The Child and Adolescent Psychiatry Outpatient Clinic rotation spans both years of training. The first year caseload consists of six to seven therapy cases along with ongoing weekly evaluations of new cases referred to the clinic. The second year caseload consists of seven to eight therapy cases and ongoing weekly evaluations. The therapy cases cpme from the three age groups with various diagnoses and are treated with individual (brief and long-term) therapy, family therapy, and medication when indicated. All trainees have separate supervisors for evaluation and treatment cases, and meet with these supervisors weekly. Each trainee has an average of five hours/week of supervision.
Clinic faculty consists of psychologists, child and adolescent psychiatrists, a psychiatric nurse practitioner, social workers, voluntary faculty who spend one to two hours weekly supervising child and adolescent psychiatry trainees, triple board trainees, general psychiatry residents, psychology externs, and postdocs.
There is a one-hour weekly teaching intake conference where emphasis is placed on differential diagnosis and treatment planning. The Training Director and clinic Medical Director periodically review caseloads to ensure that each trainee has exposure to a wide variety of cases. The various components of the rotation, including ongoing treatment, evaluations, medication treatment, and crisis intervention, are assigned as separate sub-rotations to make certain that adequate time is spent in each of these activities.
The clinic population is 60 percent male and 40 percent female; 50 percent African American; 40 percent Latino; 10 percent Caucasian. Children and adolescents ages four to 18 years are seen in the clinic, as are families when appropriate. Review of diagnostic categories indicates that the diagnostic mix is approximately 10 percent adjustment disorders; 40 percent disruptive behavior disorders; 20 percent depressive disorders; 15 percent anxiety disorders, 10 percent PTSD, 3 percent Psychotic Disorders and 1 percent pervasive developmental disorders.
Trainees are paired with social workers in the clinic and are available for consultation to patients who need psychopharmacological interventions. Trainees also interface with various community agencies as follows:
- Schools and the Committee on Special Education of the Board of Education (CSE) to help in educational planning.
- The Administration for Children's Services (ACS) in cases of child neglect, and physical/sexual child abuse.
- Community agencies including foster care agencies, mentoring programs, and other mental health service providers.
- The judicial system (e.g., Legal Aid Society, Lawyers for Children, Family Court).
Trainees have a weekly clinic scheduled. During this clinic time medication evaluations are completed and medication management appointments are scheduled.
Trainees evaluate and provide follow-up for patients in crisis. Referrals may come from existing clinic patients or from the emergency room. Patients are usually seen intensively for a brief period of time in order to facilitate stabilization and help the patients and their families manage until ongoing treatment can be initiated. Extensive supervision is provided for the resident working with such patients.
One Gustave L. Levy Place
New York, NY 10029