Child and Adolescent Psychiatry Fellowship

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Child and Adolescent Psychiatry Fellowship
Cambridge Health Alliance

Child and Adolescent
Psychiatry Fellowship
Program 2017-2018
Marshall Forstein, MD
Interim Chairman, Department of Psychiatry

Jacob Venter, MD, CPE
Division Chief, Child & Adolescent Psychiatry

Lee Robinson, MD
Training Director
1493 Cambridge Street,
Cambridge, Massachusetts 02139
(617) 575-5607

Sandra DeJong, MD
Senior Associate Training Director
1493 Cambridge Street,
Cambridge, Massachusetts 02139
(617) 665-1297

                                                GR17_216
Child and Adolescent Psychiatry Fellowship
The CHA Training Program in Child & Adolescent Psychiatry Fellowship

Table of Contents
Cambridge Health Alliance and its Mission                              2

CHA Training In Child Psychiatry                                       3

Child and Adolescent Psychiatry Training Program: First Year           4

Child and Adolescent Psychiatry Training Program: Second Year      10

Clinical and Research Leaders In The Division Of Child
And Adolescent Psychiatry                                          15

Child and Adolescent Psychiatry Teaching Faculty –
Cambridge Health Alliance                                          17

Faculty List – Division of Child and Adolescent Psychiatry         21
Child and Adolescent Psychiatry Fellowship
The CHA Training Program in
Child & Adolescent Psychiatry Fellowship
Cambridge Health Alliance                                  In 2006, after Massachusetts passed its health
                                                           care reform law, CHA formed an Accountable Care
and Its Mission                                            Organization (ACO). This means that CHA has
Since 1964, the Cambridge Hospital (now Cambridge          been working to transition away from a fee-for-
Health Alliance or CHA) has provided a model of            service payment model towards alternative payment
innovative, community-oriented healthcare in which         arrangements, in which CHA receives global insurance
trainees from all psychiatric disciplines have developed   payments from private, state and federal insurers
their skills. The CHA mission is to improve the health     in exchange for providing high quality care to our
of the Massachusetts communities we serve. As a            community of patients. To this end, CHA quickly began
safety-net healthcare system, CHA has been on the          transforming its primary care centers into patient-
cutting edge of healthcare reform, and has received        centered medical homes, and as of December 2016, all
national recognition for its innovative work. In 1988,     12 CHA primary care practices have been designated
the Victims of Violence Program at CHA received the        as Level III Patient-Centered Medical Homes by the
Gold Award from the American Psychiatric Association       National Committee for Quality Assurance (NCQA)
for innovative hospital and community service. In 1993,    and have received the MA Health Policy Commission’s
CHA was honored with the Foster G. McGraw Prize for        Patient Centered Medical Home PRIME Certification for
service to the community; in 2001, CHA received three      behavioral health integration. Additionally, in 2014, CHA
Safety Net awards for Open Access Patient Scheduling,      developed an affiliation with the Beth Israel Deaconess
Domestic Violence Programming, and Cultural and            Care Organization (BIDCO). As these efforts continue
Linguistic Competency. In 2001, the Robert Wood            to progress, and include specific planning for pediatric
Johnson Foundation selected CHA as one of seven            integrated care models, CHA will be better able to
healthcare systems for a “Pursuing Perfection” grant       focus on preventative care and population health for
to transform healthcare delivery. In 2003, CHA was         the children and families we serve.
again honored with APA’s Gold Award, this time
for its innovative work in providing a restraint-free
environment on its child inpatient psychiatric unit. In
2007, the National Association of Public Hospitals and
Health Systems presented the Chair Award to CHA for
its integrated medical student clerkship program. And
in 2009, CHA was selected as a national best practice
site for team development by the Commonwealth Fund
Safety Net Medical Home transformation initiative.

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Child and Adolescent Psychiatry Fellowship
CHA Training in Child Psychiatry                             Service Care, Consultation-Liaison, (including both
                                                             inpatient and outpatient consultation), and Residential
Training and education are key elements of CHA’s
                                                             Consultation. In addition, briefer rotations within each
mission. The CHA child psychiatry fellowship
                                                             block focus on issues such as developmental disorders,
training program has its roots in psychodynamic
                                                             pediatric neurology, preschool-age development
and psychoanalytic therapies and public sector,
                                                             and consultation, early intervention observation,
multicultural, community based care. While continuing
                                                             wrap-around care, pediatric primary care-mental
to nurture this tradition, the program also trains fellows
                                                             health integration, elective time, and consultation to
in other evidence-based treatment modalities in the
                                                             state agencies. Also in the first year, trainees begin
service of a comprehensive biopsychosocial model.
                                                             their longitudinal outpatient experience in both
Our values include training highly ethical, independent
                                                             psychotherapy and psychopharmacology. Finally, the
and responsible physicians who will give excellent
                                                             first year fellows rotate through an interdisciplinary
psychiatric care to children and families using an
                                                             outpatient diagnostic evaluation team to learn the skills
integrative approach to child psychiatry that fits the
                                                             needed to conduct outpatient assessments.
needs of individual patients and their families.
                                                             The second year is focused on seeing a diverse
The training experience is designed to develop
                                                             outpatient population for a full range of outpatient
and strengthen fellows’ abilities to develop a
                                                             treatments. In addition, second-year fellows learn
biopsychosocial formulation and treatment plan, and
                                                             about forensics in probate/family and juvenile court
implement appropriate and effective treatments.
                                                             clinic settings, and school consultation. Eight hours
Fellows are taught to consider different modalities
                                                             a week throughout the second year is available for
of treatment based upon the family’s preferences for
                                                             elective time and scholarly activity. All second-year
services, the efficacy and cost-effectiveness of certain
                                                             fellows complete a Clinical Scholarship Project. Fellows
methods for particular disorders, the capacity of a
                                                             in both years participate in quality improvement
child and family to engage in treatment, and the level
                                                             initiatives and case presentations.
of supporting evidence. The range of psychotherapy
techniques taught includes: intensive psychodynamic          The Training Program in Child and Adolescent
individual psychotherapy, intensive family therapy,          Psychiatry at Cambridge Health Alliance recruits five
brief and focused individual and family therapies,           fellows per year. Interested applicants should submit
psychopharmacology, supportive psychotherapy,                an application via ERAS by October 13, 2017. Interviews
cognitive behavioral psychotherapy, dialectical              will be offered in September through November. The
behavior therapy, psycho-educational interventions,          match list is submitted in mid-December and match
and group therapy.                                           results announced in January for the following training
                                                             year. We accept fellows only after their PGY-III year
The two-year training program includes a combination
                                                             of training (or beyond) who have passed USMLE
of didactics, clinical rotations, and independent
                                                             III, completed required Clinical Skills Examinations
scholarly work. Currently, eight to ten hours a week
                                                             (CSEs), and met all ACGME requirements for general
are protected for didactic learning. Weekly seminars
                                                             psychiatry. Our program participates in the NRMP
cover a variety of topics pertinent to our field,
                                                             match for fellows in Child and Adolescent Psychiatry.
including psychotherapy, psychopharmacology, human
                                                             We are an equal opportunity employer and training
development, and scholarly activities. Clinical rotations
                                                             program and seek to recruit minority trainees and
occur throughout both years. The first year is divided
                                                             faculty members who will assist us in providing
into five 10-week blocks in Adolescent Inpatient,
                                                             services to minority groups in our community.
Child Inpatient, Psychiatric Emergency and Transition

