Addiction Psychiatry Residency
Curriculum and Rotation
The DHMC rotation consists of inpatient, outpatient and involuntary commitment service components. Half-time rotations are either solely inpatient or a combination of outpatient and involuntary commitment components. On the inpatient service, the resident functions as team leader for an eight-bed addiction team. In that capacity, he/she supervises a PGY-I or II Psychiatry Resident and a medical student and leads a multi-disciplinary team under the supervision of Dr. Jonathan Ritvo, the medical director of the unit and primary supervisor for the entire DHMC rotation. On the outpatient clinical rotation at DHMC, the resident works with the intensive outpatient and dual diagnosis programs, running groups, evaluating and managing patients and consulting to treatment staff and supervising PGY-I residents. The outpatient clinic also includes training and supervised experience with cognitive behavioral therapy for substance abusing adolescents. On the involuntary commitment service the resident evaluates patients, prepares court letters and testifies in hearings for involuntary alcohol/drug treatment or guardianship.
The clinical experience at the DVAMC, supervised by Dr. Thomas Beresford, includes outpatient (85% time) and consultation (15% time) components. In the outpatient clinic, the resident works intensive outpatient programs, and performs intakes and treats patients in individual and group therapies. Residents work with the clinic staff in managing the disulfiram clinic and in co-leading group therapies for both uncomplicated cases and those with co-occurring major psychiatric disorders. On the consultation service, the resident is involved in outpatient liver transplantation evaluations and inpatient consultation work with PGY III residents. Dr. Beresford’s supervision also provides introduction and exposure to research issues and methods in addiction psychiatry. Residents participate in clinical research protocols and in the research team meetings in which new questions for study are formulated and developed into active protocols. Residents are encouraged to identify clinical questions and to pursue them in writing, including writing for publication.
The ARTS rotation includes clinical experience in residential therapeutic communities for adults and adolescents, a methadone maintenance clinic with specialized programs for women with children, patients with HIV, and an outpatient aftercare-program for patients who have completed residential treatment The resident participates in clinical case conferences and is supervised by Dr. Christian Hopfer.
Required courses include a half-year tutorial on the twelve-step recovery process, a half-year course on adolescent substance abuse and comorbidity and a weekly reading seminar throughout the year.
Electives
Residents are encouraged to discuss elective interests with the program director. Residents can use one half day for six months for elective work. Recently, residents have served on the Board of the Colorado Nurse Health Program as an elective. The following elective courses are open to addiction residents (contact the faculty member listed for details, schedules and syllabi):
Addiction Psychiatry
- Thomas Crowley, M.D.
- Diagnosis, treatment, and management of substance abusing patients are discussed. The use of community agencies, groups, 12-step programs, and legal issues are reviewed. Impaired physician programs are also discussed.
- PGY III psychiatric residents.
- Eight weeks – one hour/week.
Practical Use of Ego Defense Mechanisms
- Thomas Beresford, M.D.
- Taped interviews of patients by trainees and others are shown. Faculty and students work together to recognize, identify, and discuss ego defense styles.
- PGY III and IV residents and addiction research fellows.
- One hour per week, 30 sessions.
Psychiatry Grand Rounds
- Michael Allen, M.D.
- A wide variety of psychiatric topics are covered. At least two sessions are committed to addiction topics: an endowed lectureship by a national expert, and a presentation from the Addiction Research Treatment Service.
- Members and trainees of the Department of Psychiatry; psychiatrists and mental health professionals from the community.
- Weekly one hour 3-4 time per month throughout the year.
