Psychopharmacology
Pediatric psychopharmacology is taught in outpatient, inpatient, acute residential and partial hospital rotations. Residents will spend four hours per week in the Pediatric Psychopharmacology Clinic at MGH in Year 1 and two hours per week in the Clinic in Year 2.

The Pediatric Psychopharmacology Clinic, under the direction of Dr. Joseph Biederman, is committed to the evaluation and treatment of children and adolescents with major, often chronic, psychiatric disturbances (DSM IV Axis I Diagnoses). In addition, the clinic evaluates and treats children and adolescents with developmental disorders, who also require psychiatric care. The emphasis in the clinic is on long-term follow-up and continuous reassessment of treatment strategies for severely psychiatrically disturbed children. It provides specialized consultation to local psychiatrists, social agencies, community residential schools and other mental health organizations, on issues of pediatric psychopharmacology.

Teaching in pediatric psychopharmacology is based on three components: a) clinical experience, b) supervision and c) didactic seminars.

Psychopharmacology:
Clinical and Training Components
1 Diagnostic evaluations consist of a minimum of one hour with the parent and one hour with the child. These evaluations frequently include neuropsychological, social, metabolic, EEG and neuroimaging evaluations. Structured interviews are used as adjuncts to the clinical evaluations.

2 Patients meeting diagnostic criteria for specific disorders and for whom the use of psychotropic medication is indicated are accepted into the Clinic for treatment. Treatment plans follow a multimodality approach addressing the psychosocial and familial as well
as the biological aspects of the child.

3 The residents will be running a small pediatric psychopharmacology practice. The core curriculum of four hours per week will be used as two hours for evaluation of new patients, one hour for follow-up and one hour for supervision. Residents will be evaluating approximately one new patient every other week. Those patients treated through the Clinic will be followed by the evaluating resident throughout his or her residency training. Those residents interested in spending more elective time in the Clinic will be able to do so and will run larger practices.

4 The resident will follow patients requiring psychopharmacological management. He or she will have the choice of focusing exclusively on pharmacological management or assuming other additional therapeutic roles, such as conducting family therapy, individual or behavioral psychotherapies. Residents will be encouraged to assume more than one role in the management of their cases.

5 Residents will be able to function as consultants for other units within and outside the MGH and McLean Child and Adolescent Program.

6 Three types of supervision will be offered depending on the resident’s interest and caseload: a) individual b) research and c) group.

Psychopharmacology will be taught in inpatient, acute residential and partial hospital rotations. On the McLean Inpatient Unit at Franciscan Children’s Hospital, supervision will be provided by Drs. Thrassos Calligas and Andrew Stromberg. On the McLean Acute Residential and Partial Hospital Service, supervision will be provided by Dr. Michael Rater.

The core Psychopharmacology rotation is based on the MGH campus, where residents will follow patients for two years. In the selective half of Year 1 or the elective block in Year 2, residents may choose to evaluate and treat children and adolescents in the McLean Outpatient Clinic. There, they may choose to see patients through the many subspecialty clinics including Tourette's and Movement Disorders, Obsessive Compulsive Disorder, Bipolar Disorder, Attention Deficit Disorder, Psychotic Disorders, Pervasive Developmental Disorders and/or Mental Retardation Clinics.