General Information
(APPIC/NMS program code = 161912)
Track Coordinator:
Michelle Kuhn, PhD: Michelle.Kuhn@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
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 17. The children and adolescents treated on the PBMU 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. The PBMU is divided into 3 distinct programs: child (serving youth 12 and under), adolescent (serving youth 13 and up), and biobehavioral (serving youth with severe intellectual and developmental disabilities). In addition, many youth experience significant psychosocial stressors related to child abuse, neglect, and other types of trauma.
Training Experiences & Treatment Modalities
The PBMU is a multidisciplinary unit with routine contributions made by nursing, education, psychiatrists, mental health therapists, board certified behavior analysts, psychologists, case management, nutrition, speech and language pathology, adolescent medicine, pediatrics, art therapy, and music therapy. The PBMU provides children, adolescents, and their families with acute crisis stabilization through solution focused intervention and coordination with community resources. Components of the PBMU Program include: 1) intensive skill building and behavior management, 2) individual and family crisis management and stabilization centered on skill building through the use of evidence informed clinical pathways, 3) medication evaluation, 4) crisis prevention planning and 5) disposition assessment and planning, with connection to appropriate community resources. The PBMU’s model of care is grounded in positive behavior interventions and supports (PBIS).
Resident Expectations & Supervision
Residents primarily work in the child and adolescent programs and are expected to: 1) 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 psychology and psychiatry attendings, 2) participate in clinical activities related to diagnostic evaluation/formulation, including administration and interpretation of cognitive and diagnostic assessments, 3)teaching emotion regulation and distress tolerance skills, crisis prevention and safety planning, and disposition planning, 4) leading group therapy on our child and adolescent programs utilizing CBT and DBT skills. 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, safety plans, CPS reports, assessment reports, etc.) and participate in multidisciplinary treatment planning for patients assigned to their team. Psychology residents receive individual supervision from a psychologist daily, participate in group supervision with psychologists and mental health therapists once per week, and participate in daily clinical rounds.
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 room at SCH. Primary consultations include safety/risk assessment, eating disorders, medically ill children presenting with needs for behavioral management of pain, somatoform symptoms, psychological distress related to medical conditions, and disruptive or non-adherent behavior.
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, Elizabeth McCauley, PhD, Cynthia Flynn, PhD, Eileen Twohy, PhD). The resident will receive weekly individual supervision in addition to group 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
Rotation Description & Patient Demographics
This rotation provides a mix of intervention and assessment opportunities, within a clinic team that consists of psychologists, psychiatrists, mental health therapists, nurses, and case managers. New and ongoing cases are discussed during regular team meetings. Psychology residents have the opportunity to work with a variety of presenting problems including ADHD, disruptive behavior disorders, anxiety disorders, and depression, as well as less common psychiatry conditions (OCD, suspected early onset bipolar disorder, autistic spectrum, eating disorders) and medical disorders with associated psychopathology (e.g., craniofacial disorders and other genetic syndromes). The rotation includes opportunities to work with younger children as well as adolescents.
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 and psychological interventions. Primary treatment strategies include individual and group-based cognitive-behavioral and behavioral treatment approaches as well as parent training. Interventions are formulated within the context of a developmental model.
Resident Expectations & Supervision
Supervision consists of direct observation, case conferences, and weekly individual and group supervision.
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.
Specialized Neurodevelopmental Assessment and Consultation Service (SNACS)
Rotation Description & Patient Demographics
The SNACS clinic provides comprehensive developmental and psychological testing to children and adolescents with prenatal substance exposure, complex trauma, and adverse childhood experiences. Neurodevelopmental disorders frequently seen include fetal alcohol spectrum disorders, ADHD, autism, learning disabilities, and intellectual disabilities. Referrals come from hospital clinics such as neurodevelopmental, genetics, and the autism center, as well as from community providers. Our clinic serves families with diverse family compositions (kinship, foster, birth, adoptive, and multigenerational homes), racial and ethnic identities, and family histories, many of which are marginalized or stigmatized. This rotation has a strong focus on collaborative, therapeutic, and empowering evaluation models.
Training Experiences & Treatment Modalities
Psychology residents spend 6 months with the SNACS Clinic. The resident will become competent in chart review, collaboratively developing evaluation goals with the family, conducting parent and youth interviews, selecting an appropriate test battery, conducting or supervising testing, and constructing an accessible report that supports advocacy for the child’s developmental and mental health needs. The SNACS model uses motivational interviewing, cognitive behavioral, and positive behavior support principles over SNACS’ 4-5 evaluation and consultation sessions. Our primary goals are to help each youth, family, and relevant supports (school, daycare, extended family) understand the child’s unique developmental profile, ‘reframe’ their perspective of the child’s challenging behaviors and create useful accommodations to support the youth’s developmental differences and prevent unhelpful behaviors.
Residents will be paired with a doctoral practicum student for each evaluation, giving them the chance to hone their supervision skills. Residents will gain experience in determining practicum student’s strengths and training needs, assigning developmentally appropriate tasks, and reviewing work in a way that supports continued skill development. Supervision of supervision will be provided within weekly supervision meetings with Dr. Kuhn.
Resident Expectations & Supervision
Interdisciplinary consultation, information gathering from a variety of sources, and integration of psychosocial, medical, neurodevelopmental data requires that the psychology resident be well-organized and adaptable. Through supervision and SNACS retreats which involve group discussion of selected readings, the resident is exposed to different theoretical approaches to neurodevelopmental evaluation.
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.
Last Modified: October 18, 2024