Faculty Chair:

Leandrita Ortega, MD

Contact:

Frank Pieri, MD

Introduction:

The Human Behavior and Mental Health Curriculum has two components. The first is a Behavioral Intensive Rotation Curriculum and the second is the Longitudinal Behavioral Curriculum. The Behavioral Intensive Rotation occurs in two 4-week rotations and focuses on the assessment and treatment of individuals with the more severe psychiatric disorders in both the inpatient and outpatient setting. The Longitudinal Curriculum describes learning that takes place during the entire three year duration of the resident’s education.

Additionally a resident may choose to participate in additional optional experiences:

An additional rotation through the teen health clinics in school based centers with an emphasis on behavioral treatment
Additional behavioral sites may be utilized with the approval of the behavioral faculty, consent of the department head, and the approval of the training faculty.

This first section describes the Behavioral Intensive Rotation Curriculum. A separate section under its own title describes the Longitudinal Behavioral Curriculum.

Required Experiences:

Participation in the Family Medicine Center Outpatient Behavioral Services
Participation in an inpatient psychiatric service including ECT and legal proceedings for guardianship (2 half days per week)
Participation in an outpatient psychiatric service (2 half days per week)
Diagnostic Pre-test: closed-book diagnostic pretest on Kaplan & Saddock (taken the first Monday afternoon of rotation).
Test questions will be taken from Kaplan & Saddock’s Study Guide and Self-Examination Review in Psychiatry 2011 as well as other relevant resources reflecting current evidence-based information guiding assessment and treatment of psychological disorders
Post-test requiring a score of 85% to pass rotation

Activities during the Behavioral Intensive Rotation:

Rotation in an inpatient behavioral care setting
Rotation in an outpatient behavioral care setting
Active collaborative co-treatment of complex patients with behavioral health providers
Completion of a quality improvement project in integrated behavioral care in collaboration with behavioral health providers

Weekly Schedule:

Sunday	Monday	Tuesday	Wed	Thursday	Friday	Saturday
	Life Transitions Inpatient	Clinic	Life Transitions Inpatient	Clinic	Clinic
	Clinic	Life Transitions Outpatient	Didactics	Life Transitions Outpatient

Requirements:

AOA

Behavioral Medicine

The program must include training in behavioral science. At a minimum this shall include:

Psychiatric and psychological diagnoses common to family medicine.
The treatment of substance abuse.
Didactic instruction and clinical experiences.
Interviewing skills.
Counseling skills.
Psychopharmacology.
Physician well being.

ACGME

The curriculum must be structured so behavioral health is integrated into the residents’ total educational experience, to include the physical aspects of patient care.

There must be a structured curriculum in which residents are educated in the diagnosis and management of common mental illnesses.

Description of Rotation or Educational Experience

GOALS

Family physicians have incorporated knowledge of human behavior, mental health, and mental disorders into their every day practice of medicine. Your behavioral rotations (inpatient on the behavioral unit, during hospital rotations, and throughout your outpatient clinics and rotations) will stress the integration of the person as a bio-psycho-socio-cultural being, and the central role the family practitioner plays in maintaining behavioral health. This is both as the direct provider of services, the coordinator of services, and as a collaborator in service provision to treat the entire person or family. Family physicians must be able to recognize interrelationships among biologic, psychological, social and cultural factors in all patients.

Expectations:

Residents:

PGY II/III Year:

Two 4-week long intensive rotation in a combination of inpatient and outpatient settings under the supervision of the Behavioral Science Faculty.

Resident Expectations – During Inpatient Psychiatric Service:

Read entire Resident Inpatient Services Manual and Kaplan & Saddock Pocket Handbook of Clinical Psychiatry
Take closed-book diagnostic pretest over psychiatric knowledge (diagnosis and treatment of psychiatric disorders) the first Monday afternoon of rotation
Test questions will be taken from Kaplan & Saddock’s Studiy Guide and Self-Examination Review in Psychiatry
When rotating on the inpatient psychiatric unit, arrive by 7:00 am in order to participate in ECT
When rotating in the outpatient clinic, arrive by 1 PM

When rotating in other outpatient settings inquire about schedule and learning opportunities:

Complete at least one new patient assessment daily which must include all aspects of a standard initial psychiatric evaluation. The outline of an initial psychiatric assessment can be found in the Resident Manual produced by the American Psychiatric Association which will be provided. When rotating in inpatient settings or in external outpatient settings the protocols used in those settings to document behavioral services must be completed in a manner meeting the standard of care in those settings. The new patient assessments are to be reviewed by the behavioral faculty and revisions made based on feedback provided by them and by other professional staff in the settings of service.

