The goal of the primary care behavioral health position is to enhance the psychologist's skills in the assessment, consultation and treatment of children in the primary care setting.
We are not currently
recruiting for this position for the 2024-2025 training year. This fellowship would fit best for a psychologist who has previous PCBH 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 in a primary care setting.
Overview
The PCBH fellow will provide services in the Department of Pediatrics and Department of Psychiatry and Behavioral Health. 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 PCBH 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 children, adolescents and their families, the fellow will gain experience consulting with physicians, nurses and other medical team members on the 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 PCBH fellow will be exposed to and encouraged to explore different conceptual frameworks, the prevailing theoretical framework is behavioral and cognitive behavioral. Interventions include individual therapy, parent guidance, and family therapy.
The PCBH fellow will become involved in professional in-services and presentations to the larger community. The specific training activities for the PCBH will vary to some degree, based upon the training needs and interests of the fellow. At least 50 percent of the fellow's time will be spent in the Department of Pediatrics as part of an integrated primary care service.
Core Training Opportunities
Primary Care Behavioral Health-Pediatrics
The fellow will have the opportunity to work within the Department of Pediatrics as part of an integrated primary care service. The fellow will work closely with pediatricians, pediatric residents, and support staff. It is expected that the fellow will be exposed to a broad range of presenting concerns from a diverse age range. Pediatrics provides care to newborns through early twenties. The fellow will provide: Curbside consults to pediatricians regarding behavioral health questions; warm handoffs for patient's identified as needing same-day, problem focused behavioral health interventions; short-term problem focused treatment for patients; annual screening of behavioral health concerns; assistance with referral to Department of Behavioral Health for higher level of care; and education regarding behavioral health issues for residents, staff, and providers. Some common consults and specific interventions include: Problem-solving techniques; stress reduction skills, such as deep breathing and progressive muscle relaxation; parenting skills; coping strategies to assist with the diagnosis and subsequent treatment of a chronic medical condition; sleep hygiene skills; skills training to improve family/parent child interaction; toilet training techniques; weight management; help with school related issues, including academics, behavioral issues, and social concerns; ADHD assessment and strategies; tips to prepare for medical procedures; behavior management strategies; brief cognitive behavioral treatment for mild mood and behavioral issues; psychological and behavioral diagnostics; and pain management.
Individual Psychotherapy
The fellow works with children and adolescents exhibiting a wide range of emotional and behavioral problems on an outpatient basis through the Psychiatry and Behavioral Health Department. Presenting concerns can include: 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
Cystic Fibrosis Clinic
The fellow will have the opportunity to work on the cystic fibrosis multidisciplinary treatment team, including providers from genetics, nutrition, social work, nursing, respiratory therapy, and pediatric pulmonology. Patients seen on this service are at every stage of their disease, from initial diagnosis to long-term maintenance. Services that the follow 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 adjustment to the 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.
Ketogenic Diet Clinic
The fellow will have the opportunity to work on the ketogenic diet multidisciplinary treatment team with providers from neurology, nephrology, nutrition, pharmacy, and social work. The fellow will provide services on the inpatient and outpatient setting to children and adolescents with epilepsy and their families. During outpatient clinics, they will participate in an arena-based assessment of each patient and follow-up with the patient and family as indicated. Services that the fellow 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.
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.
