WOMEN’S MENTAL HEALTH - Department of Psychiatry ... · PDF fileWOMEN’S MENTAL...

WOMEN’S MENTAL HEALTH: Senior Selective - of 1

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WOMEN’S MENTAL HEALTH

Dr. Valerie Taylor Head, Women’s Mental Health Program Co-Head, Division of Equity, Gender and Population Tel: 416-323-6400 ext.4596 Fax: 416--323-7718

Email: [email protected]

Dr. Gail Erlick Robinson Postgraduate Representative Tel: 416-340-3048 Fax: 416-340-4198 Email : [email protected]

1. Essential components of a selective rotation in this program/division must include:

These positions offer experience in the outpatient assessment and treatment of mental health problems of special significance to women including: violence against women, relationship issues, developmental issues, eating problems, career/family issues, and psychological aspects of pregnancy, postpartum, pregnancy loss, gynecological problems and other medical concerns. There is also an opportunity to become involved in the inpatient assessment and treatment of women with serious mood and anxiety disorders and those who have experienced trauma. Residents will have an opportunity to participate in weekly multidisciplinary team meetings and peer supervision. Residents may be combined with other programs such as cultural, community and health, mood, psychotherapy, psychiatry, health and disease and schizophrenia.

2. Experiences in senior selective rotation in this program/division could include: Clinical work or research with programs in cultural community and health, mood, psychotherapy, psychiatry, health and disease or schizophrenia.

3. Hospital/training sites where selective rotation is offered: Centre for Addiction and Mental Health, University Health Network, Women’s College Hospital, Sunnybrook

Health Sciences Centre and the Hospital for Sick Children.

Alternate Person for Interviews with Senior Residents Seeking Selective Rotations:

Dr. Gail Robinson Tel: 416-340-3048 Fax: 416-340-4198 Dr. Bev Young Tel: 416-323-6230 Fax: 416-323-6356

Dr. Ariel Dalfen Tel: 416-586-4800 Ext: 5131 Fax: 416-586-8654 Dr. Sophie Grigoriadis Tel. 416-480-5677 Fax 416-480-6878 Completed by: Dr. Gail Erlick Robinson

mailto:[email protected]


CA

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Clinical Senior Selective – Women’s Program

Supervisor: Dr. Peter Voore

Contact: Dr. Peter Voore tel.: 416-979-4277

Email : [email protected]

The CAMH Women’s Program offers a wide range of educational experiences for residents to learn an evidence based approach to treat women with complex mood, anxiety, substance and personality disorders with a history of trauma who may have symptoms of dissociation, self harm, impulsivity, interpersonal difficulties, eating disorders, or mood dysregulation. A clinical rotation in the Women’s Program, which includes the only inpatient unit of its kind in Canada, offers junior and senior residents outstanding opportunities for learning by participating in and observing the assessment and individual and group treatment of women struggling with complex, serious mental health problems. The resident will learn efficient goal directed inpatient treatment planning as well as pharmacologic assessment and management for this patient population. There are many opportunities to learn the basics of inpatient DBT, the impact of childhood of childhood trauma on adult women and the concept of complete PTSD. The focus of the outpatient services is to provide skills-based groups and brief individual care to support ongoing recovery, personal growth and rehabilitation. This is done by teaching/reinforcing skills for improved affect regulation, distress tolerance, and interpersonal interactions while helping patients to develop self compassion and self acceptance. The rotation offers a unique opportunity to observe peer learning and its effectiveness in decreasing stigma related to trauma and mental illness. Residents may participate in outpatient assessments, individual patient care, facilitation of skills and psycho-education groups, and attend weekly multidisciplinary team meetings and regular education sessions. Inpatient and out-patient experiences may be combined during the rotation.


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Clinical Senior Selective- Women’s Mental Health

Supervisors:

Drs. Ariel Dalfen, Bev Young, Eileen Sloan, Kayli Balaban, and

Sharon Szmuilowicz

The Mount Sinai Hospital Perinatal Mental Health Program is offering a senior selective in caring for women with reproductive-related mental health concerns. Residents will develop expertise in doing outpatient assessments of women at risk of mental illness prior to pregnancy, during pregnancy as well as up to one year postpartum. They will also assess and follow patients on the obstetrics floors during pregnancy and the postpartum period. Residents will develop knowledge and expertise in treating women who are pregnant and breastfeeding with psychopharmacology as well as various modalities of psychotherapy. There are options for learning IPT, CBT, group therapy, and mindfulness based interventions for this population. In addition, the resident will have the opportunity to be involved with the Mature Women's Health Clinic at Mount Sinai by providing assessment and treatment for peri-menopausal women. Involvement in outreach to community mental health agencies that serve high risk perinatal populations is another are that the resident can be involved with. This selective will place a strong emphasis on liaising with our obstetrics and gynecology colleagues. Involvement with the team's research projects or new research initiatives may also be part of this selective experience. The resident will have the opportunity to work with various psychiatrists on the team, including Drs. Ariel Dalfen, Bev Young, Eileen Sloan, Kayli Balaban, and Sharon Szmuilowicz. The team social worker, Ms. Melissa Goldband also participates in patient care, offering interprofessional opportunities for resident learning. There is also an opportunity for residents to be involved with research projects. Ongoing epidemiological research in the department aims at describing characteristics of this complex population, such as psychiatric, gynecological and medical co-morbidities; treatment outcomes; and psychosocial factors.