When on an inpatient setting:

Round on and write a progress note on any patients previously assessed as well as any assigned by the site supervisor or behavioral faculty.
Present an initial and subsequent assessments to the unit staff at unit report.
Complete discharge summaries on patients that the resident has evaluated or followed as assigned.
Participate in group, individual, family, and milieu treatment of hospitalized patients.
Accept and complete reading and research as assigned by the Behavioral Science Faculty

Resident Expectations at the Family Medicine Center

Follow the Behavioral Science Faculty at the Life Transitions inpatient and outpatient units
Assess patients behavioral needs and develop treatment plans
Collaborate with Behavioral Health Consultants:
- In the treatment of their behavioral patients
- In the provision of behavioral care and in care that emphasizes health promotion and disease prevention
Participate in the treatment of patients’ behavioral needs utilizing biological, psychological and social techniques under the supervision of the Behavior Science Facutly

Integrated Behavioral Care Portfolio:

The resident is to prepare a portfolio documenting experience in Integrated Behavioral Care. The portfolio should include:

a copy of an initial inpatient assessment
a copy of an inpatient rounding note
pretest and posttest scores on testing over behavioral topics
a copy of an initial outpatient assessment and treatment plan for an outpatient at the family medicine center
the number, diagnoses and frequency seen of all behavioral patients treated
the number of and issues addressed for cases in which the resident collaborated with a Behavioral Health Consultant
a copy of the lecture prepared for Behavioral Health Consultants
a copy of the report of the Quality Improvement Project
a brief report of the observation of the Chronic Disease Management Group identifying the three most important therapeutic event in the group
a reading list documenting the behavioral care reading that has taken place during the month; a brief narrative summary of how the rotation met or failed to meet the resident’s personal goals for growth in the areas of behavioral health
a personal essay describing the resident’s learning and growth in behavioral care that has taken place during the month as well as a statement of personal growth goals for advanced skill in integrated behavioral care.

Note – all materials included must be purged of any information that could identify the patient personally.

Faculty:

Produce a recorded behavioral encounter for review with faculty and other residents
Prepare a behavioral health didactic in collaboration with a behavioral health consultant under the supervision of the behavioral science faculty on a behavioral topic drawn from the Board Review
Prepare and deliver a one hour lecture to students in behavioral health reviewing the pathophysiology of one chronic disease that has a substantial behavioral component which involves health related behaviors that need to change in order for the patient’s health status to improve. Examples include: hypertension; COPD; hyperlipidemia; type 2 diabetes; pathophysiologies induced by chronic alcohol dependence; pathophysiologies induced by tobacco use; pathophysiological consequences of a sedentary life style.
Consult with Behavioral Science Preceptors and Physician Faculty on behavioral care provided to all patients during the one month intensive. Submit all clinic patient encounter notes to the behavioral science faculty in addition to having those encounters reviewed, as appropriate, by the physician faculty. Progress notes in the Family Medicine Center for behavioral encounters are to be completed and maintained in a manner that satisfies clinic policy and must be completed within the time limits established by the Champion Family Medicine Clinic, Family Medicine Service, and Gerald Champion Regional Medical Center.
Participate in the group medical visits (chronic illness group, pain management group) during the one month intensive.
Complete and document a simple Quality Improvement Project based on the resident’s own Family Medicine Clinic patients.

Call:

There is no call specific to this rotation.

Patient Care

Goal

Provides patient care that is compassionate, appropriate, and effective in health promotion and treatment of behavioral disorders.

Competencies

Be able to perform a comprehensive clinical diagnostic assessment that is patient centered and results in a comprehensive understanding of the patients current psychological functioning and needs in the context of the patients network of relationships and cultures.
Development of a treatment plan in collaboration with the patient employing IBC resources that is practical and will be beneficial to the patient.
Demonstrate sensitivity to the patient experiencing the emotional aspects of organic illness and develop a treatment plan that addresses the patient’s organic illness and psychological needs.

