervisor and C/L director is John Sargent, MD - Chief of Child and Adolescent Psychiatry at Tufts. Fellows will also teach consultation psychiatry to Tufts Medical Students.
    • Systems Consultation to State Agencies
      The MA Department of Mental Health (DMH) is a state agency that sets the standards for the operation of mental health facilities and community residential programs and provides clinical, rehabilitative, and supportive services for adults and children with serious mental illness or serious emotional disturbances. The Department for Children and Families (DCF) is the child welfare agency in Massachusetts. During this 10-week rotation, first-year child psychiatry fellows will spend 3 hours a week accompanying the faculty during weekly consultations to DMH and DCF at various sites within our catchment area.

      Fellows are supervised by Nandini Talwar, MD a DMH child and adolescent psychiatrist, who has extensive experience working with state and community agencies. During the consultations, the trainees participate in discussions of complicated cases presented by DCF case managers and supervisors. Trainees learn about services and opportunities provided by state agencies, criteria for eligibility for services from state agencies, the process of investigation and assessment for allegations of abuse and neglect, as well as the various dilemmas and limitations faced by agencies when working with families and clients. In addition, the fellows will participate in a once a month interagency meeting with representation from DMH, DCF, DDS (Department of Developmental Services), DYS (Department of Youth Services), Department of Education and the Department of Public Health. This meeting provides updates about services and changes in each of the participating state agencies as well as a forum for consultation to high-risk and underserved families who are in need of services from more than one agency.
    • Substance Abuse Rotation
      During this rotation, fellows will spend one afternoon per week learning about assessment and treatment of substance use disorders in the adolescent population. During the first 10-week block of the year, fellows will observe Joseph Shrand, MD in his clinic through Riverside Community Care, seeing patients presenting for evaluation and treatment of substance use issues. During the remaining 10-week blocks of the year, Fellows will rotate through the Adolescent Substance Abuse & Addiction Program (ASAP), an outpatient clinic at Boston Children’s Hospital (BCH). Fellows will observe members of ASAP’s multidisciplinary team (which includes pediatric and/or child & adolescent psychiatry physicians, nurse practitioners and social workers). Treatments observed may include individual and/or group therapy, psychopharmacology visits, and medication assisted treatment.

    V. Elective, Walden, Integrated Care, Neurology, Global Infant-Parent Mental Health (E-WING)

    • Residential Consultation Rotation
      The Walden Street School is a therapeutic residential program of the Justice Resource Institute for young women offering a specialized trauma-informed approach, known as Attachment, Self-Regulation, and Competency (ARC). Fellows spend one day per week under the supervision of Kerry-Ann Williams, MD, participating in treatment team, groups, and milieu treatment of students at the residential school.
    • Independent Clinical and Time/Scholarly Activity
      This rotation provides 8 hours per week for 10 weeks of elective time so that fellows can pursue scholarly activities or quality improvement in their own particular area(s) of interest, meet potential mentors, and prepare for their clinical scholarship and elective time in the second year.
    • Pediatric Neurology
      The fellows spend one morning a week for 10 weeks at the Lurie Center for Autism in Lexington, MA. They learn to take a pediatric and neurological history with a particular emphasis on birth and early development. Areas addressed include the subtleties of abnormalities in processing and modulating sensory input (auditory, visual, and tactile), difficulties in perception, and/or medical conditions that are mistaken for psychiatric or behavioral disorders. Fellows review and perform a neurological evaluation, including cranial nerves, motor (fine motor, gross motor and balance) and sensory and mental status assessments. The supervising neurologist is Dr. Ann Neumeyer.
    • Global Parent-Infant Mental Health
      On Wednesday mornings, for 10-weeks, during the E-WING Block, 1 st year fellows will rotate with child psychiatrist supervisor, Alexandra Harrison, MD for a Global Infant Parent Mental Health (GIPMH) training experience. Global Infant Parent Mental Health includes the developmental science and mental health clinical treatment of infants and parents in the perinatal period. The rotation consists of (1) a reading tutorial in developmental psychology; (2) reviewing videotaped illustrations of infant development and infant-parent interactions; (3) introduction to videotape microanalysis; (4) demonstrations of the interventions of Newborn Behavior Observation (NBO) and Thula Sana (TS); and (5) discussions of cultural issues in IPMH with guest experts.
    • Outpatient Child & Adolescent Mental Health integration Service (CAMHI)
      The Child & Adolescent Mental Health integration (CAMHI) Service at CHA Cambridge Pediatrics Clinic gives first-year fellows the opportunity to work alongside an attending child psychiatrist, Shireen Cama, MD in an integrated care model for 4 hours a week for 10 weeks. Fellows will learn how to consult to, and collaborate with, pediatricians and primary care staff to address pediatric mental health needs in the primary care setting. Fellows will learn about pediatric primary care culture, workflows, staffing and the role pediatricians play in the mental health care for patients. Fellows will learn how the child psychiatrist on an integrated care team can provide consultation to pediatricians through indirect case consultations, direct “face-to-face” consultations and brief, urgent evaluations. Fellows will learn how to perform brief psychiatric interventions (both somatic and psychotherapeutic) for children and families in the primary care setting, and how to co-manage mental health care with pediatricians. As health care nationally moves towards an Accountable Care Model of delivery, this innovative rotation is designed to prepare fellows for the future of integrated pediatric health care.