SH

SC

Clinical Senior Selective – Women’s Mood and Anxiety Clinic: Reproductive Transitions

Supervisors: Drs. Sophie Grigoriadis and Joanna Mansfield

Contact: Dr. Sophie Grigoriadis tel.: 416-480-6100 x 5677

This position offers experience in the assessment and treatment of perinatal mood and anxiety disorders. Both outpatient and inpatient experiences are available. Although this program currently focuses on the perinatal period, mood and anxiety disorders at other times of the life cycle are also evaluated (i.e., PMDD, Perimenopause). Staff have expertise in the use of psychotropic medication and psychotherapy in pregnancy and postpartum. Consultation, assessment and short-term therapies are provided. Elective students will be involved in all aspects of consultation, treatment and follow-up of patients under supervision.

Learning Objectives

1. To learn to assess and treat mental health difficulties seen in women during pregnancy and postpartum.

2. To learn to conduct a risk benefit assessment of the management of mental illness during pregnancy and post partum.


SM

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Clinical Senior Selective- Women’s Mental Health

Supervisor:

Dr. Julie Maggi [email protected]

416-864-3082

We offer a senior selective in women’s mental health. In this elective, the senior resident can participate in integrated clinics in obstetrics and/or gynecology. The elective offers the opportunity to provide consultation to the OB/Gyne services, liase with the teams, and provide ongoing follow-up to women who are pregnant, postpartum, and who have primary gynecological issues. In addition, the resident will have the opportunity to follow women transitioning between outpatient and inpatient settings, allowing for continuity of care. The population is quite diverse, reflecting the area that St. Michael’s Hospital services; for instance in the obstetrical clinic we treat women with severe mental illness, women who use drugs, women of varied socioeconomic status, women who develop a psychiatric illness for the first time in pregnancy/postpartum, etc. St. Michael’s Hospital Dept of Obstetrics and Gynecology also has a program that provides obstetrical services to women with HIV, and as such, residents will have the opportunity to assess and treat women with HIV. The St. Michael’s Hospital Dept of Obstetrics and Gynecology includes several midwives, and residents will have the opportunity to work closely with them. An interested resident could develop a research project, QI project, or formal liaison component under supervision as well. Clinics currently occur 1.5 days per week, but depending on the resident’s preferences, this can be expanded to include research/QI project/liaison. Conversely, it can be shorter if a resident prefers.


UH

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Clinical Senior Selective- Women’s Mental

Health

Supervisors: Dr. Gail Erlick Robinson, Dr. Karen Abrams

Contact: Dr. Gail Robinson,

tel.:416-340-3048

These positions offer experience in the outpatient assessment and treatment of disorders of special significance to women. This program focuses on mood disorders related to:

1. obstetrical/gynecologic conditions (e.g. pregnancy, pregnancy loss, postpartum disorders, menopausal disorders, etc…)

2. the psychological impact of violence (e.g. domestic violence, sexual harassment, stalking, abuse of patients/ clients, etc…).

Staff have expertise in the use of psychotropic medication in pregnancy and postpartum. Consultation, assessment and short-term therapies are provided. Three hours per week of 1:1 supervision is available.

Learning Objectives

1. To provide experience with issues related to women’s mental health in an outpatient setting.

2. To gain exposure and increase familiarity with mental health difficulties women may experience during different stages of their reproductive life including infertility, pregnancy loss, premenstrually, pregnancy, postpartum and menopause.

3. To gain exposure and increase familiarity with risks and benefits of treatment of mental illness during pregnancy and the post partum period.

4. To learn the etiology, assessment and treatment of Premenstrual Dysphoric Disorder’

5. To learn the etiology, assessment and treatment of depression in the menopausal transition.

6. To learn the assessment and management of different types of violence against women including, domestic violence, sexual assault, sexual harassment, stalking and abuse by authority figures.


