Department of Psychiatry and Behavioral Sciences

Seminars are specifically designated as either for first-year or second-year child psychiatry residents or for both years. The sequence of didactic and clinical experience for child psychiatry residents is progressive. Also, the required seminars in the second year are generally related to areas in which the residents function as a psychiatric consultants, teachers, and future leaders, such as in the forensic arena, community programs, and administrative and organizational structions. At the same time, the residents are continuing to deepen and broaden their clinical skills.

The sequence of seminars for child and adolescent psychiatry residents' years I and II follow:

No. 01: Developmental Neuroscience and Developmental Psychopharmacology

1. M. Shafii, M.D.
2. Objectives and Content: The format of this seminar is group learning and a Socratic dialogue between the residents and the instructor. Each participant also reviews and succinctly presents a specific topic for discussion. Emphasis is on the biochemistry of the developing brain, with a review of the developmental neurobiolody of noradrenergic, serotonergic, dopaminergic, cholineric and GABAergic systems and other pathways. Developmental pharmacokinetics and pharmacodynamics and developmental neurotoxicology are the core of the seminar. In addition, some other aspects of developmental neurosciences, such as signaling mechanisms, sleep and circadian rhythms, and cognitive neurosciences, specifically attention and emotion from a neurobiological and neurophyshiatry point of view, are reviewed. The residents take a pre- and post-seminar multiple choice tests regarding developmental psychopharmacology. In addition to assigned reading, the residents are responsible for reviewing and critically assessing relevant up-to-date literature and research in specific areas of pediatric psychopharmacology. For each session, they are asked to create 5 multiple choice questions regarding the topic of the session. Each resident receives feedback on his/her performance.
3. General psychiatry residents rotating to DCAP (optional)
4. Every other year

No. 02: Biological Dimensions of Psychotherapy

1. M. Shaffi, M.D.
2. Objectives and Content: Recent research in the effect of trauma on the biological function of the cell and the molecules within the cell has opened an exciting new vista in understanding the role of psyche trauma in animals and humans. In this seminar, the monumental work of Eric Kandel, the first American psychiatrist to win the Nobel Prize (2000), will be the focus of discussion. His book, Psychiatry, Psychoanalysis and the New Biology of Mind, will be the basic text. In addition to Kandel's text, the residents will be encouraged to present published data based on research on the efficacy of various forms of psychotherapy. Emphasis will be on the transcending the chasm of mind-body dualism and the integration of the psychology and biology of the mind throughout the life cycle.
3. Psychology interns (optional)
4. Every other year

No. 03: Group Psychotherapy and Cognitive Behavior Therapy of Children and Adolescents

1. Selected Faculty
2. Objectives and Content: This seminar is taught in two components. The first is Group Psychotherapy and the second is Cognitive Behavioral Therapy. The residents learn basic background and history regarding group therapy for children and learn techniques and strategies for developing and conducting group therapy for children. In Cognitive Behavioral Therapy the residents learn a brief philosophy behind the use of cognitive behavioral therapy with children and learn specific cognitive behavioral techniques to address various types of adjustment problems in children. They review ways cognitive behavioral techniques can be used in different treatment modalities (i.e., individual group and family therapy.
3. General Psychiatry residents, Clinical Psychology interns
4. Annually

No. 04: Clinical Psychopharmacology Seminar

1. C. Peters, M.D., T. Erwin, M.D., and A. Nichols, M.D
2. Objectives and Content: Each session a member presents a patient. The group then discusses the differential diagnosis and makes a list of target symptoms amenable to psychopharmacologic interventions. Other issues include: criteria on whether or not to start a child on a psychiatric medication; necessary baseline labs; labs to monitor while medication is being used; and indicators when medication is not the primary solution to the child’s presenting problem or is not indicated. Appropriate literature is often brought into the discussion. The purpose of this seminar is to assure that all physicians who treat children with psychiatric problems recognize the need to perform a thorough psychiatric evaluation before diagnosing the child, that the diagnosis drives pharmacological treatment, and that follow-up of children on medications must involve continued re-evaluation of the diagnosis, possible comorbid diagnoses, and the ongoing risk/benefit ratio of continuing pharmacologic treatment.
3. General psychiatry residents and medical students rotating through DCAP
4. Annually