    VI. Longitudinal Outpatient Experience – First Year

    The Cambridge Hospital Child and Adolescent Outpatient Service is located at the Macht Building and provides evaluation and treatment to children from ages 2 to 18 and treats patients with a wide range of developmental, educational, emotional, behavioral and psychiatric issues. The clinic serves a  racially, ethnically, and socioeconomically diverse population.

    The Child Outpatient Service provides approximately ten thousand visits per year. Clinical services available at the Macht building on our main campus include individual, group, and family psychotherapy, psychopharmacology, a neurodevelopmental and developmental testing program, a clinic for deaf and hard-of-hearing children, and a clinic focusing on issues of gender and sexuality.

    In addition to the Cambridge Hospital based outpatient service, children and adolescents are seen by our staff at our Revere Outpatient Clinic, local school-based health centers, at CHA community pediatrics and family medicine clinics in an integrated primary care model, and at regional residential treatment and educational facilities. CHA providers also consult to the Cambridge Police Department (Safety Net Program) and to Cambridge preschool and daycare centers (Early Years Program).

    • Outpatient Psychotherapy Clinic
      Fellows spend their time learning and providing psychotherapy and psychopharmacology to diverse populations. This essential experience includes family work, individual psychodynamic psychotherapy, supportive and cognitive/behavioral interventions, consultation with community agencies and schools and general clinical case management. Many cases will involve combined treatment (both psychotherapy and medications). First-year fellows have at least three therapy hours per week, primarily for psychotherapy, but also for evaluations, family work and case management. First-year fellows receive a minimum of 2 hours of weekly outpatient psychotherapy supervision. 
    • Precepted Psychopharmacology Clinic
      The 3-hour psychopharmacology clinic is devoted to the medication management of patients in a split treatment model. It is precepted by attending child psychiatrists who are available to help fellows with diagnostic interviewing and treatment planning, to answer clinical questions and to guide fellows’ self-directed learning about evidence-based treatments in clinical practice. Preceptors provide feedback on interviewing skills and documentation. Current preceptors are Margaret Weiss, MD, PhD, and Scott Yapo, MD. The clinic is complemented by a longitudinal psychopharmacology seminar, taught by Dr. Weiss with various guest faculty who lead case discussions.  
  • Second Year Rotations

    I. Longitudinal Outpatient Clinics

    • Outpatient Psychotherapy Clinic - individual, group and family (Cambridge Hospital, 7 hours/week for 52 weeks),
    • Precepted Psychopharmacology clinic (½ time at Cambridge Hospital & ½ time at a community site:Revere Outpatient Clinic, Everett Teen Clinic, or Riverside Community Care; total of at least 7 hours/week for 52 weeks)

    II. Consultation/Liaison

    • School consultation (Cambridge Public Schools)
    • Forensic consultation, Adolescent Consultation Services to the Middlesex Juvenile Court Clinic, Cambridge and Asylum Evaluations through Kids in Need of Defense (KIND)

    III. Elective/Scholarly Activity

    • Independent Clinical/Scholarly Activity Time (8 hours/week for 52 weeks)

    Rotations: Second Year

    I. Longitudinal Outpatient Clinics

    The Cambridge Hospital Child and Adolescent Outpatient Psychiatry Service is located at the Macht Building and provides evaluation and treatment to children under age 18 and treats patients with a wide range of developmental, educational, emotional, behavioral and psychiatric issues. The clinic serves a racially, ethnically, and socioeconomically diverse population.