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Child and Adolescent Psychiatry Fellowship
CHA Child and Adolescent Psychiatry                        V. Walden Residential, Elective, Neurology,
                                                              Developmental Disorders, Integrated-Care
Training Program: First Year                                  (WENDI)
The first year is divided into five blocks of ten weeks
                                                                • Residential Consultation (Walden Street School,
each. In addition, Wednesday and Thursday afternoons
                                                                  Justice Resource Institute, 6 hours/week for 10
are devoted to a longitudinal outpatient experience
                                                                  weeks)
throughout the year.
                                                                • Independent clinical and scholarly activity time
I.   Child Assessment Unit (CAU)                                  (8 hours/week for 10 weeks)
     • Child Inpatient, Cambridge Hospital, 7th floor           • Pediatric Neurology, Lurie Center for Autism
       (27 hours/week for 10 weeks)                               (4 hours/week for 10 weeks)

II. Adolescent Assessment Unit (AAU)                            • Developmental disorders, office of Karen Levine,
                                                                  PhD (2.5 hours/week for 10 weeks)
     • Adolescent Inpatient, Cahill 3, Cambridge
       Hospital (27 hours/week for 10 weeks)                    • Neuropsychological Testing observation (6 hours)
                                                                • Outpatient pediatrics primary care-mental health
III. Psychiatric Emergency and Transition
                                                                  integration service, CHA Cambridge Pediatrics,
     Service (PETS)
                                                                  Cambridge (4 hours/week for 10 weeks)
     • Psychiatric Emergency Services (Cambridge
       Hospital ED, 8 hours/week for 10 weeks)             VI. Longitudinal Outpatient Experience (Cambridge
                                                               Hospital, Macht Building)
     • Psychiatric Transitional Service (Cambridge
       Hospital Cahill 1, 3 hours/week for 10 weeks)            • Psychotherapy (3 hours/week for 52 weeks)

     • Evaluation team (3.5 hours/week for 10 weeks)            • Precepted psychopharmacology clinic (3 hours/
                                                                  week for 52 weeks)
     • Early Intervention Observation (The Guidance
       Center, 3 hours/week for 6 weeks)
                                                           Rotations: First Year
     • Community Service Agency (Cambridge Youth
                                                           I.   Child Assessment Unit (CAU),
       Guidance Center, 5 hours/week for 10 weeks)
                                                                Cambridge Hospital - 10 weeks
IV. Consultation/Liaison                                        This clinical experience gives fellows the
     • Inpatient pediatrics consultation, Tufts Medical         opportunity to work with multidisciplinary staff,
       Center (16 hours/week for 10 weeks)                      gain experience negotiating with outside systems
                                                                such as the Department of Children and Families,
     • Outpatient pediatrics consultation, MIT Pediatric
                                                                the Department of Mental Health, and the wrap-
       Clinic, Cambridge (4 hours/week for 10 weeks)
                                                                around services of the Children’s Behavioral
     • Consultation to State Agencies (Depts. of                Health Initiative. Fellows develop assessment and
       Mental Health and Children and Families, various         treatment skills with oversight and supervision from
       locations (3 hours/week for 10 weeks)                    inpatient psychiatric attendings and visiting faculty.
     • Preschool Observation and Consultation,                  The Rotation Supervisor of the CAU rotation is Dr.
       Peabody Terrace Children’s Center (2.5 hours/            Fida Hassan.
       week for 5 weeks)
                                                                Patients range in age from 2 to 13; approximately
     • Neuro/psychological Testing Review (1.25 hours/          30 percent are from Cambridge and Somerville,
       week for 5 weeks)                                        while 70 percent are drawn from a wider
                                                                geographic area. The patients represent a diverse

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Child and Adolescent Psychiatry Fellowship
socioeconomic, ethnic, and cultural mix and present       disorders, psychotic disorders, substance abuse,
   with a wide range of diagnostic problems, including       ADHD and other disruptive disorders. Systems
   post-traumatic, disruptive, mood, psychotic,              work involves school and program (residential)
   and developmental disorders. Clinical focus is            consultation.
   on accurate diagnostic assessment, including
   individual and family evaluations, and broad-based        Faculty on both inpatient units include child
   treatment, including psychopharmacology, family           and adolescent psychiatrists, social workers,
   work and milieu therapy. The unit has received            psychologists, nurse managers, staff nurses
   recognition for its development of strategies to          and milieu counselors. Faculty members are
   reduce the use of restraint and seclusion. The unit       experienced in assessment, psychotherapy,
   has also developed a family-centered model of             play therapy, behavior modification,
   care.                                                     psychopharmacology, substance abuse and family
                                                             therapy.
   Educational activities include weekly interview and
   case formulations conference with outside faculty,        Educational activities include weekly interview and
   weekly family therapy case conference, weekly             case formulations conference with outside faculty,
   clinical supervision from outside faculty, weekly         weekly family therapy case conference; weekly
   supervision with an onsite supervisor and informal        clinical supervision from outside faculty, weekly
   supervision from psychiatric and psychology staff.        supervision with an onsite supervisor and informal
                                                             supervision as needed. Teaching opportunities
   Teaching opportunities include supervising                include: supervising medical students, general
   medical students, adult psychiatry and pediatric          psychiatry residents and pediatric residents.
   residents. Fellows also are expected to present and
   implement evidence-based treatment plans in team       III. Psychiatric Emergency and Transition
   meetings.                                                   Service (PETS)
                                                             • The Cambridge Hospital’s Psychiatric
II. Adolescent Assessment Unit (AAU),                          Emergency Service (PES)
    Cahill 3, Cambridge Hospital - 10 weeks
                                                               The PES is a consultation service based in the
   The AAU rotation provides a rich clinical experience        medical emergency room. It is the entry point for
   with adolescents and their families involving close         all acute psychiatric services, and also provides
   work with multidisciplinary staff in a team format,         evaluation and urgent treatment to children,
   both as the primary clinician on cases and as the           adolescents, adults, and families. Patients seen by
   medication consultant. Fellows gain experience              the PES team are children and adolescents aged
   negotiating with outside systems and presenting             18 and under, though adolescents outnumber
   evaluations in teams and to outside providers in            latency age children, with an equal number
   systems meetings. The Rotation Supervisor of the            of male and female patients. The Rotation
   AAU rotation is Dr. Fred Crow.                              Supervisor of the PES experience is Dr. Lee
                                                               Robinson, who provides weekly 1:1 supervision.
   This unit has 14 inpatient beds. The population
                                                               Emergency assessments are directed at
   ranges in age from 12 to 19, with approximately
                                                               determining patient needs for acute stabilization
   50 percent of patients from the local Cambridge/
                                                               and appropriate/least restrictive level of care.
   Somerville area and 50 percent from the greater
                                                               Fellows spend 8 hours a week for 10 weeks on
   Massachusetts and New England regions.
                                                               this rotation.
   Like the CAU, the patients represent a diverse
   socioeconomic, ethnic and cultural mix. CHA               • The Cambridge Hospital’s Psychiatry Transition
   provides access to an award-winning interpreter             Service (PTS)
   service including ASL for deaf and hard-of-                 The PTS is a consultation service based in Cahill
   hearing patients. The AAU serves a wide range of            1, next door to the medical emergency room.
   adolescents with diagnoses including PTSD, mood             It serves youth who were recently seen by the

