Clinical Fellowship in Outpatient Clinic

Mission

The mission of the Yale Child Study Center Outpatient Psychiatric Clinic for Children (OPC) encompasses four major goals: 1) to optimize the developmental potential of children and families by providing the most effective treatment interventions available; 2) to provide interventions based on the principles of child development and child psychopathology; 3) to focus on the importance of family involvement in treatment interventions; and 4) to use data to improve and refine our approach to child and adolescent mental health services.

Purpose

The philosophy of the Clinic is based on the belief, backed by empirical evidence, that the family and environment in which youth exist play a critical role both in understanding the youth’s functioning as well as in planning and implementing interventions. Youth do not live or function in a vacuum; the evaluation and treatment of the child or adolescent cannot occur in isolation from the context of the family and environment in which he or she lives and it is this philosophy that guides all the Clinic’s efforts in providing clinical care.

Services

Psychotherapeutic services offered include cognitive behavioral treatments for anxiety disorders and depression, trauma-focused cognitive behavioral therapy for children and adolescents who have experienced trauma, parent management training for disruptive behaviors in children under the age of 12, parent-child interaction therapy for disruptive behavior problems in young children, problem-solving skills training for clients and families, play therapy, and traditional psychodynamic psychotherapy. Parenting skills workshops for parents of children with disruptive behaviors are also offered. In some cases, particularly with older children and adolescents, parenting skills training is not sufficient to address the interactions and relationships between family members and, therefore, we also offer family therapy when indicated. The Clinic also offers social skills training groups for children and young adolescents with social skills difficulties and development of a supportive group for adolescents is underway.

Off-site services include visits to clients’ and families’ homes for the purpose of conducting in-home client and family therapy as well as visits to the clients’ schools generally for the purpose of classroom observations and consultation with school personnel around issues related to the child’s treatment at the Clinic.

Core Curriculum

Supervisors

1. Work with Individual Supervisor: Each fellow will work individually with a senior member of the section faculty who will provide individual supervision throughout the fellowship year and provide guidance on issues of special interest and/or concern. There are opportunities for more than one supervisor.
2. Rounds: Clinical Rounds is a meeting in which cases are presented on a regular schedule. All clinicians seeing clients at the Outpatient Psychiatric Clinic must attend weekly rounds. This session serves as an opportunity for clinicians to discuss their cases with a group of cross-disciplinary colleagues and to review progress and options in their work with families. Rounds are attended by the rounds leaders and all clinical staff (social workers, nurses, psychiatrists, and psychologists) assigned to that group.
3. Supervision for licensure: Each fellow will be supervised for licensure by a member of the social work faculty.

Training

The following will be a required part of the fellowship.

1. OPC Training: Fellows will receive the OPC Provider Registration and Orientation training. This training reviews the requirements and expectations of the Clinic including: clinical forms and clinical approach, charting requirements, procedures for scheduling and treatment room use, procedures for completing/submitting encounter forms, Fee Adjustment Application process.
2. Family Support Service Meetings: The entire Family Support staff and the Outpatient clinic staff meets weekly at 9 a.m. on Tuesdays. This meeting is largely didactic; topics have included modules on trauma, depression, substance abuse and other issues relevant to the work.
3. Other training: Fellows will have the opportunity to be trained and supervised in treatment modalities such as PMT, TF-CBT and CBT.

Core Clinical Experience

1. Treatment: Fellows will be assigned a caseload of 10-12. Work will include clinical assessment, treatment planning, individual psychotherapy with child or parent, family treatment, marital counseling, child guidance, support and case coordination and management. Fellows will carry a caseload that will allow time for training and supervision. The Fellow will be available by beeper Monday through Friday in cases of emergency. The fellow will be included on the monthly Urgent Access rotation for one week per month.