Clinical Child Psychology

The Clinical Child Psychology Track provides in-depth training in clinical child psychology within the context of a variety of treatment settings, including inpatient, partial hospital, outpatient, therapeutic school, and home-based environments. In each setting residents will be involved in assessment, treatment, and consultations tailored to best fit each clinical setting. Residents can work with children and adolescents across the age spectrum and with a wide variety of emotional, behavioral, and neurodevelopmental challenges. Individual, family, and group therapy interventions are utilized, with an emphasis on evidence-based practices best suited for the population being treated. Children and adolescents represent a wide range of populations in terms of race, ethnicity, socioeconomic status, sexuality, and gender identity. Residents complete three 4-month primary rotations within clinical programs that are affiliated with Bradley Hospital. The clinical psychology residents can rank-order the following rotations (described in detail below), based on their particular interests and training goals: Children’s Partial Hospital Program Rotation, Community-Based Therapeutic School Rotation, Intellectual and Developmental Disabilities Rotation, Adolescent Inpatient Unit, and Anxiety and OCD Partial Hospital program. In addition, they can participate in supplemental rotations from both the Clinical Child Psychology and Pediatric Psychology Supplemental options.

Clinical Child Psychology Primary Rotations

Each primary rotation lasts four months. Clinical psychology residents within the Clinical Child Psychology Specialty spend the equivalent of three days per week on their primary rotations.

Adolescent Inpatient Rotation

Faculty Supervisor: Katie Affleck, PhD, Claire Nicogossian, PhD, & Jennifer Wolff, PhD

This rotation provides training in empirically-supported assessment and treatment of acute psychopathology on an inpatient unit. The multidisciplinary team is comprised of psychologists, psychiatrists, social workers, nurses, and milieu staff. The AIU serves a diverse patient population in terms of race, socioeconomic status, sexuality, and gender identity. Approximately 40-45% of patients identify as a sexual or gender minority and a third of patients are involved with the Department of Children, Youth, and Families (DCYF). Primary presenting problems include depression, severe trauma histories, anxiety, psychosis, behavior problems, substance use, and emerging personality disorders.

Clinical psychology residents participate in a range of activities including diagnostic interviews, individual therapy, and group therapy utilizing. The primary interventions utilized are Cognitive Behavioral and Dialectical Behavioral Therapy and DBT-style consultation meetings are held on a regular basis. Clinical psychology residents provide empirically-based individual treatment to 3-4 patients that is tailored to short-term care (average patient length of stay is 9 days). Residents will also have exposure to Acceptance and Commitment Therapy and Motivational Interviewing throughout the rotation. Trainees attend morning rounds with the multidisciplinary team and receive individual and group supervision. Opportunities for residents to supervise practicum students and milieu staff are also available.

Children's Partial Hospital Program Rotation

Faculty Supervisor(s): Jennifer Hellmuth, PhD, Erik Hood, PhD, Ryann Morrison, PhD

In the Children’s Partial Hospital Program rotation, the clinical psychology resident has the opportunity to develop competency in assessment, treatment, and consultation with children who present with serious emotional and behavioral challenges. The children (ranging in age from 7-12 years old) display a broad range of psychopathology and typically remain in the program for 6-8 weeks. Typically, children present with high levels of co-morbidity (anxiety disorders, trauma, school refusal, mood disorders, psychotic spectrum disorders, ADHD, ODD, family conflict). The program aims to provide intensive evidence-based interventions with children and their families, beginning with a comprehensive family and child assessment, followed by goal setting with the family and child.

Clinical psychology residents will participate and receive supervision in all aspects of the partial hospital program. They will complete clinical and diagnostic evaluations of patients and their families, as well as providing individual, group, and/or family therapies. Clinical psychology residents typically have the opportunity to provide empirically-based treatments for children within individual, family, and group formats. Residents may have opportunities to consult to program staff regarding appropriate milieu interventions and the outcome of psychological assessments. Residents will also participate in planning and consultation regarding patient transition back to community settings (school and outpatient therapies).

Clinical psychology residents gain experience working collaboratively with a multidisciplinary treatment team that includes behavioral health specialists, nurses, teachers, psychologists, social workers, art therapists, speech and language pathologists, occupational therapists, and psychiatrists.

Community-Based Therapeutic School Rotation

Faculty Supervisor(s): Jamie Hollenbeck, PsyD, Lisa Freda, PsyD, Christina Bellanti, PhD, & Melanie Dubard, PhD

In the Community-Based Therapeutic School rotation, the clinical psychology resident has the opportunity to develop competency in assessment, treatment, and consultation with youth who have serious emotional, behavioral, and neurodevelopmental challenges that have interfered with their ability to be educated within the public school setting. The students (ranging in age from 3-21 years old) have been referred from school districts in Rhode Island, Massachusetts, and Connecticut for placement at the Bradley School, a community-based therapeutic day school. We have a diverse population in terms of diagnosis, race, ethnicity, sexual orientation, and socio-economic status that differs based on the specific school location. Within each school, there are a variety of classrooms organized by educational, emotional, and neurodevelopmental needs offering opportunities to work with youth with a wide variety of presenting problems and co-morbidities.

Clinical psychology residents will participate and receive supervision in all aspects of the day treatment program. They may complete cognitive, adaptive, and clinical evaluations, as well as providing individual, and group therapies. Classroom-based cognitive-behavioral interventions are provided to all students, and clinical psychology residents may serve as consultants to the classroom staff as these interventions are developed, implemented, and monitored. In addition, residents may have the opportunity to implement additional evidence-based curricula in specific classrooms, depending on their training goals, and expertise.

Clinical psychology residents gain experience working collaboratively with multidisciplinary treatment teams that include special education teachers, classroom behavior specialists, school nurses, psychologists, social workers, occupational therapists, and speech/language pathologists.

