Program Overview | Curriculum | Conferences | Training Sites |  Faculty |  Application Process

First Year Training | Second Year Training |  Examples of Electives | Academic Half Day

 First Year of Training

Inpatient Rotation

On inpatient services at the Children’s Psychiatric Institute, residents will perform complete diagnostic evaluations of the children, adolescents, parents and families entering the inpatient unit. Residents will then be responsible for integrating the treatment plan based upon the results of the evaluation, and whenever possible, following the patient and family through the continuum-of-care programs. Residents will be the team captains and responsible for psychotherapeutic and psychopharmacological treatment as well as working closely with the milieu programming. Residents will also participate when indicated in family and parent therapy as well as the group psychotherapy involving their patients.  Residents at the Children’s Psychiatric Institute will rotate for 6months each in these latency and adolescent units.

Diagnostic and Treatment Team – 2 hours/week/12 months at CPI (1ST year)

Residents perform outpatient evaluations and short-term treatment with families, parents, children, and adolescents under supervision of the staff child psychiatrist team leader and the multi-disciplinary team faculty. Collaboration with other community agencies including schools, courts, and social services is a vital treatment component.

Family Therapy – 3 hours/week (1st year)

Residents will perform family therapy while being observed by supervisors and other residents. The family therapy literature seminar will be 1 ½ hours/week over the 6 months. The major theoretical schools of family therapy will be reviewed in this seminar. Residents from Duke training program participated in the family therapy seminar during their general training.

Didactic Conferences – listed under conferences section

Basic Concepts Conference 1 hour/week (both years)

Family Therapy Literature Seminar 1 ½ hours/week/6 months (1st year)

Evidence-Based Medicine Seminar 1 ½ hours/week (both years)

Neurobiological Basis of Behavior and Cognitive Neuroscience 1 ½ hours/week/ 10 months
(1st year)

Pediatric Psychopharmacology 1 ½ hours/ week 12 months (both years)

Child Psychotherapy 1 ½ hours/week/6 months (given alternate years, taken either first or second year)

Normal Child Observation

Residents carry out systematic observations of infants, children, and adolescents in infant care center, day care settings, kindergartens, elementary and junior high schools. Group supervision is included in the four hours.

Outpatient Treatment of Families, Parents, Children, and Adolescents

Residents conduct ongoing long-term outpatient child and adolescent psychotherapy, and family therapy with one hour/week of regularly scheduled supervision with a staff child psychiatrist. Cases are carefully selected so that the resident can gain experience with a broad spectrum of psychopathology. Medication management cases are included.

Child Psychotherapy Program – (both years)

A child or adolescent is worked with in weekly sessions in Cognitive Behavioral Psychotherapy. The resident also works with the parent as part of the treatment. The case is presented to a supervisor in once/weekly case supervision.  A long-term psychodynamic psychotherapy case starting in the first year is supervised weekly.

Developmental Disorders

Residents will evaluate and treat patients of varying ages with developmental disorders in multiple treatment settings, including inpatient, outpatient treatment and psychopharmacology clinic. They will also observe these patients in multiple specialized treatment settings during their 2 years of training.

Individual Supervision – 2 hours/week

Individual supervision of inpatient work is included in the inpatient block of time.

Administration – (both years)

Child residents meet with one of the program directors at least quarterly; carting, paperwork, conference preparation and weekly clinical management meeting and policy and planning meeting weekly.

 Second Year of Training

School-Based Consultation

The School-Based Consultation Service experience has duration of 12 months at 10% of the resident’s time and is required. The primary educational activity of the School-Based Consultation rotation is real-time, direct discussions with and supervision of residents engaged in consultation to participating public schools with self-contained, therapeutic special education classrooms. The faculty supervisor is present via live and interactive videoconferencing.

Psychopharmacology Clinic

Residents will initiate medications and follow selected cases of children and adolescents on psychotropics under supervision of child psychiatric psychopharmacologists.

Developmental Disorders

Residents will evaluate and treat patients of varying ages with developmental disorders in multiple treatment settings, including outpatient treatment and psychopharmacology clinic. They will also observe these patients in multiple specialized treatment settings during their 2 years of training.