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Child and Adolescent Psychiatry Fellowship
PES team in the ER and are in need of urgent                  provides in-depth initial assessments of families
 follow-up as a bridge to outpatient care or as a              over two sessions. This setting provides an
 means for supportive re-evaluation following the              excellent opportunity for fellows to observe
 acute presentation. As with the PES, patients                 senior faculty interview patients, to receive direct
 seen in the PTS are youth aged 18 and under.                  feedback on their own interviewing skills, to
 The Rotation Supervisor of the PTS experience                 practice in-depth biopsychosocial formulation
 is Dr. Amy Mayhew, who provides supervision for               skills (both written and in presentation to the
 each case seen in weekly 1:1 supervision and staff            team), to learn local resources and systems
 meetings.                                                     available for families, and to work together
                                                               in a team setting to think through diagnostic
• The Community Service Agency (CSA) rotation                  formulations and treatment plans. The rotation
  at The Guidance Center                                       supervisor is Nicholas Carson, MD.
 This rotation introduces fellows to wraparound
 services offered in the setting of a community           IV. Consultation/Liaison
 mental health center. These services are offered
                                                             • Inpatient Consultation-Liaison
 through the Massachusetts’ Child Behavioral
 Health Initiative (CBHI), an innovative statewide             The Floating Hospital for Children at Tufts
 reform of public child mental health care                     Medical Center in downtown Boston is a 100-
 emphasizing strengths-based, wrap-around                      bed pediatric tertiary care hospital within
 community supports. Fellows participate in team               Tufts Medical Center. CHA fellows rotate at the
 evaluations of children and families, join the staff          hospital performing inpatient consultations with
 on home visits, and develop a comprehensive                   children and adolescents who have a wide range
 treatment plan. Becoming more familiar with                   of concerns including psychological difficulties
 community-based resources, working within a                   associated with pediatric illness, unexplained
 multidisciplinary treatment team, and acting as a             somatic symptoms, child abuse and neglect, pain
 psychiatric consultant to CBHI service providers              management and problems managing chronic
 are also critical goals of this rotation. The rotation        illness. In addition, fellows participate in more
 supervisor is Allison Clark, LICSW.                           specialized inpatient consultation experiences
                                                               on both the Pediatric Intensive Care Unit and
• Early Intervention Observation                               the Bone Marrow Transplant Unit at the Floating
 Fellows spend one morning per week with the                   Hospital. Fellows spend approximately 16
 Early Intervention program at The Guidance                    hours per week over a 10-week period at Tufts
 Center. This experience involves observation of               performing clinical consultations, presenting
 Early Intervention groups and of home based                   cases, attending a teaching conference, and
 assessments under the supervision of Kathy Kelts,             receiving supervision. The rotation supervisor
 LICSW. Fellows learn how preventive strategies                and C/L director is Dr. John Sargent, Chief of
 are practiced in a state-supported program.                   Child and Adolescent Psychiatry at Tufts. Fellows
 Fellows also deepen their theoretical and                     will also teach consultation psychiatry to Tufts
 practical understanding of normal development                 Medical Students and have weekly supervision
 at this stage of life and learn to distinguish it from        with Dr. Sargent.
 clinical pathology.
                                                             • Outpatient Consultation-Liaison
• Team Evaluation Clinic                                       Massachusetts Institute of Technology (MIT)
 First-year fellows spend 10 weeks during their                Health Services provides pediatric care to
 PETS rotation on a weekly 3.5-hour Evaluation                 the children of students, faculty and general
 Team. The team is multidisciplinary (psychiatry,              employees at the university. Fellows spend
 psychology, social work, family medicine,                     one afternoon (4 hours) a week for 10 weeks
 pediatrics, nursing, medical students) and                    seeing children and families referred by their MIT
                                                               pediatricians for a variety of psychiatric concerns.

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Child and Adolescent Psychiatry Fellowship
They then discuss the case in supervision with Dr.       provides updates about services and changes
 Deborah Kulick, the rotation supervisor. Fellows         in each of the participating state agencies as
 learn about the consultative frame in general and        well as a forum for consultation to high-risk and
 consultation to pediatricians in particular. There       underserved families who are in need of services
 is also the opportunity to follow one MIT case           from more than one agency.
 for outpatient mental health treatment at the
 Cambridge Hospital clinic.                              • Preschool Observation and Consultation
                                                          The Peabody Terrace Children’s Center is a
• Systems Consultation to State Agencies                  Harvard-affiliated preschool for healthy children
 The MA Department of Mental Health (DMH)                 ranging in age from 2 months to 5 years who are
 is a state agency that sets the standards for            primarily children of Harvard University faculty,
 the operation of mental health facilities and            students, and staff. The children are divided into
 community residential programs and provides              several age-based “classes,” each of which is
 clinical, rehabilitative, and supportive services for    designed to meet the developmental needs of
 adults and children with serious mental illness or       its assigned group. Supervision is provided by
 serious emotional disturbances. The Department           Susannah Sherry, MD.
 for Children and Families (DCF) is the child
 welfare agency in Massachusetts. During this 10-         Fellows spend 2.5 hours every second week for 10
 week rotation, first-year child psychiatry fellows       weeks on this rotation. The experience allows the
 will spend 3 hours a week accompanying the               fellows to observe preschool children who are,
 faculty during weekly consultations to DMH and           for the most part, on track developmentally in a
 DCF at various sites within our catchment area.          group setting while providing consultation to pre-
                                                          school staff on those children who present with
 Fellows are supervised by Dr. Nandini Talwar, a          developmental, social, emotional, communication,
 DMH child and adolescent psychiatrist who has            or other potential concerns.
 extensive experience working with state and
 community agencies. During the consultation, the        • Neuro/Psychological Testing Review
 trainees participate in discussions of complicated       Fellows will spend 1.25 hours every second
 cases presented by DCF case managers and                 week for 10 weeks reviewing psychological and
 supervisors. Trainees learn about services and           neuropsychological testing results, with our
 opportunities provided by state agencies, criteria       clinical psychologist, and neurodevelopmental
 for eligibility for services from state agencies,        testing expert, Laura Gaugh, PsyD. Throughout
 the process of investigation and assessment              the rotation, fellows will review testing results
 for allegations of abuse and neglect, as well as         offered by Dr. Gaugh, or from the fellow’s
 the various dilemmas and limitations faced by            outpatient caseload, with the goal of familiarizing
 agencies when working with families and clients.         the fellows with the types of tests they may
 Fellows will also participate in monthly meetings        encounter, and how best to interpret the testing
 with the group of senior DMH child psychiatrists         results in the context of the greater cultural
 to discuss a variety of topics including high risk       and linguistic clinical picture. Types of testing
 and complicated cases, changes and trends in the         may include tests of cognitive functioning,
 mental health system in MA, and other important          academic performance, adaptive functioning,
 issues related to public mental health care for          language, executive functioning, visuospatial and
 children. In addition, the fellows will participate      visuomotor functioning, learning and memory,
 in a once a month interagency meeting with               and social communication.
 representation from DMH, DCF, DDS (Department
 of Developmental Services), DYS (Department of
 Youth Services), Department of Education and
 the Department of Public Health. This meeting