No. 05: Practice of Child and Adolescent Dynamic Psychotherapy

1. M. Shafii, M.D.
2. Objectives and Content: Format is a mini-continuous case seminar. Residents present videotapes of samples of their psychotherapeutic sessions with children, adolescents and families. Participants make observations and comments concerning techniques of play therapy and verbal and nonverbal psychotherapy from psychodynamic, developmental and cognitive-behavioral perspectives. Emphasis is on dealing with manifest symptoms and behaviors while recognizing and helping the patient work through underlying defense mechanisms. The processes of resistance, transference, and countertranference in the therapeutic situation are examined. Residents learn similarities and differences in therapeutic work with preschool and school-aged children, adolescents, and adults. Inclusion of general psychiatry residents and psychology interns in this small group setting helps the participants appreciate the thinking and problem-solving style of various mental health disciplines. Residents begin to learn the art of supervision. The Program Director has the opportunity to observe and evaluate the residents’ progress directly and regularly and receive weekly feedback from the residents regarding their training experiences.
3. General Psychiatry Residents, Psychology intern
4. Annually

No. 06: Family Psychotherapy of Children and Adolescents

1. A. Josephson, M.D.
2. Objectives and Content: The objectives of this seminar are to familiarize residents with the normal family life cycle and enable them to identify pathological family functioning; consider the indications for involving the family and identify factors connecting with families in treatment; view the presenting problem in its context within the family; explore the interactional sequences around the symptom; co-develop a treatment plan with the family and identify family strengths. Resistance within the family is explored and the technique of reframing is discussed. The most common family pathology as it relates to specific chief complaints with children/adolescents is explored. The objectives are accomplished by both didactic and experiential means. Videotaped presentations of family therapy sessions are presented by which family crisis focuses to change and techniques for addressing these are presented and discussed. Participants present cases for discussion and these are followed throughout the seminar.
3. General Psychiatry Residents
4. Annually

No. 07: Forensic Child and Adolescent Psychiatry

1. A. Josephson, M.D. and Faculty
2. Objective and Content: This seminar acquaints developing child and adolescent psychiatrists with principals of forensic psychiatry relevant to child and adolescent psychiatry. The didactic material includes; an overview of the history of child psychiatry and the law, child and adolescent custody evaluations including termination of parental rights, child and adolescent psychiatry related to juvenile delinquency and forensic issues in child abuse. Clinical issues include giving expert testimony and guidelines for writing materials for use by the courts. Methods of teaching are primarily didactic, using assigned readings, and lecturer’s individual experiences with the legal system involvement with local child protection agencies and local judges are planned.
3. Other General Residents on rotation in child psychiatry and psychology interns
4. Every other year

No. 08: Child and Adolescent Psychiatry Grand Rounds

1. A. Josephson, M.D., Coordinator
2. Monthly Grand Rounds include: outside speakers presenting information from their field of expertise on topics related to child and adolescent mental health issues; faculty presenting their clinical work and/or research; and child and adolescent psychiatry residents’ research or scholarly work.
3. Child psychology interns, general psychiatry residents, medical and social work students, all DCAP faculty, Bingham Child Guidance Center clinical staff members and others.
4. This conference is held on the first Wednesday of the month for 1 hour (October to June), alternating with the Child and Adolescent Clinical Case Conference.
5. Annually.

No. 09: Child and Adolescent Psychiatry Clinical Case Conference

1. C. Peters, M.D.
2. Objectives and Content: This conference provides opportunities for the faculty, staff and trainees to mutually learn from one another and from occasional outside speakers. In general, presentations consist of a literature review on a topic of the speaker’s choice, accompanied by a case presentation. This often features a brief videotape of the patient and therapist designed to highlight specific aspects of the case. Following the presentation, 10 to 15 minutes are available for open discussion and all are encouraged to participate.
3. Child psychology interns, general psychiatry residents assigned to DCAP, medical and social work students, all DCAP faculty and Bingham Child Guidance Center clinical staff members.
4. This conference is held on the 3rd Wednesday of each month for 1 hour (September to June). During the year, the 1st and 2nd year child and adolescent psychiatry residents and others make one presentation
5. Annually

