Clinical Sites
Dartmouth-Hitchcock Medical Center
The training blocks at the Dartmouth-Hitchcock Medical Center consist of approximately 17 hours per week of outpatient clinical contact working with a wide variety of evaluation and treatment cases. The most frequently seen diagnoses are affective and anxiety disorders, disruptive behavior and learning disorders, eating disorders, post traumatic stress symptoms and developmental disorders. Many of the cases are complex in nature and have been referred for the expertise available at a tertiary care medical center. The clinical activity for the residents on this service includes the comprehensive evaluation of outpatient cases with an integration of family systems, psychodynamic, biologic and sociocultural perspectives, as well as the ongoing psychodynamic treatment of individual children and adolescents. In addition, residents have cases requiring family therapy, pharmacotherapy, parent guidance, behavioral modification and cognitive-behavioral treatment. Many clinical services are delivered in specialized clinics, e.g., psychopharmacology, developmental disabilities, with dedicated staff and structured assessment/treatment protocols. Residents also work in close collaboration with other clinicians in the Section, e.g., pediatric neuro-psychologists, in cases requiring multi-disciplinary evaluation or treatment.
New Hampshire Hospital Child & Adolescent Inpatient Unit
Training at New Hampshire Hospital (NHH) emphasizes the assessment and care of seriously disturbed children and adolescents who require 24 hour care. Located in Concord, NH, NHH is directly affiliated with the Department of Psychiatry as the only public-sector psychiatric hospital in the state. Patients have a wide variety of behavioral, affective, cognitive, legal, family and psychosocial problems including, psychosis, substance abuse, depression, bipolar disorder, suicidal behavior, eating disorders, sexual/physical abuse-induced syndromes and violence. In their role as clinical team leaders, residents are exposed to active treatment programs that stress post-discharge, community services planning from the time of admission. Treatment modalities include cognitive-behavioral treatment, groups, milieu treatment, pharmacotherapy, family therapy, behavioral modification and focal psychodynamic interventions. While the child/adolescent inpatient unit is a traditional inpatient unit, it is also a site where residents can participate in a variety of additional clinical and research experiences. These include 1) experiences with child mental health service system development, 2) exposure to severely disturbed children who require long term traditional individual or family treatment, 3) experience with child forensic cases and consultation to the court, 4) experience with medicating treatment resistant cases of children who require multiple medications.
Woodsville Juvenille Rehabilitation Center
The Woodside Juvenile Rehabilitation Center, located in Colchester, VT, is Vermont's only secure residential program for adjudicated adolescents. Residents are assigned primarily to the Treatment Program (The Vermont Intensive Treatment Program for Aggressive Adolescents) although they may also be asked to consult on cases in the Detention Program particularly if there is a learning opportunity. Treatment is intensive and based upon behavioral, cognitive and psychodynamic principles with minimal use of psychotropic medications. Residents participate at multiple levels of the program including assessment, treatment and medication consultation. Since the average length of stay is approximately 15 months, residents have the opportunity to follow specific cases for the duration of the rotation. Faculty holding dual University of Vermont (UVM)/The Geisel School of Medicine at Dartmouth appointments provide supervision.