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Child and Adolescent Psychiatry Fellowship
V. Walden Residential, Elective, Neurology,                  children with Laura Gaugh, PsyD. Fellows observe
   Developmental Disorders, Integrated-Care                  in-depth evaluations of cognition, emotions,
   (WENDI)                                                   language and development with youth and
                                                             participate in feedback sessions with families.
   • Residential Consultation rotation
     The Walden Street School is a therapeutic              • Developmental Disorders/Intellectual Disability
     residential program of the Justice Resource             Fellows spend approximately 2.5 hours a week for
     Institute for young women offering a specialized        10 weeks observing evaluations at the office of Dr.
     trauma-informed approach, known as                      Karen Levine, an award-winning developmental
     Attachment, Self-Regulation, and Competency             psychologist, in Lexington. The experience gives
     (ARC). Fellows spend one day per week under             fellows exposure to young children with a range
     the supervision of Dr. Kerry-Ann Williams               of developmental disorders including Autism
     participating in treatment team, groups, and            Spectrum Disorders, with or without intellectual
     milieu treatment of students at the residential         disability, and to various systems of care for
     school.                                                 these children and adolescents. Uses of play in
                                                             assessment and treatment of this population are
   • Elective/Scholarly Activity                             emphasized.
     This rotation provides 8 hours per week for 10
     weeks of elective time so that fellows can pursue      • Primary Care Mental Health Integrated
     scholarly activities or quality improvement in           Consultation-Liaison
     their own particular area(s) of interest, meet          The Pediatric Primary Care - Mental Health
     potential mentors, and prepare for their clinical       Integration (PCMHI) Service at CHA Cambridge
     scholarship and elective time in the second year.       Pediatrics Clinic gives first-year fellows the
                                                             opportunity to work alongside an attending
   • Pediatric Neurology                                     child psychiatrist (Lee Robinson, MD) in an
     The fellows spend one morning a week for                integrated care model for 4 hours a week for 10
     10 weeks at the Lurie Center for Autism in              weeks. Fellows will learn how to consult to, and
     Lexington, MA. They learn to take a pediatric and       collaborate with, pediatricians and primary care
     neurological history with a particular emphasis         staff to address pediatric mental health needs
     on birth and early development. School histories        in the primary care setting. Fellows will learn
     are also detailed. Areas addressed include the          about pediatric primary care culture, workflows,
     subtleties of abnormalities in processing and           and staffing and what role pediatricians play in
     modulating sensory input (auditory, visual, and         the mental health care for many of our patients.
     tactile), difficulties in perception and/or medical     Fellows will learn how the child psychiatrist
     conditions that are mistaken for psychiatric or         on a PCMHI team can provide consultation to
     behavioral disorders. Fellows review and perform        pediatricians through indirect case consultations,
     a neurological evaluation, including cranial nerves,    direct “face-to-face” consultations and brief,
     motor (fine motor, gross motor and balance) and         urgent evaluations. Fellows will learn how to
     sensory and mental status assessments. Fellows          perform brief psychiatric interventions (both
     are taught and expected to dictate a complete           somatic and psychotherapeutic) for children and
     report on the patients they have evaluated which        families in the primary care setting, and how to
     are then reviewed by the supervising neurologist,       co-manage mental health care with pediatricians.
     Dr. Ann Neumeyer.                                       As health care nationally moves towards
                                                             an Accountable Care Model of delivery, this
   • Neuropsychological Observation
                                                             innovative rotation is designed to prepare fellows
     During the neurology rotation, fellows will spend       for the future of integrated pediatric health care.
     six hours observing neuropsychological testing of

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Child and Adolescent Psychiatry Fellowship
VI. Longitudinal Outpatient Experience – First Year         Program) and to Cambridge preschool and daycare
   The Cambridge Hospital Child and Adolescent              centers (Early Years Program).
   Outpatient Service is located at the Macht Building      • Outpatient Psychotherapy Clinic
   and provides evaluation and treatment to children
                                                             Fellows spend their time learning and providing
   from ages 3 to 18, approximately 60% of whom are
                                                             psychotherapy and psychopharmacology to
   male and 40% of whom are female, with a relatively
                                                             diverse populations. The essential experience
   even split between children and adolescents.
                                                             includes family work, individual psychodynamic
   These children are most commonly diagnosed with
                                                             psychotherapy, supportive and cognitive/
   disorders of adjustment or trauma, depression,
                                                             behavioral interventions, consultation with
   anxiety and disruptive behaviors (ADHD, ODD).
                                                             community agencies and schools and general
   School behavioral problems, learning disabilities,
                                                             clinical case management. Many cases will
   physical or sexual abuse and family disorganization
                                                             involve combined treatment (both psychotherapy
   are frequently part of the clinical picture. The
                                                             and medications) First-year fellows have at
   cultural and ethnic mix of patients includes
                                                             least three therapy hours a week, primarily
   Portuguese, Latino, and Haitian. Treatment of such
                                                             for psychotherapy, but also for evaluations,
   families is facilitated by CHA’s excellent interpreter
                                                             family work and case management. First-year
   services.
                                                             fellows receive a minimum of 2 hours of weekly
   The Child Ambulatory Service provides                     outpatient supervision.
   approximately ten thousand visits per year. Clinical
                                                            • Precepted Psychopharmacology Clinic
   services available at the Macht building on our
   main campus include a psychotherapy clinic, a             The 3-hour psychopharmacology clinic is devoted
   psychopharmacology clinic, a neuropsychological           to the medication management of patients in
   and developmental testing program, a clinic for           a split treatment model. It is precepted by an
   deaf and hard-of-hearing children, a family therapy       attending child psychiatrist who is available to
   clinic and a group therapy program.                       help fellows with diagnostic interviewing and
                                                             treatment planning, to answer any questions
   In addition to the Macht outpatient service,              the trainee may have, and to guide fellows’
   children and adolescents are seen by our staff            self-directed learning about evidence-based
   at local school-based health centers, at CHA              treatments in clinical practice. Preceptors
   community pediatrics and family medicine clinics          provide feedback on interviewing skills and
   in both co-located and integrated primary care            documentation. Current preceptors are Malak
   models, and at regional residential treatment and         Rafla, MD, Susan Walker, MD, Sandra DeJong, MD
   educational facilities. CHA providers also consult        and Lee Robinson, MD.
   to the Cambridge Police Department (Safety Net

