- School Consultation
- Pediatric Consultation Liaison
- Pediatric Neurology
- Forensic Consultation
Each resident will have the experience of working with school personnel. School consultation is accomplished during the first year. This takes place at a school for children and adolescents who have been identified as in need of special treatment. It is a required rotation scheduled for one half day per week for ten weeks.
There are four components to the school consultation process:
- Individual Child Consultation: team meets with school personnel who are involved with the child to clarify the school's questions and concerns. School personnel includes the social worker, a school administrator, a school nurse, classroom teachers, special education teachers, and the psychologists. There is an individual interview with the child, which could also include school personnel who observe the interview and how the child responds. After an interview of approximately a half hour, the team meets to discuss their ideas and perspectives. Classroom observation, and meetings with parents are at times a part of the evaluation.
- Follow-Up of Children Seen Previously: Therapy as an ongoing modality would be best served at an established clinic, such as the University of Minnesota Medical Center, Fairview. The child psychiatry resident supervises and consults with the therapist who is already working with the child.
- Didactics for School Personnel: The psychiatric team arranges continuing education lectures on attention-deficit/hyperactivity disorder, major depressive disorder, the differential diagnoses and treatment of conduct problems, or addressing theories of child development. Hypothetical or actual cases of children displaying problems in the school are presented.
- Administrative Issues: There is a weekly meeting of the administrative and mental health team to review systems issues and coordinate care for the children.
Pediatric Consultation Liaison
Fourth year residents will be responsible for providing child mental health consultation to pediatric patients in the inpatient pediatric settings. The Director of Consultation-Liaison supervises each consultation and coordinates all referrals from pediatric inpatient and outpatient settings. Consults average five per week.
During the academic year, pediatricians will be invited to speak at the Child Clinical Grand Rounds about their areas of special competence. Discussion will center on the interaction of pediatric patient care and child and adolescent psychiatry, consultation liaison and common areas of interest.
Fellows work with the Pediatric Neurology faculty at Gillette Children's Hospital. Seizure disorders, metabolic and genetic disorders, and Tourette's syndrome are among the diagnostic entities seen. The Pediatric Neurology faculty will be responsible for all treatments and supervision of the child and adolescent residents.
Two hours of psychotherapy each week are required. During the outpatient rotation, there will be an opportunity for play therapy, supportive psychotherapy, insight-oriented dynamic therapy, cognitive-behavioral therapy, psychopharmacological interventions, and family therapy.
Departmental faculty and clinical faculty from the Twin Cities metro area support the program.
Psychopharmacology is taught in two parts:
Medication Management Clinic
The fellows receive referrals from inpatient psychiatry, psychologists, and other clinics in the hospital. A patients is followed for the entire period that they are in the program. This provides for the establishment of an ongoing doctor-patient relationship with the patient. A wide variety of medication questions comes to the Medication Management Clinic.
Medication Management Seminar
Review of general principles of treating attention-deficit/hyperactivity disorder, major depressive disorder, bipolar affective disorder, anxiety disorders, and pervasive developmental disorder and autism is provided. The Medication Seminar covers a textbook of child and adolescent psychopharmacology and recent articles that are clinically relevant in the practice of medication management. Case consultation around medication issues will be held with the fellows and faculty physicians in order to provide an ongoing clinical learning experience.
The William Mitchell College of Law and the University of Minnesota have combined to form a forensic clinic. This is scheduled for a half day per week for 20 weeks at the William Mitchell College of Law. Patients are referred from attorneys in practice for legal issues that require psychiatric expertise. The child psychiatry residents evaluate children and families, and coordinate legal questions with both the William Mitchell College of Law students and the William Mitchell College of Law faculty. Cases are discussed, recommendations are made, and the resident and child psychiatry clinical faculty member prepare reports.
Residents participate in discussions with law students about cases, learn from the faculty attorneys, and are guided in preparation of reports for the court, as well as preparation for giving testimony. Each resident will take part in a minimum of two cases. He/she will attend court either on his/her own cases or on another resident’s case. Ages range from five years old through age 17. Diagnoses of patients are: conduct disorder, oppositional defiant disorder, major depressive disorder, bipolar affective disorder, attention-deficit/hyperactivity disorder and posttraumatic stress disorder. The function of this rotation is aimed at learning how to be a consultant to the legal system, preparation of reports and court testimonies.
Fellows will participate in an in-depth review of a specific area or a research project in which research design, data gathering, data analysis, and interpretation of findings will be learned. Each fellow becomes either a part of ongoing research efforts of the faculty or develops, with the faculty members' aid, a project of his/her own. Each fellow will be expected to write a paper and/or present the results of this project. Presentation at national meetings and publication is strongly encouraged but is not a requirement for graduation.