Aside from the typical features of
most Child Fellowship programs, the University of California Irvine Program
offers a number of unique opportunities.
Partial Hospitalization Program
The
partial hospitalization program is a day program which will encompass
school, group, individual therapy, as well as family therapy for up to 12
children and adolescents frin age 11 to 18. Fellows will rotate on this
unit, under supervision of child psychiatry attending, Dr. Alan Hanft, for
four months in year one of the Fellowship. They will serve as group
co-leader, be involved in medication management, and provide individual
therapy with a special emphasis on continuity of care as many partial
patients will be transitioned to the outpatient program for further care.
UCI Adolescent Inpatient Unit
This
rotation is an eight-month rotation at approximately 90% time in year one of
the residency program. Patients’ ages range from 11 to 18 years, and we
serve multiple ethnicities and a rich diagnostic patient pool which provides
exposure to virtually all DSM-IV diagnoses. During the course of the
rotation, fellows provide individual psychotherapy based on brief therapy
models, family therapy, group therapy, consultation with schools, behavioral
contracting, and psychopharmacology. Close supervision is provided, and
psychodynamic models of both child development and family dynamics are
emphasized.
Emergency Evaluations
This
four-month rotation occurs during year one and requires a 10% commitment of
clinical time. During this rotation, residents will learn the principles of
crisis intervention, triage, and to determine if patients meet criteria for
inpatient hospitalization. Residents will learn the process for inpatient
authorization and utilization review and work with family to schedule follow
up if hospitalization is not necessary.
Outpatient Child and Adolescent Psychiatry
Psychopharmacology Clinic
This is
a 24-month rotation in years one and two and requires a 10% commitment of
clinical time. Residents receive individual supervision on each case and
group supervision is provided to discuss complex cases. Relevant general
articles and pertinent information on cases are sought using evidence-based
medicine models. The clinic population is similar to the inpatient
population in demographics and multiple diagnoses are cared for with a
special emphasis on refractory patients. New patients are seen for one hour
and follow up patients are seen for one-half hour sessions. Longitudinal
care over the course of the two-year residency is usual. Residents
coordinate care and discuss treatment with psychotherapists, primary care
physicians, specialists, and school personnel. Residents will also teach
and supervise medical students. Graduating residents are given the
opportunity to retain patients if they choose to practice in the area.
Consultation and Liaison
This has
traditionally been a four-month rotation in year one at UCI Medical Center
and requiring 5-10% clinical time. However, the UCI Department of
Pediatrics and Children's Hospital of Orange County recently combined their
programs and we are in process of developing a rotation at this facility,
which is located within 2 miles of UCI Medical Center in the City of Orange.
This exciting new opportunity will allow child psychiatry fellows to work
with experts in all areas of pediatrics. Please check back frequently
for updates regarding this rotation. Child psychiatry fellows will
continue to provide pediatric consults and emergency evaluations at UCI
Medical Center but on a more limited basis. (updated August 2009)
Court Forensic Consultation
This is
a required six-month consultation and requires 10% of clinical time. This
rotation occurs at the Orange County Juvenile Court located one-quarter mile
from UCI Medical Center. Faculty consists of an on-site presiding Juvenile
Court judge and residents will shadow judges, attorneys, expert witnesses,
prosecuting attorneys, dependency social workers, and probation officers,
and during this experience will be educated about the juvenile justice
system. Residents will also observe both criminal and dependency court.
Residents do not provide clinical services to patients but instead work with
legal professionals to observe viewpoints from different aspects of the
legal system. Residents experience working with a judge in his chambers
while important legal decision are being made.
Outpatient Child and Adolescent Psychiatry
Therapy Clinic
This is
a required 12-month rotation in year two and requires 20% clinical time.
Patients will be seen for individual psychotherapy by residents for 30- to
50-minute visits. Initial evaluation is staffed with attending psychiatrist
and both a biopsychosocial and psychodynamic formulation are presented by
the resident. Residents develop a treatment plan which may include
individual and/or family therapy.
FOCUS -- Families of Children Under Stress
FOCUS is a county-funded
treatment program specializing in the treatment of sexually abused children
and their families. FOCUS offers individual, group, family, parenting, and
pharmacotherapy treatment to patients and families referred by Orange County
Social Services for sexual abuse. During this one-year rotation, Fellows’
caseload and treatment modalities are monitored to ensure breadth of
experience and supervision. It provides a unique opportunity to practice
long-term individual psychotherapy with children of all ages, both victims
and family members of victims of sexual abuse. Fellows are also given the
opportunity to participate in family and group therapies, parenting classes,
and medication management.
Psychological Testing
This is
a required 12-month rotation year and requires 5% to 7.5% of clinical time.
Faculty consists of a full-time child neuropsychologist. Fellows learn the
purpose and methods of administration of a variety of psychological and
neuropsychological testing instruments. They learn how psychologists test,
score, and interpret various psychological tests. Testing focuses on
general cognitive and problem-solving abilities, academic achievement
levels, sensory-motor development, visual and auditory attention, executive
functions and working and delayed memory.
School Consultation
This is
a required 12-month rotation in year two and requires 5% to 7.5% of clinical
time. The rotation occurs at the UCI Child Development Center School. The
faculty consists of a full-time child psychologist, teachers, behaviorists,
graduate students, and research associates. The UCI Child Development
Center School, in association with the Orange County Department of
Education, operates a model school-based treatment program for children with
behavioral and academic problems in first through sixth grades. The program
includes daily social skills for children in the program and parent
participation through parent training and multiple family groups. Fellows
participate in all aspects of care, working with both individuals and their
families. They also assist in developing a behavioral plan to transition
children from specialty school to mainstream classes in their individual
educational program so that they may return successfully to their home
school. Residents typically see one new consult per week and are involved
in client-centered consultation for cases and systems. They provide input
directly to students, teachers, and school counselors and work closely with
the school psychologist to provide weekly individual supervision.
Pediatric Neurology
This is
a required six-month rotation in year two and requires 10% clinical time.
Faculty consists of attending pediatric neurologists. Up to two new
patients and four to six follow up patients are seen each week. This is a
traditional medical model, during which cases are initially seen and
evaluated by the resident, presented to the attending, and then seen
together for final diagnostic assessment and treatment planning. Assigned
readings and individual instruction occurs with a pediatric neurology
attending. Residents will learn to provide a comprehensive neurological
exam.
Developmental Disabilities Multidisciplinary
Clinic
This is
a required six-month rotation in year two and requires 10% clinical time.
Faculty consists of an attending child and adolescent psychiatrist,
pediatric neurologist, and two psychologists. Clinic population are clients
of the Regional Center of Orange County, an agency providing support and
placement to individuals with developmental disabilities. The purpose of
this clinic is to evaluate individuals with developmental disabilities
living in community settings who are being treated with a high number of
psychotropic medications, with the goal of reducing the number of these
medications while optimizing quality of life. Residents will learn about
evaluating adaptive behavior, using specialized rating scales and evaluation
tools for individuals with developmental disabilities, as well as the
psychiatric evaluation of an individual with developmental issues.
Research
This is
a required rotation in year two of the residency and requires 10% of
clinical time. Residents will develop working knowledge with all phases of
the research process, including literature review, subsequent treatment, IRB
approval, grant writing and timing acquisition, project management, and
publication. They will demonstrate understanding of common statistical
methods, data management, research design, as well as perform a thorough
review of the literature and establish special expertise in one area of
child and adolescent psychiatry.
