Child and Adolescent Psychiatry Training

children playing outside

The HMS Department of Psychiatry fellowship training in Child and Adolescent Psychiatry provides clinical and educational experiences unique to each training site but draws upon the entire Harvard faculty for collaboration in education and research. The philosophy of training emphasizes direct but well-supervised clinical experiences in Harvard-Affiliated Hospitals and recognizes the salience of developmental and psychodynamic theory which is enriched by a theoretical and scientifically grounded curriculum.

Supervised clinical experiences that address all core fellowship training requirements take place at three primary training sites: The Cambridge Health AllianceBoston Children's Hospital, and Massachusetts General Hospital/McLean Hospital. Each training site offers special opportunities for experiences that address the unique needs and interests of the fellows. Furthermore, each training site offers supervised experiences in inpatient, consultation/liaison, community based programs, ambulatory care, school consultation, forensics, and many other specialty areas. Small group seminars and individual supervision by experienced clinicians provide a firm grounding in diagnosis and treatment on site; these seminars emphasize the more specialized nature of the theoretical perspectives and clinical environments of the individual training sites.

All fellows participate in a core curriculum with a two-year cycle. The courses are presented in a seminar format, supplemented with selected readings, and encourage active participation of the trainees. Seminar speakers have been specifically selected from the Harvard Faculty on the basis of their clinical expertise and research contributions. The core seminars include:

First Year Fellows

  • Normal Development: A critical review of the theories and scientific underpinnings of cognitive-ego, social, emotional and intrapsychic arenas of development that provides a framework for integrating developmental processes.
  • Psychopathology: This seminar integrates the perspectives on psychopathology derived from psychodynamic theory, developmental psychology, and epidemiology, and provides a critical appreciation of current diagnostic nosology and potential future developments.

Second Year Fellows

  • Clinical Integration Seminar: A unique seminar focusing on the integration of multiple clinical perspectives into a cohesive framework for clinical intervention.
  • Quantitative Aspects of Developmental Psychiatry: This series of seminars provides the knowledge base to appraise critically future scientific developments relevant to Child and Adolescent Psychiatry. These include a user-friendly approach to statistics and experimental design, the principles of population-based studies, and an overview of developmental neuroscience.
  • Developmental Neurosciences: This series of seminars includes sessions by basic and clinical neuroscience researchers aimed at elucidating the structural, molecular and genetic bases of normative behavior and emotional reactivity and pathologic syndromes.

Elective time is provided in the two-year training period for specialized clinical experiences or for supervised research opportunities. The Harvard environment offers extraordinary opportunities for those interested in more extensive clinical training, mastery of child therapy, or research training. There remains a strong commitment to psychodynamic psychotherapy, with many supervisors actively involved in Boston psychoanalytic institutes. Research training opportunities abound with several NIH-sponsored training grants providing fellowship positions in epidemiology, genetics, mental health services, mental health policy, developmental psychology, risk factor research, psychopharmacology, and developmental neurosciences. Applicants and trainees are encouraged to design a sequence of fellowship and research training experiences consistent with their long-term career goals.

Boston Children's Hospital Child and Adolescent Psychiatry Fellowship Training Program
CAP Fellows Class of 2016 and 2017 at Boston Children's HospitalFounded in 1869, Boston Children’s Hospital is one of the oldest, largest, and most reputable hospitals in the United States. It is the primary pediatric teaching hospital for Harvard Medical School and is home to the world's largest research enterprise based at a pediatric medical center. Boston Children’s is the #1 ranked children’s hospital by U.S. News & World Report in 8 out of 10 specialties (#2 in the other two specialties).

Boston Children’s is a 404-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Boston Children's offers a complete range of health care services for children from birth through 21 years of age. The hospital has approximately 25,000 inpatient admissions each year and our 200+ specialized clinical programs schedule over 500,000 visits annually. Last year the hospital performed over 25,000 surgical procedures and 150,000 radiological examinations.

The Boston Children’s Hospital Child and Adolescent Psychiatry Fellowship Training Program has graduated over 300 child and adolescent psychiatrists who have gone on to successful careers in clinical, educational, administrative, advocacy, and research realms.  We are strongly committed to training the next generation of child and adolescent psychiatrists who will work in the nation’s evolving health care system to reach children and families. The Fellowship is structured so that the majority of required ACGME training experiences are completed in the first year, allowing substantial discovery time in the second year for personal pursuits whether clinical, education, or investigation.

Cambridge Health Alliance Child and Adolescent Psychiatry Fellowship Training Program
Since 1964, the Cambridge Hospital (now Cambridge Health Alliance, or CHA) has provided a model of innovative community-oriented healthcare in which trainees from all psychiatric disciplines have developed their skills. The CHA mission is to improve the health of the Massachusetts communities we serve. As a safety-net healthcare system, CHA has been on the cutting edge of healthcare reform, and has received national recognition for its innovative work.

Training and education are key elements of CHA’s mission. The CHA Child and Adolescent Psychiatry Fellowship Training Program has its roots in psychodynamic and psychoanalytic therapies, and public sector, multicultural community based care. While continuing to nurture this tradition, the program also trains fellows in other evidence-based treatment modalities in the service of a comprehensive biopsychosocial model. Our values include training highly ethical, independent and responsible physicians who will give excellent psychiatric care to children and families using an integrative approach to child psychiatry that fits the needs of individual patients and their families.

The training experience is designed to develop and strengthen fellows’ abilities to develop a biopsychosocial formulation and treatment plan, and implement appropriate and effective treatments. Fellows are taught to consider different modalities of treatment based upon the family’s preferences for services, the efficacy and cost-effectiveness of certain methods for particular disorders, the capacity of a child and family to engage in treatment, and the level of supporting evidence. The range of psychotherapy techniques taught includes: intensive psychodynamic individual psychotherapy, intensive family therapy, brief and focused individual and family therapies, psychopharmacology, supportive psychotherapy, cognitive behavioral psychotherapy, psycho-educational interventions, and group therapy (including dialectical behavior group therapy).

Massachusetts General Hospital / McLean Hospital Child and Adolescent Psychiatry Residency
The Child and Adolescent Psychiatry Residency of the Massachusetts General Hospital/McLean Hospital provides a two-year program of specialized training in child and adolescent psychiatry. The training program is an integral part of the General Psychiatry Residency Program at Massachusetts General Hospital (MGH) and McLean Hospital, as well as the Pediatric Residency Training Program at MGH.

Residents join staff in providing the best possible comprehensive care for children, adolescents and their families. Child and adolescent psychiatry training at MGH and McLean Hospital is based on the philosophy that no single conceptual framework is sufficient to understand human behavior. Residents are taught to approach patients and their families from a developmental perspective using five clinical orientations: psychodynamic, psychosocial, biologic, behavioral and cognitive. They are challenged to understand clinical issues in depth and to attempt formulations that integrate conceptual models.

Our program recognizes that adequate training for the current and future practice of child and adolescent psychiatry is, of necessity, demanding. Beyond attaining essential knowledge, skills and attitudes, residents need to develop a sense of professional identity that includes being a secure physician, an advocate for children, a sensitive therapist and a thoughtful participant or consultant within team structures. A primary goal of the Training Program is to produce leaders in the field of child and adolescent psychiatry.

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