Objectives

Demonstrate diagnostic criteria by accurately diagnosing behavioral disorders through the use of the diagnostic criteria in the most recent version of the Diagnostic and Treatment Manual of the American Psychiatric Association and the ICD 10 as assessed by observation of and review of video-recorded assessments and charted documentation of patient assessments.
Demonstrate the skillful use of Motivational Enhancement Techniques by documenting the patient’s stage of change and noting the strategy for facilitating the patient’s move to the next stage as assessed by observation and review of video-taped sessions, case presentations, research results, and record reviews.
Demonstrate the attitude of cultural competency in the interview, assessment, and/or intervention by documenting cultural factors in chart notes showing cultural sensitivity in the assessment and treatment plan as evaluated by direct observation, video-taped sessions and case presentations.
Demonstrate skill in gathering comprehensive bio-psycho-socio-cultural information about a patient. Techniques may include a standard behavioral health assessment including a mental status exam as well as other techniques and instruments like the BATHE technique and the MMSE or Montreal Cognitive Assessment. This objective is assessed through a review of the assessment documentation, by direct observation and by review of video-taped assessment sessions and by record reviews.
Demonstrate skill in the initial management of psychiatric emergencies such as the suicidal patient or the acutely psychotic patient as assessed through case presentations, direct observation and/or video-taped sessions.
Demonstrate skill in the use of IBC resources in the assessment, treatment planning, treatment provision and outcome assessment of patient’s behavioral needs.

Medical Knowledge

Goal:

Demonstrates knowledge of established and evolving biomedical, clinical, epidemiological and behavioral sciences, as well as the application of this knowledge to patient care.

Competencies

Understand normal and abnormal psychosocial growth and development across the life cycle and be able to apply this knowledge to the care of the individual patient.
Understand the bio-psycho-social-cultural factors and interactions that maintain behaviors and that promote behavior change,
Understand the principles supporting the efficacy of psychological, behavioral, and biological interventions.

Objectives:

In the appropriate setting, the resident should demonstrate the ability to apply knowledge of:

General behavioral knowledge

Normal, abnormal and variant psychological and psychosocial growth and development across the life cycle
Recognition of interrelationships among biological, psychological and social factors in all patients
Reciprocal effects of acute and chronic illnesses on patients and their families
Factors that influence adherence to a treatment plan
Family functions and common interactional patterns in coping with stress
Awareness of one’s own attitudes and values, which influence effectiveness and satisfaction as a physician
Stressors on physicians and approaches to effective coping
Knowledge of the indications for and a basic understanding of the process and results of special procedures in psychiatric disorder diagnosis, including psychological testing, laboratory testing and brain-imaging
Knowledge of the indications for psychiatric or psychological consultation

Mental health disorders

Disorders principally diagnosed in infancy, childhood or adolescence
Delirium, dementia, amnestic and other cognitive disorders
Substance-related disorders
Schizophrenia and other psychotic disorders
Mood disorders
Anxiety disorders
Somatoform disorders
Factitious disorders
Dissociative disorders
Sexual and gender identity disorders
Eating disorders
Sleep disorders
Impulse control disorders
Adjustment disorders
Personality disorders
Problems related to abuse or neglect
Additional conditions

Therapeutic Interventions

Behavioral modification techniques
Stress management
Exposure
Breathing techniques
Muscle relaxation
Imagery
Cognitive restructuring
Smoking cessation, obesity management and other lifestyle changes
Chronic pain management
Techniques of individual, couple, family and group therapies
Crisis-counseling techniques
Identification of, intervention in and therapy for drug and alcohol dependency and abuse
Appropriate care of health disorders listed above.
Proper use of psychopharmacologic agents
Diagnostic indications and contraindications
Dosage, length of use, monitoring of response, side effects and compliance
Drug/foods/OTC drug/nutritional supplement interactions

These knowledge areas will be evaluated by objective testing following didactic presentations and through record reviews and through direct observations of resident-patient interactions and video-taped sessions.

Practice- Based Learning and Improvement

Goal:

Investigates and evaluates his/her care of patients; appraises and assimilates scientific evidence, and continuously improves patient care based on constant self evaluation and lifelong learning.

