Child & Adolescent Psychiatry Residency
Curriculum

The curriculum provides a broad range of clinical and didactic training experiences which have been developed by the residency training committee team and continues to evolve based on fellow feedback.

First Year

First year fellows will learn fundamental skills such as how to gather developmentally appropriate psychiatric history, perform a developmentally appropriate mental status exam, and obtain collateral information from families, primary care physicians, and schools. Having such skills, fellows will then be able to develop differential diagnoses, biopsychosocial formulations, and treatment plans. Fellows will rotate through our child and adolescent inpatient units, the pediatric emergency department and consultation liaison service, and outpatient pediatric neurology and genetics clinics. Additionally during two months of community rotation, fellows get the unique opportunity to rotate in pediatric subspecialty clinics in endocrine and adolescent medicine, where they get exposure to adolescents struggling with gender dysphoria as well as disordered eating. Fellows also join a public school psychiatry consultation as well as interventional psychiatry clinics including TMS, ECT, and esketamine. Fellows will carry both individual (play and CBT) and family therapy patients during their first year with weekly individual supervision and group supervision as well. Fellows will also be able to competently prescribe psychiatric medications to adolescents and children and have knowledge of their indications, adverse reactions, typical doses, therapeutic ranges, potential interactions with other medications, and signs and symptoms of toxicity. By the end of the first year, fellows should be able to provide competent child and adolescent psychiatric evaluations and recommendations, manage crises, and offer consultations to other medical services.

Second Year

The second year of training is devoted to treating children and adolescents with psychiatric disorders with more autonomy, honing skills learned in the first year. Fellows will experience junior attending roles as they rotate through our partial hospitalization programs, extended day treatment program, and ED rotation. Fellows will also have the unique opportunity to rotate with the on-site therapeutic school, inpatient autism unit, and adolescent substance abuse/dual diagnosis program. Fellows will also rotate with the outpatient autism clinic, the pediatric metabolic clinic, and the young adult collaborative care program. They are also given a unique opportunity to be in a role of medical educator to junior tyrainees. Second year fellows are given four months elective time to pursue clinical interests and/or research that inspires them, and will be fully supported and mentored to design their own rotation. Second years fellows will carry their caseload of outpatients as well as continue learning therapy by conducting individual and family therapy, psychodynamic therapy, cognitive behavioral psychotherapy, play therapy, brief psychotherapy, and therapy combined with medication management. Second years fellows are given two weekly individual psychotherapy supervisors for additional support and breadth of learning. Fellows are encouraged to fulfill teaching and leadership roles during their rotations, didactics, and at community presentations, conferences, and grand rounds.

Didactic Learning

Administrative Psychiatry and Leadership (APL)

The Administrative Psychiatry and Leadership seminar series is a two-year curriculum led by course directors Dr. Malik and Dr. Joychan, covering a variety of topics essential for a child psychiatry fellow’s personal and professional development. Session topics may include:

• Systems of care and the child psychiatrist’s role as a leader, team member, and advocate
• Career planning, including job search, contract negotiation, interview skills, and a panel of guest speakers from various clinical settings
• Financial planning, including disability insurance and retirement planning
• Leadership skills, including conflict management, leadership qualities, communication styles, team building, and psychological safety

Advanced Principles of Child Psychiatry (APCP)

This is a two-year longitudinal course using problem-based and case-based learning to cover major diagnostic areas, as well as audio-visual presentations to review seminal articles and related neurobiology. Break-out groups in class promote active learning and allow the group to drive the treatment planning for the case.

Advanced Formulation

Sessions focus on broadening and deepening our understanding of our patients, by reflecting upon the culture, religion, and community that surrounds them.

Clinical Skills Verification (CSV’s)

To assist with meeting the Clinical Skills Evaluation requirements established by the ACGME and ABPN, our program creates opportunities twice yearly for our fellows to participate in CSV evaluations. We are fortunate to offer our fellows the oral board examination experiences with both school-aged children and adolescents. We host the multi-site CSV in the late fall, and we visit another local child psychiatry training program for the spring CSV, maximizing the diversity of our board examiner pool. We offer CSV preparation classes and provide opportunities for practice CSV’s to our fellows as well.

Craft & Art of Psychotherapy (CAP)

Using readings, case studies, and videos, this two-year longitudinal course utilizes a developmental perspective to cover the theoretical principles of child and adolescent development and explore the application of play therapy and other therapeutic modalities over the course of development.

