Child and Adolescent Services / West Haven Mental Health Clinic

Overview

The West Haven Mental Health Clinic is a satellite program of the Connecticut Mental Health Center that provides outpatient psychiatric services to children, adolescents, and adults living in the city of West Haven. The placement on the Child and Adolescent Service at the West Haven Mental Health Clinic provides psychology fellows from several primary sites with a focused, secondary experience working with children and adolescents in an outpatient setting. Previous experience working with children and adolescents is desirable but not necessary for applicants to choose this option as a secondary placement.

Placement Options

The West Haven Mental Health Clinic is only available as a secondary placement for the full year at 15 hours per week.

Applicants who may choose this secondary placement include those with a primary placement at (a) Forensic Addiction Services / Forensic Drug Diversion Clinic, (b) Hispanic Behavioral Health Services / Hispanic Clinic, (c) Substance Abuse Services / SATU, or (d) The Consultation Center.

Applicants who choose the Young Adult Service (YAS) as their primary placement always have the West Haven Mental Health Clinic as their secondary placement.

Number of Fellows

There are usually five or six secondary fellows at this site.

The Setting

The West Haven Mental Health Clinic is a satellite program of the Connecticut Mental Health Center that provides outpatient psychiatric services to children, adolescents, and adults living in the city of West Haven. The clinic is composed of an Adult Service and a Child and Adolescent Service. The Child and Adolescent Service provides outpatient treatment to an ethnically diverse population of minor children experiencing both acute and chronic psychiatric difficulty. The service treats 70 to 100 clients annually. Most of the clients are 4 to 17 years of age; and most are of Italian-American, African American, Latino, or mixed heritage. All of the clients are living in urban poverty, and most have experienced psychological trauma in the context of severe family stress. Many are also involved with the special education, child protection, or juvenile court system.

Services available through the Child and Adolescent Service include: (a) intake-triage, (b) crisis intervention, (c) individual psychotherapy, (d) group therapy, (e) parent intervention, (f) family therapy, (g) psychological assessment, (h) pharmacotherapy, and (i) clinical consultation with professionals in other service delivery systems. Most children admitted to the service receive a comprehensive initial assessment and some form of individual psychotherapy with complementary parent or family intervention. Clinical consultation with school and child protection systems is very common. The setting emphasizes the integration of a developmental perspective on child and adolescent psychopathology with a community perspective on service delivery. Although the validity of all theoretical perspectives is acknowledged, every effort is made to integrate the best available empirical evidence into a multisystemic perspective on assessment and treatment.

The Internship

The Child and Adolescent Service at the West Haven Mental Health Clinic provides psychology fellows from several primary sites with a focused, secondary experience working with children and adolescents in an outpatient setting. When coupled with one of the primary placements, this site provides fellows with an opportunity to learn more about (a) service delivery systems for children and adolescents, (b) the intergenerational transmission of psychiatric difficulty, personality disturbance, substance abuse, and intimate partner violence, and (c) the outpatient psychiatric assessment and treatment of children and adolescents. Because the service cares for children and adolescents whose parents have often been in systems of care for adults, the placement provides fellows with an opportunity to see the impact of clinical problems being addressed at their primary site on children living with an affected parent. The placement also provides fellows with an opportunity to pursue the development of knowledge and skill needed to work with clients across the lifespan.

While working as a member of an interdisciplinary treatment team, psychology fellows with a secondary placement on the Child and Adolescent Service serve as a primary clinician for a caseload of four clients. Attention is given to diversifying clinical assignments in terms of age, gender, ethnic heritage, and presenting problem. Every effort is also made to both match the special interests of the fellow and address gaps in their exposure to children and adolescents. Secondary fellows also have the opportunity to choose a psychotherapy development project of interest to them. Choices currently involve opportunities to learn Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) for children and adolescents or a mentalizing-based therapy for parents.

Supervised experience in the delivery of clinical services is used as the primary mechanism to expose fellows to clinical work with children and adolescents in a local system of care. With support and supervision, fellows are responsible to conceptualize and coordinate a program of ambulatory assessment and treatment for their assigned clients. Throughout the year, fellows (a) complete comprehensive initial assessments, (b) provide individual psychotherapy, and (c) provide parent and family intervention. They also work collaboratively with an attending psychiatrist, consult with school staff, and consult with professionals working in other service delivery systems.

Evidence-Based Practices

The following evidence-based practices (EBPs) are used in this placement setting. Fellows generally have exposure to most of these EBPs, but they do not necessarily receive training or supervised experience in all of them. The EBPs include: (a) Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), (b) Circle of Security, (c) Coping Cat, (d) cognitive-behavioral therapies for depression, anxiety, anger management, and school refusal, (e) Interpersonal Therapy for Depressed Adolescents (ITP-A), (f) play therapy, (g) parent management training, and (h) mentalizing-based therapy for parents.

Scholarly Activity

Secondary fellows at this site usually pursue a scholarly activity at their primary site. With approval, fellows interested in service delivery to children and adolescents could pursue a program evaluation or quality improvement project at this site as their scholarly project.

Faculty

Thomas McMahon, Ph.D., Secondary Advisor
Christy Olezeski, Ph.D., Secondary Advisor
Nakia Hamlett, Ph.D., Secondary Advisor
Michelle Silva, Psy.D., Supervisor
Sheryl Silverstein, Ph.D., Supervisor
John Collins, Ph.D., Supervisor
Annita Sawyer, Ph.D., Supervisor
Myriel Rodriguez, Ph.D., Supervisor

Supervision

All of the clinical work done by the Child and Adolescent Service is supervised by an interdisciplinary treatment team comprised of faculty representing the disciplines of psychiatry, psychology, social work, and nursing. All secondary fellows at this site attend a weekly treatment team meeting. They also have 90 minutes of individual supervision weekly with a licensed child psychologist who serves as a clinical consultant concerning the assessment and treatment of assigned cases. Individual supervision is tailored to match the fellow's previous experience. Fellows also have 60 minutes of group supervision weekly as part of their psychotherapy development project. Interdisciplinary huddles within the clinic are common in order to deal with immediate problems that occur in the treatment of children and adolescents. All supervisors have specialized training and expertise in clinical child and adolescent psychology.

Seminar & Specialized Training

This placement offers fellows an opportunity to learn more about evidence-based practice with children and adolescents.

In addition to the Core Seminar, secondary fellows participate in an applied seminar that focuses on the psychiatric assessment of children, adolescents, and young adults. During the summer, the seminar is used to orient fellows to clinical work with children and adolescents in the local system of care. During the remainder of the year, didactic presentations by faculty with complementary reviews of clinical material presented by trainees are used to explore clinical issues frequently encountered in developmentally oriented assessment and treatment of younger clients. Participation in this seminar is a requirement for all fellows with a secondary placement on the Child and Adolescent Service.

Applicant Qualifications

Applicants choosing the Child and Adolescent Service as a secondary site must have an interest in working with children and adolescents in an ambulatory setting. Previous experience working with children and adolescents in a clinical setting is desirable but not necessary.

Regulations issued by the Connecticut Department of Children and Families require that applicants who match to this secondary placement have a physical examination, tuberculosis screen, and additional background checks completed before they begin the internship. These special requirements are reviewed during the interview process, and forms to complete the requirements are mailed with letters of acceptance following the APPIC match.

For Further Information

For further information, contact Dr. Thomas McMahon at thomas.mcmahon@yale.edu.