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Training in Child and Adolescent Psychiatry

The Harvard Department of Psychiatry Residency Training in Child and Adolescent Psychiatry provides clinical and educational experiences unique to each training site but draws upon the entire Harvard faculty for collaboration in education and research. The philosophy of training emphasizes direct but well-supervised clinical experiences in Harvard-Affiliated Hospitals and recognizes the salience of developmental and psychodynamic theory which is enriched by a theoretical and scientifically grounded curriculum.

Training Experiences

Supervised clinical experiences that address all core residency training requirements take place at three primary training sites: The Cambridge Health Alliance, Children's Hospital/Judge Baker Children's Center, and Massachusetts General Hospital/McLean Hospital. Each training site offers special opportunities for experiences that address the unique needs and interests of the residents. Furthermore, each training site offers supervised experiences in inpatient, consultation/liaison, community based programs, ambulatory care, school consultation, forensics, and many other specialty areas. Small group seminars and individual supervision by experienced clinicians provide a firm grounding in diagnosis and treatment on site; these seminars emphasize the more specialized nature of the theoretical perspectives and clinical environments of the individual training sites.

All residents participate in a core curriculum with a two-year cycle. The courses are presented in a seminar format, supplemented with selected readings, and encourage active participation of the trainees. Seminar speakers have been specifically selected from the Harvard Faculty on the basis of their clinical expertise and research contributions. The core seminars include:

First Year Residents

  1. Normal Development: A critical review of the theories and scientific underpinnings of cognitive-ego, social, emotional and intrapsychic arenas of development that provides a framework for integrating developmental processes.
  2. Psychopathology: This seminar integrates the perspectives on psychopathology derived from psychodynamic theory, developmental psychology, and epidemiology, and provides a critical appreciation of current diagnostic nosology and potential future developments.

Second Year Residents

  1. Clinical Integration Seminar: A unique seminar focusing on the integration of multiple clinical perspectives into a cohesive framework for clinical intervention.
  2. Quantitative Aspects of Developmental Psychiatry: This series of seminars provides the knowledge base to appraise critically future scientific developments relevant to Child and Adolescent Psychiatry. These include a user-friendly approach to statistics and experimental design, the principles of population-based studies, and an overview of developmental neuroscience.
  3. Developmental Neurosciences: This series of seminars includes sessions by basic and clinical neuroscience researchers aimed at elucidating the structural, molecular and genetic bases of normative behavior and emotional reactivity and pathologic syndromes.

Elective time is provided in the two-year training period for specialized clinical experiences or for supervised research opportunities. The Harvard environment offers extraordinary opportunities for those interested in more extensive clinical training, mastery of child therapy, or research training. There remains a strong commitment to psychodynamic psychotherapy, with many supervisors actively involved in Boston psychoanalytic institutes. Research training opportunities abound with several NIH-sponsored training grants providing fellowship positions in epidemiology, genetics, mental health services, mental health policy, developmental psychology, risk factor research, psychopharmacology, and developmental neurosciences. Applicants and trainees are encouraged to design a sequence of residency training and research training experiences consistent with their long-term career goals.

Training Sites

Cambridge Health Alliance Child and Adolescent Psychiatry Residency Training

The Cambridge Health Alliance Division of Child and Adolescent Psychiatry provides inpatient, outpatient, partial hospital, emergency, and acute home-based services to children, adolescents, and families. A full range of diagnostic assessments and multidisciplinary treatment is provided on two inpatient units, one for children up to age 12, and one for adolescents aged 12 to 19. Outpatient services include individual, group, and family therapy, psychopharmacology, neuropsychological evaluation, assessment of school functioning, cognitive behavioral interventions, and consultation to pediatricians and schools. Under the current curriculum, eight hours a week are dedicated to didactic learning. Weekly seminars cover a variety of topics pertinent to our field including psychotherapy, psychopharmacology, behavioral therapies, child development, research, and research methodology. Clinical rotations are offered in inpatient and outpatient child and adolescent psychiatry, consultation/liaison psychiatry, school consultation, learning disabilities, pediatric neurology, forensic and probate work, substance abuse, and emergency/outreach services.

The Training Program in Child and Adolescent Psychiatry explores the psychosocial and psychodynamic elements of clinical intervention and development, including the normal, the resilient, and the pathological dimensions. . Exposure to a broad array of therapeutic modalities affords the Fellows flexibility in their treatment choices, thereby giving them the tools to meet the unique needs of each patient. We incorporate both didactic and supervised clinical experiences to provide the Fellows training in this integrative approach. Our training program recruits five Fellows per year for its two year training program. Fellows begin their outpatient experience their first year in order to follow patients over a two year period. In addition, the first year Fellows rotate through the outpatient diagnostic team to begin to learn the skills needed to conduct both outpatient and inpatient assessments. The second year is focused on seeing a diverse outpatient population in several settings. Elective time is an important component of our training program because it allows the fellows to pursue their individual interests. The Division of Child and Adolescent Psychiatry maintains a dual commitment to service and training. It is our clinical mission to provide the highest level of service to the full spectrum of socioeconomic, ethnic, and linguistic populations in our service area and to do so in a manner that emphasizes patient access, clinical flexibility, and the highest standards of care. Equally important, our academic mission is to provide a training experience that reflects our clinical values while teaching an integrated approach to the care of children, adolescents, and their families.

