PROGRAM DESCRIPTION:

The CHAMP Clinic is a UCLA program that focuses on differential diagnosis and treatment of pediatric mood disorders, including bipolar disorder and major depression. The CHAMP Clinic involves three components: comprehensive diagnostic assessment of pediatric illness, pharmacological treatment, and psychological treatment.

The Clinic sees many patients with complicated and highly comorbid clinical presentations and focuses on providing a comprehensive differential diagnostic evaluation, using the “Kiddie” Schedule for Affective Disorders and Schizophrenia (K-SADS) as a format. Under faculty supervision, trainees take lead roles in conducting these evaluations and receive supervision in differential diagnosis.

CHAMP is one of the few rotations where one can get concentrated training in family therapy. Family treatment is manual-guided, evidence-based, and relatively brief (e.g., up to 12 sessions). It is based primarily on the family-focused therapy (FFT) model of care, which is both strategic and psychoeducational in orientation. Mood and behavior management techniques are used to teach families and children effective communication and problem-solving skills. Psychoeducation is used to teach coping skills for managing mood episodes (e.g., manic episodes of bipolar disorder) and prevent future episodes. Often, strategic or structural family therapy techniques are included (e.g., modifying dysfunctional interactions, strengthening alliances between family members). Supervision involves live observation of family intervention sessions via video or Zoom with a team that includes three experienced licensed clinical psychologists.

Medication backup for patients is provided by our child psychiatrist, Drs. Horstmann, and child psychiatry fellows under her supervision. Psychology trainees gain exposure to psychopharmacological interventions through the co-management of patients with mood disorders who require medication as well as psychological treatments.

CHAMP is a good way to get experience with diagnostic assessment, family therapy or both for adolescents and children with mood disorders, experience which will be essential to future clinical practice

DAY, TIME, AND LOCATION:

Mondays 12 pm – 6pm Semel, Room A8-256

Interns may select either the assessment or therapy elective within the clinic, or they may elect both. The assessment elective (including supervision) runs from 12-2:15 pm and the therapy elective (including supervision) runs from 2:15pm-6pm.

DURATION OF ELECTIVE: 6 months

FACULTY AND STAFF:

David Miklowitz, Ph.D.

Patricia Walshaw, Ph.D.

Sarah Marvin, Ph.D.

Alissa Ellis, Ph.D.

Angus Strachan, Ph.D.

Elizabeth Horstmann, M.D.

TRAINING PROVIDED:

Trainees should expect to have 3-4 assessments during the assessment elective.

The therapy elective includes family therapy sessions, group supervision, and whenever possible, observing others’ sessions. The commitment for either option is 6 months. Family therapy trainees should expect to see 2 patients per week either as primary therapist or co-therapist, with ‘real-time’ group supervision provided before and after (and sometimes even during) sessions. Individual supervision is provided during or outside of clinic hours on an as-needed basis.

DIVERSITY TRAINING:

Patients at CHAMP represent a diverse population in terms of ethnic, gender identity, religion, and socioeconomic background. Trainees receive instruction and direct supervision in considering how diversity factors not only impact access to and use of care but also how this plays a role in both developing a differential diagnosis and case formulation and a treatment plan. Specific discussion occurs regarding how the identity of the patient and family and their culture plays a role in their beliefs about the causes and treatment of mental health issues and the use of DSM diagnostic terminology. Supervision is provided on how to incorporate one’s knowledge and understanding of culture into providing feedback in a sensitive and effective manner that would benefit the family. As family therapy is a focus in CHAMP, intergenerational cultural factors and levels of assimilation often play a role in approach to treatment (we have many families where the child/adolescent is a first-generation American with parents from another country). Often, we see adolescents with gender identity concerns. Supervision is provided around the impact of the trainee’s and supervisor’s own identities and how these play a role in our approach to patients and potential biases that may arise.

SUPERVISION PROVIDED:

Method of Supervision: Direct Observation, Videotape, Case Presentation

Format: Group

Hours Per Week: 3.5 group

Days and Times: Monday 2:15 – 6:00 PM

Names of Supervisor(s): David Miklowitz, Sarah Marvin, Patricia Walshaw, Alissa Ellis, Angus Strachan, and Elizabeth Horstmann