OCD and Anxiety Partial Hospital Rotation in the Pediatric Anxiety Research Center

Faculty Supervisor(s): Michael Walther, PhD, Andrea Gold, PhD, & Jennifer Freeman, PhD

This rotation provides training in empirically supported assessment and treatment of severe obsessive-compulsive/anxiety disorders in children and adolescents in a partial hospital setting. The multidisciplinary team is comprised of clinical psychology and psychiatry residents and fellows, as well as psychologists, psychiatrists, and milieu staff. Mornings and afternoons are spent working with youth with severe anxiety/obsessive-compulsive symptoms within the Bradley Hospital Intensive OCD and Related Disorders Program (morning and afternoon partial hospital programs).

In the OCD and Anxiety program, trainees will have opportunities to assess and treat children and adolescents who present with severe OCD and other functionally impairing anxiety disorders and are likely to benefit from a primary exposure model of treatment. Resident will also have training opportunities within the OCD program’s DBT-X Track, which integrates exposure and dialectical behavior therapy (DBT) approaches for high-risk, multi-problem patients with OCD/anxiety co-occurring with severe emotion dysregulation and suicidality/self-injury. The OCD program provides integrated daily (morning or after-school) hospital- and community-based treatment for children and adolescents (aged 5-18 years) with primary OCD/anxiety and a range of co-morbid disorders. Patients participate in individual and group-based exposure therapy, as well as psychoeducation, motivational enhancement, family therapy, and psychopharmacologic assessment and treatment. Patients also receive 2-5 home or community visits every week. Residents will be responsible for attending treatment team meetings (on the three days they are in the program) and treating 3 cases in conjunction with a staff psychologist. Treatment will include both individual and family therapy. Residents will also spend time daily in the milieu, working on individual and group-based exposure treatment with patients and working with milieu therapists. Group supervision will be provided during treatment team meetings.  Residents will receive at least 2 hours of individual supervision each week.  Opportunities for residents to supervise milieu staff will occur during treatment team meetings, as well as during milieu time. Opportunities will also exist for residents to participate in home/community visits, facilitate DBT skills training and peer coaching groups, and/or attend the DBT-X consultation team meeting if they are interested.

Pediatric Consultation Liaison

Faculty Supervisors: Margaret Mannix, PhD & Emily Katz, MD

The Pediatric Consultation/Liaison rotation for child track interns entails participation with the Child and Adolescent Psychiatry team consulting to Hasbro Children’s Hospital’s medical inpatient floors. Interns provide assessments and treatment for patients who are awaiting inpatient hospitalization due to suicidality, aggression, or acute presentations as well as those who have comorbid medical and psychiatric concerns. The team consists of several triple board fellows, child psychiatry fellows, and psychology post-doctoral fellows and residents. Common referral questions include pain complaints, eating disorders, adjustment to chronic illness, problems with adherence to medical regimens, and suicidality. Families are ethnically diverse from a wide variety of cultural and socioeconomic backgrounds. Supervision is provided by the Child and Adolescent Psychiatrist who directs the service and by Dr. Mannix, a Pediatric Psychologist and Assistant Director of the service.

Virtual Adolescent Partial Hospital Program (APHP) / Bradley REACH Rotation

Faculty Supervisor: Elisabeth Frazier, PhD, Molly Hedrick, PhD, Carla Correia, PsyD

In the virtual Adolescent Partial Hospital Program (APHP) / Bradley REACH rotation, the clinical psychology resident has the opportunity to develop competency in family, individual, and group therapy with adolescents who present with serious emotional and behavioral challenges. Adolescents display a broad range of psychopathology and typically remain in the program for 3-4 weeks. The program aims to provide intensive therapeutic interventions with adolescents and their families, as well as consultation with their schools, in a telehealth format. Clinical psychology residents will participate in and receive supervision in all aspects of the partial hospital program. They will complete clinical evaluations of patients and their families, as well as provide individual, group, and family therapies. Clinical psychology residents typically have the opportunity to provide empirically-based treatments for adolescents within individual and group formats and for families (as co-therapist initially). Clinical psychology residents will also participate in planning and consultation regarding patient transition back to community settings (school and outpatient therapies). Clinical psychology residents gain experience working collaboratively with a multidisciplinary treatment team that includes milieu therapists, nurses, teachers, psychologists, occupational therapists, art therapists, social workers, and psychiatrists.

Clinical Child Psychology Supplemental Rotations

One day per week throughout the training year is available for supplemental rotations. Supplemental rotations involve half day or full day experiences, and rotation length may be 4, 6, 8, or 12 months. Each clinical child psychology resident is asked to select at least one pediatric supplemental and one clinical child supplemental, though additional supplementals typically are chosen, as long as scheduling allows.

Trainee may choose Supplemental Rotations from the Pediatric Psychology and/or Clinical Child Psychology Specialty options (see additional supplemental options under Pediatric Psychology description).

Anxiety Clinic Rotation

Faculty Supervisor(s): Jennifer Herren, PhD & Erin O’Connor, PhD

The purpose of the PARC Anxiety Clinic rotation is to allow trainees to gain more specialized and long-term experience in the assessment and treatment of children and adolescents with anxiety disorders, with an emphasis on pediatric Obsessive-Compulsive Disorder (OCD). The patient population includes primarily outpatient child and adolescent cases with diagnoses including OCD, Generalized Anxiety Disorder, Separation Anxiety Disorder, Social Anxiety Disorder, Panic Disorder, and school avoidance. Children with Selective Mutism, Trichotillomania, and Tic Disorders may be seen as well. The focus of the training is on the delivery of principle-based CBT. While specific CBT intervention is case and diagnosis-dependent, the use of exposure therapy is emphasized. This rotation offers the opportunity to see cases at an outpatient level that have stepped down from a partial level of care, have co-morbid medical problems and/or physical complaints, involve family-based exposure interventions, as well as have other comorbid diagnoses, such as Autism Spectrum Disorder and depressive disorders. This supplemental rotation requires participation for half a day per week.

