General Information
(APPIC/NMS program code = 161912)
Acting Track Coordinator:
Joy Kawamura, PhD: Joy.Kawamura@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 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 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, parent-support, 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 through solution focused intervention and works to facilitate connections to community resources. Components of the PBMU Program include: 1) intensive skill building of a 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.
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, and disposition planning; 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 and a psychiatrist on a weekly basis, 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.
Neuropsychological Consultation Service
Rotation Description & Patient Demographics
The Neuropsychological Consultation Service provides evaluations to most clinics in the hospital, including Psychiatry, Neuro-oncology, Hematology, Genetics, Cardiology, Rheumatology, Neurodevelopmental and Neurology. Neurodevelopmental disorders frequently seen include autism, ADHD, learning disabilities, and intellectual disabilities. In addition, children are seen before neurosurgical intervention and during treatment and follow-up of brain tumors.
Training Experiences & Treatment Modalities
Psychology residents are primarily affiliated with the Neuropsychological Consultation Service. In addition, residents participate in the School Contract Evaluations which provides an independent evaluation of children and adolescents with learning problems. The resident is involved in the neuropsychological assessment of a wide age range of children and becomes familiar with a number of commonly used neuropsychological assessment instruments. The psychology resident will become competent in using a structured interview to gather developmental and diagnostic information from parents. The resident is involved in consultation with schools and in reporting results to parents, referral sources, and treatment teams.
Resident Expectations & Supervision
Interdisciplinary consultation, information gathering from a variety of sources, and integration of psychosocial, medical, neuropsychological data requires that the psychology resident be well-organized and adaptable. Through supervision and directed readings, the resident is exposed to different theoretical approaches to pediatric neuropsychology.
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, emergency room, and outpatient clinics at SCH as well as to community care providers. 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, Brent Collett, PhD, Cynthia Flynn, PhD, Elizabeth McCauley, PhD, ABPP, and Eileen Twohy, PhD). A weekly teaching conference is held to conduct case discussions or didactic presentations on topics relevant to C/L services. 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
Molly Adrian, PhD
Michelle Kuhn, PhD
Rotation Description & Patient Demographics
This rotation provides a mix of assessment and treatment opportunities, within a clinic team that consists of psychologists, child psychiatrists, nurses, and case managers. New and ongoing cases are discussed during twice weekly team meetings. Psychology residents will 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 rare 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. Assessments of children typically include observation and videotaping of parent-child or family interaction. School visits and developmental testing of the child are often done. Primary treatment strategies include parent-child interaction training, brief family therapy, school consultations, and cognitive-behavioral treatment for the child. Interventions are formulated within the context of a developmental model. There are opportunities for training in psychopharmacology, Dialectical Behavioral Therapy (DBT) and cognitive-behavioral treatments for OCD.
Resident Expectations & Supervision
Supervision consists of direct observation, review of recordings, 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.