Clinical Child Track

The Clinical-Child track extends and deepens the interns base of professional development and promotes a rich understanding of the intrapsychic, familial, school, social and community/systems aspects of child psychopathology and psychotherapy.

Toward these goals, the track provides intensive clinical and didactic experience in the range of activities that comprise the role of the clinical-child psychologist. Training is built around a core of experiences in treatment, assessment, and consultation with children, adolescents, parents, families, school and agencies. This training is integrated with a broad range of clinical seminars. Emphasis is on the development of those clinical skills and theoretical concepts that are essential for psychologists entering a variety of career activities in the child mental health area.

The tracks theoretical orientation reflects an integration of intrapsychic, developmental, family interactional, and cognitive-behavioral points of view.

Activities

  • The Child Track intern carries a caseload resulting in 10-12 outpatient hours per week. These cases are primarily drawn from the Child and Adolescent Psychiatry Clinic and involve working with children, adolescents and families representing a wide range of ages, types of disorders and treatment techniques. Child Track interns may also take on an adult treatment case if they elect to do so (e.g., through the Student Counseling Service). One-to-one supervision is provided by different faculty at a minimum of 4 hours per week. There are also opportunities to collaborate with faculty in ongoing evaluations of treatment cases.
  • Each intern performs and observes psychological assessments of children and families referred by our own clinics, school-based programs, and the community. Interns receive (at least) weekly supervision of their assessments and work as part of an ongoing Child and Adolescent Assessment Team through which they complete 4 - 5 assessments per year. (Adult Track interns may not complete a child or adolescent assessment while on the Child Rotation, and the Child and Adolescent Assessment team is not a required part of the rotation.)
  • Each intern completes several diagnostic evaluations as part of the Child and Adolescent Diagnostic Team. For this team, interns (or residents or fellows) conduct an evaluation (which can include play, psychological assessment, diagnostic interview, family meeting, etc.) while the supervisor and team of other clinicians (interns, residents, and fellows) observe via video camera. The intern consults with the team during the initial diagnostic assessment session and then works closely with the supervisor for the remaining evaluation and feedback sessions (often 4 to 5 sessions in total). (Adult Track Interns on the Child rotation typically complete one Diagnostic Evaluation.)
  • Interns attend and present case formulations on a rotating basis during the weekly Child and Adolescent Clinic Staffing meeting. (Adult Track interns on the Child rotation typically present one case at staffing meetings).
  • Each child intern participates, on a 4 month rotation, in the weekly Child Psychiatry/Medical Follow up consultation appointments at the Dept. of Pediatric Surgery's Outpatient Pediatric Medical Trauma Clinic. This program adds a psychological screening/psycho-education component to the standard post-hospital-discharge pediatric medical follow up. Cases involve children who have experienced various medically traumatic injuries (falls, motor vehicle accidents, pedestrian/car/bike accidents, etc.), with pediatric patients ranging in age from a few weeks old to late adolescence. Interns have an opportunity to observe both the medical follow up appointment and the psychological screening interview and psycho-education geared specifically to normalizing certain reactions and providing resources to the family when/if they are needed. Over time, the intern will conduct some of these interview themselves, under supervision of the faculty member involved

Throughout the training year, interns may participate in the following subspecialty clinics and programs:

The Attention Deficit Hyperactivity Disorders Program (Dr. Kevin Antshel)

is a nationally recognized center for the assessment and treatment of ADHD. Clients referred to this clinic for evaluation undergo a comprehensive protocol of rating scales, interviews, and psychological testing. ADHD Clinic Interns observe and/or participate in ADHD evaluations. (All Child Track interns participate, 1 intern every 8 weeks)

The Anxiety Disorders Clinic (Dr. Nancy Goodman)

is a specialty clinic designed to assess and treat children and adolescents presenting with generalized anxiety disorder, phobias, social anxiety, separation anxiety, panic disorder, as well as obsessive compulsive disorder. A didactic seminar is offered that explores diagnostic issues and treatments, with a focus on empirically validated approaches, particularly cognitive behavioral therapies. The seminar also offers the opportunity for group supervision on challenging anxiety related cases. (Elective)

ENHANCE Excellence in Health Care for Abused and Neglected Children (Dr. Ron Saletsky)

is a nationally recognized multidisciplinary (pediatrics, child psychiatry, developmental pediatrics, social work) clinic which provides comprehensive health care to children in foster care. An intern involved with the ENHANCE Clinic will gain experience in diagnostic interviewing, developmental evaluations, multidisciplinary consultation, and systemic issues. Interns work in a primary care setting to address mental health issues of foster care children. (All Child Track interns participate, 1 intern at a time for a period of 4 months)

