Post-Doctoral Psychology Fellowship

Pediatric Psychology Fellowship

The goal of the pediatric psychology fellowship is to enhance the psychologist's skills in the assessment and treatment of problems of children and adolescents with medical disorders. This fellowship would fit best for a psychologist who has previous pediatric psychology training, or who has solid general skills in assessment and psychotherapy, along with a background in child developmental and behavioral interventions with children. It is anticipated that psychologists completing this training program plan a career that would include working with children and adolescents with medical problems and providing psychological services in a medical setting.

Focus Area

The pediatric psychology fellow will participate in several areas specific to children with medical or medically related disorders. Children and their parents are treated as outpatients or medical inpatients.

The expected caseload is an average of 12-24 hours of direct patient contact per week. Very close supervision is provided in the early phase of the pediatric psychology fellowship training experience, tapering as the fellow grows more comfortably independent on the inpatient units. The focus is immediate intervention on a short-term basis. In addition to working with infants, children, adolescents and their families, the fellow will gain experience consulting with physicians, nurses and other medical team members on the consultation-liaison service.

While the pediatric psychology fellow will be exposed to and encouraged to explore different conceptual frameworks, the prevailing theoretical framework is behavioral and cognitive behavioral. The fellow must begin with a firm foundation in child development and the principles of behavior modification. Pediatric psychology focuses on normative behavior and stresses an educative approach.

Accordingly, the pediatric psychology fellow will become involved in professional inservices and presentations to the larger community. The specific training activities for the post-doctoral fellow in pediatric psychology will vary to some degree, based upon the training needs and interests of the fellow. Approximately 50 percent of the fellow's time will be spent doing pediatric inpatient consultation.

Each pediatric psychology fellow's progress is assessed via quarterly evaluations by each supervisor. Fellows also provide quarterly evaluations of each supervisor and the psychology fellowship program. The program director meets monthly with each fellow to review the fellow's progress and to discuss any concerns.

The goal of the evaluation process is to enhance the performance of the fellow, supervision, and the program. In case of disagreements over evaluations, or other grievances, a due process policy and procedure exists calling for the involvement of the primary supervisor; if not adequately resolved, then the Program Director, and finally the Director of Medical Education. Specific details of this procedure are available in the Fellowship Program Policies and Procedures Guide and the Graduate Medical Education Policies and Procedures Manual.

Training Opportunities

The following training opportunities are major components of the pediatric psychology fellowship:

Neonatal intensive care units (inpatient consultation) Web Link
The pediatric psychology fellow will provide assessment and therapeutic support for families who have a newborn infant in the intensive care unit. The fellow will assist families in coping with chronic illnesses, varying levels of compromised infants, and the care of a vulnerable child. Common issues include parental depression and anxiety regarding their baby, issues of death and dying, out of home placements, and ethical decisions regarding level of treatment interventions. Fellows will attend weekly rounds with the medical staff team members.

Pediatric unit and pediatric intensive care units (inpatient consultation) Web Link
In this setting, pediatric psychologists work with children and their families who are hospitalized (St. Joseph's Children's Hospital) for medical reasons. The pediatric psychology fellow will learn to conduct assessments for suspected psychophysiologic disorders, parenting capacity, child abuse, child and family coping capacity, assessment of pediatric patients following suicide attempts, adherence to medical regimen, pain management, and the degree to which family dysfunction may interfere with medical treatment. Fellows will obtain experience with a wide range of medical patients, including patients with cancer, diabetes, congenital handicapping conditions, kidney failure, feeding disorders, conversion disorders, cardiac problems, seizures and other neurological conditions, gastrointestinal disorders, respiratory conditions, and issues of death and dying.

Department of Psychiatry and Behavioral Health (outpatient service) Web Link
The pediatric inpatient fellow provides clinical treatment of patients through the Department of Psychiatry and Behavioral Health. Patients seen in this setting will include pediatric patients who were referred following discharge from the hospital or who present for outpatient treatment upon the referral of a pediatrician. In addition, the pediatric psychology fellow has substantial opportunities to work with children and adolescents exhibiting a wide range of emotional and behavioral problems, including attention deficit hyperactivity disorder, anxiety disorders, depressive disorders, somatization disorders and behavior disorders. Thus, the fellow specializes in clinical work with children with medical problems and also develops skills in working with children presenting a variety of issues. Assessment with patients includes interview, collateral contacts with family and other professionals, and psychological tests and behavioral questionnaires. The pediatric psychology fellow will conduct diagnostic assessments, conceptualize the case, devise a treatment plan, and implement interventions under regular supervision.