Child and Adolescent Psychiatry Fellowship

Introduction to Child and Adolescent Psychiatry (Summer Orientation)
This course is an introduction to the practical and theoretical aspects of child psychiatry including basics of assessment, interview techniques, psychological testing, child development, psychopathology, and psychopharmacology. The course consists of one-hour sessions five times/week for 10 weeks over the summer and includes and overview of various pathological entities, psychotherapeutic techniques, research issues, and ethical and forensic issues. Sessions are varied and may consist of lectures, video presentations, demonstration interviews and discussions of readings.

Normal Development and Developmental Psychopathology
This is an integrated course in normal child development and child and adolescent psychopathology presented in a biopsychosocial and developmental framework. It occurs weekly for 40 sessions every other year. Within each of the four modules (Infancy, Toddler and Preschool, Middle Childhood, and Adolescence) classical studies as well as more recent research findings are presented. Teaching consists of a mixture of lectures, seminar/discussions, case histories, videotape examples and live presentations of normal children, and patient interviews. Fellows may give presentations from their own caseloads. Required readings are distributed weekly to be read prior to the session. There is a selected core bibliography that includes Spitz, Bowlby, Piaget, Erikson, Ainsworth, Rutter, Kagan, Kohlberg, Offer, and others.

Research Methods in Child and Adolescent Psychiatry
This is a 12-session module given in alternating years to provide trainees with knowledge of library search methods, experimental design, observation and measurement techniques, statistical methods, and the analysis of behavioral data. Current data papers are also used to evaluate experimental design. Research questions from trainees who may be involved in research electives are encouraged.

Theories and Practice of Family Therapy
This is an intensive eight-session course in techniques of family therapy with particular focus on clinical situations in which children and adolescents are considered to be the identified patient. Instructors from diverse backgrounds and disciplines contribute to the teaching. Videotapes and readings are used.

Classical Readings in Child and Adolescent Psychiatry and Psychoanalysis
This 12-session class provides a theoretical background for child psychodynamic/psychoanalytic and developmental theories. Readings include works by A. Freud, D.W. Winnicott, H. Harlow, J. Bowlby, J. Itard, W. Gull, L. Kanner, M. Rutter, and D. Stern.

Basic Neurobiology and Clinical Psychopharmacology of Child and Adolescent Disorders
This is a 36-sessions course in which seminal papers on theories of neurochemistry of brain functioning and the neurochemical mechanism of psychoactive drugs are reviewed. Data from controlled clinical medication trials are then presented for each group of disorders seen in children and adolescents. There is an attempt to integrate the clinical psychopharmacology and the neurobiological basis of disorders. In addition, practical issues in pharmacotherapy including FDA approved and off-label indications, dosage, techniques of clinical management, and side effects are discussed. Both traditional and experimental drug treatments are presented, but ethical issues in the use of off-label treatments, issues of informed consent, and conservative management are emphasized.

Child and Adolescent Psychopathology
This is a 36-session course during which members of the full-time faculty and selected voluntary attendings provide instruction regarding the full range of childhood and adolescent psychopathology. Lectures, discussions, readings, and case examples are all used. The course provides a conceptual approach to diagnosis and reviews empirical data related to the DSM-IV, reviewing all the DSM-IV syndromes. There is detailed teaching of diagnostic criteria, etiology, and clinical course of these disorders. Journal articles, chapters, review articles (including the JAACAP 10-year reviews series), and AACAP Practice Guidelines are used as the basis of discussion.

Therapeutic Interventions
Over the course of 36-sessions, trainees are taught principles of treatment and practical aspects of a full-range of therapeutic modalities used in the treatment of children and adolescents. Initial topics covered include individual psychotherapy, the role of play and types of play therapies, cognitive and behavioral therapies, crisis intervention, group therapy, techniques of brief therapy, theories and practice of inpatient and residential treatment, cultural issues in treatment, work with community agencies and schools, and a variety of interdisciplinary treatments (e.g., educational remediation, speech and language therapy, use of creative arts). Later in the course, a rationale is presented for the use of combinations of therapeutic interventions in the treatment of specific disorders and special populations (e.g., autism, mental retardation, suicidal behaviors, HIV, working with chronically medically ill children, physical and sexual abuse, psychosis, mood and anxiety disorders, disruptive disorders, elimination and feeding disorders). Throughout the seminar AACAP Practice Parameters are reviewed and discussed.

Ethical and Forensic Issues in Child and Adolescent Psychiatry
This is an eight-session course in which both forensic and ethical issues are presented. Readings are assigned for each session. Topics in the forensic section of the course include the Tarasoff decision to warn/protect, civil commitment, voluntary/involuntary treatment of minors, termination of parental rights, adoption, divorce, child abuse, the child as witness, juvenile delinquency and family court, and providing expert testimony. Topics in the ethics section of the course include principles of medical ethics, ethical issues in pediatric psychopharmacology, ethical issues in research, and ethical issues in the practice of psychotherapy.

Psychiatric Practice / Transition to Practice
This eight-session series reviews a variety of topics crucial to the practice of psychiatry. Topics include an introduction and overview of managed care, utilization management, quality assurance, an overview of practice opportunities, transition to various private practice settings after training, an overview of financial planning and insurance including personal and professional liability insurance, disability and life insurance.

Cognitive-Behavioral Therapy
The Director of the Eating and Weight Disorders Program offers a three-month, weekly course in the theory and practice of cognitive behavioral therapy (CBT). This course covers foundation principles of CBT, as well as applications for a range of disorders including anorexia nervosa, bulimia nervosa, binge eating disorder, panic disorder/agoraphobia, obsessive-compulsive disorder, and major depressive disorder. Lectures for each disorder include the cognitive model, efficacy findings, research on combining CBT with pharmacological treatment, specific techniques and their theoretical underpinnings, and a review of the treatment protocol with case examples.