Child Track - Pediatric Psychology

Pediatric Psychology 

The Pediatric Psychology Track provides in-depth training in pediatric psychology within a general medical setting. It is designed to teach clinical psychology residents assessment, treatment, and consultation skills across a continuum of care settings.

The Pediatric Psychology training opportunities are organized to provide clinical psychology residents with primary rotations emphasizing three different settings of pediatric psychology: 1) inpatient pediatric psychology, 2) partial hospitalization (day treatment) pediatric psychology, and 3) clinic-based consultation and integrated care pediatric psychology. Children with co-occurring medical and psychological problems constitute the primary treatment population. Training is provided to a variety of pediatric populations via hospital clinics and services (see descriptions below). Trainees also maintain long-term treatment cases via year-long participation in the oncology service. Behavioral interventions constitute the primary therapeutic modalities. Experiences in family and group therapies are also incorporated. Trainees complete all three of the primary rotations listed, as well as supplemental rotations from the Pediatric Psychology and Clinical Child Psychology options.

Pediatric Psychology Primary Rotations

Each primary rotation lasts four months. The first rotation runs from July through October, the second rotation runs from November through February, and the third rotation runs from March through June. Residents in the Pediatric Psychology Specialty will participate in all three of the following primary rotations, organized by level of care provided.

Inpatient Care Rotation
Faculty Supervisors: Rawya Aljabari, PhD, Emily Katz, MD, Margaret Mannix, PhD
The Medical/Psychiatric Inpatient Program serves a diverse population of children and adolescents struggling with co-occurring psychiatric and medical illnesses requiring inpatient psychiatric hospitalization (typically short-term).  Patients come from all areas of the country for treatment. Treatment may address the safety and stabilization of patients who have co-occurring concerns such as eating disorders, somatoform disorders, gastrointestinal illnesses, diabetes, seizures, pain syndromes, and complex presentations needing diagnostic clarification. This 16-bed unit in Hasbro Children’s Hospital is staffed by pediatricians, psychologists, psychiatrists, and other health professionals who collaborate to provide acute psychiatric and medical care. This includes multidisciplinary assessments leading to individualized care plans, individual therapy, family therapy, daily group therapy, community meetings, and milieu therapy. Trainees will spend two months gaining exposure to all elements of the program by serving as a clinician for cases in the program. Patients on the Medical/Psychiatric Inpatient Program often step down to the Partial Hospitalization (day treatment) Program.

The Pediatric Consultation/Liaison experience entails two months of participation with the Child and Adolescent Psychiatry team consulting to Hasbro Children's Hospital's medical inpatient floors. The team consists of both psychiatry and psychology trainees. Common referral questions include pain complaints, eating disorders, adjustment to chronic illness, problems with adherence to medical regimens, and suicidality. Patients with known developmental disorders are often followed by the CL service. Since this service provides care to all of Hasbro Children's Hospital, families are ethnically diverse from a wide variety of cultural and socioeconomic backgrounds. Residents and fellows are expected to serve as the primary clinician on new consultations and to provide follow-up care as indicated. More specifically, residents and fellows will: evaluate medically ill children for co-morbid mental health disorders that may be playing a role in their medical presentation and treatment; provide evaluation and disposition planning of pediatric patients medically admitted in the wake of suicidal or self-injurious behaviors; develop behavioral plans for patients who are having difficulty coping with their illness or participating in their care; provide short-term psychological treatment and psychoeducation to patients and their families; work closely with medical, nursing, social work, child life, and PT/OT staff to coordinate care, especially behavioral treatments to medically hospitalized children; provide psychoeducation to staff members and families to help them provide developmentally and psychologically appropriate care to minimize the patient's distress or discomfort and prevent or limit iatrogenic trauma to patients and their families; and participate in twice-weekly team rounds.

Partial Hospitalization Care Rotation
Faculty Supervisors: Rebecca Laptook, PhD, Holly Manning, PhD, Jack Nassau, PhD, & Matt Willis, MD
The Partial Hospitalization Care rotation uses the Hasbro Children’s Partial Hospital Program setting to provide intensive training in interventions for youth with co-occurring pediatric illness and psychiatric conditions in a day treatment model. The purpose of this rotation is to help the trainee develop competence in the assessment and treatment of children, adolescents, and families with complicated medical, emotional, and behavioral presentations.

