Child & Adolescent Psychiatry Residency

Several additional institutions in the area work with the residency program to provide other opportunities for rotations.

training
goals

 

Affiliated Training Sites

Residents will spend core rotations at the Boston Juvenile Court Clinic and multiple schools within the Boston Public School System. With permission of the Training Director, elective time may be spent at other affiliated institutions described below or at any clinical or research facility in the metropolitan Boston area. The elective time is offered to permit clinical, academic and research experiences in diverse facilities.

Arlington School
This 11-month per year day school, located in a historic building on the Belmont campus, with full approval status by Department of Education (DOE), serves up to 50 college-bound middle and high school students who have significant psychiatric challenges. It is under the direction of Karen Clasby.

Boston Juvenile Court Clinic
The Boston Juvenile Court Clinic is one of the oldest juvenile court clinics in the country. The Clinic provides evaluation and some treatment services for the Boston Juvenile Court, seeing about 900 individuals referred by the court annually. The referrals typically involve cases of delinquency, status offense and child abuse matters, with problems related to a high prevalence of exposure to various types of trauma, as well as associated anxiety and mood disorders, substance abuse problems, disruptive behavior disorders, learning disorders and personality disorders. Faculty consists of a multidisciplinary team providing evaluation, consultation and treatment services for the court. The Clinic has an active research program, largely examining post-traumatic stress disorders, and an eight-year longitudinal study of abused and neglected children. Residents will have opportunities to visit the courtroom, consult to attorneys, probation officers, judges and social service agency workers and may serve as expert witnesses in cases evaluated. The Clinic has close ties with the Children and the Law Service, a division of the Law and Psychiatry Service of MGH.

Brockton Public Schools Therapeutic Support Program
This program serves 150 elementary, middle and high school students in a combination of neighborhood and substantially separate (.4i) schools in the city of Brockton. Each of these students is at high risk for dropping out of district day or residential school placement, or for suspension or expulsion because of behaviors and disabilities related to their psychiatric disorders and/or psychosocial duress. McLean’s clinical team provides intensive case management, consultation and education to the faculty and staff and succee at local school placements. The Program Director is Diane Gallagher.

Massachusetts General Hospital Center for Mental Health and Media
The Center for Mental Health and Media is an outreach, production and research center devoted to mental health, behavioral health, neuroscience and healthy child development. Founded in 2001, this is the first organization of its kind in the United States to combine in-depth knowledge of mental health, public health and behavioral science with sophisticated media communication skills.

The Center, under the director of Larry Kutner, Ph.D., Cheryl Olson, M.P.H., S.D., and Gene Beresin, M.D., is a division of the Massachusetts General Hospital and an affiliate of Harvard Medical School. It collaborates with Harvard colleagues across institutions and disciplines.

Research shows that Americans get much, if not most, of their mental health information from media news and entertainment. Some programs perpetuate myths and misinformation. But when used well, the many forms of mass and targeted media—including newspapers, radio, television, and the Internet—can counter the inaccurate and destructive stereotypes. They can also provide information, reassurance and perspective that can transform the lives of mentally ill people and their families.

To accomplish these goals, the Center:

• Designs and produces media-based behavior change programs for a variety
of audiences, using a wide range of media.

• Consults on mental health issues to media producers and journalists.

• Educates the public and policymakers about mental health and media issues.

• Teaches academics and health professionals how to work more effectively with
media professionals.

• Conducts research on media effects, and the effectiveness of media programs
and campaigns.

 

Kennedy Hope Academy
This year-round residential school is a joint venture of McLean and the Franciscan Children’s Hospital and Rehabilitation Center. Located in Brighton on the Franciscan campus, Kennedy Hope serves up to 14 children and adolescents who present with a combination of mental retardation and/or autistic spectrum disorders together with severe psychiatric and behavioral challenges. Many of the students also have significant medical and neurologic disorders. A positive behavioral support version of applied behavioral analysis supplements intensive family and individual therapy, state-of-the art diagnostics and psychopharmacology, round-the-clock pediatrician availabilty and individually tailored educational plans. Program Director is Jonathon Simmons, Ph.D. and Medical Director is John Julian, M.D.

