Residency/Extern Programs

Externship Program

The RDTC offers three externship program tracks: the General Track Externship; the Game-Based Cognitive-Behavioral Therapy (GBCBT) Track; and the Family Life Education Center (FLEC) Track. Graduate psychology students may apply to any or all of the tracks depending on their individual interests.

The General Track Externship offers students the opportunity to conduct psychosocial evaluations of child suspected to have been physically and/or sexually abused and/or neglected; to conduct Comprehensive Health Evaluations for Children (CHEC) psychological screenings of children recently placed into foster care; and to conduct individual, family, and group therapy with children who have experienced maltreatment. Students receive weekly individual supervision with a licensed psychologist representing various theoretical orientations, including Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), psychodynamic therapy, and integrative approaches. Externs also participate in weekly group supervision/didactics to educate them about issues relevant to trauma and maltreatment. For information, please contact Karyn C. Smarz, Ph.D., at ksmarz@barnabashealth.org or (973) 753-1183.

The Game-Based Cognitive-Behavioral Therapy (GBCBT) Track offers students the opportunity to learn the GBCBT approach in depth and to apply it in both individual and group therapy contexts. GBCBT externs carry individual therapy cases, co-lead groups, conduct psychosocial evaluations of children suspected to have been physically and/or sexually abused and/or neglected, and conduct pre- and post-assessments of treatment cases. Externs receive weekly individual and group supervision with a licensed psychologist trained in GBCBT. Students are also encouraged to participate in a clinical outcome study assessing the efficacy of GBCBT groups, and have the opportunity to present their findings at local and national conferences and workshops. For information, please contact Craig Springer, Ph.D., at cspringer@barnabashealth.org or (973) 735-9363.

The Family Life Education Center (FLEC) Track offers graduate students the opportunity to work with DCP&P-involved families who are seeking to comply with services to achieve reunification, and with at-risk adults and adolescents referred by other agencies for prevention services. Externs conduct assessments and psychosocial intakes, consisting of mental status assessments and DSM-IV-TR diagnoses; conduct conjoint family therapy sessions; teach parenting skills to individual clients; have the opportunity to co-lead teen and/or young parent groups, and may conduct Comprehensive Health Evaluations for Children (CHEC) psychological screenings of children recently placed into foster care. Externs also have the opportunity to provide training and outreach to community groups. Externs receive weekly individual and group supervision with a licensed psychologist, and receive training in Combined Parent-Child Cognitive-Behavioral Therapy and the Active Parenting Now curriculum. For information, please contact Karyn C. Smarz, Ph.D., at ksmarz@barnabashealth.org or (973) 926-6894.

Residency Overview

Child Abuse Pediatrics Rotation
Child Abuse Pediatrics is a new pediatric subspecialty, which focuses on the evaluation and treatment of children when there is a concern for neglect or abuse. Child Abuse Pediatrics is a multi-disciplinary experience that will allow the resident to gain the knowledge and skills necessary for providing medical care for the abused child. The rotation will also allow the resident to become familiar with the different agencies outside the hospital that are involved in the response to child abuse.

Resident Responsibilities
The resident will attend RDTC (Regional Diagnostic and Treatment Center) clinic and assist with child abuse medical exams under the supervision of the child abuse attending. The resident will also participate in ER or inpatient consults as these situations occur.

The resident will observe at least one RDTC psychosocial evaluation. This is a psychological evaluation which assesses the child for possible trauma associated with the abuse.

The resident will participate in at least one CHEC (Comprehensive Health Evaluation for Children) medical evaluation and one CHEC psychological evaluation. CHEC exams are comprehensive evaluations for children who have been taken into foster care.

The resident will be expected to review self-educational materials on child abuse and neglect. Some of these will be required and others at the resident’s discretion.

The resident will attend at least one MDT (multidisciplinary team) meeting. Representatives from all agencies involved in the care of the child attend MDT’s. This includes medical and psychological clinicians from the RDTC, as well as representatives from DYFS, the Essex County Prosecutor’s Office, and the Children’s Advocacy Center.

As opportunities arise, the resident may also observe forensic interviews, court preparation, and/or court testimony. The resident may attend a regional Fatality Review Board meeting, at which child deaths which occurred in the region are discussed. The resident may also participate in outreach training and advocacy and quality improvement activities through the RDTC.