The Hasbro Children’s Partial Hospital Program (HCPHP) uses a family systems oriented, day hospital format to treat children with a wide range of pediatric illnesses that have been refractory to standard treatment. The children treated at the HCPHP have either a medical illness complicated by psychological factors (e.g., diabetes with treatment non-adherence), a psychiatric illness complicated by physical factors (e.g., a restrictive eating disorder with cardiac involvement), or both. Children treated range in age from 6 to 18 years and attend the program five days a week, 8 hours a day, for a median length of stay of 17 days. The HCPHP has a multidisciplinary staff, including psychologists, pediatricians, child psychiatrists, pediatric nurses, nutritionists, teachers, and milieu therapists. Residents participate fully as members of the multidisciplinary treatment team and have close collaboration with colleagues from all disciplines during their training. Trainees will learn how to assess the individual, family, and academic needs of patients and how to develop interventions within an interdisciplinary framework. Since the program has a strong family intervention focus, residents observe and participate in family systems therapy.

Clinic-Based Consultation and Integrated Care Rotation
Faculty Supervisors: Heather Pelletier, PhD, Julie Boergers, PhD, & Janet Anderson, EdD
The Clinic-Based Consultation and Integrated Care Rotation gives trainees exposure to the practice of pediatric psychology consultation in multiple settings and with a variety of patient populations. Trainees participate in four half-day clinics. The purpose of this rotation is to help trainees develop competence in the provision of outpatient care and familiarize themselves with models of psychologist involvement in integrated care settings.

The Pediatric GI Disorders Rotation is part of a multidisciplinary clinical program for children with GI-related disorders such as inflammatory bowel disease (Crohn’s, colitis), recurrent abdominal pain, irritable bowel syndrome, encopresis, and feeding difficulties. The Pediatric GI Disorders Rotation is organized through the Department of Pediatrics, Division of Pediatric Gastroenterology. Residents participate in the evaluation and treatment of GI-related disorders with a diverse population, including the opportunity to work with younger patients (ages 2-5), patients with developmental delays, and families from low SES backgrounds.

The Pediatric Rehabilitation Rotation provides training in the assessment and treatment of patients with mental health, emotional, or behavioral factors impeding progress with speech, occupational, or physical therapy and/or coping/adjustment to chronic illness, with emphasis on mobility differences. Patients are primarily children and adolescents, but work will have a heavy emphasis on family therapy and family systems approaches. Presenting problems are most often related to anxiety, depression, pain management, cerebral palsy, spinal muscular atrophy, sensory integration difficulties, developmental delays, “slow to recover” concussion injuries, coping/adjustment to chronic illness, or parenting.  We use an eclectic treatment approach that has a foundation in CBT, but also includes DBT, ACT, and family systems while supporting the family in establishing longer-term treatment in the community, if necessary. Trainees conduct initial assessments and functional analysis as well as consult and coordinate with other providers (e.g., speech, OT, PT, neurology, primary care).

The Pediatric Sleep Disorders Clinic is a multidisciplinary program providing comprehensive assessment and family-based, culturally tailored treatment of child and adolescent sleep problems. The clinic serves a population that is racially, ethnically, and socio-economically diverse. Comorbid conditions, including neurodevelopmental disorders and obesity, are common. Trainees have an opportunity to work with video or in-person interpreters. Typical presenting problems include bedtime refusal, insomnia, difficulty maintaining sleep, delayed sleep phase, sleepwalking, sleep terrors, nighttime fears, excessive daytime sleepiness, and snoring/breathing difficulties. Trainees conduct both initial evaluations and follow-up visits for patients with sleep disorders.

The Pediatric Cardiology Rotation entails providing integrated behavioral health services in Hasbro’s Pediatric Heart Center. Common referral questions are wide-ranging and include individual and familial adjustment to chronic illness, preparation for medical procedures, transition to increased responsibility for medical care in children and adolescents with congenital heart disease, behavioral factors contributing to postural orthostatic tachycardia syndrome (POTS), and complaints of cardiac symptoms without cardiac origin (i.e. often co-occurring with depression or anxiety). There is some opportunity for trainees to tailor cases to their interests. Trainees on the rotation will communicate with an interdisciplinary treatment team that includes the disciplines of cardiology, nursing, exercise physiology, diagnostic imaging, psychology, and social work. Treatment provided is typically CBT-based individual and family therapy. Trainees conduct both initial evaluations and follow-up visits independently and/or using a co-therapy model with the supervisor.

