Psychotherapy Clinic-CAP 2

Rotation Co-Directors: Eric Spiegel MD and Neha Navsaria PhD

Other: Michael Bunis, PsyD, Staff Psychologist

Number of residents per rotation: Five

Length of Rotation: 41.6 weeks

Time of Rotation: Second year of training

Frequency of Rotation: One afternoon per week

Goal

The goal is to provide the CAP resident with a strong foundation in Child and Adolescent Psychotherapy to enhance the quality of practice of Child and Adolescent Psychiatry regardless of main treatment modality.

Objectives

To develop competencies in the following areas:

Patient Care

The rotation co-Directors recognize that residents come to Child and Adolescent Psychiatry training with variable previous grounding and experience in Psychotherapy. Nevertheless, the competencies outlined below are expected of all trainees:

  • Building of therapeutic alliance with patients and if applicable, with the family members of patients
  • Engaging patient and family in psychotherapeutic treatment
  • Refinement of interviewing and communication skills
  • Understanding how psychiatric symptoms can be exacerbated or moderated by environmental variables
  • Recognition and tolerance of transient provider discomfort during therapeutic sessions unique to practice of psychotherapy
  • Conceptualize the development of improved patient resiliency through psychotherapy

Medical Knowledge

The resident will gain medical knowledge through a combination of clinic specific supervision, mandatory psychotherapy seminar, supervised reading of the pertinent CAP or related literature.

  • The role of parents and families in developmental psychopathology
  • Major developmental theories
  • Understand theory and evidence related to major psychotherapeutic modalities including CBT , motivational interviewing, solution focused brief therapy and family therapy

Practice Based Learning

In addition to supervised clinical activities, the resident will participate in weekly group supervision including review and discussion of videotaped psychotherapy sessions

  • Insight into one’s behavior and how it facilitates or not the psychotherapeutic process
  • Insight into one’s communication and how it facilitates or not the psychotherapeutic process
  • Learn to appreciate, recognize and work with patterns of patient and family behaviors during sessions

 Professionalism

Psychotherapy training will provide the resident with the opportunity to deepen the development of multiple aspects of professionalism

  • Mindful intra-professional development by managing adaptively their countertransference to youth and to the family members with psychopathology
  • Mindful use of self-disclosure
  • Appreciation and respect of boundary issues
  • Attention to termination issues in psychotherapy
  • Providing clear and constructive feedback to peers

Interpersonal/Communication Skills

The resident will effectively communicate with patients and their families within a psychotherapeutic context

  • Broaden the use of therapeutic understanding by increasing the number of communication techniques.
  • Communication of therapeutic goals
  • Addressing problem-solving and decision making
  • Attention to complex interactional issues: parent-child, family-child, parent-provider, child-provider and group

System Based Care

  • Understanding the role of psychotherapist vs. physician
  • Conceptualizing the role of the psychotherapist-psychiatrist
  • Understanding the advantages and limitations of medical vs. psychosocial model systems
  • Bridging mental health systems for the benefit of patient and families

Measurement of Objectives

  • Review of videotaped interactions
  • Direct Observations
  • Feedback by other professionals

Description of Rotation

The fellow will participate in a weekly clinic where he/she will participate in: (i) a group supervision session including both rotation directors and peers and in (ii) the clinical care of up to 4 patients and/or families per week (except during the 3 months of the C/L rotation where it is expected that the fellow will see up to 2 patients or families per week. Portions of the clinical care are directly observed by one of the rotation directors.