Autism Intensive Behavior Treatment (IBT) Program Rotation

Faculty Supervisor(s): Karyn Blane, PsyD

This rotation provides the opportunity for clinical psychology residents to acquire knowledge and experience with applied behavior analytic (ABA) treatment methodology and individualized interventions for children across SES levels with Autism Spectrum Disorder (ASD). This home-based training focuses on understanding the science of ABA and involves the systematic application of behavioral methods to promote behavior change and the learning of new skills in the home and community settings. In addition, parent training and the generalization of skills are essential components of the treatment. The age range of the population is 2-7 years old. Clinical psychology residents can participate in this supplemental rotation for a half-day or one full day per week. Trainees can participate as members of treatment teams by directing individualized discrete trial training programs, consulting with families to promote consistency across environments, planning and implementing social and play opportunities for children, and developing techniques to monitor and assess the effectiveness of intensive behavioral treatment programs. Practical solutions and recommendations are emphasized across this rotation to support optimal progress for the children and families, and to maintain skills across settings. Trainees must have reliable transportation to be able to fully participate in this rotation.

Autism Spectrum Disorders (ASD) Assessment Clinic Rotation

Faculty Supervisor(s): Casey Cragin, PsyD

The purpose of this rotation is to allow clinical psychology residents to obtain more specialized training in the assessment and diagnosis of autism spectrum disorder in toddlerhood and early childhood. There is a heavy emphasis on differential diagnosis and case conceptualization, as well as translating evaluation findings into meaningful treatment and educational recommendations. The clinical psychology resident will gain experience in clinical assessment methods, including semi-structured interviews, formal and informal observational methods, and selection, administration, scoring, and interpretation of appropriate psychometric assessments. The clinical psychology resident’s experience will be tailored to their background and goals. Typically, there are 1-2 new evaluations scheduled each month, with additional follow-up visits in which the clinical psychology resident participates. Clinical psychology residents can participate in this supplemental rotation for one half-day or full-day per week. The full-day option offers additional exposure to comprehensive report writing and ongoing family consultation and treatment.

Early Childhood Rotation

Faculty Supervisor(s): Christine Low, PhD, Rebecca Newland, PhD, Rachel Herman, PhD, & Rebecca Silver, PhD

This rotation provides the opportunity for clinical psychology residents to receive specialized training in early childhood mental health. The rotation focuses on early childhood mental health consultation, primarily in early care and education settings. This service involves assessment of identified children at their early learning program (including classroom observations, standardized questionnaires, and interviews with family caregivers and teachers), feedback and recommendations provided to families and childcare staff, and individualized follow-up supports and coaching to implement recommendations in the classroom. This consultation service serves children and families across the state, and prioritizes programs who accept state childcare subsidies; approximately 10% of children served are in foster care. Clinical psychology residents participate for a half-day per week, for a minimum of 6 months. Mileage will be reimbursed at the federal rate.

Outpatient Psychotherapy for children/teens with Developmental Disabilities: Verrecchia Clinic Rotation

Faculty Supervisors: Karen Cammuso, PhD

The Verrecchia Clinic Rotation provides clinical psychology residents with the opportunity to gain experience in providing outpatient therapy services (e.g., parent training, individual and group therapy) with children, adolescents, and young adults with developmental challenges, including Autism Spectrum Disorders (ASD). The clinic is part of Bradley Hospital’s Outpatient Services. Patients are school-aged (5-22) and include referrals from the community as well as from partial and inpatient levels of care. Patients in this clinic often exhibit complex psychiatric (e.g., depression, mood dysregulation, anxiety, ADHD, and disruptive behavior disorders) and medical (e.g., genetic disorders, sleep and feeding problems) presentations unique to individuals with developmental disabilities. The focus of the training is learning to use specialized evidence-based therapies, as well as strategies to support neurodiverse patients in the therapy setting. Groups offered include parent training, CBT/exposure therapy for anxiety, and adapted DBT (anticipated). Residents can co-lead groups based on schedule availability. A minimum six-month commitment of four hours per week is required, and clinical psychology residents may participate for up to 8 hours weekly.

Pediatric Consultation Liaison

Faculty Supervisors: Margaret Mannix, PhD, Emily Katz, MD, Ashley Brown, PhD, Alison Manning, MD

The Pediatric Consultation/Liaison rotation for child track interns entails participation with the Child and Adolescent Psychiatry team consulting to Hasbro Children’s Hospital’s medical inpatient floors. Interns provide assessments and treatment for patients who are awaiting inpatient hospitalization due to suicidality, aggression, or acute presentations as well as those who have comorbid medical and psychiatric concerns. The team consists of several triple board fellows, child psychiatry fellows, and psychology post-doctoral fellows and residents. Common referral questions include pain complaints, eating disorders, adjustment to chronic illness, problems with adherence to medical regimens, and suicidality. Families are ethnically diverse from a wide variety of cultural and socioeconomic backgrounds. Supervision is provided by the Child and Adolescent Psychiatrist who directs the service and by Dr. Mannix, a Pediatric Psychologist and Assistant Director of the service.

Stride Clinic (Early Psychosis) Rotation

Faculty Supervisors: Elizabeth Thompson, PhD

The Stride Clinic rotation provides opportunities for trainees to gain specialized training in the assessment and treatment of psychosis-spectrum disorders in youth. This outpatient clinic offers diagnostic assessment and individual, family, and group therapy, integrated within a multidisciplinary team that provides psychiatric care and wraparound services in the community. Clinical psychology residents will receive in-depth training in semi-structured diagnostic interviewing, including specialized assessment of psychosis-spectrum conditions, as well as training in differential considerations and preparing treatment recommendations based on assessment findings. Another focus of training is on the delivery of CBT for psychosis (CBTp), as well as other evidence-based interventions (e.g., DBT, ACT, social skills training). The clinic also provides consultation services, primarily within Lifespan’s adolescent inpatient and partial hospital programs. This supplemental rotation requires at least one half-day commitment per week.

