Adolescent Psychiatry Training Research Articles

Embracing different languages and local differences: Co-constructive patient simulation strengthens host countries' clinical training in psychiatry.

Global education in psychiatry is heavily influenced by knowledge from Western, high-income countries, which obscures local voices and expertise. To adapt a human simulation model to psychiatric education in a context that is specific to local languages and cultures. We conducted an observational study consisting of six human simulation sessions with standardized patients from two host countries, speaking their native languages, and following an adaptation of the co-constructive patient simulation (CCPS) model. As local faculty became increasingly familiar with the CCPS approach, they took on the role of facilitators-in their country's native language. Fifty-three learners participated: 19 child and adolescent psychiatry trainees and 3 faculty members in Türkiye (as a group that met online during 3 consecutive months); and 24 trainees and 7 faculty in Israel (divided into 3 groups, in parallel in-person sessions during a single training day). Each of the six cases reflected local realities and clinical challenges, and was associated with specific learning goals identified by each case-writing trainee. Human simulation has not been fully incorporated into psychiatric education: The creation of immersive clinical experiences and the strengthening of reflective practice are two areas ripe for development. Our adaptations of CCPS can also strengthen local and regional networks and psychiatric communities of practice. Finally, the model can help question and press against hegemonies in psychiatric training that overshadow local expertise.

Family OSCEs in Child and Adolescent Psychiatry Training: Formative Evaluation Involving Adolescent Simulated Patients.

Family OSCEs in Child and Adolescent Psychiatry Training: Formative Evaluation Involving Adolescent Simulated Patients.

Family dyads, emotional labor, and holding environments in the simulated encounter: co-constructive patient simulation as a reflective tool in child and adolescent psychiatry training

BackgroundPatient simulation has been used in medical education to provide a safe and supportive learning environment for learners to practice clinical and interpersonal skills. However, simulation involving pediatric populations, particularly in child and adolescent psychiatry, is rare and generally does not reflect the child-caregiver dyad or the longitudinal aspects of this care, nor does it provide learners with an opportunity to engage with and reflect on these dynamics.MethodsWe organized as an educational opportunity a series of seven observed patient simulation sessions with a cohort of a dozen child and adolescent psychiatrists (eight fellows approaching graduation and four senior educators). In these sessions, we utilized the co-constructive patient simulation model to create the simulation cases. We included the use of at least two patient actors in most sessions, and two of the case narratives were longitudinally followed across multiple simulation sessions. We approached the data collected during the simulations and their respective debriefings by using thematic analysis informed by a symbolic interactionist approach.ResultsBased on data from the debriefing sessions and longitudinal narratives, we identified four overarching themes: (1) Reflecting on dyadic challenges: role reversal and individuation; (2) Centering the child, allying with the parent, and treating the family system; (3) Ambivalence in and about the parent-child dyad; and (4) Longitudinal narratives and ambivalence over time.ConclusionThe emotional experience of the simulations, for interviewers and observers alike, provided an opportunity to reflect on personal and professional experiences and triggered meaningful insights and connections between participants. These simulated cases called for emotional labor, particularly in the form of creating holding environments; in this way, the simulated encounters and the debriefing sessions became dialogic experiences, in which the patient and provider, parent and child, and learner and instructor could co-construct meaning and foster professional development as reflective practitioners.

10.2 Going Downstream to Enhance the Diversity of Child and Adolescent Psychiatry Training Programs: Lessons From the Canadian Experience

10.2 Going Downstream to Enhance the Diversity of Child and Adolescent Psychiatry Training Programs: Lessons From the Canadian Experience

A preventive approach: What the field of child and adolescent psychiatry can learn from neonatology

As a resident physician training in pediatrics, adult psychiatry, and child and adolescent psychiatry, I've had the opportunity to explore three different fields of medicine. While it can sometimes be challenging to navigate the differences between them, this training has allowed me to reflect on what aspects of each field I'd like to incorporate into my career. This past year I've had the chance to spend one half‐day a week as a pediatrician in the Women and Infants’ neonatal intensive care unit (NICU) follow‐up clinic while spending the rest of my week working on various inpatient psychiatry units at Bradley Hospital. My time spent working with the families in the NICU follow‐up clinic has led me to envision a similar preventative care model for children and families at high risk for mental health concerns.

