Available for the 25-26 training year

PROGRAM DESCRIPTION:

The Child OCD, Anxiety, and Tic Disorders Program specializes in the evaluation and evidence-based treatment of children and adolescents with OCD, anxiety, tic, and body-focused repetitive behavior (e.g., trichotillomania, skin picking) disorders.

DAY, TIME, AND LOCATION: Mondays 1 – 5 pm or 1 – 6 pm, plus 30 min for prep/documentation/phone calls 300 Medical Plaza, Room 1208 HOURS PER WEEK: 4.5 or 5.5 ROTATIONS: 6 months (July – December, January – June) FACULTY AND STAFF:

John Piacentini, Ph.D. Emily Ricketts, Ph.D.

Margaret Stuber, MD

Juliet Edgcomb, MD

Julia Revillion Cox, Ph.D.

Michael Treanor, Ph.D.

TRAINING PROVIDED:

Treatment is typically manual-guided, relatively brief in nature, and based on cognitive behavioral techniques. Additional anxiety management techniques and family interventions are used to enhance adherence and strengthen and maintain treatment gains. Medication management for patients as needed is provided for in Clinic, by child psychiatry trainees under the supervision of Drs. Stuber and Edgcomb. Psychology trainees gain exposure to psychopharmacological interventions for OCD, anxiety, and tic disorders through the co-management of patients requiring this combined treatment. A structured assessment battery is administered pre- and throughout treatment allowing for the systematic evaluation of treatment outcome. In addition to ongoing therapy, the Program also provides comprehensive diagnostic evaluations on a consultative basis to youngsters with typically complicated or highly comorbid clinical presentations. Under faculty supervision, trainees have the opportunity to take lead roles in conducting these evaluations. Treatment manuals for some of the disorders seen in clinic are provided to trainees at the start of the rotation. The first 1-2 hours of clinic are spent in: 1) didactic instruction in the assessment and treatment of OCD, anxiety, tics, body-focused repetitive behaviors, and co-occurring problems, and 2) group supervision for ongoing clinic cases. The remainder of time is spent delivering clinical care to patients. Trainees are expected to carry 2-3 cases at any one time along with occasional 1-2 visit diagnostic consultations. Each session is observed by faculty (and available trainees) via a one-way mirror. Additional real-time supervision and instruction is provided during and between sessions. Individual supervision is provided outside of regular clinic hours on an as needed basis. The total time commitment is 4.5 or 5.5 hours per week.

DIVERSITY TRAINING:

Patients and families seen in Clinic represent considerable diversity with regard to racial/ethnic, acculturative, socioeconomic, and religious status as well as sexual identity/gender orientation. Issues of diversity are addressed in several ways. Trainees receive specific didactic instruction and experiential practice in sensitively and appropriately querying factors related to diversity during assessment, integrating these findings into case conceptualization, and subsequently integrating any relevant factors into treatment and discussing how these factors may play a role with our patients and their parents. Didactic instruction includes formal readings and related discussion (e.g., how a family’s religious practices may influence a patient’s scrupulosity OCD symptoms). Experiential practice includes participating in treatment rounds, observing, and being shadowed in the conduct of assessment and intervention, and participation in team-based treatment planning. When relevant to individual youths/families, trainees also participate in the practice of cultural sensitivity (e.g., use of translators when parents prefer to speak a non-English language, consultation with experts/leaders in the relevant area [such as religious leaders], discussions with parents about their cultural practices and how the child’s behavior may fit within or deviate from typical practice or beliefs, etc.). By the end of the training year, trainees demonstrate an understanding of and sensitivity to diversity issues in the assessment and treatment of pediatric anxiety-related disorders, as well as awareness of one’s own cultural and ethnic background and its potential impact on this work.

SUPERVISION PROVIDED:

Method of Supervision: Direct Observation, Case Presentation

Format: Individual and Group

Hours Per Week: 3 – 4 (1 hour for group, live supervision, available for additional time as needed)

Days and Times: Mondays 1 – 5 pm or 1 – 6 pm, plus availability to meet during the week as needed

Names of Supervisor(s): John Piacentini, PhD ABPP, Emily Ricketts, PhD, Margaret Stuber, MD, Juliet Edgcomb, MD, Julia Revillion Cox, PhD, Michael Treanor, PhD