WC

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WOMEN’S COLLEGE HOSPITAL

Inquires: Pam Kavanagh Tel: 416-323-6400, Ext. 4381

Email:[email protected]

Educational Opportunities for Residents

The WMHP is a vital part of Women’s College Hospital and works collaboratively with many WCH women-centered medical and surgical programs to offer comprehensive assessments, treatments and psychotherapy to women and their families. The WMHP also sees male patients, many of whom have also come to value the program’s women-centered philosophy (collaboration, empowerment and relational connection). There are 3 component programs (Mental Health in Medicine, Reproductive Life Stages and Trauma Therapy Program) in our WMHP and all 3 offer a variety of elective and selective experiences. There are opportunities for training in a broad range of individual and multiperson psychotherapy modalities. Psychodynamic and relational, individual and group psychotherapy is in great demand by female and male patients in all three programs. These 3 component programs work collaboratively with each other in identifying areas of overlap in the patients’ and families’ mental health care needs, and several of our staff participate in the clinical and educational activities of more than one component program. Each program offers separate training opportunities and for residents who would like to participate in more than one component of WMHP, supervisors are available to help residents plan an elective/selective experience that will offer that opportunity.

WC

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Clinical Senior Selective - Trauma Therapy Program

Contact Dr. Erin Carter

Tel: 416-323-6400 Ext. 4919


Selective and Elective Opportunities

The Trauma Therapy Program offers a broad range of educational experiences for residents to learn about the psychological impact of chronic childhood traumatization, adulthood revictimization and other psychological traumas that can occur in adulthood. Residents will learn about the relationship between childhood trauma and major psychiatric disorders (such as mood, anxiety and dissociative disorders) and the importance of addressing the role of trauma in the comprehensive treatment of the patient. In our program there is an emphasis on helping patients understand the function of their survival, albeit maladaptive, coping strategies such as eating disorders, self-harm behaviour and substance abuse to manage intolerable affects and memories. Residents will have ample opportunity to learn psychotherapy skills to help patients develop more adaptive affect regulation and distress tolerance skills. Residents will participate in the assessment and treatment of patients and, in doing so, develop expertise in a broad range of trauma treatments; (psychopharmacological, partial day hospitalization) and individual and group psychotherapy modalities (supportive - expressive, CBT, psychodynamic/relational, expressive arts and body -oriented).




Interdisciplinary ambulatory care learning is an important component of this program, and residents will work with clinicians and students from psychology, social work, occupational therapy, expressive arts therapies and nursing. There are both selectives and electives available in the Trauma Therapy Program, with Dr. Nancy McCallum as the primary supervisor. Residents can participate in this elective from ½ day up to 5 days/week. Residents also have the option of doing a selective or elective where they can divide their educational experience between any of the 3 components of the Women’s College Hospital, Women's Mental Health Program (TTP, Reproductive Life Stages Program and Mental Health in Medicine Program)

WC

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Clinical Senior Selective - Trauma-focused Treatment

Primary Supervisor: Dr. Nancy McCallum

Tel: 416-323-6400 Ext. 4937 [email protected]

or Eva-Marie Stern at 416.323.6400 Ext. 4983; [email protected]

Aiming to offer a rich learning experience to Residents who want to better understand and treat patients who suffer from post-traumatic stress, WCH has designed a new participatory 6-month-long (1 to 3 days/week) course. This selective will draw on the Trauma Therapy Program's treatment approach, which has made it an international model of care. TTP functions as a multi-disciplinary, relational/psychodynamic service which promotes understanding of patients' psychological safety as a primary concern, and addresses the prevalence and long-term effects of childhood abuse. Residents will be provided with opportunities to practice group and individual therapy with on-site supervision. They will have access to team-based consultation and will have the opportunity to contribute to the future direction of the Program through direct care and research. Various theoretical, experiential and creative educational forums will be available to complement their course.



WC

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Clinical Senior Selective - Children, Families and Parental Mental Illness

Supervisor: Dr. Cintia Padoin (child psychiatrist)

Contact Dr. Erin Carter

Tel: 416-323-6400 Ext. 4919


Senior Selective and Elective for Senior Residents Women’s College has recently started an innovative service within the Reproductive Life Stages program, focused on the unique needs of families with mentally ill parents. Parenting support and workshops, as well as child psychiatry are provided on site within a unique interdisciplinary community of care. LEARNING OBJECTIVES

1. To learn about the effects of parental mental illness on children and families (and vice versa) 2. To participate in assessments of child mental health concerns and parent-child or family relationship

concerns 3. To explore the ways in which personal history and current circumstances influence parenting and

children 4. To become familiar with attachment theory as relates to our patient population 5. To observe and/or conduct treatment with children and families, including (depending on need,

interest and length of rotation): parent-infant therapy; child CBT; child play therapy; family therapy; parent counseling; child pharmacotherapy

6. To observe and/or participate in parenting groups for mothers with anxiety/depression 7. To collaborate with a variety of WCH clinicians and community resources, including CAS where

relevant, in promoting family wellbeing Residents should have completed their core child psychiatry rotation before starting this (s)elective. Residents are encouraged to complement this experience with concurrent work in any of the WCH Women’s Mental Health Programs (Reproductive Life Stages Program, Trauma Therapy Program, and Mental Health in Medicine Program).