With End of PHE, States Begin Disenrolling Medicaid Enrollees

With End of PHE, States Begin Disenrolling Medicaid Enrollees

CMS Extends Virtual Supervision of Residents to End of Year

CMS Extends Virtual Supervision of Residents to End of Year

Self-injury and suicidal behavior in children and youth population: Learning from the pandemic

IntroductionSuicidal behaviour and self-harm are increasing in children and adolescents. Non-suicidal self-harm are a dysfunctional method of emotional regulation, and it must be distinguished from suicidal behaviours. MethodsNarrative review of the current situation on suicide and self-harm in Spain. Descriptive study of suicidal behaviours in paediatric emergencies. ResultsMental health consultations were analysed (March-2019 to March-2020 and March-2020 to March-2021) in a multicentric study of the SEUP (Spanish Society of Pediatric Emergencies), finding a 122 % increase of the diagnosis of "non-accidental drug intoxication” and 56 % of “suicide/suicide attempt/suicidal ideation”. In another prospective analysis, 281 attempts were recorded, with the patient profile being: female (90.1 %), 14.8 years old, 34.9 % without previous psychiatric diagnosis; 57.7% with previous suicidal behaviour. The presence of psychiatric disorders, especially depression, and previous attempts, are the best-known risk factors for suicidal behaviour, although other factors are involved (family, personal or social). Pediatricians should be trained to deal with questions about suicide and acquire the skills to conduct an interview with a supportive and empathetic attitude. In Spain, suicide prevention plans are heterogeneous among communities, and there is not a unified national suicide prevention plan. ConclusionsPrimary, hospital and mental health care resources for paediatric population should be strengthened to prevent suicidal behaviours. Specific training for school staff, and child and adolescent psychiatry training for paediatricians and nurses are crucial in the prevention of suicide in children and adolescent population.

Autolesiones y conducta suicida en niños y adolescentes. Lo que la pandemia nos ha desvelado

IntroductionSuicidal behavior and self-harm are increasing in children and adolescents. Non-suicidal self-harm are a dysfunctional method of emotional regulation, and it must be distinguished from suicidal behaviors. MethodsNarrative review of the current situation on suicide and self-harm in Spain. Descriptive study of suicidal behaviors in pediatric emergencies. ResultsMental health consultations were analyzed (March-2019 to March-2020 and March-2020 to March-2021) in a multicentric study of the Spanish Society of Pediatric Emergencies (SEUP), finding a 122% increase of the diagnosis of «non-accidental drug intoxication» and 56% of «suicide/suicide attempt/suicidal ideation». In another prospective analysis, 281 attempts were recorded, with the patient profile being: female (90.1%), 14.8 years old, 34.9% without previous psychiatric diagnosis; 57.7% with previous suicidal behavior. The presence of psychiatric disorders, especially depression, and previous attempts, are the best-known risk factors for suicidal behavior, although other factors are involved (family, personal or social). Pediatricians should be trained to deal with questions about suicide and acquire the skills to conduct an interview with a supportive and empathetic attitude. In Spain, suicide prevention plans are heterogeneous among communities, and there is not a unified national suicide prevention plan. ConclusionsPrimary, hospital and mental health care resources for pediatric population should be strengthened to prevent suicidal behaviors. Specific training for school staff, and child and adolescent psychiatry training for pediatricians and nurses are crucial in the prevention of suicide in children and adolescent population.

HARNESSING CHILD AND ADOLESCENT PSYCHIATRY EXPERTISE THROUGH BEHAVIORAL HEALTH EDUCATION IN COLLABORATIVE CARE PROGRAMS AND PEDIATRICS RESIDENCY TRAINING INTERVENTIONS

Collaborative care is a model of behavioral health integration that promises to improve behavioral health outcomes in primary care settings. Significant gaps in the basic education of primary care providers (PCPs) and child and adolescent psychiatrists limit broad dissemination of the collaborative care model. Innovations are needed to address the training gap among child and adolescent psychiatry trainees, as well as pediatric trainees, particularly around integrated models such as collaborative care.

