Rotations
Child and Adolescent Inpatient Units
The Child and Adolescent Psychiatric Inpatient Units are acute-care facilities that serve patients ranging in age from 5 through 17 who present with a broad range of extreme psychiatric, developmental and learning disorders. The units strive to consider all factors that can affect the adjustment, psychopathology, evaluation, and treatment of patients, including psychiatric, socio-cultural, and family variables. Patients receive intensive, individualized attention to their multiple needs. The interdisciplinary staff works together closely to provide patients with a therapeutic milieu that incorporates academic and recreational activities as well as parental psycho-education in the form of a weekly “Family Night” led by the Nursing staff. An on-site special education school, P.S.35M, provides special education and related services staff to all patients.
Inpatient Unit rotation requirements are as follows:
Externs completing the inpatient rotation will be required to work two mornings a week, from 9:00 a.m. to 12:00 p.m., over the 6-month-long rotation. Primary responsibilities will include providing direct care to patients on both units in the form of psychological assessment, collateral interviews, and participation in unit social skills groups. Psychological testing is tailored to the needs of the patient, and may include cognitive, projective, and neuropsychological measures. Each unit also provides opportunities for training in evaluating and interviewing new patients. Trainees will be expected to attend and participate in treatment team meetings with interdisciplinary staff, conduct special education classroom observations, hold and/or attend collateral meetings with caregivers and outside agencies, and attend related case conferences and didactic seminars. Opportunities for co-leading a psychotherapy group on the adolescent unit will be available as staffing and unit needs permit.
While this rotation can be challenging, trainees may expect a very rich, diversified and rewarding training experience. Supervision will be provided daily in individual and group formats. Within the parameters of these requirements, each trainee’s experience will be individualized according to interest, training needs, graduate program requirements, and patient needs.
Child and Adolescent Psychiatry Clinic (In addition to being a rotation option, all externs are required to spend one day a week in this clinic for the duration of the training period)
The Clinic provides outpatient psychiatric treatment to children and adolescents from two to eighteen years of age from a multicultural and multilingual population.
Externs will be required to undertake the following duties:
- Co-lead outpatient psychotherapy groups for patients attending the hospital-based special education school, P35M (12:1:1 school at Bellevue Hospital). Externs will also have the opportunity to co-lead English-speaking and Spanish-speaking parenting groups for parents of children & adolescents in the Child & Adolescent Psychiatry Clinic.
- Carry a caseload of three outpatient psychotherapy cases. Given individual interests, the option of treating additional patients will be possible.
- Perform psychological testing and assessment.
- Observe intakes, which include psychosocial history, mental status examination, diagnosis and initial treatment planning.
- Participate in group and individual weekly supervision.
Pediatric Psychiatry Consultation Liaison
This is a closely supervised child rotation most suitable for externs with interest in developing evaluation and psychological assessment skills with the child and adolescent outpatient population. Externs will be exposed to children and adolescents with complex psychiatric and medical presentations within the Pediatric Psychiatry Consultation Liaison Clinic and the specialized School Function Clinic.
Training opportunities:
- Psychosocial intakes with children, adolescents, and their families. Patients are drawn from a general pediatric population that includes all outpatient medical specialty clinics and inpatient pediatric medical unit. The patients range in age from birth to 22 years.
- Psychological, educational, neuropsychological, and projective assessments. This includes exposure to a host of assessment instruments for all age levels. Experience with administration, data interpretation and report writing that emphasizes recommendations for placement, resources, and in-class accommodations.
- Collaboration with an interdisciplinary team of psychologists, psychiatrists, social workers, and pediatricians.
- Exposure to NYC and private school systems, implementation of accommodations and class placement based on patient’s particular learning and emotional needs.
- Participation in weekly interdisciplinary case conference and opportunity to present diagnostic case material from intake, family, and patient interviews. Presentation in bi-monthly Psychological Assessment case conference.
Requirements: Externs must have a) previous experience with child population in a psychiatric/ clinical setting and b) some previous child testing experience.
Pediatric Infectious Diseases
Externs work in the Pediatric Infectious Disease Clinic, providing clinical care to children, adolescents, and young adults who are HIV/AIDS infected. They also provide care to parents and sibling of those diagnosed with HIV/AIDS. Psychology referrals in the PIDC typically include anxiety disorders, depressive disorders, and behavioral disorders. Education on HIV/AIDS is provided through Infectious Disease Grand Rounds and individual meetings with the on-site HIV health educator.
Under supervision, externs conduct individual therapy for patients. They are also trained to conduct annual mental health assessments, which include administering the standard testing battery, writing reports, and providing feedback to families. Additional opportunities for school consultation may be available. Co-facilitating therapy groups may be available as well. Externs also have the opportunity to participate in ongoing clinical research projects.
Administration for Children’s Services-Bellevue Mental Health Service
The Administration for Children’s Services is the New York City agency responsible for child welfare and protection. The ACS-Bellevue Mental Health Service acts as a consultation service for the ACS Pre-Placement Services by identifying the mental health needs of children and adolescents removed from their homes by the child protective system and brought to the ACS Children’s Center (located next door to Bellevue Hospital). These children and adolescents are temporarily housed at the center (normally between 24 and 72 hours) until they are returned to their homes or until foster care placement is secured for them. Neglect, physical abuse, and sexual abuse are but a few of the reasons they are removed from their homes.
The program is the only service in the country where a mental health team is on site within the pre-placement phase of child protective services. Common referrals to the ACS-BMHS are due to concerns regarding oppositional and disruptive behaviors, truancy, educational problems, emotional distress and traumatization, risk assessment, medication questions, and juvenile justice issues. The ACS-BMHS provides multiple psychiatric and psychological services including psychiatric clearances, mental health evaluations, crisis interventions, brief supportive therapy, therapeutic/activity groups, and in-service training workshops.
This is a unique elective opportunity for those individuals who have interests in the areas of attachment, trauma and loss, forensic psychology, community mental health, juvenile justice, and foster care. Clinical responsibilities include:
- Conducting supervised mental health evaluations and diagnostic assessments of children and adolescents referred to the ACS-BMHS.
- Performing psychological assessments.
- Engaging in individual and group psychotherapy.
- Intervening when crises arise.
- Participating in and giving a presentation in multidisciplinary rounds and in-service training.