The Verrecchia Autism-focused Placement

This rotation is a full year autism-focused training experience, funded by the Verrecchia Family Fund, that is comprised of partial hospital, outpatient, in-home ABA, and assessment rotations.  The clinical psychology resident will complete two 4-month autism-specific experiences and one 12-month autism-focused supplemental experience.  For their final primary rotation, the resident will select from available primary rotations offered within the Child Track. 

The two 4-month primary autism-focused experiences will be:

1) Center for Autism and Developmental Disabilities (CADD) Partial Hospitalization Program/Safequest

Faculty Supervisors: Kathryn LaChance, PhD & Maria Regan, LICSW

This rotation provides clinical psychology residents with the opportunity to gain experience providing evidence-based practices to children/adolescents with autism and related disorders, including individual, family, and group therapy, in the context of partial hospital/Intensive Outpatient programs. At CADD PHP, residents will learn to examine cases using a behavioral lens and collaborate with various professionals (BCBA, Speech-Language Pathologist etc.) using the same behavioral orientation. Residents will learn to use behavioral strategies within a group setting while simultaneously teaching patients various skills. Residents will also gain experience supporting parents in implementing behavioral strategies in family sessions. While at CADD Safequest, residents will learn to use a module approach to treatment and learn how to adapt strategies for children/adolescents with ASD and other comorbid disorders such as anxiety and depression. Residents will learn to individualize treatment by using a combination of behavioral strategies, CBT, and DBT informed practices. Residents will provide parent training (behavior and skills coaching) and provide more process-oriented family therapy sessions. Additionally, residents will gain experience using a variety of clinical assessment measures to inform treatment and have the opportunity to observe the use of clinical assessment on a programmatic level. Lastly, residents will gain exposure to a variety of clinical presentations with varying degrees of intellectual functioning and developmental levels of children (ages 6-18) with ASD and related disorders.

2) Early Childhood Autism Evaluation and Intensive Behavioral Treatment

Faculty Supervisors: Karyn Blane, PsyD & Casey Cragin, PsyD

This rotation provides a 2 ½ day weekly opportunity over 4 months for clinical psychology residents to acquire knowledge and experience with (1) applied behavior analytic (ABA) treatment methodology and individualized interventions for young children with Autism Spectrum Disorders (ASD), and (2) ASD evaluations in young children.

(1) ABA: The clinical psychology resident will spend 2 days/week with the Intensive Behavioral Treatment (IBT) team. This specialized training focuses on understanding the science of ABA and involves the systematic application of behavioral methods to promote behavioral change and learn new skills in the home and community settings. The age range of the population is 2-8 years old. The clinical psychology resident will participate as a member of a homebased treatment team(s) by directing individualized discrete trial training programs, compiling and analyzing data, developing practical materials and techniques to generalize children’s skill acquisition levels, consulting with families to promote consistency across environments, and conducting functional behavior assessments, as needed.

(2) Evaluations: The clinical psychology resident will spend ½ day weekly at Women & Infants Hospital’s Center for Children and Families participating in early childhood evaluations. This experience allows clinical psychology residents to obtain more specialized training in the assessment and diagnosis of autism spectrum disorder in toddlerhood and early childhood. There is a heavy emphasis on differential diagnosis and case conceptualization, as well as translating evaluation findings into meaningful treatment and educational recommendations.  The clinical psychology resident will gain experience in clinical assessment methods, including semi-structured interviews, formal and informal observational methods, and selection, administration, scoring, and interpretation of appropriate psychometric assessments. The clinical psychology resident’s experience will be tailored to their background and goals. Typically, there are 1-2 new evaluations scheduled each month, with additional follow-up visits in which the clinical psychology resident participates.

The 12-month Supplemental autism training will be:

Outpatient Psychotherapy for children/teens with Developmental Disabilities: Verrecchia Clinic Rotation

Faculty Supervisors: David Lichtenstein, PhD, Kristin Knapp-Ines, PhD, BCBA-D, & Karen Cammuso, PhD, ABPP

The Verrecchia Clinic Rotation provides clinical psychology residents with the opportunity to gain experience in providing outpatient therapy services (e.g., parent training, individual and group therapy) with children, adolescents, and young adults with developmental challenges, including Autism Spectrum Disorders (ASD). The clinic is part of Bradley Hospital’s Outpatient Services. Patients are school-aged (5-22) and include referrals from the community as well as from partial and inpatient levels of care. Patients in this clinic often exhibit complex psychiatric (e.g., depression, mood dysregulation, anxiety, ADHD, and disruptive behavior disorders) and medical (e.g., genetic disorders, sleep and feeding problems) presentations unique to individuals with developmental disabilities. The focus of the training is learning to use specialized evidence-based therapies, as well as strategies to support neurodiverse patients in the therapy setting. Groups offered include parent training, CBT/exposure therapy for anxiety, and adapted DBT (anticipated). Residents can co-lead groups based on schedule availability. A minimum six-month commitment of four hours per week is required, and clinical psychology residents may participate for up to 8 hours weekly.

Pediatric Psychology 

The Pediatric Psychology Track provides in-depth training in pediatric psychology within a general medical setting. It is designed to teach clinical psychology residents assessment, treatment, and consultation skills across a continuum of care settings.

