Psychiatry Inpatient Service Treatment Team

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Colleen Ryan, MD, is the medical director of the Boston Children's Hospital Inpatient Psychiatry Service. Dr. Ryan is the senior child and adolescent psychiatrist on the unit. She is involved in monitoring all aspects of the IPS program.

Each team also includes social workers, nurses, a pediatrician and a nutritionist. Since Children's is a teaching hospital, trainees in any of these disciplines may be included in your child's treatment team. When your child is admitted to the Inpatient Psychiatry Service, they will be assigned to a specific treatment team and will be assigned a case clinician (therapist) within that team who will manage your child's care.

Roles of other staff and providers

Members of each treatment team meet daily to review your child's progress, behavioral changes, medical and nutritional needs, contacts with outpatient providers and discharge planning. Because there are so many different people involved in your child's care, it is important to know what role each person plays. Below is an explanation of the staff and providers' different roles:

The case clinician (therapist) may be a psychiatrist, a psychologist or a social worker. This staff person will work the closest with your child and family on a daily basis. The clinician will meet with your child several times each week to provide individual therapy and will meet with the family once or twice a week. If the clinician is a social worker or psychologist, a psychiatrist will be assigned to prescribe any medication. The case clinician will also be responsible for contacting your child's outpatient providers, making recommendations for additional service needs and coordinating your child's discharge and aftercare plan. If you have questions about your child's treatment plan or care, the case clinician would be the primary person to contact.

The nursing team is comprised of two registered nurses and two milieu counselors. The nursing staff provides the direct supervision and daily care of your child and will usually be the first people that you see when you come onto the unit. The nursing team works closely with the doctors and clinicians to develop a treatment plan, assess your child's response to medications and behavioral interventions, and make recommendation for changes. The nursing team also works closely with the family to provide teaching, communicate issues with the treatment team and facilitate the transition home.

The attending (or staff) psychiatrist leads your child's team and oversees your child's care throughout the entire hospitalization. The psychiatrist reviews each patient's progress on a daily basis and is involved in decisions about medication changes, treatment issues and discharge planning. Contact the psychiatrist if you have any questions about treatment that have not been addressed by your child's therapist.

The pediatrician and/or nurse practitioner will provide a physical exam shortly after your child is admitted to the hospital. They will order any necessary lab tests or procedures your child may need and will be involved in managing any medical issues during your child's hospitalization. They will also communicate with your child's outpatient pediatrician to gather information and coordinate your child's medical needs after discharge.

The clinical dietitian is involved if your child has any special nutritional needs or eating issues. They will assess your child's nutritional needs, monitor weight and vital signs and adjust meal plans as necessary. The dietitian also works with the team to develop a concise discharge plan addressing nutritional and aftercare plans for children with eating disorders.

The therapeutic recreation specialists provide group structure for your child to promote interaction with other children, assess motor skills and ability to concentrate and teach children ways to productively use free time and develop new coping skills.

There are two teachers on the IPS unit, one for the school-age program and one for adolescents. They can work with your child's school to better understand your child's learning needs, facilitate a plan to help your child complete assignments while hospitalized and make recommendations for additional services or testing your child may need. They provide tutoring to patients while they are hospitalized.

The program director is a senior nurse who oversees all aspects of the IPS program. She attends daily clinical rounds and facilitate communication with all caregivers. She supervises nursing staff and recommends how to manage children who are having a difficult time. She is available to meet with parents who have unanswered questions or concerns about their child's treatment.

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