    The Child and Adolescent Outpatient Psychiatry Service provides approximately ten thousand visits per year. Clinical services available on the main campus of the Cambridge Hospital include individual, group, and family psychotherapy, psychopharmacology, a neurodevelopmental and developmental testing program, a clinic for deaf and hard-of-hearing children, and a clinic focusing on issues of gender and sexuality.

    In addition to the Cambridge Hospital based outpatient psychiatry service, children and adolescents are seen at our Revere Outpatient Psychiatry Clinic, local school-based health centers, at CHA community pediatrics and family medicine clinics in an integrated primary care model, and at regional residential treatment and educational facilities. CHA providers also consult to the Cambridge Police Department (Safety Net Program), to Cambridge preschool and daycare centers (Early Years Program), and provide medical directorship for children’s services to Riverside Community Care- Cambridge.

    Outpatient Psychotherapy Clinic
    Second-year fellows continue their work in evaluating and treating children and families. The emphasis is on a flexible approach and increasing each fellows’ breadth and depth of treatment modalities. The fellows are expected to have a minimum of sevenclinical hours of outpatient psychotherapy, including co-leading a weekly group. Second-year fellows have 4-5 hours of weekly outpatient supervision. This includes 4 hours of individual supervision for psychotherapy (individual, group, and family therapy) in addition to group-based CBT supervision, supplemental Gender and Sexuality supervision, and group-based supervision for school consultation.

    Precepted Psychopharmacology Clinic
    Second-year fellows spend at least 7 hours per week throughout the year performing psychopharmacology evaluations and medication management in a split-treatment model. Fellows spend roughly half of their time at the CHA Macht/Cambridge Hospital Outpatient Psychiatry Clinic and the other half at one of our community-based sites, including CHA Revere Outpatient Psychiatry Clinic, CHA Everett Teen Health Center, or Riverside Community Care- Cambridge.  Preceptors provide feedback on interviewing skills, treatment planning, coordination of care, coding and documentation. Time each week is devoted to supervision of cases and didactics focusing on the review of seminal articles in pediatric psychopharmacology.

    II. Consultation/Liaison

    School Consultation

    The Cambridge Public School system serves a diverse ethnic and socioeconomic community from kindergarten through grade 12. Child psychiatry fellows spend three hours per week for nine months assigned to  either an elementary school (kindergarten through fifth grade) or high school, according to their interest, exposure to different age groups, and availability of placement. Fellows complete up to three evaluations of students with safety and/or mental health concerns (e.g. aggressive behavior) in the school setting and under close supervision. These comprehensive assessments often clarify the diagnosis and help guide the school and family with regards to understanding treatment options for helping promote success in the school environment.

    Forensic Consultation

    Juvenile Court: Adolescent Consultation Services (ACS) is a private non-profit agency which operates the Juvenile Court Clinics for the Middlesex County Juvenile Courts. ACS offices are located in the Juvenile Court in Cambridge. Upon order of the Judge, Juvenile Court Clinic staff conduct comprehensive diagnostic evaluations of youth and families involved in the court. The rotation supervisor is Mathilde Pelaprat, PsyD.

    Educational activities include multiple diagnostic interview sessions with the entire family and the referred youth, review of collateral documents, completion of the comprehensive forensic report (Delinquency, Child Requiring Assistance, or Care and Protection case) for the court, including a dynamic formulation and realistic recommendations. Introduction to the juvenile court setting and staff including judges and probation officers involves observation of juvenile court and the opportunity to give testimony if requested as part of the case.

    Asylum Evaluations: CHA works with the nonprofit Kids in Need of Defense (KIND) to provide mental health evaluations for children seeking asylum in the United States. Under the supervision of Dr. Malak Raflak, 2nd-year fellows complete at least one asylum evaluation on a rotating basis throughout the year, except when on the Juvenile Court rotation. The evaluation typically includes writing an affidavit for immigration court, and may involve testifying if requested as part of the case.