Competencies:

Identify strengths, deficiencies, and limits in one’s knowledge and expertise in behavioral assessment and induced behavior change.
Develop the ability to incorporate feedback from videotaped patient sessions.
Demonstrate the use of evidence-based medicine for behavioral science case presentations and in improving the quality of behavioral health assessments and interventions.
Set personal learning and improvement goals for behavioral medicine.
Identify and perform appropriate learning activities in this curricular area.
Systematically analyze one’s own practice using quality improvement methods, and implement changes with the goal of practice improvement

Objectives:

The resident will use evidence based resources in generating and evaluating treatment alternatives and document their use as part of the intervention described in the patient’s chart as evaluated by chart audits and reviews.
The resident who is on the Inpatient Behavioral Rotation will make a brief presentation during Wednesday afternoon didactic session about a previously agreed upon topic.
The resident completing the Inpatient Behavioral Rotation will include in the portfolio a brief narrative summary of how the rotation met or failed to meet the resident’s personal goals for growth in the areas of behavioral health. If the resident failed to meet stated goals, the summary will include a plan for meeting those goals in the future. This narrative will be evaluated during the portfolio review.
The resident will provide a brief narrative on the behavioral case scheduled at the end of each year that describes the diagnosis, treatment, and outcome of the case, and how the resident was able to gain knowledge toward mastery of behavioral techniques or diagnosis (1-2 paragraphs), which will then be reviewed as part of the resident’s portfolio.
The resident will engage in video-taping of a patient interaction demonstrating their behavioral skills a minimum of once during the PGY I year, twice during the PGY II year, and then once during the PGY III year. The video will be reviewed by behavioral faculty and feedback will be given regarding areas of mastery or growth. If the evaluation of the video-recorded session reveals growth needs beyond what would be expected of a resident at that year of education, further video-recording and assistance will be provided on a case by case basis.

Systems Based Practice

Goal

Demonstrates an awareness of and responsiveness to the larger context and system of health care and effectively calls on system resources to provide optimal health care.

Competencies:

Be able to recognize, initiate treatment for and utilize appropriate referrals for mental health disorders to optimize patient care.
Be able to intervene effectively and professionally in emergent psychiatric, domestic violence, child abuse, and disaster situations.
Be able to collaborate effectively with health professionals from other disciplines and with community based resources in the treatment of patient’s behavioral health care needs.
Advocate for patients within the current health care system and continually strive toward system improvements to improve treatment of behavioral disorders.

Objectives:

Practices cost-effective care by collaboration with the patients in identifying and choosing appropriate cost sensitive treatments as part of treatment selection documented in the patient record and evaluated by direct observation of resident/patient interactions, video-taped interactions and record reviews.
Demonstrates an understanding of barriers to patient care, documentation of their socio-economic, living, and mobility resources and reflects that understanding in treatment management as evaluated by observation of resident/patient interactions and chart audits and reviews.
Is prepared to intervene effectively and professionally in emergent psychiatric, domestic violence, child abuse, and disaster situations and demonstrates that preparation through identifying the criteria for accessing services and utilizing resources for Child Protective Services, domestic violence interventions, and the physician’s role in a disaster situations as evidenced by responses to test items at relevant didactics and through observation of resident functioning as documented in the REDI system.
Collaborates effectively as evidenced by working with behavioral students and acting as both an effective teacher and learner as assessed through student evaluations, end of rotation behavioral feedback (narrative), and co-videotaped sessions with behavioral students.
Makes referrals that are sensitive to the patient’s resource limitations to community based services such as St. Lukes, nursing homes, and prescription drug benefit programs. Knows what services, referrals, treatments, modalities, and community support services are available and how to use these effectively as documented in the chart and evaluated through observation of resident/patient interactions and chart reviews and audits.
Demonstrates the coordination of care between other healthcare providers and the patient attending session, writing consultant notes regarding collaborative sessions with other providers.

Professionalism

Goal:

The resident will display a commitment to professional responsibilities, adherence to ethical principles and sensitivity to a diverse population

Competencies:

Have heightened sensitivity to persons bearing the stigma of “mental illness” and demonstrate respectful and nonjudgmental patient centered care to these individuals who often face discrimination.
Protect patient autonomy and the right to give informed consent to treatment.
Understand the special importance of confidential communications between patient and provider in behavioral consultations.