                                                                                                       page 9
CHA Child and Adolescent Psychiatry                          The Child Ambulatory Service provides
                                                             approximately ten thousand visits per year. Clinical
Training Program: Second Year                                services available at the Macht building on our
I.   Outpatient Clinics                                      main campus include a psychotherapy clinic, a
                                                             psychopharmacology clinic, a neuropsychological
     • Outpatient Psychotherapy Clinic (individual,
                                                             and developmental testing program, a clinic for
       group and family, 7.5 hours/week for 52 weeks),
                                                             deaf and hard-of-hearing children, a family therapy
       Cambridge Hospital
                                                             clinic and a group therapy program.
     • Precepted Psychopharmacology clinic (4.5-5
       hours/week for 52 weeks), Cambridge Hospital          In addition to the Macht outpatient service,
       and The Guidance Center                               children and adolescents are seen by our staff
                                                             at local school-based health centers, at CHA
     • Urgent Evaluation Services (as needed, estimated
                                                             community pediatrics and family medicine clinics
       2 hours/month)
                                                             in both co-located and integrated primary care
II. Consultation/Liaison                                     models and at regional residential treatment and
                                                             educational facilities. CHA providers also consult
     • School consultation, Cambridge/Somerville
                                                             to the Cambridge Police Department (Safety Net
       public schools (3 hours/week for 40 weeks)
                                                             Program) and to Cambridge preschool and daycare
     • Forensic consultation, Middlesex Probate/             centers (Early Years Program).
       Family Court Clinic and Adolescent Consultation
                                                             Outpatient Psychotherapy Clinic
       Services to the Middlesex Juvenile Court Clinic,
                                                             Second-year fellows continue their work in
       Cambridge (4 hours/week for 26 weeks)
                                                             evaluating and treating children and families.
III. Elective/Scholarly Activity                             The emphasis is on a flexible approach and
                                                             increasing each fellows’ breadth and depth of
     • Independent Clinical/Scholarly Activity Time
                                                             treatment modalities. The fellows are expected
       (8 hours/week for 52 weeks)
                                                             to have a minimum of eight clinical hours of
                                                             outpatient psychotherapy, including co-leading
Rotations: Second Year
                                                             a weekly outpatient group. Second-year fellows
I.   Outpatient Clinics                                      have 3-4 hours of weekly outpatient supervision.
     The CHA Child and Adolescent Outpatient Service         This includes 2 hours of individual supervision
     provides evaluation and treatment to children from      for psychotherapy in addition to group CBT
     ages 3 to 18, 60 percent of whom are male and 40        supervision, group supervision for groups and
     percent of whom are female. The clinic population       group supervision for school consultation.
     is evenly split between children who are 12 or under,
                                                             Precepted Psychopharmacology Clinic
     and half of whom are 13 or older. These children
     are most commonly diagnosed with attention-             Second-year fellows spend approximately 4.5- 5
     deficit/hyperactivity disorder, adjustment disorders,   hours a week over two afternoons all year long
     depressive disorders, posttraumatic stress disorder,    performing psychopharmacology evaluations
     anxiety disorders and oppositional defiant disorder.    and medication management in a split-treatment
     The clinic also treats youth with autism spectrum       model. Fellows are primarily assigned either to the
     disorders, bipolar disorder, psychotic disorders,       Outpatient Department at CHA or to both CHA
     and substance use disorders. School behavioral          OPD and a CHA-affiliated site in the community.
     problems, learning disabilities, physical or sexual     Dr. Debra Rosenblum and Dr. Nicholas Carson
     abuse and family disorganization are frequently         are the CHA OPD clinic preceptors. Currently, the
     part of the clinical picture. The cultural mix of       community site is The Guidance Center, where the
     patients includes Latino, Haitian and Portuguese, as    rotation is precepted by their Medical Director, Dr.
     well as a variety of other ethnicities.                 Tyrone Williams. Preceptors provide feedback on
                                                             interviewing skills, treatment planning, coordination

                                                                                                           page 10
of care, coding and documentation. Time each            Forensic Consultation
   week is devoted to supervision of cases and             Probate and Family Court: The Family Service
   didactics focusing on the review of seminal articles    Clinic is a department of the Middlesex Probate
   in pediatric psychopharmacology.                        and Family Court, with offices in Cambridge. The
                                                           clinic staff performs comprehensive evaluations
   Urgent Evaluation Service
                                                           of families following parental separation in which
   Second-year fellows will spend approximately five       custody and visitation of minor children are
   months performing clinical assessments of youth         disputed issues. These evaluations focus on the
   who have been referred to the Macht Outpatient          needs, interests and welfare of the child in the
   Clinic due to acute mental health problems that fall    context of parental conflict. Children evaluated
   short of requiring an emergency room evaluation         range in age from under one year to 18 and
   but are concerning for potential significant decline    come from diverse socioeconomic and ethnic
   prior to a regular outpatient evaluation. Such          backgrounds. The rotation supervisors are Barbara
   referrals are seen within one week of referral. These   Hauser, LICSW and John Baker, Ph.D.
   evaluations are supervised by Sandra DeJong, MD.
                                                           Educational activities include Introduction to the
II. Consultation/Liaison                                   Probate and Family Court, including observation of
   School Consultation                                     court proceedings and the provision of testimony
                                                           during these proceedings, multiple diagnostic
   The Cambridge Public School system serves a
                                                           interview sessions with the referred children and
   diverse ethnic and socioeconomic community from
                                                           their parents, review of collateral documents and
   kindergarten through grade 12. Child Psychiatry
                                                           completion of a comprehensive report for the
   fellows spend 3 hours per week for nine months
                                                           court, concluding with recommendations.
   in consultation to a diverse cultural public student
   population                                              Juvenile Court: Adolescent Consultation
                                                           Adolescent Consultation Services (ACS) is a private
   Fellows either choose to work in an elementary/
                                                           non-profit agency which operates the Juvenile
   middle school (kindergarten through eighth
                                                           Court Clinics for the Middlesex County Juvenile
   grade) or high school according to their interest,
                                                           Courts. ACS offices are located in the Juvenile
   exposure to different age groups and availability
                                                           Court in Cambridge. Upon order of the Judge,
   of placement. The school population is a highly
                                                           Juvenile Court Clinic staff conduct comprehensive
   culturally diverse population representing a
                                                           diagnostic evaluations of youth and families
   broad range of socioeconomic backgrounds from
                                                           involved in the court. The rotation supervisor is
   Cambridge communities.
                                                           Mathilde Pelaprat, PsyD.
   Fellows complete up to three evaluations of
                                                           Educational activities include multiple diagnostic
   students with safety and/or mental health concerns
                                                           interview sessions with the entire family and the
   (e.g. aggressive behavior) under close supervision.
                                                           referred youth, review of collateral documents,
   These assessments often clarify the diagnosis and
                                                           completion of the comprehensive forensic
   help with understanding the treatment obstacles
                                                           report (Delinquency, Child Requiring Assistance,
   and how to manage a particularly challenging
                                                           or Care and Protection case) for the court,
   student.
                                                           including a dynamic formulation and realistic
   This rotation is supervised by James Barrett, PhD,      recommendations. Introduction to the juvenile
   Director of School-Based Mental Health Programs         court setting and staff including judges and
   for the Cambridge Health Alliance.                      probation officers includes observation of juvenile
                                                           court and the opportunity to give testimony.