2.121 A Needs Assessment of Cyberbullying Curricula in Psychiatry Residency Training

Research indicates that most teens have faced some form of cyberbullying (Anderson, 2018; Cook, 2021). Cyberbullying victims are at higher risk of developing depression, self-harm, suicide attempts, substance abuse, and anxiety (Englander et al, 2017; John et al, 2018; Zhu et al, 2021). It is unclear how much instruction child and adolescent psychiatry trainees are provided on this topic. The purpose of this study is to assess trainees’ comfort in evaluating and treating victims of cyberbullying.

2.125 A Needs Assessment of Child and Adolescent Psychiatry Postgraduate Training in Equity, Diversity, and Inclusion Principles

The current social climate has brought attention to historic and systemic inequities impacting child and youth mental health. Despite this, equity, diversity, and inclusion (EDI) principles have not been a major component of Canadian child and adolescent psychiatry training. This study reports the results of a needs assessment conducted to examine the state of national child and adolescent psychiatry EDI curricula as part of a larger project grounded in Kern’s framework for curriculum development, with the ultimate goal of co-designing an evidence-informed educational intervention focused on EDI themes relevant to child and adolescent psychiatry.

DIAGNOSTIC AND THERAPEUTIC DEVELOPMENTS IN INTELLECTUAL DEVELOPMENTAL DISORDER: WHAT'S NEXT?

The objectives of this presentation are: 1) to understand the latest innovations in precision medicine and genetics with intellectual developmental disorder (IDD); and 2) to explore ways that these latest innovations are informing clinical practice and training in child and adolescent psychiatry to improve care and quality of life for individuals with IDD.

2.122 Triple Board Experiences Across the Nation: Navigating Strengths and Challenges in Combined Training Programs

Triple board program (TBP) trainees complete training in pediatrics, general psychiatry, and child and adolescent psychiatry. TBPs produce versatile physicians, able to provide a wide breadth of patient care and reach underserved populations, particularly within the mental health field. Previous wellness survey scores among residents have indicated higher rates of burnout in TBP residents in comparison to noncombined residency training programs. The primary aim of this survey was to assess factors related to increased burnout, professional fulfillment, and protective factors promoting resiliency and wellness among TBP residents.

Joint Forces for Child and Adolescent Psychiatry Training: 1st ESCAP/UEMS-CAP/EFPT Training Day for CAP Trainees

IntroductionAs the Covid-19 pandemic brought about travel and social restrictions, many activities including specialty training events for medical specialty trainees moved online. The European Federation of Psychiatric Trainees, European Society for Child and Adolescent Psychiatry and hild and Adolescent Psychiatry (CAP) Section of UEMS joined forces to turn challenges into an opportunity for CAP trainees and jointly organized the 1st ESCAP/UEMS-CAP/EFPT Training Day.ObjectivesThe main aim was to offer CAP trainees throughout Europe high quality and up to date training content free of charge, making use of the different strengths of the organizing associations.MethodsContent of the Training Day was prepared according to feedback and demand from CAP trainees, collected through a questionnaire prior to the event. This event took place online and ran 9 webinars/workshops as well as a plenary case session where trainees presented real life cases made more challenging with the pandemic and representatives from 3 organizing associations discussed the cases from different perspectives. Remaining webinars/workshops covered a wide range of themes including but not limited to research, leadership, administrative and management skills as well as scientific topics such as eating disorders, medically unexplained symptoms, psychosis.ResultsAlmost 200 CAP trainees from 31 countries participated in the event and received certificates of completion. The outcome of the event is being evaluated via quantitative and qualitative methods and similar events will be planned accordingly.Conclusions1st ESCAP/UEMS-CAP/EFPT Training Day for CAP trainees was a success for reaching many trainees from across Europe and experimenting with different formats which will inspire future initiatives.DisclosureNo significant relationships.

