General Information
(APPIC/NMS program code = 161912)
Track Coordinator:
Eileen Twohy, PhD: Eileen.Twohy@seattlechildrens.org
Current General Child Track Psychology Residents
Track Map
Current General Child Track Psychology Residents
Seattle Children’s Hospital
Dept. of Psychiatry and Behavioral Sciences
Division of Child and Adolescent Psychiatry
Department of Psychiatry and Behavioral Sciences – Division of Child and Adolescent Psychiatry
Seattle Children’s Hospital (SCH) is a private, nonprofit, University-affiliated, 407-bed hospital with numerous outpatient clinics. It is the primary pediatric training site for the University of Washington School of Medicine and is the major regional children’s medical center. SCH is also the major training site for the Department of Psychiatry and Behavioral Sciences’ Division of Child and Adolescent Psychiatry. The Division of Child and Adolescent Psychiatry at SCH provides a variety of services for children with acute and chronic medical problems that are associated with developmental and psychological consequences as well as for children with primary psychiatric disorders. The psychology resident has an excellent opportunity to engage in a wide range of clinical activities and to become skillful with a variety of assessment methods and treatment modalities. Along with patient contacts and consultation to multidisciplinary teams, residents are expected to become familiar with the literature pertinent to their clinical activities and to attend didactic sessions and conferences on the services assigned. Psychology residents have opportunities to participate in research projects during their rotations at SCH. In the following section, a brief overview of each service is given.
Psychiatry and Behavioral Medicine Unit (PBMU)
Rotation Description & Patient Demographics
The Psychiatry and Behavioral Medicine Unit (PBMU) is a 41-bed acute care psychiatric unit that provides multidisciplinary assessment, crisis intervention and stabilization, and long-term treatment planning for children and adolescents between the ages of 4 and 18. The children and adolescents seen on this unit present with a variety of severe psychological/psychiatric problems, including psychotic, mood, disruptive, anxiety, eating, and developmental disorders, as well as chronic medical problems with concomitant behavioral difficulties. In addition, many youths experience significant psychosocial stressors related to child abuse and neglect, and other types of trauma.
Training Experiences & Treatment Modalities
The PBMU is a multidisciplinary unit with routine contributions made by psychiatry, psychology, mental health therapists, nursing, education, nutrition, speech and language pathology, adolescent medicine, pediatrics, art therapy, recreational therapy, and occupational and physical therapy. The PBMU provides children, adolescents, and their families with acute crisis stabilization and works to facilitate connections to community resources. The PBMU model of care is based on Modified-Positive Behavior Interventions and Supports and is divided into three programs, child (for youth 12 and under), adolescent (youth 13 and up), and biobehavioral (for youth with severe intellectual and developmental disabilities). Components of the PBMU Program include: 1) individual and family crisis management and stabilization, 2) medication evaluation, 3) crisis prevention/safety planning and 4) disposition assessment and planning, with connection to appropriate community resources.
Resident Expectations & Supervision
Residents are expected to:
- participate in team care and to function as a team clinician (individual and family intervention) for a range of patients with support and direction from psychiatry and psychology attendings,
- participate in clinical activities related to diagnostic evaluation/formulation, teaching emotion regulation and distress tolerance skills (including diagnostic specific skills outlined in clinical pathways and group therapy), crisis prevention planning, safety planning, and disposition planning. Residents also lead group therapy multiple times per week and participate in structured assessment, including diagnostic assessment and cognitive evaluation. Residents review and integrate information from outside sources (school, caseworker, previously involved mental health professionals, current providers, etc.), write reports (daily chart notes, case formulations, support letters, Crisis Prevention Plans, CPS Reports, etc.) and participate in multidisciplinary treatment planning for patients assigned to their team. Psychology residents receive individual supervision from a psychologist daily, and group supervision through daily clinical huddles and weekly patient reviews.
Evaluation of Psychology Residents
Psychology residents participate in standard evaluation practices that are part of the overall internship which includes self-evaluation, evaluations by their supervisors, resident evaluation of their supervisors, and resident evaluation of the rotation site.
Consultation/Liaison (C/L)
Rotation Description & Patient Demographics
The Consultation/Liaison Service provides clinical consultations to the inpatient pediatric units and the emergency department. Primary consultations include psychiatric evaluation, safety/risk assessment, treatment planning, and brief intervention for medically ill children presenting with needs for behavioral management of pain, somatoform symptoms, psychological distress related to medical conditions, disruptive or non-adherent behavior, eating disorders, and suicidality.
Training Experiences & Treatment Modalities
The psychology resident will learn how to conduct consultations with patients in tertiary and primary care settings. Opportunities for limited-term interventions are available. The C/L conferences are open to all C/L team members including Nursing, Social Work, Psychiatry, Psychology, and students.
Resident Expectations & Supervision
All consultations are supervised by the attending psychiatrist and attending psychologist on service (Ian Kodish, MD, PhD, Cynthia Flynn, PhD, Elizabeth McCauley, PhD, ABPP, and Eileen Twohy, PhD). The resident will receive weekly individual supervision in addition to informal supervision provided during rounds conducted on each new patient.
Evaluation of Psychology Residents
Psychology residents participate in standard evaluation practices that are part of the overall internship which includes self-evaluation, evaluations by their supervisors, resident evaluation of their supervisors and resident evaluation of the rotation site.
Child and Adolescent Outpatient Psychiatry Program
Rotation Description & Patient Demographics
This rotation provides a mix of assessment (intake interview) and treatment opportunities, within a clinic team that consists of psychologists, child psychiatrists, nurses, and case managers. Psychology residents have the opportunity to work with a variety of presenting problems including ADHD, disruptive behavior disorders, anxiety disorders, post-traumatic stress disorder and other trauma-related conditions, and depression, as well as less common psychiatric conditions (OCD, suspected early onset bipolar disorder, autistic spectrum, eating disorders, FASD) and rare medical disorders with associated psychopathology (e.g., craniofacial disorders and other genetic syndromes). The rotation includes opportunities to work with younger children through late adolescence.
Training Experiences & Treatment Modalities
The psychology resident learns to work collaboratively with other disciplines, e.g., some cases are treated by a combination of medication, medical specialty teams, and psychological interventions. Assessments typically include clinical interviewing and questionnaire administration, as well as consultation with other providers and collateral contacts, as needed. Primary treatment strategies include behavioral parent training, brief family therapy, school consultations, parent and child/adolescent group therapy, and individual treatment for adolescents. Interventions are formulated within the context of a developmental model. There are opportunities for training in psychopharmacology and specific evidence-based practices, per resident interests. Commonly used evidence-based practices include: behavioral parent training, CBT, DBT, motivational interviewing, exposure (including with response prevention), trauma informed models (TF-CBT, attachment, self-regulation, and competency), positive behavior support, behavioral activation, among others.
Resident Expectations & Supervision
Supervision consists of direct observation, review of recordings, case conferences, case conceptualization, and weekly individual and group supervision. Didactic training in specific evidence-based practices is often coordinated per resident interests.
Evaluation of Psychology Residents
Psychology residents participate in standard evaluation practices that are part of the overall internship which includes self-evaluation, evaluations by their supervisors, resident evaluation of their supervisors and resident evaluation of the rotation site.