The Pediatric Psychology training opportunities are organized to provide clinical psychology residents with primary rotations emphasizing three different settings of pediatric psychology: 1) clinic-based consultation and integrated care pediatric psychology, 2) partial hospitalization (day treatment) pediatric psychology, and 3) inpatient pediatric psychology. Children with co-occurring medical and psychological problems constitute the primary treatment population. Training is provided to a variety of pediatric populations via hospital clinics and services (see descriptions below). Trainees also maintain long-term treatment cases via year-long participation in the oncology service. Behavioral interventions constitute the primary therapeutic modalities. Experiences in family and group therapies are also incorporated. Trainees complete all three of the primary rotations listed and also choose supplemental rotations from the Pediatric Psychology and Clinical Child Psychology options.

Pediatric Psychology Primary Rotations

Each primary rotation lasts four months. The first rotation runs from July through October, the second rotation runs from November through February, and the third rotation runs from March through June. Residents in the Pediatric Psychology Specialty will participate in all three of the following primary rotations, organized by level of care provided.

Partial Hospitalization Care Rotation

Faculty Supervisors: Rebecca Laptook, PhD, Holly Manning, PhD, Kelsey Borner, PhD, Deborah Rasile, PhD, Jack Nassau, PhD, & Matt Willis, MD

The Partial Hospitalization Care rotation uses the Hasbro Children’s Partial Hospital Program setting to provide intensive training in interventions for youth with co-occurring pediatric illness and psychiatric conditions in a day treatment model. The purpose of this rotation is to help the trainee develop competence in the assessment and treatment of children, adolescents, and families with complicated medical, emotional, and behavioral presentations.

The Hasbro Children’s Partial Hospital Program (HCPHP) uses a family systems oriented, day hospital format to treat children with a wide range of pediatric illnesses that have been refractory to standard treatment. The children treated at the HCPHP have either a medical illness complicated by psychological factors (e.g., diabetes with treatment non-adherence), a psychiatric illness complicated by physical factors (e.g., a restrictive eating disorder with cardiac involvement), or both. Children treated range in age from 6 to 18 years and attend the program five days a week, 8 hours a day, for an average length of stay of 6-8 weeks. The HCPHP has a multidisciplinary staff, including psychologists, pediatricians, child psychiatrists, pediatric nurses, nutritionists, teachers, and milieu therapists. Residents participate fully as members of the multidisciplinary treatment team and have close collaboration with colleagues from all disciplines during their training. Trainees will learn how to assess the individual, family, and academic needs of patients and how to develop interventions within an interdisciplinary framework. Since the program has a strong family intervention focus, residents observe and participate in family systems therapy.

Clinic-Based Consultation and Integrated Care Rotation

Faculty Supervisors: Christina D’Angelo, PhD, Julie Boergers, PhD,  Janet Anderson, EdD, & Pamela Scalise, PsyD

The Clinic-Based Consultation and Integrated Care Rotation gives trainees exposure to the practice of pediatric psychology consultation and treatment in multiple settings and with a variety of patient populations. Trainees participate in four half-day clinics. The purpose of this rotation is to help trainees develop competence in the provision of outpatient pediatric psychology care and familiarize themselves with models of psychologist involvement in integrated care settings.

The Pediatric Hematology rotation provides unique training in the assessment and treatment of children and adolescents with sickle cell disease and thalassemia across settings (e.g., outpatient specialty clinic, inpatient setting, outpatient intervention, outpatient assessment). Patients and families are primarily Black or Latino and from diverse socioeconomic and cultural backgrounds. Residents will be integrated within the multidisciplinary team (consisting of hematologists, social workers, nutritionists, dentists, and nurses) on which psychology team members typically meet with every patient, completing brief consult-based assessments and coordinating closely with other team members. There are also opportunities to see patients with SCD when they are admitted for an inpatient hospitalization. Depending on resident interest, there may be opportunities for residents to pick-up patients from this clinic for brief, short-term, outpatient intervention. Presenting problems may be related to mood, behavior, anxiety, feeding/sleeping difficulties, adherence, pain management, school concerns, and illness adjustment. The primary treatment approach will be CBT with some family-systems, MI, and acceptance and commitment therapies. Residents will also have the opportunity to assist with our new cognitive screening protocol. Given the neurocognitive sequelae of sickle cell disease, our clinic has launched a standardized screening protocol in which all children are referred at specific ages for a brief cognitive screening battery. The Sickle Cell Disease program is growing and there will likely be opportunities for residents to engage in program development as well (e.g., education-based group development/implementation, development of educational handouts) if interested.

The Pediatric Sleep Disorders Clinic is a multidisciplinary program providing comprehensive assessment and family-based, culturally tailored treatment of child and adolescent sleep problems. The clinic serves a population that is racially, ethnically, and socio-economically diverse. Comorbid conditions, including neurodevelopmental disorders and obesity, are common. Trainees have an opportunity to work with video or in-person interpreters. Typical presenting problems include bedtime refusal, insomnia, difficulty maintaining sleep, delayed sleep phase, sleepwalking, sleep terrors, nighttime fears, excessive daytime sleepiness, and snoring/breathing difficulties. Treatment is typically family-based and incorporates behavioral and cognitive-behavioral modalities. Trainees conduct both initial evaluations and follow-up visits for patients with sleep disorders.

The Pediatric Cardiology Rotation entails providing integrated behavioral health services in Hasbro’s Pediatric Heart Center. Common referral questions are wide-ranging and include individual and familial adjustment to chronic illness, preparation for medical procedures, transition to increased responsibility for medical care in children and adolescents with congenital heart disease, behavioral factors contributing to postural orthostatic tachycardia syndrome (POTS), and complaints of cardiac symptoms without cardiac origin (i.e. often co-occurring with depression or anxiety). There is some opportunity for trainees to tailor cases to their interests. Trainees on the rotation will communicate with an interdisciplinary treatment team that includes the disciplines of cardiology, nursing, exercise physiology, diagnostic imaging, psychology, and social work. Treatment provided is typically CBT-based individual and family therapy. Trainees conduct both initial evaluations and follow-up visits independently and/or using a co-therapy model with the supervisor.

