Outpatient Child and Adolescent Psychiatry
Outpatient Psychiatry is a required rotation in both the first and second years. Fellows spend 50-60% of the time in the OPD during the three Harlem-based semesters. Fellows spend 10% of their time in the Harlem OPD during their QCPC inpatient semester in order to affort them an opportunity to see patients for up to two years. Each fellow has a primary supervisor and meets weekly with a psychiatrist and a psychologist for psychotherapy supervision.
Fellows will have evaluate and treat numerous children and adolescents over the course of their training. Children range in age from 3-18 and present with the complete range of childhood psychopathology. Evaluations take place in the morning and are supervised on site by an attending Child and Adolescent psychiatrist. Treatment planning conferences give physicians in training the opportunity to work with the treatment team and to develop multimodal treatment plan for each patient. Patients are seen follow up in the afternoon; supervised opportunities to treat patients with both medication and psychotherapy are provided. The supervision is conducted both 1:1 and in groups. Special emphasis is given to evidence-based pharmacotherapy and psychotherapy. Family psychotherapy didactics and supervision with a focus on cultural competency, also is provided.
There are a variety of clinical experiences that are integrated into the outpatient experience at Harlem Hospital. These include:
Psychoeducational Testing. Many patients that fellows treat in the OPD will require psychoeducational testing. The OPD is closely affiliated with the the Developmental Evaluation Center, where psychoeducational testing is provided. Fellows will have the opportunity to attending formal didactics taught by the director of the DEC, Victoria Pinderhughes, PhD, and also to observe actual testing conducted with their patients. Finally, fellows will attending and participate in the multidisciplinary conferences that occur after occupational therapy, speech and psychological testing takes place.
Liaising with Community Systems of Care. OPD patients have many needs that need to be addressed. Our outpatient clinic collaborates with internal and external medical providers, as well as a number of local schools and agencies in order to coordinate care for our patients and families. Clinical supervisors make a point of teaching fellows how to effectively collaborate with schools and advocate for patients needs with the board of education. During the OPD experience, trainees have ample opportunities for school visits, classroom observation and formal school consultations.
Attention to Comorbid Substance Abuse. The OPD has a grant-funded program that geared toward supporting the needs of children and families whose lives have been affected by substance abuse. Staff clinicians have received special training in serving these families with individual and family-based services. families who have experienced or are experiencing difficulties because of alcohol and substance abuse. The goal is to help families overcome the negative impact of substance abuse and prevent children and adolescents from becoming chemically dependent.
Mobile Crisis Services. The OPD also has a grant-funded mobile crisis service that provides urgent evaluations in the community. Fellows and permanent staff also draw upon this service when a patient on their service needs to be visited at home. During the course of their OPD experience, fellows are encouraged to go out on home visits along with a supervising attending psychiatrist.
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