Pathways Academy
This year-round day school with full approval status by DOE serves up to 32 students ages 6 to 22 who have Asperger’s and related disorders as well as co-morbid psychiatric conditions. Small classrooms feature a social and language pragmatics approach with full-time occupational therapist, speech and language therapist and developmental neuropsychologist. It is located on the Belmont campus in space designed and renovated to meet the specific sensorimotor needs of this population. Pathways Academy, under the leadership of Helen Murgida, is part of the McLean Center for Neurodevelopmental Services (CNS), which also includes the summer day Camp New Connections. The CNS is led by Roya Ostovar, Ph.D.

Shriners Burns Hospital
Residents may rotate through the Shriners Burns Hospital in their first- or second-year elective time. The Shriners Burns Hospital is an international referral center for burn injuries and a major center of research on burn injuries in children and adolescents. It is located across the street from Massachusetts General Hospital. A splendid new nine-story hospital opened on the same site in December 1995. There are extensive opportunities for child and adolescent psychiatric research: diagnostic, psychotherapeutic and psychopharmacological. There are two inpatient units: a 12-bed acute burn unit and an 18-bed plastic and reconstructive surgical unit. Approximately 7,000 children who have survived burns are followed at the hospital, seen in the clinic and periodically readmitted. Many patients are under 5 and all ages through 19 are represented. All patients have acute or postoperative pain management problems.

Approximately 505 have PTSD symptoms, 20% ADHD, 20% conduct disorders, 25–35% mood disorders, up to 60% phobic anxiety disorders and about 10% enuresis at some time. The population includes normal children, but also those who are accident-prone, neglected or abused children and children of parents with PTSD, depression or alcoholism. Many children and families have survived near-death experiences due to burns or have grieved the loss of a loved one. Modalities include diagnostic assessment, preoperative preparation, crisis intervention, short- and long-term psychotherapy, group and family therapy, hypnosis and pharmacotherapy. There are extensive opportunities for child and adolescent psychiatric research. Average caseload consists of two to six inpatients. The residents may perform two or three outpatient consultations during a 10-week rotation. All residents have individual once-weekly supervision, as well as conferences and seminars. Faculty consists of one two-thirds-time senior child and adolescent psychiatrist, one half-time pediatrician, two full-time trauma surgeons, several part-time plastic and reconstructive surgeons, one half-time psychologist, three full-time social workers, one fifth-time senior research child and adolescent psychiatrist, one half-time child psychiatry research fellow and other staff in associated disciplines, such as anesthesiology, nursing, physical therapy and special education.
 
Spaulding Rehabilitation Hospital
Spaulding Rehabilitation Hospital is the largest rehabilitation hospital in the region. Spaulding has 284 beds and treats more than 3,000 inpatients a year. It includes a 19-bed pediatric rehabilitation unit, one of the few such units in the area. The clinical program consists of a broad range of pediatricians and specialists. Referrals come primarily from New England but are also from other states and foreign countries. The children range in age from infancy to 22 years and come from a very broad range of socioeconomic backgrounds. They demonstrate a variety of medical problems requiring intensive rehabilitation. The average length of stay is approximately one and a half months, ranging from one week to two years. The children’s associated psychiatric diagnoses vary considerably. Organic mood disorders, major depression, post-traumatic stress disorder and adjustment disorders are frequently seen.

Spaulding is located five minutes from the Massachusetts General Hospital and 30 minutes from McLean Hospital. Child psychiatry residents may rotate, part-time in either year, for three to six months. Consultation experience is required but Spaulding, as a placement, is elective. The faculty consists of one half-time child psychiatrist. The residents attend the pediatric psychiatry consultation rounds at the Massachusetts General Hospital, as well as the child psychiatry rounds at Spaulding.

Residents completing this elective are at Spaulding 10 to 12 hours weekly over two or three days and have responsibility for two or three pediatric inpatients and their families. Treatment approaches include individual psychotherapy, family therapy, group therapy with adolescents and psychopharmacotherapy. Behavior modification programs are also utilized. The residents are supervised individually by the staff child psychiatrist.