    III. Elective/Scholarly Activity

    Independent Clinical/Scholarly Activity: Fellows have the equivalent of 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 either create an elective proposal or choose from a variety of electives currently offered by our faculty. Either of these options will require the fellow to choose a mentor or supervisor to work with during the elective. In addition, fellows work together to complete a longitudinal group quality/performance improvement project, focused on supporting health equity among our patients, and every fellow completes a scholarly project by the end of the second year. The fellow’s elective time may or may not pertain to the same material as their quality/performance improvement or scholarly project. In the past, fellows have chosen a wide range of projects, including conducting a pilot research project on pharmacological treatment of weight gain in adolescents on neuroleptic medications, developing a school-based curriculum on cyber-bullying, and incorporating screening for food insecurity into the Child and Adolescent Outpatient Psychiatry Department.

  • Seminars and Didactics

    A defining feature of our didactics is the Harvard Consolidated Seminar Program. In this program, all first-year fellows in the Harvard-affiliated child psychiatry training programs (Cambridge Health Alliance, MGH/McLean, and Boston Children’s Hospital) come together to participate in a 3-hour seminar program. Internationally renowned Harvard faculty are guest lecturers on a variety of topics in child mental health research, assessment and treatment. The seminars are coordinated by CHA faculty Sandra DeJong, MD, MSc, and Jennifer Harris, MD.

    First-Year Seminars

    • Systems Issues – Joel Goldstein, MD
    • Typical Development – Susannah Sherry, MD
    • The Pragmatics of Child Psychiatry – Shireen Cama, MD and CHA Faculty
    • Introduction to Child/Adolescent Psychotherapy – Shireen Cama, MD and CHA Faculty
    • Introduction to Health Equity, Improvement, Scholarship and Leadership – Lee Robison, MD and Shireen Cama, MD
    • Behavioral Therapies – Sarah Samuelson, PsyD with Lauren Marchette, PhD and Courtney Rotolo, LICSWIntroduction to Pediatric Psychopharmacology – Margaret Weiss, MD, PhD
    • Harvard Consolidated Seminar Program:
      • Child Development – Karlen Lyons-Ruth, PhD
      • Child Psychopathology – Sandra DeJong, MD, MSc, Jennifer Harris, MD and Harvard faculty
    • Health Equity, Improvement, Scholarship and Leadership – Lee Robinson, MD and Shireen Cama, MD
    • Race in Child Psychiatry: Fostering Resilience and Understanding – Priya Sehgal, MD
    • Trauma Case Conference – Courtney Rotolo, LICSW
    • Inpatient Clinical Interviewing Seminar – Tim Dugan, MD and Judy Tsafrir, MD
    • Inpatient Family Therapy Case Conference – John Sargent, MD and Corky Becker, PhD
    • Family Therapy Seminar – Dorothy Kelleher, PsyD and Cynthia Mittelmeier, PhD
    • School C/L – Nancy Rappaport, MD
    • Forensics – Adam Rosen JD, PhD
    • Parenting – Susannah Sherry, MD, and Ann Hess, MD
    • Pediatric Psychopharmacology – Margaret Weiss, MD, PhD and visiting faculty
    • Telepsychiatry – Sandra DeJong, MD, MSc

    Second-Year Seminars

    • Learning How to Teach – Sandra DeJong, MD, MSc
    • Immigration Issues and Asylum Evaluations – Malak Rafla, MD
    • Child Psychotherapy – Jennifer Harris, MD and Theodore Murray, MD
    • Culture and Society – Xenia Johnson-Bhembe, MD
    • Infancy and Attachment: Clinical Implications – Ayelet Barkai, MD, Ann Epstein, MD, and Susannah Sherry, MD
    • Gender and Sexuality – Cindy Telingator, MD and John Wechter, EdD
    • Clinical Scholarship, Nick Carson MD
    • School C/L and Supervision – Nancy Rappaport, MD  and Deborah Kulick, MD
    • Psychodynamic Psychotherapy – Jennifer Harris, MD, Theodore Murray, MD, and Alexandra Harrison, MD
    • Play Therapy – Neal Kass, MD
    • Behavioral Therapies – Sarah Samuelson, PsyD with Lauren Marchette, PhD and Courtney Rotolo, LICSW
    • Neuroscience and Genetics – Elizabeth Fenstermacher, MD
    • Transitions to Practice – Joel Goldstein, MD
    • Integration Seminar – Scott Yapo, MD
    • Ethics and Professionalism  – Sandra DeJong, MD, MSc
    • Gender and Sexuality Case Conference- Cindy Telingator, MD and Elizabeth Baumann, PhD
    • Cultural Psychiatry Case Conference- Priya Sehgal, MD
    • Complex Psychopharmacology Case Conference- Kerry-Ann Williams, MD
    • Health Equity, Improvement, Scholarship and Leadership – Lee Robinson, MD and Shireen Cama, MD
    • Family Therapy (elective) – Dorothy Kelleher, PsyD, and Lyn E. Styczynski PhD
    • Pediatric Psychopharmacology- Nicholas Carson, MD and Debra Rosenblum, MD