                                                                                                         page 11
III. Elective/Scholarly Activity                              These are:
   Independent Clinical/Scholarly Activity                    1. Introduction to Scholarly Activities Seminar,
   Fellows have the equivalent of one day a week                 Summer Seminar in the first year.
   in the second year to pursue clinical activities           2. Clinical Scholarship Seminar, Sept-June, both
   according to their particular interests, and to               years; critical evaluation of the literature to
   complete a scholarly project. Fellows are expected            answer a clinical question in the first year;
   to either create an elective proposal or choose               presentation for scholarship requirement in the
   from a variety of electives currently offered by              second year.
   our faculty. Either of these options will require
                                                              3. Presentations during Preschool Observation
   the fellow to choose a mentor or supervisor to
                                                                 Rotation, Community Service Agency rotation,
   work with during the elective. In addition, fellows
                                                                 Neurology rotation and Harvard Consolidated
   complete a scholarly project by the end of the
                                                                 Seminar in the first year.
   second year. The elective may or may not pertain
   to the same material as the scholarly project. In          4. Option of preparing a poster for Mysell Research
   the past, fellows have chosen a wide range of                 Day and CHA Poster Day.
   projects, including making a video about toddler           5. Completion of a scholarly project during the
   and preschool development, conducting a pilot                 second year elective time.
   research project on pharmacological treatment of
   weight gain in adolescents on neuroleptics, and            Seminars and Didactics
   developing a school-based curriculum on cyber-             A defining feature of our didactics is the Harvard
   bullying.                                                  Consolidated Program. In this program, all first-year
                                                              fellows in the Harvard-affiliated child psychiatry
   Clinical Scholarship Expectations                          training programs (MGH/McLean, Children’s
   The Accreditation Council of Graduate Medical              Hospital and Cambridge Health Alliance) come
   Education (ACGME) requires that all training               together to participate in a 3-hour didactic session
   programs meet standards in the area of scholarship.        made up of two core seminars: Child Development
   According to the guidelines, faculty is responsible        and Child Psychopathology. Internationally
   for ensuring there is an environment of inquiry and        renowned Harvard faculty are guest lecturers on
   scholarship. Scholarship is required of both faculty       a variety of topics in child mental health research,
   and fellows. In the Department of Psychiatry at            assessment and treatment. The seminars are
   Cambridge Health Alliance and at Harvard Medical           coordinated by CHA faculty Maria Sauzier, MD and
   School, scholarship is defined broadly and may             Karlen Lyons-Ruth, PhD.
   include the scholarship of discovery, the scholarship
   of integration, the scholarship of teaching and         First-Year Summer Seminars
   the scholarship of application. Guidance and             Scholarly Activities – Nick Carson, MD and
   technical support should be provided to fellows by       second-year fellow Sol Adelsky, MD
   faculty. The scholarship requirement of the Child        Systems Issues – Joel Goldstein, MD
   Psychiatry Fellowship program is designed to meet
   the ACGME requirements and provide flexibility           Normal Development – Susannah Sherry, MD
   for Fellows to pursue special scholarly interests.       Introduction to Child Psychiatric Illness – Malak Rafla,
   While all clinical service experiences, supervision      MD and second-year fellow Kevin Coughlin, MD
   and seminars are an integral part of developing          Pragmatics of Child Psychiatry –Lee Robinson,
   scholarship, specific components are intended to         MD and CHA Faculty Introduction to Pediatric
   address the development of attitudes, skills and         Psychopharmacology – Sandra DeJong, MD
   behaviors that lead to a potential academic career.

                                                                                                             page 12
First-Year Seminars: September–June                      Psychodynamic Psychotherapy – Jennifer Harris, MD
 Clinical Scholarship (with second-years) -              and Theodore Murray, MD
 Nick Carson, MD and John Hamilton, MD, MSc              Play Therapy – Neal Kass, MD
 Harvard Consolidated Program:                           Neuroscience of Addictions – Sandra DeJong, MD
 Child Development – Maria Sauzier, MD,                  Transitions to Practice – Joel Goldstein, MD
 Karlen Lyons-Ruth, PhD (Course Directors)
                                                         Cognitive-Behavioral Therapy – Jeanne Strassburger,
 Child Psychopathology – Maria Sauzier, MD               PhD , Lauren Krumholz, PhD
 and Harvard faculty
                                                         Trauma-Focused CBT – Sandra DeJong, MD
 Inpatient Clinical Case Conference – Tim Dugan, MD
                                                         Family Therapy (elective) – Jill Harkaway, EdD
 and Judy Tsafrir, MD
                                                        In addition to the above seminars, first- and second-
 Inpatient Family Therapy Case Conference –
                                                        year fellows have twice-monthly training meetings with
 John Sargent, MD
                                                        the program directors to discuss training issues, and
 Family Therapy Seminar – Jill Harkaway, EdD            also meet monthly with a facilitator Jeanne Heiple, MD,
 Introduction to Child Evaluation – CHA Faculty         for a peer support group.

