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 Pediatric Psychology Fellowship Overview

​​​​​​​​​​​​​​​​​The goal of the pediatric psychology position is to enhance the psychologist’s skills in the assessment, consultation and treatment of children in medical inpatient and outpatient specialty clinics. 

We are currently accepting applications for the pediatric psychology position, with a start date of August 28, 2023.​​​ 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 includes working with children and adolescents with medical problems and providing psychological services in a medical setting.

Overview

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. Training on these services is guided by the observable practice activities (OPAs).  

The expected caseload is an average of 22-24 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 demonstrates effective performance on the observable practice activities (OPAs) of each service. The attending psychologist assesses the fellows' performance on the OPAs and provides formative feedback. OPA performance contributes to the semiannual Clinical Competency Committee (CCC) summative evaluation of the fellow with respect to the core competencies and their essential components.

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.  Fellows participate in the weekly fellowship seminar, the bi-weekly case consultation staffing, the monthly professionalism seminar, the monthly leadership seminar and quarterly patient safety/quality improvement forums.

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 in-services 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 inpatient consultation.

Core Training Opportunities

Inpatient units

In our regional children's hospital, the fellow will consult to the Pediatrics Unit, Pediatric Intensive Care Unit (PICU), and the Neonatal Intensive Care Unit (NICU). The fellow will also work with patients on the Pediatric Rehabilitation Inpatient Team (PRIT). Through these practice settings you will be exposed to a broad range of patient ages and medical concerns. You will collaborate in patient care with physicians from endocrinology, hematology/oncology, respiratory diseases, surgery, orthopedics, neonatology, gastroenterology, nephrology, trauma and cardiology. Fellows are involved with the inpatient unit services throughout their fellowship.

Neonatal Intensive Care Unit (NICU)

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 and Pediatric Intensive Care Unit

In this setting, pediatric psychologists work with children and their families who are hospitalized for medical reasons. The pediatric psychology fellow will learn to conduct assessments for suspected psycho-physiologic 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. The fellow 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.

Individual Psychotherapy

The fellow works with children and adolescents, with a focus on coping with chronic medical illnesses, on an outpatient basis through the Psychiatry and Behavioral Health Department. However, fellows may also 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. Assessment includes interview, collateral contacts with family and other professionals, and psychological tests and behavioral questionnaires. The fellow conducts diagnostic assessments, conceptualizes the cases, devises treatment plans, and implements interventions

Fellows are trained in short-term therapy involving relatively rapid assessment of patients' problems and the formulation of interventions lasting five to ten sessions. In addition, efforts are made to provide experience in longer-term therapy particularly for children and adolescents with persistent psychological problems and/or trauma.

OTHER TRAINING OPPORTUNITIES

Diabetes Clinic

The fellow will have the opportunity to work with providers from nutrition services, social work, and pediatric endocrinology.  The fellow will provide services in the inpatient and outpatient settings to children and adolescents diagnosed with diabetes and their families. This includes patients newly diagnosed with diabetes to those who have been managing this chronic illness for quite some time.  Services that the fellow will provide include: (a) initial assessment of the patient and family's strengths and weaknesses, (b) family and individual treatment that focuses on coping and adjusting to a new diagnosis, adherence issues, and other disease-specific issues, (c) individual and family treatment related to general psychological difficulties that may impact optimal diabetes management, and (d) inpatient psychological consults with families and patients. 

Hematology-Oncology Clinic

The fellow will have the opportunity to work on the oncology/hematology multi-disciplinary treatment team, including providers from pediatric oncology/hematology, social work, child life, and nursing. Patients seen on this service are at every stage of their disease, from initial diagnosis to maintenance phase of treatment.  Services that the fellow will provide include:  (a) initial assessment of the patient and family's strengths and weaknesses, (b) family and individual treatment that focuses on coping and adjusting to a new diagnosis, adherence issues, and other disease-specific issues, (c) individual and family treatment related to general psychological difficulties, and (d) inpatient psychological consults with families and patients during hospitalizations. 

A Fellow's Perspective

Dr. Sarah Long was our pediatric psychology fellow from 2011-2013. Upon graduation she took a position at St. Jude Children's Research Hospital in Memphis. Here is her perspective on a day in the life of a Pediatric Psychology Fellow - YouTube video 9 minutes, 30 seconds​​​​​