Goals:
The resident will understand the unique aspects of eliciting a medical history from a child when there is a concern for abuse.
The resident will understand how interpreting the results of a medical exam on an abused child is both similar to and different from interpreting results from a general pediatric perspective.
The resident will be able to complete an external genital exam and correctly identify the anatomical structures of the external genitals.
The resident will improve his/her recognition of patterns of injury, and begin to formulate interpretations of those patterns.
The resident will be able to develop differential diagnoses, which include but are not limited to child abuse.
As needed, the resident will assist with literature reviews for specific cases of child abuse.
The resident will begin to develop management plans for assessing and treating a child for abusive injuries.
The resident will learn when, how, and to whom to appropriately report abuse.

Residency Requirements

Child Abuse Pediatrics Rotation
Overview:
Child Abuse Pediatrics is a new pediatric subspecialty, which focuses on the evaluation and treatment of children when there is a concern for neglect or abuse. Child Abuse Pediatrics is a multi-disciplinary experience that will allow you to gain the knowledge and skills necessary for providing medical care for the abused child. The rotation will also allow you to become familiar with the different agencies outside the hospital that are involved in the response to child abuse.

Pre-Test:
When a computer becomes available, you will be expected to take a pre-test to assess your knowledge of child abuse prior to beginning the rotation. Your evaluation will not be based on how well or poorly you do on the pre-test. It is designed to help us and you assess where your knowledge base is as you start.

Outpatient RDTC clinic:
You are expected to attend RDTC clinic. You should review the patient’s information ahead of time and be prepared to present the case to the attending. You will need to observe at least one complete examination before being allowed to take a medical history yourself. In general, we do not want you interviewing the child regarding the incident history. If the child starts to tell you what happened, don’t stop them, but document their statements verbatim. You will observe/perform the general physical exam with the attending. You will be expected to write a mock “summary and conclusions”on one of the patients.

Inpatient/ER RDTC consults:
If a consult arises, you will participate in the consult. It may be your responsibility to review the patient chart, labs, and imaging studies, as well as speak to the service requesting the consult. After presenting the case to the attending, you will participate in taking the history and the examination.

RDTC psychosocial evaluations:
Children referred for a child abuse evaluation receive a psychosocial evaluation by an RDTC psychologist. You will be expected to observe at least one psychosocial evaluation. These generally take place at the Children’s Advocacy Center on Washington Street.

CHEC evaluations:
Comprehensive Health Evaluation for Children exams are for children taken into foster care and are comprised of two parts: a medical exam, including thorough record review, and a psychological evaluation. You will be expected to attend at least one CHEC medical evaluation and one CHEC psychological evaluation.

Multidisciplinary Team Meetings:
MDT’s are held approximately once a week on Tuesday afternoons at the Children’s Advocacy Center (Winona’s House) on Washington Street in Newark. If possible, you are expected to attend at least one MDT.

Reading assignments:
There is a binder filled with core articles for you to read. You are required to read at least three sexual abuse and three physical abuse articles. You can choose other articles to focus on as various topics arise during the rotation. There are also textbooks and learning CD’s available for you to review in the office. You will be given a “table of contents” of the core articles. On it, please indicate which articles you read as you read them and turn the list in to Dr. Weiner at the end of your rotation. You will be expected to prepare a presentation on the topic of your choice, including a written summary of the topic which will be added to the resident binder for your colleagues.

As opportunities arise, you may also observe forensic interviews, court preparation, and/or court testimony. You may attend a regional Fatality Review Board meeting, at which child deaths which occurred in the region are discussed. You may also participate in outreach training and advocacy and quality improvement activities through the RDTC.

Didactic:
There may be opportunities for didactic teaching with either of the child abuse attendings. Topics may include overviews of sexual abuse or physical abuse or topics of your choice.

Confidentiality:
Doctor-patient confidentiality extends to all patients you see and/or discuss, including those discussed at multidisciplinary meetings which include non-medical personnel. Remember that the cases have legal and criminal implications. Any information you learn or discuss may not be repeated outside the RDTC office or shared with anyone else without the permission of the RDTC medical director. This is to protect the patients, but also to protect you.

Individual resources:
This rotation may be emotionally difficult for some residents, whether from a personal past history of abuse or because it is difficult to listen to patients’ history of victimization. The RDTC attendings are available to assist you with any difficulties you may have concerning the things you see and hear during your rotation. Sometimes an opportunity to debrief can help with negative feelings. We also realize that you may not want to discuss personal experiences with us. You can also contact NBIMC Behavioral Health (Outpatient: 973-926-7024 or Crisis Hotline: 973-926-7444)

RDTC Experience Check List

  • Dates
  • Outpatient RDTC Clinic
  • Inpatient/ER Consult
  • Written summary
  • Presentation
  • RDTC psychosocial
  • CHEC medical
  • CHEC psychological
  • MDT
  • Other:

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