    In addition to the above seminars, first- and second-year fellows have twice-monthly training meetings with the program directors to discuss training issues, and also meet monthly with a facilitator Jeanne Heiple, MD, for a peer support group.

    Family Therapy Training, CHA

    Family Therapy is often a core component of any successful psychiatric treatment of a child or adolescent. The guidelines of the Accreditation Council of Graduate Medical Education, the Practice Parameters of the American Academy of Child and Adolescent Psychiatry and the recommendations of the Group for the Advancement of Psychiatry Committee on the Family all underscore the role of working with families. To this end, the CHA child psychiatry fellowship offers a very strong grounding in Family Therapy training opportunities. These opportunities aim to provide fellows with a basic conceptual understanding of family therapy as well as a range of experiences across treatment settings with different kinds of families and family issues.

    In the first year, fellows participate in a year-long seminar that introduces Family Therapy theory, assessment, and intervention. The seminar consists of didactics and observation of family consultations using a one-way mirror, with a daylong “Family Therapy Retreat” to wrap-up the academic year. The focus of this seminar is on acquiring basic knowledge, skills and attitudes in working with family systems. This seminar is taught by Dorothy Kelleher, PsyD and Cynthia Mittelmeier, PhD. In the second year, an elective advanced seminar is available. This seminar, taught by Dorothy Kelleher, PsyD and Lyn E. Styczynski PhD, provides clinical training in Family Therapy through case consultation and/or live supervision using a one-way mirror. Case supervision is also offered by members of the faculty.

    Fellows also participate in inpatient Family Consultations, conducted on both the Child Assessment Unit and the Adolescent Assessment Unit, and participate in a Family Therapy Case Conference, precepted by John Sargent, MD and Corky Becker, PhD.

    Program in Psychodynamics

    The Program in Psychodynamics is an elective opportunity for fellows in both years across all three Harvard Child Psychiatry Fellowship programs. Its goal is to foster the career development of fellows with an interest in psychodynamic psychotherapy, psychodynamic research, and psychoanalysis. The core activity is a monthly dinner meeting at the home of program faculty to discuss relevant topics in the context of case presentations. The program offers a flexible set of opportunities for enrichment in the Fellowship and two years post Fellowship. In collaboration with the Boston Psychoanalytic Society and Institute (BPSI), the Program in Psychodynamics allows fellows to enhance and deepen their psychodynamic interests and to integrate psychodynamic scholarship into the rigorous clinical training provided to all CHA child psychiatry fellows.

    Teaching during Child Training

    All our fellows are required to teach during their child training. Fellows have a hands-on, interactive "Learning to Teach" seminar in the summer of their second year. Fellows can then choose teaching responsibilities based on their interests. In the past, fellows have co-taught seminars, taught medical students and general psychiatry residents on the inpatient units and outpatient evaluation teams, given lectures as part of standing seminars, developed curricula for public education, given talks in community settings, and helped organize and teach an onsite Harvard Medical School course on interviewing patients.

    Minority Trainee Mentoring Alliance (MTMA)

    Multidisciplinary first-year trainees (i.e. nursing, psychology, psychiatry, social work) in the Department of Psychiatry at CHA who self-identify with a minority group or groups (e.g. ethnic, racial, sexual, religious) are invited to the Minority Trainee Mentoring Alliance (MTMA). This program is sponsored by the Diversity Task Force at CHA and is an opportunity for first-year trainees to meet and talk with others who have transitioned into this unique academic setting. Second-year trainees and current faculty who are former CHA trainees are also present to offer support and their valuable insights to acclimating to CHA, to Harvard Medical School and to New England (for those who are spending their first year here in the Boston metropolitan area). This initiative is led by Dr. Treniece Lewis-Harris, the Director of Child Psychology Outpatient Training at CHA.