Objectives:

Resident is respectful & provides appropriate diagnosis and treatment of patients with multiple issues: i.e. pain; fibromyalgia; or personality disorder as indicated by evaluations in the REDI system and patient feedback
Shows respect for others specifically for issues related to gender, sexual orientation, race, culture, and patient belief systems by incorporating the patient’s beliefs into interventions that are patient centered as evaluated by direct observations and video-tapes of resident/patient interactions.
Demonstrates commitment to ethical principles pertaining to: the provision of and withdrawing of clinical care; confidentiality of patient information; informed consent to treatment; and business practices as evaluated by record reviews and test questions at the appropriate didactic presentations.
Maintains a respectful demeanor in demanding and stressful situations assessed by direct observation and notation in REDI systems.
Demonstrates knowledge of ethical issues in medical practice, including informed consent, patient autonomy, confidentiality and quality of life as evaluated by record reviews and responses to test questions at the appropriate didactic presentations.
Demonstrates sensitivity and responsiveness to patient’s culture, age, gender, sexual orientation and disabilities as evidenced by direct observation, review of records, a review of video-taped encounters and a review of consultations with preceptors.

Interpersonal and Communication Skills

Goal:

The resident will demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals.

Competencies:

Demonstrate the ability to effectively interview and evaluate patients for mental health disorders using appropriate techniques and skills to enhance the doctor/patient relationship.
Demonstrate effective and compassionate communication with the patient and the patient’s family regarding the behavioral needs of and the reduction of risk factors and recommendations for ongoing treatment, screening and disease prevention.
Understand and be able to educate patients and their families about behavioral disorders, the psychological aspects of medical disorders, the disease model of addiction and its expected course, and treatment alternatives.
Demonstrate effective presentation skills both to preceptors and as part of educating other residents and other professionals.
Demonstrate the ability to communicate clearly with consultants in a manner that leads to more effective collaboration in treatment.
Demonstrate skill in clear, sufficient, and parsimonious medical records documentation.

Objectives:

The resident will communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds. This communication will use appropriate language, vocabulary, and concepts to promote understanding and patient self-determination and will be documented in chart notes and will be evaluated by direct observation by preceptors and staff, record reviews, and in video-taped sessions.
The resident will collaborate with behavioral students in providing behavioral care through patient counseling and psychotropic medication management as evidenced by observation of video-taped collaboration, direct observation and record reviews.
Incorporates feedback and demonstrates a willingness to learn by modifying the relevant behaviors in subsequent videotaped session as evaluated by review of video-tapes
During the PGY III year the resident will demonstrate effective group leadership by using conflict management and motivational enhancement skills to help individuals and groups move to action stages of change as evaluated by 360 evaluations and preceptor evaluations.
The resident will demonstrate skills in setting limits with patients who violate the policies of the clinic in a manner that:
- encourages appropriate boundaries and expectations
- delineates clear behavioral expectations
- provides termination and referral for those patients whose conduct are detrimental to the provider/patient relationship, the clinic, or other patients or service providers of the clinic

Evaluated by direct observation of interactions; review of documentation on patients on probation or termination; video-taped sessions; 360 evaluations.

Resident will demonstrate appropriate presentation skills through topic presentations during family medical service rounds; research presentations; and community teaching opportunities as evaluated by feedback on presentations given in rounds (formal feedback forms) or rating forms from research presentation;
Consistently update problem lists, medical lists, Charts on 5-west, and the EMR so continuity of care can be maintained as evaluated through chart audits.

Teaching Methods

Teaching methods will include:

1) Lecture (see attached list)

2) Use of videotaping as detailed above with feedback for critical improvement of skills

3) Direct observation and collaborative modeling during treatment of patients in all areas

4) Use of directed readings and review of readings

5) Review of charts with behavioral focus with feedback to both resident and advisor

6) Direct behavior plans for assistance in modifying resident behaviors with patients as agreed upon by the training faculty

7) Simulations

8) Case based teaching

9) Research projects

10) Self-directed learning.

Assessment Method (residents)

1) REDI system assessments for individual interventions

2) 360 feedback system

3) Review of assessments, psychiatric histories and physicals

4) Chart Audits

5) Evaluation of video tapes of sessions and multi-rater evaluation of resident interactions with patients

6) Review of presentation feedback forms and incorporation of feedback into next presentations

7) Objective tests over content of conferences/didactics

8) Portfolio review

9) Written evaluations completed by other behavioral health care providers and students on the Behavioral Health Unit (5 – W), the Family Medicine Service, and in the Family Medicine Center

Assessment Method (Program Evaluation)

1) Residents will rate behavioral faculty at the end of their inpatient rotation with the opportunity to provide feedback to enhance the rotations effectiveness.