The purpose of the Eating Disorder Clinic rotation is to provide training in the assessment and treatment of eating disorders. Patients are primarily adolescents, with some children and young adults (college-aged). An integrated treatment approach is employed, with a foundation in Family Based Treatment for Anorexia Nervosa (FBT) and incorporation of DBT, CBT, and trauma-informed treatment approaches. Trainees will conduct initial assessments and may follow patients for short-term therapy in clinic. The clinic is made up of a multidisciplinary team including adolescent medicine, psychology, social work, and dieticians. Currently patients are seen in the East Greenwich (Monday mornings) and Providence (Coro building, Tuesday mornings) locations.

Inpatient Care Rotation

Faculty Supervisors: Rawya Aljabari, PhD, Marc Perkel, PsyD, Emily Katz, MD, Margaret Mannix, PhD, Ashley Brown, PhD, Alison Manning, MD

The Medical/Psychiatric Inpatient Program serves a diverse population of children and adolescents struggling with co-occurring psychiatric and medical illnesses requiring inpatient psychiatric hospitalization (typically short-term).  Patients come from all areas of the country for treatment. Treatment may address the safety and stabilization of patients who have co-occurring concerns such as eating disorders, somatoform disorders, gastrointestinal illnesses, diabetes, seizures, pain syndromes, and complex presentations needing diagnostic clarification. This 16-bed unit in Hasbro Children’s Hospital is staffed by pediatricians, psychologists, psychiatrists, and other health professionals who collaborate to provide acute psychiatric and medical care. This includes multidisciplinary assessments leading to individualized care plans, individual therapy, family therapy, daily group therapy, community meetings, and milieu therapy. Trainees will spend two months gaining exposure to all elements of the program by serving as a clinician for cases in the program. Patients on the Medical/Psychiatric Inpatient Program often step down to the Partial Hospitalization (day treatment) Program.

The Pediatric Consultation/Liaison experience entails two months of participation with the Child and Adolescent Psychiatry team consulting to Hasbro Children's Hospital's medical inpatient floors. The team consists of both psychiatry and psychology trainees. Common referral questions include pain complaints, eating disorders, adjustment to chronic illness, problems with adherence to medical regimens, and suicidality. Patients with known developmental disorders are often followed by the CL service. Since this service provides care to all of Hasbro Children's Hospital, families are ethnically diverse from a wide variety of cultural and socioeconomic backgrounds. Residents and fellows are expected to serve as the primary clinician on new consultations and to provide follow-up care as indicated. More specifically, residents and fellows will: evaluate medically ill children for co-morbid mental health disorders that may be playing a role in their medical presentation and treatment; provide evaluation and disposition planning of pediatric patients medically admitted in the wake of suicidal or self-injurious behaviors; develop behavioral plans for patients who are having difficulty coping with their illness or participating in their care; provide short-term psychological treatment and psychoeducation to patients and their families; work closely with medical, nursing, social work, child life, and PT/OT staff to coordinate care, especially behavioral treatments to medically hospitalized children; provide psychoeducation to staff members and families to help them provide developmentally and psychologically appropriate care to minimize the patient's distress or discomfort and prevent or limit iatrogenic trauma to patients and their families; and participate in twice-weekly team rounds.

Oncology Service

Faculty Supervisor: Margaret Mannix, PhD

Trainees complete a year of experience with the Pediatric Oncology Rotation, a multidisciplinary clinical program for children with cancer or hematological disorders and their families. Psychology trainees provide evaluation and treatment and consult to members of the multidisciplinary team (pediatric hematologists/oncologists, social workers, nurses, child life specialists, rehabilitation therapists). Since this service provides care to all of the pediatric oncology patients at Hasbro Children's Hospital, families are ethnically diverse from a wide variety of cultural and socioeconomic backgrounds. Common referral concerns include adjustment to diagnosis, pain management, difficulty with procedures or treatment regimens, anxiety, depression, and bereavement. Oncology patients with pre-morbid developmental disorders will be referred to clinicians on this service. Depending on their medical status and the needs of the family, patients are seen during inpatient stays, during outpatient visits to the Tomorrow Fund Clinic, or during outpatient visits in the trainee’s office. Opportunities may also exist for group therapy, didactic presentations to families, and consultation to schools.

Pediatric Psychology Supplemental Rotations 

Trainees in the Pediatric Psychology may choose Supplemental Rotations from the Pediatric Psychology and/or Clinical Child Psychology Specialty options (see additional supplemental options under Clinical Child Psychology description).

Pediatric Rehabilitation Clinic

Faculty Supervisor: Melissa Pielech, PhD

The Pediatric Rehabilitation rotation provides training in assessment and multidisciplinary outpatient treatment of patients who present to Children’s Rehabilitation Services with persistent pain conditions, somatic symptoms, and/or Functional Neurological Disorders. Patients are children and adolescents (≥ 8-years-old), as well as their caregivers. Psychology services in this setting are provided using a consultation and brief intervention model. Rehabilitation therapists (i.e. physical and occupational therapists) refer patients to psychology for evaluation and treatment (as indicated). Treatment utilizes evidence-based, family-centered approaches to treating pain/ somatic symptoms and associated psychopathology (primarily ACT and CBT) and involves frequent communication with the patient’s rehab providers to ensure consistency in our multidisciplinary approach. Trainees are responsible for conducting an initial assessment and functional analysis. The initial assessment is then used to develop a case conceptualization and inform the selection of specific skills to deliver/address in ongoing therapy. Referrals to community providers for longer-term treatment are provided, as needed. Trainees consult and coordinate with occupational, physical, and speech therapists, as well as other providers, such as the neurologist or pediatrician. 

