Clinical Sites
Dartmouth-Hitchcock Medical Center
The training blocks at the Dartmouth-Hitchcock Medical Center consist of approximately 17 hours per week of outpatient clinical experience working with a wide variety of evaluation and treatment cases. The most frequently seen diagnoses are affective and anxiety disorders, disruptive behavior and learning disorders, eating disorders, post traumatic stress symptoms and developmental disorders. Many of the cases are complex in nature and have been referred for the expertise available at a tertiary care medical center. The clinical activity for the residents on this service includes the comprehensive evaluation of outpatient cases with an integration of family systems, psychodynamic, biologic and sociocultural perspectives, as well as the ongoing psychodynamic treatment of individual children and adolescents. In addition, residents have cases requiring family therapy, pharmacotherapy, parent guidance, behavioral modification and cognitive-behavioral treatment. Many clinical services are delivered in specialized clinics, e.g., psychopharmacology, developmental disabilities, with dedicated staff and structured assessment/treatment protocols. Residents also work in close collaboration with other clinicians in the Section, e.g., pediatric neuro-psychologists, in cases requiring multi-disciplinary evaluation or treatment.
The Anna Philbrook Children's Center
Training at the Philbrook Center emphasizes the assessment and care of seriously disturbed children and adolescents who require 24 hour care. Patients have a wide variety of behavioral, affective, cognitive, legal, family and psychosocial problems including, psychosis, substance abuse, depression, bipolar disorder, suicidal behavior, eating disorders, sexual/physical abuse-induced syndromes and violence. In their role as clinical team leaders, residents are exposed to active treatment programs that stress post-discharge, community services planning from the time of admission. Treatment modalities include cognitive-behavioral treatment, groups, milieu treatment, pharmacotherapy, family therapy, behavioral modification and focal psychodynamic interventions. While the Philbrook Center is a traditional inpatient unit, it is also a site where residents can participate in a variety of additional clinical and research experiences. These include 1) experiences with child mental health service system development, 2) exposure to severely disturbed children who require long term traditional individual or family treatment, 3) experience with child forensic cases and consultation to the court, 4) experience with medicating treatment resistant cases of children who require multiple medications.
Protective Services System of Care
The Protective Services System of Care rotation is based in Concord, NH. Residents are assigned to the district office of the NH Division of Children, Youth and Families (DCYF) where they serve as consultants to the protective services staff and their clients. Residents have a unique opportunity to both learn about and work with the multiple agencies affecting the lives of mentally ill, at-risk children and their families. Experiences include intake assessments, crisis evaluations, home visits, court appearances, multi-disciplinary treatment team meetings and clinical consultations. Supervision is provided by Dartmouth Medical School faculty and senior DCYF staff.
Woodsville Juvenile Rehabilitation Center
The Woodside Juvenile Rehabilitation Center is Vermont's only secure residential program for adjudicated adolescents. Residents are assigned primarily to the Treatment Program (The Vermont Intensive Treatment Program for Aggressive Adolescents) although they may also be asked to consult on cases in the Detention Program particularly if there is a learning opportunity. Treatment is intensive and based upon behavioral, cognitive and psychodynamic principles with minimal use of psychotropic medications. Residents participate at multiple levels of the program including assessment, treatment and medication consultation. Since the average length of stay is approximately 15 months, residents have the opportunity to follow specific cases for the duration of the rotation. Faculty holding dual University of Vermont (UVM)/Dartmouth Medical School appointments provide supervision.