Upstate Medical University Juvenile Trauma Center (Dr. Wendy Gordon)

serves children and families who have experienced trauma stemming from abuse, violence, accidents, natural disasters, or death of a family member. The center offers a 12 to 15 session protocol for symptom reduction that focuses on the development of coping strategies and an understanding of common reactions to trauma. Services are also offered for children who may require longer-term treatment. Interns have the opportunity to actively participate in their own clinical cases, and receive training in trauma-oriented cognitive behavioral therapy. (All Child Track Interns and Adult Interns on the Child rotation participate)

Adolescent DBT (Dialectical Behavior Therapy) Program

is intended to treat teenagers who have suicidal thoughts and/or self-harming behavior. Comprehensive DBT has three main components: Individual DBT which reinforces learning that takes place in skills group and provides additional coaching and psychotherapy for the adolescent. Family involvement is often necessary and will be incorporated into treatment based on the needs of the adolescent. Multi-Family Skills Group is a two-hour, 20-week group in which both the adolescent and parent(s) participate. Telephone Coaching is provided to help the adolescent and parent(s) use their DBT skills in times of distress. Interns co-facilitate group DBT treatment for adolescents and their parents. (Elective)

Social and Emotional Skills Group for Children on the Autistic Spectrum (Amy Beale, LMSW-R)

The child therapy group uses a play-based model to foster social relationships and emotional skill building. The group activities are designed to increase shared attention and engagement with others in order to build the child's interest and pleasure in relating to others. Activities foster communication of both emotions and ideas. Structured problem solving activities and role play offer children the opportunity to practice negotiating and expand their repertoire of interaction skills. Children are also taught relaxation skills in order increase emotional regulation. Interns co-facilitate these skills groups for children with Autism. (Elective)

Psychological and Developmental Assessment Clinic (Dr. Jessica Costosa-Umina)

This specialty clinic uses psychological testing to enhance understanding of particularly challenging cases and generate useful recommendations. Batteries often include completing a review of records, a clinical interview, collaboration with referring or other providers, as well as completing a range of psychological measures. Interns will be observed by staff to assist with proper administration via live feed video. Interns will also have the opportunity to observe staff conduct psychological tests. Batteries can include, depending on the clinical question, a general cognitive measure (i.e. WISC – V); an academic measure (i.e. WIAT – III); collateral report measures (i.e. BASC 3); developmental measures (i.e. ADOS – 2); objective personality measures (i.e. Millon Preadolescent Clinical Inventory) and projective measures (i.e. Rorschach Inkblots R-PAS scoring system; storytelling tasks , i.e., Roberts, TAT/CAT). (All child track interns participate)

The Child and Adolescent Psychiatry Intake/Consultation Service

The gateway to the overall array of services in our Child and Adolescent Psychiatry Clinic. Whenever parents call the clinic for an appointment, a consultation is scheduled with a clinical child psychologist. The goal of the consultation is to provide the family with some direction and to determine the need for further services. Psychology interns have the opportunity to be involved in this process by observing and/or actively participating in the consultations. (This is a required activity for Adult Track interns on the Child Rotation.)

Child Track Seminars

Child Track interns participate in didactic experiences that are specific to Child and Adolescent Treatment. Each week interns attend Child Rounds during which research and/or clinical material is presented and discussed by professionals from various disciplines. Child Track Interns also attend a weekly Child Psychotherapy Seminar along with the Adult Track interns on the Child Rotation. Child Track Interns and interested Adult Track interns also attend a weekly Adolescent DBT seminar.

Additional seminars include:

  1. All child interns, and adult interns on the child rotation (along with social work interns and child psychiatry fellows), attend the weekly Juvenile Trauma Seminar. This 10 month seminar provides didactics, readings, and interactive discussion related to the "essential ingredients" for normal child development and attachment to occur, and the ways in which traumatic events in a young child's life (complex developmental trauma) can impact neurological, emotional, and physical development. The goal of this seminar is to provide an understanding of the long term impact of early, chronic trauma on a child's neurological, emotional, physical and behavioral functioning, and ways providers can intervene with these children and families utilizing a "trauma-focused lens".

  2. All child interns, child and forensic fellows, and adult interns on the child rotation will attend the year-long, monthly Child Abuse Seminar. This seminar focuses on a wide range of topics, all related to issues involving child abuse. This includes the mandated certification class for the NYS Mandated Reporting of Child Abuse and Neglect, as well as other topics from normal vs. abnormal sexual development, legal issues in child abuse and neglect, paraphilias, and medical conditions often mistaken for abuse or neglect among others.

  3. Interns are required to complete approximately of 4 -5 psychological test batteries. Interns attend weekly didactic training seminars that focus on psychological and developmental evaluations and feedback. Topics include administration, scoring, and interpretation of a range of psychological measures. Interns are supervised in scoring and interpretation of the measures in writing comprehensive, integrative psychological reports and providing useful feedback to providers and patients and their families.

 

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