Feeding Disorders Clinic

Faculty Supervisors: Sarah Hagin, PhD, Christina D’Angelo, PhD

The Pediatric Feeding Disorders rotation is a unique interdisciplinary outpatient clinical program for children with significant nutritional and feeding disorders associated with chronic illness or disability. The Feeding Disorders program is organized through the Department of Pediatrics, Division of Pediatric Gastroenterology and involves the disciplines of Pediatric GI, Nutrition, Nursing, Occupational Therapy, Speech Pathology, and Pediatric Psychology. Psychology trainees will participate as members of this interdisciplinary team, conducting evaluations and cotreating children and families with a family-oriented and behaviorally based approach to treatment. The Pediatric Feeding Disorders team serves a highly diverse population, including patients from a wide variety of racial and ethnic groups, ages (0-8), and diagnoses (e.g., developmental delays, ASD). Trainees will also have the opportunity to work with interpreters on a regular basis.

SibLink Group

Faculty Supervisors: Wendy Plante, PhD

The Pediatric Sibling Group Rotation is part of SibLink, a clinical program that addresses the needs of siblings of children with chronic medical, neurodevelopmental, and behavioral disorders. This is an opportunity for residents to learn about chronic pediatric conditions from the perspective of another child in the family, to conduct sibling evaluations, and to tailor and co-facilitate a manualized group treatment for specific sibling needs. Groups are organized for siblings 4-13 years old and are designed to foster sibs’ understanding of and positive adaptation to their siblings’ conditions.

Medicine-Pediatrics Primary Care

Faculty Supervisor: Janet Anderson, EdD

The Internal Medicine and Pediatrics Clinic (Med-Peds Clinic) is a family medicine, primary care service. Patients, typically young children, adolescents and young adults, are both culturally and clinically diverse and may present with traditional mental health concerns (e.g. mood and anxiety disorders, behavior problems, ADHD and trauma) and/or various behavioral health concerns (e.g., weight management, medication compliance, chronic pain, toileting). At the Med-Peds Clinic, trainees will evaluate and treat pediatric patients and families who are referred for behavioral health services by the clinic’s primary care physicians and medical residents. They will collaborate with and provide consultation services for medical staff when in the clinic. This rotation is one-half day per week.

Pediatrics Primary Care

Faculty Supervisor: Michelle Pievsky, PhD

The pediatric primary care continuity clinic runs from Hasbro Children's Hospital. Children from infancy until adulthood are followed by medical residents, attendings, and advanced practice providers. Patients at the clinic are mostly from Providence, and mostly on Medicaid. The population is very diverse, speaking a number of languages and coming from varied cultural backgrounds. Clinical concerns include early childhood development, ADHD, depression, anxiety, externalizing behavior problems, feeding and eating difficulties, sleep problems, OCD, and others. Trainees will meet with previously scheduled patients referred for brief therapy and complete same-day warm handoffs. Trainees will provide consultation to pediatric providers and have the opportunity for co-training with pediatric and triple-board residents. This rotation is one half-day per week. Trainees will gain experience with brief intervention, increase their exposure to a variety of both common and rare presenting problems in a diverse patient population, and learn about models of integration of behavioral health into primary care practices. Psychology residents who are interested in quality improvement research may have the opportunity to participate in a QI project in primary care, as well. 

Pediatric GI Clinic

Faculty Supervisors: Sarah Hagin, PhD, Jan Anderson, EdD

The Pediatric GI Disorders Rotation is part of a multidisciplinary clinical program for children with GI-related disorders such as inflammatory bowel disease (Crohn’s, colitis), recurrent abdominal pain, irritable bowel syndrome, encopresis, and feeding difficulties. The Pediatric GI Disorders Rotation is organized through the Department of Pediatrics, Division of Pediatric Gastroenterology. Residents participate in the evaluation and treatment of GI-related disorders with a diverse population, including the opportunity to work with younger patients (ages 2-5), patients with developmental delays, and families from low SES backgrounds.

Trainees in the Pediatric Psychology Track may choose Supplemental Rotations from the Pediatric Psychology Track and/or Clinical Child Psychology Specialty options.

Pediatric Diabetes Clinic

Faculty Supervisor: Christine Nunes, PsyD

The Pediatric Diabetes rotation is a multidisciplinary outpatient clinical program for children with Diabetes Mellitus. The Diabetes Clinic is organized through the Department of Pediatrics, Division of Pediatric Endocrinology and involves the disciplines of Pediatric Endocrinology, Nutrition, Nursing, Diabetes Education, and Pediatric Psychology. Psychology trainees will participate as members of this multidisciplinary team, conducting evaluations and treatment of children and families as they relate to Diabetes Mellitus. The goal for trainees is to independently provide individual and family-based therapy to meet goals developed with the family and multidisciplinary team by the end of the rotation.

Fostering Health Clinic

Faculty Supervisors: Christine Nunes, PsyD

The Fostering Health Clinic is a primary care service for children who are or have been in the foster care system. The population includes young children (under 1 y/o) through adolescence. The patient population is culturally and clinically diverse and may present with traditional mental health concerns (e.g. mood and anxiety disorders, behavior problems, ADHD) and/or various behavioral health concerns (e.g., weight management, chronic pain, developmental delays, toileting, sleep disruption). Within the Fostering Health program, visits are integrated care encounters with the medical provider on service that day. There may be opportunity to have a small case load of outpatients but mostly the sessions are family-based therapies that occur during the primary care visit. 

Neurodevelopmental Disorders Rotation 

Faculty Supervisor: Michelle Pievsky, PhD 

This rotation provides the opportunity for residents to receive specialized training in neurodevelopmental disorders in toddlerhood, childhood, and teenage years. Residents will participate in clinical diagnostic interviews and psychological assessment, with the opportunity to train in the Autism Diagnostic Observation Schedule, 2^nd Edition (ADOS-2). The resident will be part of a multidisciplinary team consisting of psychologists, developmental-behavioral pediatricians, social workers, family support specialists, neurologists, and geneticists. Supervision will be provided primarily by psychologists, with supplemental supervision by developmental-behavioral pediatricians. This supplemental rotation is available for one half-day per week.  