 School C/L – Nancy Rappaport, MD                       Family Therapy Training, CHA
 Medical C/L – Amy Mayhew, MD, MPH                      Family Therapy is often a core component of
 Neuropsychological Evaluation – Laura Gaugh, PsyD      any successful psychiatric treatment of a child or
                                                        adolescent. The guidelines of the Accreditation
 Forensics – Barbara Hauser, LICSW,                     Council of Graduate Medical Education, the Practice
 Adam Rosen and JD, PhD                                 Parameters of the American Academy of Child and
 Parenting – Susannah Sherry, MD, and Ann Hess, MD      Adolescent Psychiatry and the recommendations
 Pediatric Psychopharmacology – Lee Robinson, MD        of the Group for the Advancement of Psychiatry
 and visiting faculty                                   Committee on the Family all underscore the role
                                                        of working with families. To this end, the CHA child
Second-Year Summer Seminars                             psychiatry fellowship offers a very strong grounding
 Administration and Leadership – Lee Robinson, MD       in Family Therapy training opportunities. These
                                                        opportunities aim to provide fellows with a basic
 Learning How to Teach – Sandra DeJong, MD
                                                        conceptual understanding of family therapy as well as
 Integrated Psychiatric Assessment –                    a range of experiences across treatment settings with
 Allison Warshof, LICSW and visiting faculty            different kinds of families and family issues
 Child Psychotherapy – Jennifer Harris, MD
                                                        In the first year, fellows participate in a year-long
 and Theodore Murray, MD
                                                        seminar that introduces Family Therapy Theory,
 Culture and Society – Xenia Johnson, MD                assessment, and intervention. The seminar consists of
 Infancy and Attachment: Clinical Implications –        didactics and observation of family consultations using
 Ayelet Barkai, MD, and Ann Epstein, MD                 a one-way mirror, with a daylong “Family Therapy
                                                        Retreat” to wrap-up the academic year. The focus of
 Gender and Sexuality – Cindy Telingator, MD
                                                        this seminar is on acquiring basic knowledge, skills and
 and John Wechter, EdD
                                                        attitudes in working with family systems. This seminar
Second-Year Seminars: September-June                    is taught by Jill Harkaway, EdD. In the second year, an
 Clinical Scholarship (with first-years), Nick Carson   elective advanced seminar is available. This seminar,
 MD and John Hamilton MD, MSc                           taught by Jill Harkaway and Elizabeth Brenner, LICSW,
                                                        provides clinical training in Family Therapy through
 School Supervision – Nancy Rappaport, MD               case consultation and/or live supervision using a
 Integration and Special Topics – Don Condie, MD,       one-way mirror. Case supervision is also offered by all
 and Sandra DeJong, MD                                  members of the faculty.

                                                                                                          page 13
Fellows also participate in inpatient Family               trainees to meet and talk with others who have
Consultations, conducted on both the Child                 transitioned into this unique academic setting. Second-
Assessment Unit and the Adolescent Assessment Unit,        year trainees and current faculty who are former
and participate in a Family Therapy Case Conference,       CHA trainees will also be present to offer support
precepted by John Sargent, MD.                             and their valuable insights to acclimating to CHA,
                                                           to Harvard Medical School and to New England (for
Program in Psychodynamics                                  those who are spending their first year here in the
The Program in Psychodynamics is an elective               Boston metropolitan area). This initiative is led by Dr.
opportunity for fellows in both years across all three     Treniece Lewis-Harris, the Director of Child Psychology
Harvard Child Psychiatry Fellowship programs. Its goal     Outpatient Training at CHA.
is to foster the career development of fellows with an
interest in psychodynamics, psychodynamic research,
psychoanalysis and psychodynamic psychotherapy.
                                                           Training Office:
The core activity is a monthly dinner meeting at the       Lee Robinson, MD
home of program faculty to discuss relevant topics         Training Director
defined by the program participants. The program           1493 Cambridge Street,
offers a flexible set of opportunities for enrichment      Cambridge, Massachusetts 02139
in the fellowship and two years post fellowship.           (617) 575-5607
In collaboration with the Boston Psychoanalytic
Society and Institute (BPSI), the Program in               Sandra DeJong, MD
Psychodynamics allows fellows to enhance and               Senior Associate Training Director
deepen their psychodynamic interests and to integrate      1493 Cambridge Street,
psychodynamic scholarship into the rigorous clinical       Cambridge, Massachusetts 02139
training provided to all CHA child psychiatry fellows.     (617) 665-1297

Teaching during Child Training                             Lee Robinson, MD
All our fellows are encouraged to teach during their       Instructor in Psychiatry,
child training. Fellows have a hands-on, interactive       Harvard Medical School
“Learning to Teach” seminar in the summer of their         Training Director Division of Child
second year. Fellows are then assigned teaching            and Adolescent Psychiatry
responsibilities based on their interests. In the past,    Staff Psychiatrist, Pediatric Primary
fellows have co-taught seminars, taught medical            Care Mental Health Integration
students and general psychiatry residents on the           Dr. Robinson completed his general psychiatry
inpatient units and outpatient evaluation teams, given     residency training at Columbia University – New York
lectures as part of standing seminars, developed           State Psychiatric Institute, and his child and adolescent
curricula for public education, given talks in community   psychiatry fellowship training at Cambridge Health
settings and helped organize and teach an onsite           Alliance. He has worked in primary care-mental
Harvard Medical School course on interviewing              health integration, providing psychiatric consultation
patients.                                                  to primary care providers for children and adults,
Minority Trainee Mentoring Alliance (MTMA)                 has provided consultation to the Department of
                                                           Mental Health (DMH) around issues of developmental
Multidisciplinary first-year trainees (i.e. nursing,
                                                           disorders, and works in private practice. Dr. Robinson’s
psychology, psychiatry, social work) in the Department
                                                           current academic interests include autism and
of Psychiatry at CHA who self-identify with a minority
                                                           neurodevelopmental disorders, primary care-mental
group or groups (e.g. ethnic, racial, sexual, religious)
                                                           health integration, addressing social determinants of
are invited to the Minority Trainee Mentoring Alliance
                                                           mental health, and education. He was a past PRITE
(MTMA). This program is sponsored by the Diversity
                                                           Fellow, and a recent graduate of the Kraft Center for
Task Force at CHA as an opportunity for first-year
                                                           Community Health Practitioner Program, in which he

