Psychotherapy Clinic

Rotation Co-Directors: T. Eric Spiegel, MDNeha Navsaria, PhD

Other: Michael Bunis, PsyD

Number of Fellows per Rotation: Five

Length of Rotation: 41.6 weeks

Time of Rotation: Second year

Frequency of Rotation: One afternoon per week

Goal

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

Objectives

To develop competencies in the following areas:

Patient Care

The rotation co-directors recognize that fellows 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 therapeutic alliances with patients and their family members, if applicable
  • 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 the practice of psychotherapy
  • Conceptualize the development of improved patient resiliency through psychotherapy

Medical Knowledge

The fellow will gain medical knowledge through a combination of clinic-specific supervision, mandatory psychotherapy seminars, and supervised reading of pertinent 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 fellow 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 fellow with the opportunity to deepen the development of multiple aspects of professionalism.

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

Interpersonal/Communication Skills

The fellow 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 patients 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 they will participate in a group supervision session including both rotation directors and peers and in 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.