Rotation Director: Natasha Marrus, MD, PhD
Other faculty: Angela Reiersen, MD, MPE
Number of Fellows per Rotation: 1-3 Fellows
Length of Rotation: 10.2 weeks, 1 morning per week
Time of Rotation: Second year
Location: St. Louis County Special School District Schools
The goal is to provide the fellow with an understanding of the factors impacting a consultation in a school setting or related to optimizing child function in a school environment. Adequate consultation in a school setting hinges on understanding the uniqueness of the school environment.
To develop competence in the following areas:
The fellow will learn consulting skills at various schools within the St. Louis Special School District and at the 4444 clinic with up to two weekly consultations with the SSD.
- Understanding presentations of functional impairment in school settings including behavioral and educational difficulties
- Observing and interpreting family relationships and teacher-child relationships and their relevance to presenting problem
- Understanding how psychiatry symptomatology can be exacerbated or moderated by the school environment
- Work effectively with the professionals involved in teaching
The fellow will gain medical knowledge through a combination of supervised clinical activities, mandatory divisional didactics, and supervised reading of pertinent or related literature.
- Understand specific learning disabilities and their relationships to behavioral disorders
- Develop concepts of psychiatric presentations in a school context
- Understand the academic and social implications of various psychiatry disorders including ADHD and depression
In addition to supervised clinical activities and self-initiated and suggested readings, the fellow will participate in 1:1 supervision by the attending faculty and other divisional supervision including individual and team supervision.
- Continuing to appraise oneself of current knowledge concerning the pathogenesis and etiology of psychiatric disorders in particular as they relate to school functioning and outcomes
- Becoming familiar with models of school consultations
- Understand the structural and organizational aspects of the school or school systems
- Gaining knowledge of special education laws
- Appreciate the pros and cons of 504 plans and IEPs
The fellow will demonstrate sensitivity and compassion to children, adolescents, and to their families/caretakers affected by psychopathology and will continue to develop relationships with other professionals or professionals in training, including supervisors, colleagues, students, and allied professionals.
- Developing intra-professionally by managing their own emotional reactions to youth psychopathology and to the attitudes of other professionals towards youth psychopathology
- Convey information both written and especially oral as clearly as possible without the use of jargon
- Demonstrating a commitment to continued professional development
- Perform a consultation that respectfully addresses the specific questions paused by the school teacher, school counselor, or school administrator
- Appreciate the professional role of the consultant versus the primary provider
The fellow will effectively communicate with patients, their families, school teachers, school counselors, and school administrators.
- Talking with and obtaining a history from school personnel
- Tailoring communication to the needs of school professionals
- Respectfully appreciate that the teaching of children with psychopathology can be anxiety-provoking to non-mental health professionals
- Understanding the roles of other professionals including teachers, special education teachers, aides, school psychologists, school counselors, school nurses, and principals
- Understanding the constraints of the systems within which these other professionals operate
- Understanding the limitation of community mental health care for children and its impact on psychiatric presentations in a school setting
Measurement of Objectives
- 360 evaluations
- Standard program evaluations
- Feedback from other professionals
Description of Rotation
The fellow will observe and participate in the evaluation of children referred by the St. Louis Special School District for psychiatric evaluations.