Clinical Experience in Child and Adolescent Psychiatry

Team Leadership: Martin Plawecki, MD, Noha Minshawi-Patterson, PhD and Corissa Dionisio, MD

Autism spectrum and other developmental disorders are increasingly common yet finding psychiatric services remains a challenge due the complexities surrounding their care. The Autism Spectrum and Development Disorders Outpatient Program consists of psychologists and psychiatrists aiming to provide behavioral and psychopharmacologic treatment to this underserved population with patients from all over the state, and not-infrequently out-of-state. Psychiatric residents and fellows rotating in this clinic will have the opportunity to treat this population, addressing common medical and psychiatric comorbidities, and collaborate with psychologists providing behavioral intervention and standardized assessments. The cases are frequently challenging, but the impact is as frequently profound. 

Team Leadership: Leslie Hulvershorn, MD and Zachary Adams, PhD

The Adolescent Dual Diagnosis Program at Riley Hospital for Children approaches youth drug addiction differently from other rehabilitation and mental health clinics in the region. We are the first and only substance abuse therapy program in the Midwest to use ENCOMPASS to tackle this treatment gap. ENCOMPASS is an evidence-based therapy program for kids and teens ages 10-18 who struggle with the difficult combination of substance abuse and mental health disorders. This program brings together cognitive behavioral therapy, motivational interviewing, contingency management, medication assisted treatment, measurement-based care and family therapy. In addition to being certified to use ENCOMPASS to treat our patients, we are the only site certified by the University of Colorado to train other therapists to learn to use the ENCOMPASS model. 

Team Leadership: Kelda Walsh, MD and Ann Lagges, PhD

The Tic/Anxiety/Compulsion (TAC) clinic is a multidisciplinary clinic focusing in the care of children with tic and anxiety spectrum disorders, including selective mutism, Tourette disorder and separation anxiety disorder. Kelda Walsh, MD is the medical director of TAC and supervises residents, who manage these complex patients with several families of medications. Therapy training is led by Ann Lagges, PhD; therapeutic modalities include Comprehensive Behavioral Intervention for Tics (CBIT), exposure and response prevention (E/RP), and anxiety management therapy. TAC clinic sessions begin with a short didactics section each week in which shared patients are reviewed and team members take turns reviewing articles and key diagnoses and treatments. 

Team Leadership: Rachel Yoder, MD, Gabriela Rodriguez, PhD and Hillary Blake, PsyD

The ADHD and Disruptive Behavior Program integrates cognitive behavioral therapy, parent management training, executive functioning therapy, and medication management to comprehensively address these common, multifactorial concerns. Within the ADHD/DBD program learners have full responsibility for their patients with supervision. Residents and fellows become experts at assessing these incredibly common presenting concerns including their comorbidities and environmental contributing factors. This includes gaining expertise in evaluation of and approach to trauma, anxiety, depression, and developmental concerns. Correspondingly, residents and fellows also become adept at communicating and interfacing with schools and community resources.  

Director: Kristen Schroeder, MD

The BHAC is a secured space with four patient rooms within the Riley pediatric emergency room. Child and Adolescent Psychiatry (Physician and a Nurse Practitioner), Pediatric Emergency Medicine Physicians, Behavioral Health Clinicians, Nursing, and Medical Technicians work together to provide emergency psychiatric care to patients in Riley Hospital for Children, as well as some child and adolescent patients throughout the state by use of our phone line. Learners including medical students, residents and fellows are also incorporated into the team in different ways at different times of the day. In 2019, there were over 850 resource or assessment consults for patients completed by the BHAC team. The top chief complaints were suicidal ideation, aggression/agitation, suicide attempts, or non-suicidal self-injury in children ranging 3 - 19 years old  

Team Leadership: Rachel Yoder, MD and Gabriela Rodriguez, PhD

In the family-based treatment program, children and caregivers are both seen for individual cognitive behavioral therapy, parent management training, and if applicable, medication management. By providing integrated mental health care for both children and their caregivers, FBT offers a convenient and comprehensive way for families to address mental health concerns together. Residents see both caregivers and children for medication management appointments and meet weekly with the FBT team (child psychologist, adult therapist, child and adult psychiatrist) to develop integrated family treatment plans. Residents also have the opportunity to observe and gain skills in parent management training. Through FBT, residents gain keen insight into and are able to directly positively impact caregiver mental health, a major contributing and perpetuating factor of child mental health.