    Gender and Sexuality Clinic
    The Gender and Sexuality Clinic (GSC) at CHA lives within the Department of Child and Adolescent Outpatient Psychiatry. The clinic provides multidisciplinary compassionate psychiatric care to sexual and gender minority children, adolescents and families. In addition to direct service, the GSC has also seeded a training program across disciplines including the development of a rotation for second year Child Psychiatry Fellows. Through clinical supervision, teaching, and consultation, the GSC helps train the next generation of psychiatric professionals in compassionate care for Sexual and Gender Minority patients employing a full interdisciplinary model including collaborations with
    Pediatrics, Family Medicine and MGH Pediatric Endocrinology to consult with the team supporting young transgender patients seeking medical treatment. The clinic is led by Cynthia Telingator, MD and Elizabeth Baumann, PhD.
     
    Health Equity, Improvement, Scholarship, and Leadership (HEISL)
    Our fellowship program aims to develop leaders in community child and adolescent psychiatry. To support fellows in this effort, we have created the Health Equity, Improvement, Scholarship, and Leadership (HEISL) curriculum within our fellowship. Throughout both years of training, fellows will participate in seminars as well as group and individual projects to learn the knowledge, skills, and behavior required to be leaders in improving the health and care for families in need. Through a guiding framework of health equity, fellows will learn about important principles and practices such as: social determinants of health and structural competency, implicit bias and bystander training, coproduction of health care, population mental health, value-based care, health disparities research, quality and performance improvement science, change leadership, human-centered design, and personal narrative and advocacy. The HEISL curriculum is structured around a 1.5 year-long group quality/performance improvement project targeting a barrier of health equity for our patients. The HEISL curriculum is co-led by Lee Robinson, MD and Shireen Cama, MD.

  • Clinical Scholarship Opportunities

    We are dedicated to helping fellows pursue their interests in child psychiatry through scholarship activities. In the Department of Psychiatry at Cambridge Health Alliance and at Harvard Medical School, scholarship is defined broadly and may include the scholarship of discovery, the scholarship of integration, the scholarship of teaching and the scholarship of application. Guidance and technical support are provided to fellows by faculty.

    The scholarship requirement of the Child Psychiatry Fellowship program is designed to meet the ACGME requirements and provide flexibility for fellows to pursue their own interests. While all clinical service experiences, supervision and seminars are an integral part of developing scholarship, specific components are intended to address the development of attitudes, skills, knowledge, and behaviors that lead to innovation and leadership in the field. These include:

    1. Introduction to scholarship themes and techniques in the Health Equity, Improvement, Scholarship, and Leadership Summer Seminar in the first year.
    2. Health Equity, Improvement, Scholarship, and Leadership Seminar, September-June, both years; topics include, searching the literature, presentation skills, quality improvement vs. research, evidence-based care, health care disparities, social determinants of health, clinical service research, population health, and leadership.
    3. Clinical Scholarship Seminar, Sept-June, in the second year, learning how to develop, finish, and present a clinical scholarship project.
    4. Longitudinal Group Quality/Process Improvement Project from January of first year through June of second year focused on a health equity focused project of the class’ choosing.
    5. Opportunity to apply for CHA Clinical Learning Environment Innovation Awards Program, a small grants program offering trainees up to $2000 to support initiatives that will improve patient experience of care and staff experience of caring for our patients.
    6. Case and topic-specific presentations during rotations, seminars and specialized forums including the Child Complex Case Review Conference (CCCRC) and/or the Patient Safety/Difficult Case Conference.
    7. Option of preparing a poster for Harvard Psychiatry Research and Mysell Day and CHA Academic Poster Day, as well as support for presenting scholarly work in venues such as Grand Rounds.
    8. Institutional support and funding to present original scholarly work at local, regional and national conferences.
    9. Completion and presentation of a scholarly project during the second year elective time.

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  • Supervision

    Fellows have four to six hours of supervision per week. For first-years, this includes supervision from two individual therapy supervisors, a psychopharmacology clinic supervisor and rotation supervisors.

    In their second year, the fellows have supervisors in the areas of individual, family, group and behavioral therapies as well as two psychopharmacology clinic supervisors. They also have supervisors for each rotation including school consultations and forensic evaluations.

    In addition, first and second year fellows have an administrative supervisor who helps fellows learn to manage their clinical and administrative commitments effectively and efficiently.

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