Oncology Service
Faculty Supervisor: Margaret Mannix, PhD
Trainees complete a year of experience with the Pediatric Hem/Onc Rotation, a multidisciplinary clinical program for children with cancer or hematological disorders and their families. Psychology trainees provide evaluation and treatment and consult to members of the multidisciplinary team (pediatric hematologists/oncologists, social workers, nurses, child life specialists, rehabilitation therapists). Since this service provides care to all of the pediatric oncology patients at Hasbro Children's Hospital, families are ethnically diverse from a wide variety of cultural and socioeconomic backgrounds. Common referral concerns include adjustment to diagnosis, pain management, difficulty with procedures or treatment regimens, anxiety, depression, and bereavement. Oncology patients with pre-morbid developmental disorders will be referred to clinicians on this service. Depending on their medical status and the needs of the family, patients are seen during inpatient stays, during outpatient visits to the Tomorrow Fund Clinic, or during outpatient visits at the Psychology Clinic. Opportunities also exist for group therapy, didactic presentations to families, and consultation to schools.

Pediatric Psychology Supplemental Rotations 

Trainees in the Pediatric Psychology may choose Supplemental Rotations from the Pediatric Psychology and/or Clinical Child Psychology Specialty options (see additional supplemental options under Clinical Child Psychology description).

Feeding Disorders Clinic
Faculty Supervisor: Sarah Hagin, PhD

The Pediatric Feeding Disorders rotation is a unique interdisciplinary outpatient clinical program for children with significant nutritional and feeding disorders associated with chronic illness or disability. The Feeding Disorders program is organized through the Department of Pediatrics, Division of Pediatric Gastroenterology and involves the disciplines of Pediatric GI, Nutrition, Nursing, Occupational Therapy, Speech Pathology, and Pediatric Psychology. Psychology trainees will participate as members of this interdisciplinary team, conducting evaluations and cotreating children and families with a family-oriented and behaviorally based approach to treatment. The Pediatric Feeding Disorders team serves a highly diverse population, including patients from a wide variety of racial and ethnic groups, ages (0-8), and diagnoses (e.g., developmental delays, ASD). Trainees will also have the opportunity to work with interpreters on a regular basis.

Hematology Clinic
Faculty Supervisor: Margaret Mannix, PhD

The Pediatric Hematology rotation provides training in the assessment and treatment of children and adolescents with sickle cell anemia or thalassemia.  Patients attend The Comprehensive Sickle Cell and Thalassemia Clinic at Hasbro for multidisciplinary treatment. Presenting problems may be related to depression, anxiety, adherence, pain management, and illness adjustment.  Patients and families are from diverse socioeconomic backgrounds and the majority are of African and Hispanic descent.  The primary treatment approach will be CBT with some family systems, MI, and acceptance and commitment therapies. Trainees are responsible for conducting an initial assessment that will guide the intervention plan; some patients may be referred out for therapy and some may be followed longitudinally by the trainee. Trainees consult and coordinate with the multidisciplinary team including the pediatric hematologist, social worker, and nurse.

SibLink Group
Faculty Supervisor: Wendy Plante, PhD

The Pediatric Sibling Group Rotation is part of SibLink, a clinical and research program that addresses the needs of siblings of children with chronic medical, neurodevelopmental, and behavioral disorders. This is an opportunity for residents to learn about chronic illness from another child’s eye, to learn a model for integrating clinical service and research, and to conduct manualized group treatments for children. Groups are organized for siblings 4-7 and 8-13 years old and are designed to foster sibs’ understanding of and positive adaptation to their brothers’ and sisters’ conditions. Trainees conduct intake and follow-up evaluations and serve as leaders of sibling groups.

Primary Care
Faculty Supervisors: Janet Anderson, EdD

The Internal Medicine and Pediatrics Clinic (Med-Peds Clinic) is a primary care service. Patients, typically adolescents and young adults, are both culturally and clinically diverse and may present with traditional mental health concerns (e.g. mood and anxiety disorders, behavior problems, ADHD) and/or various behavioral health concerns (e.g., weight management, chronic pain, toileting). At the Med-Peds Clinic, trainees will evaluate and treat pediatric patients who are referred for mental health services by the clinic’s primary care physicians and medical residents, and also provide consultation services for medical staff when in the clinic. This rotation is one-half day per week.

Trainees in the Pediatric Psychology Track may choose Supplemental Rotations from the Pediatric Psychology Track and/or Clinical Child Psychology Specialty options.

 

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