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The Children's Hospital Training Program in Child and Adolescent Psychiatry

Children's Hospital, with over 300 beds, is the largest and best-known pediatric hospital in the United States. It is world-renowned for its clinical and research work with children and adolescents. Its faculty includes outstanding clinicians and researchers in almost all areas of Pediatrics and Child and Adolescent psychiatry. Its training programs are outstanding, offering cutting edge experiences in all aspects of the clinical care of children. The hospital serves as a primary and tertiary care center for Metropolitan Boston and beyond. It is dedicated to providing care for all children and spearheads many national efforts as an advocate for the well being of the next generation. The Department of Psychiatry, with over 14,000 outpatient visits annually, offers the entire range of clinical services for children. The Department has a very strong and active consultation-liaison service and an 18-bed inpatient unit providing clinical care for Boston's most disturbed children. The Department has a very strong and active consultation-liaison service and an 18-bed inpatient unit providing clinical care for Boston's most disturbed children. Additionally it offers on-going affiliations with the Boston Latin High School, the Cambridge Court Clinic and numerous community sites. There are extensive elective opportunities within the Department. The combination of diverse clinical opportunities coupled with a carefully planned didactic program provides trainees with rich training in Child and Adolescent Psychiatry. Grounded in the developmental and psychodynamic roots of the field, it provides a contemporary but balanced approach to individual short and long-term work, family and group therapy, behavioral medicine, consultation/liaison work, crisis intervention and psychopharmacology among others. The Department has a national reputation for its research work focusing on prevention, risk factors, affective disorders, clinical outcomes and the interface between Pediatrics and Psychiatry. There are many opportunities for trainees to collaborate in these efforts

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Massachusetts General Hospital/Mclean Hospital Training Program in Child and Adolescent Psychiatry

Massachusetts General Hospital (MGH) is one of the nation's most renowned teaching hospitals. It is an internationally recognized primary, as well as tertiary-care facility. Founded in 1811, its initial charter states its tripartite goals of patient care, physician training, and research into the causes of illness. The MGH Psychiatry Service is an active partnership between the academic teaching hospital and the public sector community health system. The Service has 482 faculty composed of 286 psychiatrists, 180 psychologists, and 16 representatives of epidemiology, psychobiology, public administration, biostatistics, and neurochemistry. The Service maintains a pluralistic orientation with practitioners and academicians of various theoretical persuasions and clinical orientations working together and learning from each other. The Child and Adolescent Service maintains an extensive outpatient clinic with multiple subspecialty divisions, an active consultation service to pediatrics, the Cancer Center and the general hospital emergency department, and close ties to the Shriners Burns Institute, the Spaulding Rehabilitation Center, the Boston Juvenile Court Clinic, and the Eric Lindemann Mental Health Center, along with its affiliated public sector neighborhood community clinics and public schools. MGH provides in-depth training experience in psychodynamic psychotherapy, family therapy, behavior and cognitive therapy, group therapy, psychopharmacology, consultation-liaison psychiatry to the department of pediatrics, emergency department, and to local schools, courts and community agencies, and experiences in a wide range of psychiatric research. Among its faculty are outstanding clinicians and investigators in psychopharmacology, psychotherapies, behavioral medicine, eating disorders, substance abuse, psychiatric trauma, childhood psychopathology, genetics of psychiatric disorders, adoption and custody, forensic psychiatry, community psychiatry, mental health and media, and psychiatric education.

McLean Hospital is the largest psychiatric teaching facility of Harvard Medical School. Founded in 1811 as the original psychiatric department of the MGH, it moved to Belmont in 1895. McLean Hospital operates the largest psychiatric neuroscience research program of any Harvard University-affiliated facility and of any private psychiatric hospital in the country. The Child and Adolescent Program at McLean Hospital is one of the foremost clinical programs for helping young people and their families copy with psychiatric illness and the challenges it often brings. There are extensive ties with community services, and each therapeutic program of children and adolescents in inpatient, residential and outpatient services is tailored to the specific needs of the child and family. McLean Hospital offers a full range of services: acute inpatient, partial hospitalization, short- and long-term residential, outpatient treatment and specialized academic programs. McLean has three special education schools and a Learning Evaluation Clinic. The Outpatient Services offer comprehensive treatment, including individual, group and family therapy and medication management. Specialty clinics in pediatric psychopharmacology serve children with Tourette's disorder, obsessive compulsive disorder, attention deficit hyperactivity disorder, mood disorders, psychosis and developmental disorders. The faculty conducts extensive research in developmental disabilities, childhood psychosis, genetics of psychiatric disorders, neuroimaging, substance abuse, group psychotherapy, dialectical behavior therapy, and a wide range of psychopharmacological studies of child and adolescent psychiatric disorders.

For further information about Harvard Residency Training in Children and Adolescent Psychiatry, or an application, please contact:

Cynthia Telingator, M.D.
The Cambridge Health Alliance
1493 Cambridge Street
Cambridge, MA 02139
e-mail: ctelingator@challiance.org
617-665-1587

or

Enrico Mezzacappa, M.D.
Children's Hospital
300 Longwood Avenue
Boston, MA 02115
e-mail: Enrico.mezzacappa@childrens.harvard.edu 617-232-8390

or

Eugene Beresin, M.D.
Massachusetts General Hospital
Department of Psychiatry, Bulfinch 449
Boston, MA 02114
e-mail: eberesin@partners.org
617-726-1620

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Department Of Psychiatry Harvard Medical School - 2 West - Room 305 - 401 Park Drive - Boston, MA 02215