The AMPS Program consists of an interdisciplinary team including a physician, a nurse practitioner, a psychologist (psychiatrist if needed), physical therapists, occupational therapists, a music therapist, an art therapist, a school coordinator, a social worker, an aquatic specialist and support staff. We treat children and adolescents with amplified pain through intensive physical, occupational and psychological/creative arts therapy to restore function without pain medications. This is a daily program, Monday-Friday, 8 a.m. to 4 p.m., that may take from one to seven weeks (average four weeks), and can be either inpatient or outpatient, depending on the need.
Our mission is to provide a comprehensive holistic interdisciplinary team approach to the individualized treatment and care of children with Amplified Musculoskeletal Pain/RND. We uphold this mission by empowering children and their families through instilling confidence and providing hope to restore overall healthy life function.
Interns participating in the AMPS Program will provide psychological services to patients including a minimum of two sessions per week, co-treatment with PT/OT and consultation with the interdisciplinary team to inform treatment planning. Interns will also work with parents and participate in family meetings, as appropriate. Additionally, interns will have the opportunity to consult with patients’ schools and outside mental health treatment providers, as appropriate. There are also opportunities to participate in patient and parent group psychotherapy.
Interns are expected to attend RND rounds and patient care meetings. Specific training objectives of the rotation will be tailored to each intern’s training needs, goals and objectives.
This rotation takes place in seven public schools in Philadelphia: A large 1200-student K-8 school where interns are engaged in providing mental health services to children and families, and six K-8 schools where interns learn how to provide state-of-the-art consultation services to school behavioral health staff (SBHS) as part of a large dissemination and implementation study.
The rotation is designed to educate psychology-graduate students and post-doctoral fellows in psychology and psychiatry about the delivery of mental health and other health services in urban schools. Trainees work closely with other clinical and educational disciplines to provide consultation, education and direct services. Trainees use a problem-solving approach based on a conjoint behavioral consultation model to foster collaboration and mutual support between parents/caregivers and teachers on behalf of children who present with various problems. Children with disruptive behavior, aggression, peer victimization and bullying, mood problems, excessive anxiety, academic performance deficits, underachievement, attention deficit disorder, poor impulse control, acculturation issues, and other adjustment difficulties are referred for this service.
Referrals on behalf of children 3 to 18 years of age are accepted for intervention services. Intervention models typically entail child and family behavior therapy, parent education and training (in individual or group formats), teacher and school consultation and, when indicated, closely monitored and evaluated medication trials conducted alone or in combination with cognitive-behavioral and psychoeducational strategies. You will develop skills pertinent to developmental psychopathology, school consultation, child and family behavior therapy, home-school collaboration, psychopharmacology, and outcome assessment.
For families coping with ADHD, challenges related to treatment utilization and adherence arise for a variety of reasons, including family beliefs and stress, and limited provider availability. Group treatment formats are one method by which barriers might be reduced. Also, through group discussion and shared problem solving, parents and children derive support from others coping with ADHD, potentially increasing utilization and adherence.
The ADHD Center’s parent group treatment programs (Boot Camp, Family-School Success [FSS], and Back-to-School) are intended to support diagnosis acceptance and treatment initiation/adherence. Additionally, the groups focus on developing and maintaining strong, collaborative family-school relationships to support educational success. Group participants are parents of elementary aged children with ADHD. Also, in spite of the availability of effective parent training programs, many children with ADHD experience significant organizational skills impairments. The Time Management, Organization, Planning and Study Skills (TOPS) program is a skills-training group intervention targeting middle school students with organizational deficits. This group also helps parents and teachers support students’ implementation and practice of skills to promote generalization.
These programs seek to enhance the capacity of urban, under-resourced schools and communities to more proactively address problems related to bullying and aggression, and to promote social skills, problem solving, leadership, academic success, and a positive school climate. Our initiatives are supported by several grants awarded to Principal Investigator, Stephen Leff, PhD, including the PEW Charitable Trusts Foundation and the Department of Education/Institute for Education Sciences (IES). Further, our efforts are supported at the highest level within the Children’s Hospital of Philadelphia, as our school-based bullying prevention programs are part of the Violence Prevention Initiative (VPI) that was developed as a charge from the Hospital CEO.
A clinical opportunity for interns includes facilitating the PRAISE Program in South Philadelphia elementary schools. PRAISE (Preventing Relational Aggression In Schools Everyday) is an empirically supported school-based bullying prevention program for 3rd-5th grade youth. It is run by our clinicians in partnership with teachers. PRAISE is a 20-session classroom intervention designed to help at-risk African American elementary age youth handle physical, social, verbal and cyber bullying and aggression through instruction in valuable anger management and problem solving strategies, empathy and perspective taking skills, and how to handle being a bystander of aggression and bullying.