No. 10: Development and Psychopathology Seminar: An Integrated Approach

1. C. Peters, M.D., Coordinator with participation of faculty
2. Objectives and Content: An integrated approach is used to present child and adolescent normal development and psychopathology. Instead of having separate seminars on both normal development and psychopathological disorders, the coordinators have integrated the presentation of normal development with psychopathological disorders. Case presentation and case formulation are discussed from a psychological, cognitive-developmental, biological and family system point of view. Perspectives are integrated with theoretical and data based literature.
3. Psychology interns and pediatric psychology fellows
4. Annually

No. 11: Psychological Assessment

1. F. Smith, Ph.D. and T. Stockhammer, Ph.D.
2. Objectives and Content: This seminar introduces the residents to the essentials of psychodiagnostic assessment (psychological evaluation/testing) and provides an opportunity, on an elective basis, to learn how to administer psychological screening tools. Upon completion, the residents will be able to facilitate the integration of psychological diagnostic services in clinical work, become a discriminate consumer of diagnostic psychological services, and be able to communicate to professionals, parents, and referring agencies psychodiagnostic findings, along with psychiatric and clinical impressions.
3. None
4. Annually

No. 12: Developmental Disabilities and Pediatric Genetics

1. J.Hersh, Ph.D. and other faculty
2. Objectives and Content: In this seminar the emphasis is on the relationship between genetics and developmental disabilities. Cytogenetics, inborn errors of metabolism, common pediatric genetic syndromes, neurogenetics, genetic counseling and genetic screening are discussed.
3. None
4. Every other year

No. 13: Psychiatric Aspects of AIDS and HIV in Children Adolescents and the Family

1. Chief Child Psychiatry Residents, Coordinator
2. Objectives and Content: Psychiatrists, public health, and other professionals with extensive experience in dealing with AIDS and HIV are invited to present in this seminar. Emphasis is on identification, recognition, and management of psychiatric symptoms related to AIDS and HIV with discussion on the impact of AIDS and HIV on the family, siblings, school, and the community.
3. Faculty and other residents rotating through child psychiatry
4. Every other year

No. 14: Department of Psychiatry and Behavior Sciences Grand Rounds

1. Faculty, general psychiatry and child psychiatry residents and guest faculty
2. Objectives and Content: Various topics of clinical, research and scholarly interest are presented for approximately 40-50 minutes with 10-15 minutes discussion time. First year child psychiatry residents (PGY-4) are required to present in Departmental Grand Rounds.
3. Faculty, general psychiatry residents, medical students, professional staff, psychiatrists and mental health professionals in the community
4. Annually

No. 15: Pediatric Neurology

1. C. Peters, M.D. (Coordinator) and Neurology Faculty
2. Objectives and Content: Review neuroanatomy with special focus on: the limbic system; hemispheric interconnections; interaction between cortical and subcortical structures; provide an introduction to neuropsychological assessment; study the development of attention and memory; neuropsychology of learning disabilities; review of the neurological examination with emphasis on developmental stages and diagnostic procedures; and review various neurological disorders with special emphasis on tics and Tourette’s Disorder, epilepsy and epileptic seizures, muscular dystrophies, Down’s Syndrome, cerebral palsy, metabolic diseases, infections and trauma.
3. Other residents on rotation, psychology interns
4. Every other year

No. 16: Research Design and Methodologies, biennial

1. R. El-Mallakh, M.D.
2. Objectives and Content: The objective is to prepare the attendees to be more sophisticated consumers of the research literature. The course is based upon a set of ten articles, all written by child psychiatrists and published in the Journal of the American Academy of Child and Adolescent Psychiatry in the past decade. The articles are brief, humorous reports of “research projects” given as vivid and colorful caricatures illustrating common errors in planning and interpretation of experimental studies in the field of mental health. The instructor also teaches a brief primer on the basic goals and methods of statistics. Each resident is given an anonymous form rating the course and asking for suggestions for future improvements. The resident together will develop a research project, of their choosing, under the supervision of the instructor.
3. None
4. Every other year

No. 17: Child and Adolescent Psychiatry Administration and Management

1. A. Josephson, M.D.
2. Objective and Content: This seminar aquaints the residents with principles of administrative psychiatry. An overview of how legal, economic and institutional influences affect psychiatric care. This series of didactic seminars is framed by a systems orientation with attention given to how organizations are structured in hierarchical and matrix fashions. A brief review of psychiatric economics is part of the course including such topics as health care system, utilization review, quality assurance and performance improvement.
3. Other General Residents on psychiatry rotations and psychology interns
4. Every other year