For 6 months residents participate in the integrated intensive services for children and adolescents at the University of Rochester Medical Center in Strong Memorial Hospital (SMH). In this setting, residents evaluate and direct the treatment of children ranging in age from 5 to 18 who require acute, intensive intervention. A major portion of this activity occurs on our 15-bed Inpatient Program. Residents also follow patients discharged from this unit as they are treated in the Partial Hospital Program and the Outpatient Clinic.
During the alternate 6 months the resident participates in the very active, multidisciplinary consultation program providing service to the Department of Pediatrics and other agencies in Rochester. In addition to responding to requests for inpatient consultation, the resident serves as a consultant through assigned rotations in the Pediatric Neurology Clinic and Adolescent Medicine Clinic. The resident also accompanies faculty in consultation to schools in Monroe County, and participates in faculty evaluations of children with developmental disabilities.
Throughout the 2 years of the residency program residents take an active role in the Child and Adolescent Outpatient Clinic of Strong Memorial Hospital. It is in this setting that residents develop the skills of the primary provider of mental health services. The clinic is multidisciplinary in its approach, and clinical care is provided by social workers, nurse clinicians and clinical psychologists in addition to resident and faculty child psychiatrists. While they are on the Intensive Services rotation, most of the residents' caseload in the outpatient clinic is derived from the intensive units. However, other cases are selected to give the opportunity for a breadth of experience. During their consultation rotation, the residents are assigned cases from the clinic intake program as well as from their consultations in Pediatrics. Supervision is intensive and involves both live observation and videotape review.
Pre-School Day Treatment
The Crestwood Children's Center operates a Day Treatment Program for young children with emotional disorders. Residents rotate in this program for a period of 4 to 6 months for 12 hours each week. Residents participate in classroom activities, "living with the children" in their milieu. In addition to providing psychiatric diagnosis and treatment planning, residents take part in multidisciplinary treatment planning and design a continuing education presentation that is delivered to the staff.
Anthony Jordan HealthLink
This mental health program provides primary mental health care to residents of inner city Rochester. The program is a part of the Anthony Jordan Health Center providing health and dental services to patients of all ages in the core of Monroe County. For 4 hours each week for 3 months, the resident provides psychiatric consultation and direct service as an integral part of the mental health team that includes senior child psychiatry faculty.
Monroe County Children's Shelter
This secure detention facility provides the context for the resident to learn about the psychiatric disorders common among youth who have entered the juvenile justice system. Residents participate in an ongoing program of mental health consultation for 4 hours each week for three months. In this setting, the resident becomes familiar with the role of the child psychiatrist in the juvenile justice system. This rotation serves as an adjunctive part of the forensic psychiatry portion of the residency.
Mobile Crisis Intervention
The Rochester Psychiatric Center (RPC) operates a rural mobile crisis team which assists Livingston County schools and agencies with emergency mental health needs of children and youth. Services are geared to provide immediate crisis intervention directly to individuals and families. Team members respond to emergencies on short notice, traveling to homes, schools or agencies. Follow-up services include short-term individual and family psychotherapy as needed. The resident accompanies a senior social worker as she responds to assigned emergencies. This social worker provides on site supervision, and child psychiatry faculty at RPC provide additional consultation. The resident participates in this program on rotation for 6 hours a week for a minimum of 3 months.
Long Term Residential Treatment
St. Joseph's Villa of Rochester operates a residential treatment center for youth from a variety of cultural and socio-economic backgrounds. Residents spend twelve hours each week for 6 months participating with child psychiatry faculty in the care of adolescents who require long term residential treatment. The emphasis of this rotation is on the development of the resident's skills as a consultant rather than as a primary caregiver for these intensely troubled youth.
Community Mental Health
The Unity Health System (St. Mary's and Park Ridge Hospitals) operates two Mental Health Centers where residents have the opportunity to work with patients and their families in a typical community outpatient setting. This is usually a 6 month rotation for eight hours per week. In addition to their roles as treatment providers, residents also function as extensions of the on-site child psychiatry faculty in their role as clinic administrators. Residents are required to develop a small administrative project under the direct supervision of the faculty as a means of understanding the role of the psychiatrist as a leader and administrator in a complex system. In addition, this is the site where residents can develop facility with the use of electronic medical records.
Residents continue to follow selected cases in the Child and Adolescent Outpatient Clinic in Strong Memorial Hospital at the University of Rochester Medical Center. In addition, they serve as psychopharmacology consultants as a part of that clinic's psychopharmacology service.