Didactic Conferences – listed under conferences section

Basic Concepts 1 ½, hours/week – 12 mos (both years)

Post Traumatic Stress 1 ½ hours/week- 12 mos.

Evidence-Based Medicine Seminar 1 ½ hours/week x 2/mo. (both years)

Psychopharmacology 1 ½ hour/week 12 mos. (both years)

Child Psychotherapy 1 ½ hours/week/6 months (given alternate years, taken
either first or second year)

Pediatric Consultation

Residents will provide consultation to and liaison with pediatricians for inpatient setting pediatric patients. They will provide 24 hour emergency consultative service to the pediatric services. Consultations will be supervised by the service attending.

Outpatient treatment of families, parents, children, and adolescents

Residents conduct ongoing long-term outpatient child and adolescent psychotherapy, parent therapy, and family therapy with one hour/week of regularly scheduled supervision with a staff child psychiatrist. Cases are carefully selected so that the resident can gain experience with a broad spectrum of psychopathology. Medication management cases are included.

Duke Outpatient Psychiatry Clinics

Duke Child & Family Study Center --- Affiliated Clinic --- Crabtree Clinic

Subspecialty Programs – 4 hours/week / 3 months

Pediatric Neurology Rotation – 4 hours/week/3 months

Several specialty settings including: Autism Clinic, Behavioral Disorders Clinic, and General Pediatric Neurology Clinic.

Developmental Delay Clinic- 4 hours/week/ 3 months

Psychopharmacology Clinic – 4 hours/week/ 3months

Substance Abuse Rotation – 4 hours/week/3 months

Elective Tracks

Towards the end of the first residency year, residents submit a written statement concerning their clinical, administrative, academic, and research interests and how these will be developed during the elective time in the second residency year. The purpose of the elective rotations is to provide a further foundation for eventual professional career goals in child and adolescent psychiatry. (Those wishing to enter a research, academic career track should initiate research activities in the first year of child psychiatry).

Any of the aforementioned services and rotations in the first year of residency can be resumed and/or expanded. The multiple resources within the Department of Psychiatry, Duke University , State facilities, etc. provide a broad array of available opportunities for further specialized training.

Normal Child Observation – (both years)

Residents carry out systematic observations of infants, children, and adolescents in infant care center, day care settings, kindergartens, elementary and junior high schools. Group supervision is included in the four hours.

Child Psychotherapy Program – (both years)

A child or adolescent is worked with in weekly sessions in Cognitive Behavioral Psychotherapy. The resident also works with the parent as part of the treatment. The case is presented to a supervisor in once/weekly case supervision.  A long-term psychodynamic psychotherapy case starting in the first year is supervised weekly.

Individual Supervision – 2 hours/week

Supervision is provided at each clinical site by the faculty member responsible for the care
Psychotherapy supervision is part of this time.

The following are examples of elective programs:

Research

Within the Division, there is the opportunity for hands-on research with staff members in the current areas of their research:

• Neurobiology and genetics of affective disorders.
• Childhood epidemiology.
• Attention deficit disorder.
• Anxiety and Affective Disorders in children and adolescents

Clinical

• Substance abusing youth, attention deficit disorders, anxiety syndromes, depression, etc.
• Eating Disorders
• Sexual abuse treatment – participation in evaluations and legal activities involving sexually abused youth.
• Anxiety and Affective Disorders in children and adolescents

Academic

• Organization of and participation in teaching activities with medical students and general psychiatry residents.
• Inauguration of pilot clinical research studies which can evolve into academic clinical research activities.

It should be emphasized that these elective areas are only a few examples of the many which are possible utilizing the multiple resources available within Duke and CPI and the surrounding university and state facilities. A post-residency training year may e available for selected individuals in one of these specialty areas.

*Entry into the elective tracts is dependent upon the child resident demonstrating sufficient mastery of the core curriculum areas in the first residency year.

A satisfactory clinical, clinical research or basic research paper is required for graduation. Residents will present their papers at a child Psychiatry Grand Rounds at the conclusion of their two year residency. Topic approval to be requested by April 1 of last year.

Academic Half Day

Materials from the Duke Psychiatry seminars in Child and Adolescent Programs will be posted here soon. Please watch for announcements regarding these postings.