Complex Case Conference

We have partnered with the Child & Adolescent Psychiatry Fellowship programs at University of Connecticut Health, Creighton University Medical, and University of Tennessee Health Sciences Center to develop an interinstitutional case conference, where each program presents a complicated and unique case on a rotating basis via Zoom. A panel of experts joins the discussion as well.

Consultation Liaison Teaching Rounds (Ted Talk Tuesday)

Weekly class sessions occur during the four-month C/L rotation, in which the fellow or psychology trainee presents an interesting case, generating discussion regarding hypotheses and potential differential diagnoses. Following the case presentation, every participant returns the following week to give a 10-minute expert talk on their assigned question.

Continuous Case Conference

This monthly seminar is hosted by a psychotherapist/child psychiatrist who have expertise in infant mental health and parent consultation and are interested in the process of therapeutic change, integrating developmental theory with psychoanalytic theory. This instruction offers group supervision.

Diversity, Equity, Inclusion and Justice (DEIJ)

This seminar is a two-year curriculum led by course directors, Dr. Malik and Dr. Joychan. This seminar aims to educate trainees on the roots of structural racism and healthcare disparities, address DEIJ-related issues in learning and healthcare environments, emphasize the importance of dialogue, and discuss how to advocate for and create meaningful change in their communities and the healthcare system. Topics covered include racial trauma, structural racism in psychiatric practice, implicit bias, microaggressions, social determinants of health and mental health, and cultural competency.

Family Therapy

This monthly course focuses on the principles and practice of working with children and their family systems. The major theoretical frameworks, including Structural Theory and Object Relations Theory, are reviewed. Techniques for each phase of the family therapy process are explored. The fellows learn through a combination of reading, discussion, role-play, case material, and videos how to apply the theoretical framework effectively in clinical practice.

Forensics

This two-year longitudinal course is dedicated to understanding the role of the child psychiatrist in clinical forensic child psychiatry. Lectures focus on teaching the legal and theoretical background of forensic practice. Faculty case presentations serve to illustrate clinical application to forensic practice and emphasize principles of advocacy.

Infant and Parent Mental Health

Seminar by Dr. Alexandra Harrison.

Introduction to Psychoanalytic Theory

Taught by psychoanalysts, this course covers the development of psychoanalytic theory from early Freud to the present. Major developments in the field are discussed using selected readings. The focus is on an understanding of the essential features of drive, psychology, structural theory, ego, psychology, object relations theory, and self-psychology. Applications to clinical work across the lifespan are a constant feature.

Live Interview Course

This is a quarterly course allowing a variety of faculty to demonstrate an interview with a new child or adolescent, modeling different techniques for engagement while accessing the child’s life story as it relates to their current struggles. The fellows practice their formulation skills and review as a group the following week.

Law, Ethics, and Psychiatry

This seminar emphasizes the critical appraisal of current trends and controversies in the field. Special emphasis is placed on the interface of medical-legal and ethical issues. Fellows present papers that serve as a springboard for in-depth discussion.

Occum’s Razor

This is a monthly seminar focused on sharpening clinical thinking throughout a journey of exploration triggered by recent clinical experiences.

Psychopharmacology and Pharmacogenomics

This is a monthly seminar hosted by a pharmacy professor, an expert in pharmacogenomics, and a child and adolescent psychiatrist designed to review the basic and more advanced elements of prescribing and monitoring psychiatric medications. Discussion of clinical presentations, along with pharmacokinetic gene abnormalities and drug interactions, guide treatment planning. Clinical pearls are shared, and consultation is readily available.

Special Topics

This is an exciting two-year longitudinal seminar led by expert guest lecturers on a variety of current topics, including infant mental health, refugee mental health, sexual trafficking, cannabidiol oil research, and private practice.

Reactions to Patients – “T” group with Dr. D and Dr. S

The practice of child and adolescent psychiatry involves key skills of observing, listening, and taking note of our own affective experience. Since our patients and families often seek our help during times of crisis or instability, it is important that we recognize the emotional reaction that our patients’ circumstances evokes within us as clinicians. This course allows for an open, confidential, and nonjudgmental discussion of the challenges inherent in treating children and families, through dissecting our own emotional experience treating them. Each week a fellow presents a challenging case (from an affective or treatment standpoint) in order to learn about the way in which our reactions inform a deeper understanding of our patients and consequently our therapeutic interventions.

Youth Culture

This fun quarterly course uses the venue of viewing films or trending modalities (gaming, Tik Tok videos, etc) to examine current trends among today’s youth or clinically relevant topics. Fellows, with the support of a faculty mentor, discuss the role of development, culture, social media, peer influence, and community, and how they intersect to contribute to the youth’s presentation.