                                                                                                             page 14
studied healthcare utilization patterns for children with   Editor of the Child Psychiatry Resident In-Training
autism. Dr. Robinson has been a Team Leader on the          Examination (PRITE). She will be stepping into the
Thursday Child Evaluation Team, has supervised and          Senior Associate Training Director role in July 2017.
taught adult psychiatry residents in psychotherapy
and acute child assessment, has taught the fellows on       Roopali Bhargava, BA
topics of autism and healthcare reform, and supervised      Training Coordinator
them for psychopharmacology, psychotherapy, and             Division of Child & Adolescent Psychiatry
scholarly electives. He was the Associate Training          Roopali Bhargava graduated from McGill
Director for 2016/2017 training year, and will be           University with a degree in Psychology.
assuming the role of Training Director in July 2017.        She joined CHA in December 2012
                                                            bringing with her many years of experience in
Sandra DeJong, MD, MSc                                      program/project management and administration.
Assistant Professor of Psychiatry,                          Roopali’s recent positions include Global Operations
Harvard Medical School                                      Manager at an international nonprofit educational
Senior Associate Training Director,                         organization, Regional Program Director for
Division of Child and Adolescent                            Earthwatch Institute and Event Manager at the
Psychiatry                                                  New England Aquarium. In addition to being the
Dr. DeJong trained in pediatrics and General Psychiatry     Coordinator for the training program she is also the
at the University of Massachusetts Medical Center in        administrative coordinator for the Child Psychiatry
Worcester, MA, and in Child and Adolescent Psychiatry       Division leadership team at Cambridge Health Alliance.
at Massachusetts General and McLean Hospitals.
She has worked in an outpatient community hospital          Clinical and Research Leaders
setting providing consultations and medication
management to patients referred from pediatricians,         The field of child and adolescent psychiatry has seen
as well as inpatient child psychiatry consultation          tremendous growth recently in areas of epidemiology,
and private practice. In addition, she served as co-        diagnosis, neurobiology, treatment and health services
Investigator with Dr. Jean Frazier on an NIMH-funded        research. The Department of Psychiatry at CHA is
multi-site research project in the treatment of early-      particularly committed to advancing the scientific
onset psychosis, and has written about the use of           knowledge base regarding the mental health of
antipsychotic medications in children.                      children living in culturally diverse community settings,
                                                            and in training mental health professionals in clinical
In the fall of 2004, Dr. DeJong assumed the position of     excellence, research investigation and academic writing
Associate Training Director in the Division of Child and    for the promotion of this knowledge.
Adolescent Psychiatry and became Training Director
in July, 2013. Current academic interests include           Cambridge Health Alliance is a health care system with
neurodevelopmental disorders, e-professionalism             strong clinical, academic and research programs and
and integrating technology into clinical practice,          diverse faculty interests. The training program and the
ethics in child psychiatry, and psychiatric education.      faculty are committed to providing top educational
She is the author of Blogs and Tweets, Texting and          opportunities for our fellows within the Cambridge
Friending: Social Media and the Internet in Health          Health Alliance, as well as at affiliated Harvard teaching
Care published by Elsevier in 2014. She serves on the       hospitals.
Steering Committee and the Executive Council of             Jacob Venter, MD, CPE
the American Association of Directors of Psychiatry         Instructor in Psychiatry, Harvard Medical
Training (AADPRT), and is the current AADPRT                School Chief, Division of Child and
President. She currently also serves on the Ethics          Adolescent Psychiatry
Committee of the American Association of Child and
Adolescent Psychiatry. She participated in the 2014         Dr. Venter hails from South Africa and
ACGME Subspecialty Milestones Taskforce to develop          completed his Child and Adolescent
Milestones for Child/Adolescent Psychiatry and as           Psychiatry training at CHA and a child and adolescent
                                                            neuropsychiatry research fellowship at Harvard

                                                                                                               page 15
Medical School. He has held a number of positions          Benjamin Cook, Ph.D., M.P.H.
at CHA including Director of Intensive Services. His       Assistant Professor, Department
clinical interests include autism, trauma, early-onset     of Psychiatry, Harvard Medical School
psychosis and mitochondrial disorders. Most recently       Director, Center for Multicultural Mental
he has served as Division Chief of Psychiatry at Barrow    Health Research and Health Equity
Neurological Institute, Phoenix Children’s Hospital,       Research Lab
Arizona. He obtained his certification as a physician      Dr. Cook holds a Ph.D. in Health Policy from Harvard
executive in 2013, and stepped into the role of Division   University and is a health services researcher
Chief of Child Psychiatry at CHA in 2016.                  focused on reducing and understanding underlying
Nicholas Carson, MD, FRCPC                                 mechanisms of racial/ethnic disparities in health and
Instructor in Psychiatry,                                  mental health care. He has been principal investigator
Harvard Medical School                                     on several major R01 grants from the NIMH and AHRQ
Medical Director, Child and Adolescent                     investigating mechanisms underlying disparities in
Outpatient Psychiatry Services                             episodes of mental health care, a R01 Supplement
Clinical Research Associate, Center for                    developing state by state report cards on mental
Multicultural Mental Health Research                       health care disparities, and a Milton Foundation grant
                                                           supporting research on tobacco use and mental
Dr. Carson is a graduate of the child psychiatry           health. His methodological work focuses on improving
fellowship at Cambridge Health Alliance and                statistical methods for the measurement and tracking
completed residency training in psychiatry at the          of healthcare disparities, and he has received awards
University of Pennsylvania in the Clinical Research        from NIMH and AcademyHealth for this work. His other
Scholars Program. His research in mental health            research interests include improving mental health
services for multicultural communities has explored        of immigrant populations, comparative effectiveness
the quality and social determinants of mental health       research and its influence on healthcare disparities,
treatment among Haitian youth at CHA. He is co-            substance abuse treatment disparities, and healthcare
investigator on several major NIH-funded grants at         equity. Dr. Cook assists with the Scholarly Activities
the Center for Multicultural Mental Health Research on     seminar for first-year fellows and provides mentorship
topics of patient provider communication, mechanisms       on research methods and analysis to fellows and
of health care disparities, and intervention research to   faculty interested in pursuing quantitative research
improve patient participation in treatment. Dr. Carson     studies.
also studies the effects of mass media and technology
on the mental health and development of youth,             Katherine E. Grimes, MD, MPH
including an on-going, trainee-initiated survey of media   Associate Clinical Professor of
use among inpatients on the adolescent unit at the         Psychiatry, Harvard Medical School
Cambridge Hospital.                                        Director, Children’s Health Initiative,
He also serves on the Media Committee of the               Cambridge Health Alliance
American Association of Child and Adolescent               Dr. Grimes is the Director of the Children’s
Psychiatry. Dr. Carson teaches the summer Scholarly        Health Initiative, a health services research group
Activities seminar for first-year fellows, co-leads the    focused on improving mental health access and
Clinical Scholarship (Journal Club) seminar for first      treatment quality for children and adolescents,
and second-year fellows, precepts the second-year          particularly those at greatest risk for health disparities.
psychopharmacology clinic, and is a Team Leader on         Dr. Grimes is currently the co-principal investigator of
the Friday Evaluation Team. He was the Associate           a 4-year, $4 million grant from the Substance Abuse
Training Director of the Child Psychiatry Fellowship       and Mental Health Services Administration (SAMHSA)
Program from July 2013-June 2016 before assuming           titled “Enhancing Systems of Care: Supporting Families
the role of Medical Director for the Child and             and Improving Youth Outcomes ‘E-SOC,’” which aims
Adolescent Outpatient Psychiatry Services in               to integrate services for children with, or at-risk of,
July of 2016.

                                                                                                               page 16
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