Juvenile Justice/Behavioral Health 

One clinical psychology resident will specialize in a combination of adolescent substance use and forensic mental health with the Juvenile Justice/Behavioral Health. Each clinical psychology resident completes two 12-month primary rotations and two 12-month minor rotations within clinical programs affiliated with Rhode Island and Bradley Hospitals. Specifically, the clinical psychology resident will complete a combination of rotations at the Rhode Island Family Court Mental Health Clinic, Adolescent Substance Use Program, and Rhode Island Training School. Training emphasis is on the necessary integration of substance use and mental health assessment and treatment for youth who are justice-involved or at-risk for justice involvement and thereby exponentially at-risk for poor long-term behavioral health outcomes.  All experiences will emphasize interdisciplinary collaborations in providing integrated behavioral health assessment and treatment and inter professional learning across multiple disciplines, including, but not limited to, psychology, medicine, nursing, juvenile justice and social work. The clinical psychology resident participates in the following primary rotations: Rhode Island Family Court Mental Health Clinic and Adolescent Substance Use Program Rotations as well as minor rotations at the Rhode Island Training School and Bradley Hospital Inpatient Rotations.

All Juvenile Justice/Behavioral Health rotations serve a diverse population. A majority of youth are racial/ethnic minorities, with a large representation of Latino families. Trainees will have exposure to working with interpreters. In addition, the range of diagnostic presentations are also diverse including trauma-related disorders, substance use, anxiety, depression, developmental disorders, and behavioral disorders.

Primary Rotations

The clinical psychology resident will complete two primary rotations for 12-months. 

Adolescent Substance Use Rotation (12-months: 3 half days)

Faculty Supervisor(s): Robert Miranda, Jr., PhD, Elisabeth Frazier, PhD

This rotation provides training in empirically supported assessment and treatment of adolescent substance use disorders in an intensive outpatient setting and a step-down outpatient level of care.   Youth may be court-involved, school-referred, or privately referred.  This rotation provides training and exposure to individual, group, and family-based substance abuse treatment.  The multidisciplinary team is comprised of psychologists, psychiatrists, social workers, licensed mental health clinicians, and milieu staff. Clinical psychology residents will have opportunities to assess adolescents with recent substance use who present with a range of co-occurring issues (including suicidality, non-suicidal self-injury, and behavior problems). Residents are responsible for conducting an initial diagnostic assessment and conducting evidence-based (motivational enhancement, cognitive-behavioral) individual, group, and family-based treatment in an intensive outpatient setting and step-down level of care. Co-therapy may also occur. Clinical psychology residents will participate in and receive supervision (individual and group) in all aspects of the substance use treatment services.

RIFC Mental Health Clinic Rotation (12-months; 1 full day and 1 half day)

Faculty Supervisor(s): Kathleen Kemp, PhD

In the Mental Health Clinic rotation, the clinical psychology resident will develop competency in forensic mental health and substance use assessment of children and adolescents with open status or delinquency petitions, including some proportion of juvenile drug court offenders. The court clinic population includes juveniles court-ordered by Rhode Island Family Court (RIFC) judges to receive a comprehensive mental health, trauma-focused, and/or dual diagnosis evaluation as well as forensic evaluations specific to competency to stand trial, risk assessments, and sexual risk assessments.  In addition to conducting comprehensive mental health evaluations (that include both juvenile and caregiver), trainees may also have the experience of performing emergency (acute risk) assessments, as well as participating in consultations to the bench.   The emphasis of training is on learning procedures of evidence-based forensic mental health and dual diagnosis assessment and writing forensic behavioral health reports, as well as providing testimony related to submitted forensic reports and clinical consultations. Clinical psychology residents will participate in and receive supervision in all aspects of the juvenile mental health clinic services.  Clinical psychology residents gain experience working collaboratively with a multidisciplinary treatment team that includes case managers, social workers, psychologists, judges, probation, and child welfare workers.  

Minor Rotations

The clinical psychology resident will complete two minor rotations for 12-months. 

Rhode Island Training School (Juvenile Detention) Rotation (12-months 1 half day)

Faculty Supervisor(s): Elisabeth Frazier, PhD, Katie Affleck, PhD, and Elizabeth Lowenhaupt, MD

In the Juvenile Detention rotation, the clinical psychology resident has the opportunity to develop competency in assessment, treatment, and consultation with detained (pre-adjudicated) and incarcerated (post-adjudicated) youth who have serious emotional, behavioral, and developmental challenges. The youth (ranging in age from 12-19 years old) reside in the Rhode Island Training School, the state’s sole juvenile detention facility, in two separate facilities (one for detention and one for post-adjudicated youth).  The emphasis of training is on learning and implementing evidence-based substance use and dual diagnosis individual, group, and family-based treatment, as well as learning and conducting evidence-based forensic substance abuse and dual diagnosis assessment for juvenile detainees.  

Clinical psychology residents may also serve as consultants to the RI Training School staff as assessments are submitted and interventions are implemented. Clinical psychology residents will participate in and receive supervision (individual and group) in all aspects of the juvenile detention services. Clinical psychology residents gain experience working collaboratively with multidisciplinary treatment teams that include psychologists, psychiatrists, nurses, social workers, juvenile program workers, probation officers, child welfare case workers, judges, correctional administrators, and special education teachers.

Adolescent Inpatient Unit Rotation (12-months 1 half day)

Faculty Supervisor(s): Katie Affleck, PhD

The clinical psychology resident spends one morning each week on the adolescent inpatient unit which serves youth ages 11-18 who are hospitalized for severe mental health presentations. The resident conducts diagnostic assessments and provides DBT/CBT groups.