2) Residents will complete an annual anonymous faculty evaluation

3) Residents will rate behavioral providers as part of the 360 interviewing and assessment process, being able to provide anonymous feedback for constructive change in rotation or style for areas outside of the inpatient rotations.

4) The behavioral faculty will review outcomes on in-training exams as related to behavioral questions or areas to determine if their areas that need to be addressed on an individual or program level to enhance mastery of the area.

Human Behavior and Mental Health Curriculum

Level of Supervision

The resident is directly supervised by the attending physician or psycholgist during all procedures performed in the hospital. The PGY1 Resident will have supervision provided by a Senior Resident and Attending. The Senior Resident will be supervised by the Attending. The attending will see all patients on the service each day and will document their involvement in the patient’s care. An Attending will be available 24 hours a day.

Educational Resources:

Readings:

Didactic:

18 Curricular Content Teaching Areas Rotated Through a 36 Month Sequence

Specific Content in the 18 Areas May Be Covered by Lectures, Readings, Links to Tutorials

Note: Lectures will typically cover multiple specific content areas within a category.

Physician-Patient Communication
1. Patient-Centered Medical Interview, Interviewing Skills.ppt
2. The Difficult Patient Encounter
3. Ethnic, Cultural, Religious and Gender Differences in Communication
Motivational Interviewing for Improving Health Behaviors
1. Improving Patient Compliance with Medical Regimen
2. Smoking Cessation
3. Weight Management and Obesity
4. Alcohol and Substance Abuse Assessment and Treatment
5. Stress Management
Behavioral Evaluation and Treatment
1. Behavioral Evaluation and Treatment.
2. Mental Status Exam
3. Mental Health Diagnosis with the DSM-IV
4. Brief Psychotherapeutic Interventions by Family Physicians
5. Psychosocial Human Development in the Lifespan
Biopsychosocial Stages of Human Growth and Development
1. Developmental Milestones
Family: Assessment, Structures, and Dynamics
1. Family Theory
2. Domestic Violence
3. Child Abuse/Elder Abuse
4. Chronic Illness: Impact on Patient and Family Coping Styles
Assessment and Treatment of Disorders Usually First Diagnosed in Infancy, Childhood, and Adolescence
1. Pediatric Motor & Speech Red Flags
2. Assessment and Treatment of Attention Deficit Hyperactivity Disorder
Adolescent Behavioral Health
1. Assessment and Treatment of Adolescent Mood Disorder
Psychosocial Issues for Middle and Older Adult Patients and their Families
1. Bio-Psycho-Social Disorders Treatment of the Elderly.ppt
2. Assessment and Treatment of Delirium and Dementia
Mental Disorders Due to a General Medical Condition
1. Mental Disorders Due to GMC.ppt
2. Common Psychological Sequellae of Common Medical Disorders
3. Psychological Effects of Non-psychotropic Medications (List)
4. Assessment and Treatment of Psychological Aspects of Pain Disorders
Mood Disorders
1. Assessing and Treating Mood Disorder in the Primary Care Setting; Pharmacological and Brief Psychotherapeutic Interventions (upload Hoover powerpoint)
2. Assessment and Treatment of Bipolar Disorder.ppt
3. Depression in Pregnancy and the Postpartum Period
4. Cognitive-Behavioral Therapy of Depression
Anxiety Disorders
1. Pharmacotherapy of Anxiety Disorders.ppt
2. Pharmacotherapy of PTSD and TBI.ppt
3. Assessment and Treatment of Sleep Disorders.ppt
4. Cognitive-Behavioral Therapy of Anxiety Disorders
Schizophrenia and Other Psychotic Disorders
1. Schizophrenia and Other Psychotic Disorders
Assessment and Treatment of Somatization Disorders
1. Assessment and Treatment of Somatization Disorders.
Assessment and Treatment of Eating Disorders
1. Assessment and Treatment of Eating Disorders
Personality Disorders
1. Personality Disorders.ppt
Assessment and Treatment of Adjustment Disorders
1. Assessment and Treatment of Adjustment Disorders
Psychopharmacology
1. Review of Psychopharmacology
2. Serious and Common Side Effects of Psychotropic Medications [Dangerous Drug Reactions.ppt]
Professional Issues
1. Legal and Ethical Aspects of Mental Health Assessment and Treatment
2. Asssessment and Management of Suicide and Violence Risk
3. Patient Competency Evaluations
4. Test Taking Strategies and the ITE.ppt

Resources and Texts

Diagnostic and statistical manual of mental disorders, fourth edition: primary

care version/ in collaboration with representatives of American Academy of

Family Physicians. 1st ed. Washington, DC: American Psychiatric Association,

c1995.