Psychodynamic Child and Adolescent Psychiatry and the Future of Our Field

The Accreditation Council for Graduate Medical Education (ACGME) requirements for child and adolescent psychiatry training require that child and adolescent psychiatry fellows demonstrate competence in psychodynamic psychotherapy.1 Child and adolescent psychiatry educators may turn to JAACAP to find up-to-date advances in psychodynamic psychotherapy to teach. However, the term psychodynamic appears to be hard to find, literally. A search on https://www.jaacap.org/ of past issues for psychodynamic2 resulted in 4 articles published in the past year, but none have the word psychodynamic in the title. Three articles describe newer evidence-based forms of psychotherapy: brief focused parent-infant psychotherapy, adolescent-focused therapy, and mentalization-based treatment. These are are described in their respective articles as "psychodynamic-based," as "psychodynamically informed," and having "historical roots in psychodynamic psychotherapy." As none are specifically titled psychodynamic therapy, it is unclear whether teaching these modalities would satisfy the ACGME requirement of competence in psychodynamic psychotherapy. Comparatively, this linguistic dilution does not seem to affect cognitive-behavioral therapy (CBT), another psychotherapy required by the ACGME1: specialized branches such as trauma-focused CBT, CBT for psychosis, and CBT for insomnia all retain the parent name of CBT. Therefore, it is important to define psychodynamic.

An international medical education perspective on training in child and adolescent psychiatry.

An international medical education perspective on training in child and adolescent psychiatry.

An international medical education perspective on training in child and adolescent psychiatry.

An international medical education perspective on training in child and adolescent psychiatry.

Training Needs Assessment Survey in Pediatric Consultation-Liaison Psychiatry.

Despite growing recognition of how curriculum modules can benefit child and adolescent psychiatry (CAP) training, there are few standardized teaching resources for pediatric consultation-liaison psychiatry (PCLP). A Special Interest Group (SIG) of the American Academy of Child and Adolescent Psychiatry Physically Ill Child Committee (PICC) conducted a needs assessment to establish interest in, and availability of, a library of online, self-paced learning modules specific to PCLP. An email needs assessment survey was distributed to the PICC listserv in the fall of 2019 with four core areas of inquiry: (1) clinical service description, (2) teaching barriers, (3) interest in curriculum resources, and (4) interest in evaluation resources. Respondents were representative of typical academic PCLP programs. The response rate was 28% (n = 39). Programs endorsed barriers to teaching including high service obligations and limited protected teaching time. All respondents indicated that they would utilize high-quality, online learning modules. Psychiatric complications of medical illness, catatonia, and delirium were identified as priority topics in the care of pediatric patients with comorbid medical conditions. There are currently no published educational studies regarding the training needs for PCLP programs, even among tertiary care academic facilities. This training needs assessment is the first step in establishing a national PCLP training curriculum. New paradigms to develop standardized curriculum resources for PCLP are needed.

The Impact of COVID-19 on Pediatric Telepsychiatry Training in Child and Adolescent Psychiatry Fellowships.

ObjectiveThis report summarizes findings from a 2020 survey of US child and adolescent psychiatry training programs that explored the impact of the COVID-19 pandemic on pediatric telepsychiatry training. The authors hypothesized that telepsychiatry training significantly increased during the pandemic, in part due to legal and regulatory waivers during the COVID-19 public health emergency.MethodsIn August 2020, an anonymous, 28-question online survey was emailed to all (138) accredited child psychiatry fellowships on the Accreditation Council for Graduate Medical Education website. Forty-nine programs responded (36%). This analysis focuses on three of the 28 questions relevant to the hypotheses: characteristics of the program’s training in telepsychiatry; perceived impediments to clinical training; and perceived impediments to didactic training pre-COVID onset vs. post-COVID onset, respectively. Total scores were created to investigate differences in training programs and impediments to including telepsychiatry pre- and post-COVID onset. Paired sample t-tests were used to compare means pre- and post-COVID onset.ResultsResults provided support for significant differences between training components related to telepsychiatry pre- and post-COVID onset, with participants reporting more training components post-COVID onset (M = 5.69) than pre-COVID onset (M = 1.80); t(48) = 9.33, p < .001. Participants also reported significantly fewer barriers to providing clinical experiences in pediatric telepsychiatry post-COVID onset (M = 2.65) than pre-COVID onset (M = 4.90); t(48) = − 4.20, p < .001.ConclusionsDuring the COVID-19 pandemic, pediatric telepsychiatry training in child psychiatry fellowships increased significantly. Perceived barriers to providing clinical, but not didactic, training decreased significantly.