Training Toolkit for Systems-Based Practice

Developed by: Work Group on Community-Based Systems of Care
Approved by Council: October 2009

New! Supervignettes available!

To help child and adolescent psychiatry training programs meet the ACGME's mandated core competency in systems-based practice, the Work Group with funding from an Abramson Grant created this training tool kit for child and adolescent psychiatry residency programs. The tool kit was piloted by 15 child and adolescent psychiatry residency programs with evaluation data and other feedback used to inform revisions prior to Council approval in 2009.

For more information on the development of the tool kit, the best way to use the modules, and frequently asked questions, please read the Trainer Guide. There is also a Resident Guide written by residents from the Work Group and from pilot training programs that addresses questions raised by participating residents.

The tool kit is organized into thirteen modules, each covering an important component of systems-based practice. Two types of modules are included. Process modules discuss an important process for the child and adolescent psychiatrist to understand and consider in systems based practice. System modules discuss the basic elements of individual child-serving systems in the U.S. and the potential roles of the child and adolescent psychiatrist working with and in these systems. Each module contains learning objectives, core information in handout form and case vignettes.

Process Modules

  1. Systems-Based Practice Overview (Revised August 2019)
  2. Consultation (Revised August 2019)
  3. Family-Driven, Youth-Guided Care (Revised August 2019)
  4. Cultural Considerations in Systems-Based Practice (Revised March 2016)
  5. Organizational and Financial Structures in Mental Health Systems (Revised March 2016)

System Modules

  1. Education System (Revised August 2019)
  2. Child Welfare System (Revised November 2014) 
  3. Juvenile Justice System (Revised June 2014)
  4. Primary Health Care System (Revised March 2016)
  5. Mental Health System
  6. Developmental Disabilities System
  7. Substance Abuse Treatment Services System
  8. Early Childhood Services System
  9. Responding to Natural Disasters (New July 2020)

The evaluation vignettes and the answers for the discussion vignettes are not included in the modules. A pre-test, post-test, and trainer orientation are also available in the Overview module.To receive the evaluation vignettes, answers, or any of the other resources for the modules, please contact

New! Supervignettes
The supervignettes are designed to test residents' knowledge after studying the modules on systems-based practice. Both vignettes provide questions that cover topics from the process and system modules. To receive the answers and scoring sheets, please contact

  1. Celia
  2. James

This toolkit is a living document. If you have any suggestions, changes, additions you think would improve the training, please forward your comments to Thank you to the Work Group, training directors, residents, and all other individuals who contributed to this tool kit. A complete list of contributors and reviewers can be found here.

Beyond Private Practice Webinar Series
The Beyond Private Practice webinar series was organized by AACAP’s committee on Community-Based Systems of Care and sponsored by the Center for Mental Health (CMHS). The series was created with the intention of educating child and adolescent psychiatrists (primarily residents and ECP) about potential roles and job opportunities within the systems of care. The webinars were also created with the intention of being used by child and adolescent Training Directors in coordination with AACAP’s toolkit on systems-based practice modules which were created to meet CAP competency residence requirements. Go to our webinar page.