Primary Care Psychiatry and Behavioral Medicine: Brief Office Treatment and

Management Pathways. Feinstein, R.E. and Brewer, A.A. Springer, c1999.

Behavioral Medicine in Primary Care: a Practical Guide. Feldman, M.D., and

Christensen, J.F. McGraw Hill, c2003.

Julien, R. (2011) A Primer of Drug Action. Worth.

Stahl, S. (2008) Stahl’s Essential Psychopharmacology: Neuroscientific Basis and

Practical Applications (Essential Psychopharmacology Series) 3rd edition.

Stahl, S (2009) The Prescriber’s Guide, Antidepressants (Stahl’s Essential

Psychopharmacology) by Stephen M. Stahl (Paperback – April 27, 2009)

Useful Websites

US National Library of Medicine

American Academy of Child and Adolescent Psychiatry

Academy of Pediatrics Behavioral Health Competencies

http://www.aap.org/commpeds/dochs/mentalhealth/

Newsletter of the Department of Psychiatry and Behavioral Sciences – Johns Hopkins University – Hopkins Brain Wise

Daniel Carlat, M.D. – The Carlat Report – Newsletter – Evidence Based

WebMD – Psychiatry

Continuing Medical Education Credit in Behavioral Health

Listing of 100 Common Psychotropics with Data – by Trade Name and Generic Name

http://www.threewishespress.com/

Brain and Nervous System – Neuroanatomy and Neurophysiology

American Academy of Neurology

WebMD – Neurology

Neuromuscular Disease Center – Washington University – Saint Louis

Interactive Brain Atlas – Department of Biological Structure University of Washington

Diagnosis

DSM – IV Code Lookup

Treatment Recommendations – Guidelines

American Psychiatric Association – Psychiatry Online – Practice Guidelines

Treatment Algorithms – Schizophrenia – Major Depressive Disorder – Bipolar Disorder – Texas Institute of Medicine

Treatment Guidelines in All Health Care – US Department of Health

Treating Alcohol Abuse in Primary Care – Boston University School of Medicine Curriculum

Video review criteria:

New patient or problem

Use of the following techniques

Good History and psychosocial factors assessment

Informed consent

Using open-ended questions –open-ended early, close ended late.

Use of empathy to elicit response

Non-verbal communication skills

Use of motivational interviewing skills

Appropriate diagnosis and education of patient on symptoms

Use of brief intervention techniques.

Consider and make referrals as appropriate

Appropriate follow-up times.

Faculty Chair:

Contact:

Introduction:

Required Experiences:

Weekly Schedule:

Requirements:

AOA

ACGME

Description of Rotation or Educational Experience

GOALS

Expectations:

Residents:

PGY II/III Year:

Resident Expectations – During Inpatient Psychiatric Service:

Integrated Behavioral Care Portfolio:

Faculty:

Call:

Patient Care

Goal

Competencies

Objectives

Medical Knowledge

Goal:

Competencies

Objectives:

Practice- Based Learning and Improvement

Goal:

Competencies:

Objectives:

Systems Based Practice

Goal

Competencies:

Objectives:

Professionalism

Goal:

Competencies:

Objectives:

Interpersonal and Communication Skills

Goal:

Competencies:

Objectives:

Teaching Methods

Teaching methods will include:

Assessment Method (residents)

Assessment Method (Program Evaluation)

Level of Supervision

Educational Resources:

Readings:

Didactic:

Resources and Texts

Useful Websites

Review Regulations and Laws Regarding Involuntary Committment and Treatment

Registration for New Mexico Controlled Substances Prescription Monitoring

Behavioral Health Webcasts and Videos

Pharmacology – Clinical Psychopharmacology

Brain and Nervous System – Neuroanatomy and Neurophysiology

Diagnosis

Treatment Recommendations – Guidelines

Video review criteria:

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