Interns also have the opportunity for applied clinical research experiences through an intervention development grant. Over the next three years, our team will be developing the Partner for Prevention (P4P) Program, a multi-component bullying prevention program for urban schools. Through qualitative methods such as focus groups, interviews, and participant observations with youth and diverse school staff and community members, we will be modifying PRAISE, as well as developing program components for playground and lunchroom consultation, teacher training, and parent/community outreach. Interns would have the opportunity to participate in school-based qualitative activities, qualitative data analysis, program development, and a systemic pilot study of the new program in the last year of the grant.
COTTAGe provides training in the cognitive behavioral approaches to obsessive-compulsive disorder (OCD) and other anxiety disorders, tics and trichotillomania in a pediatric population. The outpatient treatments include exposure and response prevention for OCD, cognitive behavioral treatments (CBT) for pediatric anxiety (consistent with the Coping Cat manual), and habit reversal training for tics, trichotillomania and other body-focused repetitive behaviors. Patients are seen in an outpatient context and are largely 6-18 years old. Some adult patients may also be seen for tics and trichotillomania. There is often a heavy focus on family involvement in treatment and relapse prevention, especially for the younger patients. In addition, there is an opportunity to attend workshops presented by the clinic intended to train community clinicians on the treatments described above.
The training model consists of observation of others’ ongoing cases, watching videos of previous cases, ongoing weekly supervision, and periodic live observation by a supervisor.
The ABC provides training in the cognitive behavioral approaches to primary anxiety disorders, selective mutism, and other disorders that commonly present with anxiety (selective eating, sensory sensitivities). The outpatient intervention is cognitive behavioral treatments (CBT) for pediatric anxiety (consistent with existing manuals and treatments supported by the scientific literature). Patients are seen in an outpatient context and range in age from 4 to 18 years. There is typically a strong focus on family involvement in treatment and relapse prevention.
The training model consists of observation of others’ ongoing cases, ongoing weekly supervision, and periodic live observation by a supervisor.
The Department of Child and Adolescent Psychiatry and Behavioral Sciences Outpatient Clinic provides training in Cognitive Behavioral Treatments (CBT) to address the needs of youth presenting with depressive disorders and depressive symptoms in response to episodic or chronic stressors. The types of treatment modalities include behavioral activation, cognitive restructuring, emotion regulation, problem solving, relaxation techniques, and parent-child communication strategies. Parents are often involved in the treatment depending on the age of the patient, and behavioral management or behavioral family therapy techniques may be employed. The youth will range in age from 8 to 18 years. The training model utilizes the intern as the primary clinician conducting treatment sessions, with the supervising clinician present in the treatment room for live supervision.
This rotation provides training in the assessment of and intervention with children, adolescents, and families presenting with eating disorder concerns. There are two sites for the rotation:
The Family Stress and Illness Program provides family based outpatient services to address the psychological needs of children and families experiencing acute or chronic illnesses. The unique strengths of families are recognized through all aspects of care, in particular the essential impact families have on illness management and health outcomes. Priority is assigned to providing care for children and families who have recently experienced inpatient medical hospitalization and require ongoing psychological care to optimize healthy adjustments.
This rotation offers an opportunity to be part of an outpatient interdisciplinary team comprised of medicine, nursing, nutrition, social work and psychology. Our patient population includes children and adolescents with a range of presenting gastrointestinal conditions that include Inflammatory Bowel Disease, Functional Gastrointestinal Disorders, Eosinophilic Esophagitis, as well as Defecation Disorders.
This rotation is generally completed as a four-hour rotation. However, other arrangements may be made to accommodate needs of a particular intern’s training interests/schedule.
Required training activities include:
Intern will attend Cancer Survivorship Program (CSP) clinic each week (Wednesdays) and will shadow the supervisor as she provides consultations to families referred by the CSP medical team. Over the course of the rotation, the intern will take on more responsibility in providing the consultation. Intern will participate in team rounds to prepare for patients (morning of clinic). There will be the opportunity to provide ongoing outpatient therapy to one to two survivors/families initially seen in these consultations. Interns will also be expected to make follow-up phone calls to patients after consults, as needed. In addition, since many of the survivors face learning/cognitive problems, interns will also be expected to help navigate school and learning issues and make referrals for psychoeducational testing.
Each consult must be documented by a consultation note within a few days.
Interns will be responsible for writing consultation notes, initial evaluations and progress notes. Consultation and progress notes should be completed on the day of the patient visit. Initial evaluations (including treatment plan) should be completed within three sessions.