WC

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Clinical Senior Selective- Reproductive Life Stages Program Women’s Mental Health Program

Supervisors: Dr. A. Fishell,

Dr. D. Meschino, Dr. J. Barlas Dr. E. Carter Dr. A. Israel Dr. S. Vigod Dr. I. Gafni

Dr. C. Padoin

Inquires: Pam Kavanagh Tel: 416-323-6400, Ext. 4381 Email:

[email protected]

SENIOR SELECTIVE AND ELECTIVE OPORTUNITIES AND JUNIOR ELECTIVE OPORTUNITIES

Place: Women’s College Hospital Time: To be arranged individually No. of residents: (1 per month) Inquires: Pam Kavanagh, at 416-323-6400, Ext. 4381 [email protected]

The RLS Program is focused on defining the psychological/psychiatric needs of women during their reproductive life and to develop services, programs and partnerships to enhance access to care, education, research, and provincial outreach. The program includes expertise in reproductive psychiatry, mood and anxiety disorders, medical psychiatry, women’s mental health research, nursing, social work and psychotherapy.

The selective/elective opportunities offer residents participation in psychiatric assessments and treatment of women with mood and anxiety disorders related to the menstrual cycle, pregnancy, postpartum, infertility, perinatal loss and the menopausal transition. Residents will also have opportunity to take part in assessments regarding pre-pregnancy consultations and prevention of mood and anxiety disorders during pregnancy and postpartum period. Treatment options include individual, couple, group and family therapy in addition to pharmacological interventions. Residents will have the opportunity to observe/participate in multiple research studies currently underway in the program. Residents will also have opportunity to take part in a shared care model of care and attend the RLS Program clinical and research rounds, and participate in the Women’s Mental Health Program Grand Rounds at WCH, WMHP psychopharmacology rounds and the psychopharmacology Motherisk rounds at Sickkids.




WC

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Clinical Senior Selective- Reproductive Life

Stages Program

RLS Program Team

Elaine Barrons (psychiatric nurse) Alicja Fishell (psychiatrist)

Erin Carter (psychiatrist) Aliza Israel (psychiatrist) Inbal Gafni (psychiatrist)

Diane de Camps Meschino (psychiatrist, Leader RLS Program)

Joanna Barlas (psychiatrist) Dr. C. Padoin

Maura O’Keefe (MSW, therapist) Greer Slyfield Cook (MSW, therapist)

Simone Vigod (psychiatrist) Lindsay Witton (MSW, therapist)

Inquires: Pam Kavanagh

Tel: 416-323-6400, Ext. 4381 Email:[email protected]

SENIOR SELECTIVE AND ELECTIVE FOR SENIOR RESIDENTS

LEARNING OBJECTIVES

1. To provide unique experience with focus on women’s mental health in context of reproductive biology in an outpatient and inpatient settings guided by CanMEDS proficiencies.

2. To gain exposure and increase familiarity with mental health difficulties women may experience during different stages of their reproductive life (including women with history of trauma).

To increase familiarity with diagnosis (including measures scales) and co-morbidities of mood, anxiety and psychotic disorders during pregnancy and post partum period, and with recognition of risk factors contributing to mental illness during pregnancy and post partum period.

To gain exposure and increase familiarity with management of women at high risk for harming themselves and/or child, and with Mental Health Act.

To increase familiarity with diagnosis (including measures scales) and treatment of mood and anxiety disorders as related to menstrual cycle and menopausal transition.

3. To gain exposure and increase familiarity with risks and benefits of treatment of mental illness during pregnancy and post partum period.

To increase familiarity with treatment options (medications, psychotherapy) of mood, anxiety and psychotic disorders during pregnancy and post partum period.

To gain exposure and increase familiarity with effects of mental illness during pregnancy and post partum period on the fetus, neonate and child, and long term psychological sequelae of such exposure.

4. To be introduced to a unique team approach of taking care of women with mental illness in context of shared care model between psychiatrists and therapists with different backgrounds, such as social work and nursing.



WC

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Clinical Senior Selective- WCH Jr/Sr Psychiatry Research Elective/Selective

Contacts:

Simone Vigod, MD, MSc, FRCPC at [email protected],

Valerie Taylor, MD, PhD at [email protected] or

Catherine Classen, PhD at [email protected]

The WMHP at Women's College Hospital offers research rotations for junior and senior residents in the following content areas: women's mental health, reproductive mental health, trauma, medical psychiatry and mental health systems. Methodologies include biological, clinical and epidemiological research. Electives/selectives may be month-long or longitudinal (I.e 1 day/week) for junior residents. For senior residents, full 6-month and/or year-long rotations are offered. In addition, we are able to supervise Clinician-Scientist Stream and Clinician-Scientist Program residents.




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