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CLINICAL OPPORTUNITIES: 

Participants in the Addiction Psychiatry Fellowship program at the UIC gain experience in:

  1. The practical aspects of detoxifying patients with substance-related disorders from any of a variety of substances.
  2. Psychotherapeutic treatment of patients with substance-related disorder (along with interventions aimed at significant others) in both residential and outpatient settings.
  3. Treatment of patients with comorbid substance-related disorders and other psychiatric and medical disorders.
  4. Methadone and buprenorphine maintenance treatment as well as other pharmacotherapies for substance-related disorders.
  5. Treating patients from a variety of socioeconomic, gender, ethnic, and age backgrounds with substance-related disorders.
  6. Treatment of substance-related disorders in various settings such as VA, emergent/urgent care, “community”, consult-liaison in general hospital, and private practice settings.
  7. Treating substance-related disorders in adolescents.
  8. Managing patients with acute and particularly chronic pain.

Fellows may have an opportunity to identify populations or settings of particular interest to them and to develop rotations in conjunction with faculty that permit the Fellow to gain more in-depth knowledge in those areas of interest.

 

SPECIFIC CLINICAL SITES:

Please note that, aside from the year-long UIC Recovery Clinic rotation, seeing substance use-disordered patients in the UIC general outpatient and adolescent clinics, and the six to twelve-month VA outpatient group therapy experiences, rotations vary in length, depending on Fellow need and/or interest. Required rotations below are asterisked although there may be elective components to the below required experiences.

  1. Outpatient general addiction treatment*.
    1. See the Positive Sobriety Institute (impaired professionals), and VA DDTC (opiate replacement) rotations below.
    2. General outpatient rotations take place in outpatient settings at the Jesse Brown VA Medical Center, the University of Illinois Hospital and Clinics (“UIC”), and Thresholds (a multisite comprehensive public sector mental health program). We are well-aware of the importance of addressing “behavioral addictions”. While we don’t offer specific rotations in these areas, we expect that these will be addressed as a patient receives treatment in any of the below settings.
      1. VA --- Fellows will spend at least 6-12 months co-facilitating an ongoing outpatient group for highly motivated patients who also have a history of multiple treatment failures. Female Fellows will have an opportunity to co-facilitate a special Women’s Group (sorry no men allowed in this group) at the VA for 6-12 months. At the VA also, the Fellow may have an elective rotation in the Addiction Treatment Program (ATP), a general addiction outpatient program, providing outpatient treatment of a variety of intensities in group and individual formats.
      2. UIC --- Fellows will spend at least a day and one-half to two days per week over the course of the Fellowship year in various UIC outpatient clinics. The Fellow will see patients (who are referred from various settings) in an office-based practice, an important part of which will include outpatient individual psychotherapy with addicted patients. The UIC outpatient experience will also include ongoing work in UIC’s Recovery Clinic, which has an emphasis on pharmacotherapies for various substance-related disorders and any comorbidities. And, an elective additional rotation involving addiction/primary care integration at UIC’s Mile Square Health Center (UI-Health’s primary care program) is planned to begin in January 2019. Some previous Fellows have elected to do psychoeducational or other psychotherapy groups with addicted patients or with patients at risk for addiction in various psychiatric or non- psychiatric outpatient clinics at UIC.
      3. Thresholds --- Fellows will spend a half-day per week or more for periods of up to 6 months or more seeing addicted patients in a community mental health center population. Here, the emphasis will be on buprenorphine management of opioid addiction.
      4. Mile Square Health Center --- Fellows will spend a half-day per week or more for periods of up to 6 months or more seeing addicted patients in UI Health’s primary care clinic. Here, the emphasis will be on primary care/ addiction treatment integration; many patients will need MAT for opioid use disorder but Fellows will be addressing other addiction-related issues as well.
  2. Psychiatry Consult-Liaison Service (with a focus on patients with substance-related disorders)*: These rotations will take place in the UIC Hospital or at the VA. Fellows will provide consultation to medical, obstetric (for example, high-risk OB), surgical (including transplant), and other non-psychiatric inpatient services around the diagnosis, management, and post-discharge referral of patients with substance-related disorders.
  3. Opiate Replacement Treatment at VA*: This rotation takes place at the Jesse Brown VA Medical Center in the Drug Dependence Treatment Center (DDTC) clinic, a specialized opioid replacement program. The Fellow evaluates and follows patients with opioid dependence and gains experience with opioid replacement therapies—methadone and buprenorphine maintenance treatment. Replacement treatment also includes the treatment of any psychiatric comorbidities that these patients are struggling with and particularly psychosocial treatments that are an important part of the opioid replacement experience.
  4. Adolescent Addiction Treatment*: This rotation takes place in a special clinic at UIC’s Institute for Juvenile Research (IJR). This clinic provides trauma-focused chemical dependence treatment to adolescents. Here, the Fellow will treat one or two outpatients and their families over the course of the Fellowship year. An additional adolescent experience for Fellows with an interest in adolescent substance use disorders can be elected at the Linden Oaks Hospital in Naperville, Illinois and at other sites which are currently being developed.
  5. Substance Abuse Residential Rehabilitation Treatment Program at the VA (SARRTP)*: Here, Fellows work with patients who are participating in a minimum 35- day live-in residential program. The Fellow will screen patients for entrance into this program, follow patients who are in the residential program, and will gain experience with the various treatment modalities these patients receive.
  6. Impaired Professionals Treatment at the Positive Sobriety Intstitute*. This is a comprehensive chemical dependence program located adjacent to the Northwestern Memorial Medical Center in Chicago. This program has an expertise in the treatment of patients, who have a history of functioning in settings of high accountability. Outpatient, intensive outpatient, day hospital, residential, and outpatient detoxification services are examples of the sorts of treatments that the Fellow will see in this program.
  7. UIC Pain Medicine Service or the Jesse Brown VAMC Pain Clinic*: Here, Fellows will learn how to manage patients who may or may not be substance-impaired, particularly with chronic pain, using a variety of modalities. The Fellow will be working in a multidisciplinary pain treatment setting where a variety of techniques such as psychoeducation, various other verbal interventions, various physical therapies, various medication therapies, and various interventional procedures are employed.
  8. Other clinical opportunities: Depending on need and/or interest, the Fellow may have an opportunity to use existing programs at UIC and/or the VA for additional elective rotations. Examples would include rotations focused on women’s mental health, high-risk obstetrics, PTSD, HIV-impacted patients or the Veterans’ Justice Outreach program (a forensic rotation).