Pediatric Psychology Rotation

The Pediatric Psychology rotation is in the Division of General Pediatrics and Adolescent Health of the Department of Pediatrics. It addresses problems of behavior, child development, coping with illness, and learning. It focuses on the developmental and psychological aspects of pediatric medical care. Because a variety of social, educational, psychological and medical factors contribute to children s total well-being, interns on the Pediatric Psychology rotation participate and work cooperatively with many subspecialty services of the Department of Pediatrics. The interdisciplinary approach is utilized because the behavioral, psychological, psychosocial, and medical problems are affected by children s stages of development and often are too complex to be resolved by any single professional or discipline. Overviews of selected medical conditions are presented by physicians or fellows in the Department of Pediatrics to interns on this rotation.

Patients are referred to the Pediatric Psychology service both from within The University of Minnesota Medical Center, Fairview as well as from the community for a broad range of psychological concerns. The patient population comprises both general mental health services and specialty services related to health issues. Psychotherapeutic services may include behavioral therapy, cognitive-behavioral therapy, crisis intervention, family therapy, parent counseling, play therapy, stress management, supportive therapy, as well as exploration of issues related to chronic illness, death, dying, and bereavement. Interns provide both outpatient and inpatient consultative services, primarily on an individual and family basis. They may also become involved in group interventions. Interns are estimated to direct their time and effort among assessment (50-70%), outpatient psychotherapy (5-20%), and inpatient consultation (5-20%) activities. Halfway through the rotation interns switch the pediatric subspecialty services to which they consult so that they gain exposure to the major subspecialties and chronic illness populations. Throughout the rotation interns have opportunities to work with outpatients and medical inpatients. Interns typically complete three psychological evaluations per week on the Pediatric Psychology rotation.

Interns work primarily with child and adolescent patients and have opportunities to work with patients ranging in age from neonates to adults. Because certain medical conditions (e.g., cystic fibrosis) have historically been treated primarily by pediatricians, interns may work with a few young or even middle-aged adults with specific medical conditions. Training activities include participation in Pediatric Psychology walking rounds, Cystic Fibrosis Psychosocial Rounds, General Pediatrics Psychosocial Rounds, and weekly training activities, as available, through the Division of General Pediatrics (e.g., a family symposium, adolescent symposium, and journal club). In providing comprehensive services, interns may work with identified patients, parents, siblings, and other family members. In addition, interns may become involved with the schools, courts, Child Protection, and other agencies. The rotation offers the following primary consultative services:

Assessment of Developmental Disorders:Standardized psychological tests, structured interviews, naturalistic observations and conferences with outside agencies (i.e., education, public health, social services) are utilized in the comprehensive assessment of mental retardation and developmental disability. Opportunities may be available for participating in developmental assessments of survivors of the Neonatal Intensive Care Unit (NICU), as well as children with genetic disorders, fetal substance exposures, organ and bone marrow transplantation recipients, and hematology/oncology patients. Interns may also be involved in evaluating the effectiveness of dietary and medical management of phenylketonuria. Such assessments include measurements of intelligence, behavior, personality, and academic achievement. The clinical activities involving fetal substance exposure have increased in recent years.
Psychological Management of Patients with Acute and Chronic Illnesses:Pediatric Psychology interns participate as team members in the care and management of patients with cystic fibrosis, childhood cancer, renal disease, and rehabilitation needs. The focus is on the promotion of positive adjustment and successful coping in children and families within the context of the continuum of acute, chronic, and life-threatening illness. Systematic parent training programs may be used, as warranted by referrals, to help parents accept and cope with the diagnosis and care of medically ill children. Psychological assessments of patients, parents, and families provide information pertinent to patient management. Psychological evaluations focus on cognitive functioning, emotional and personality development, relationships with parents and siblings, understanding of illness, adherence and participation in care, family composition, parents' management of the child patient and siblings, and family members' support systems. Such profiles of patients and families functioning help in designing and implementing medical and psychosocial care of medically ill children.
Management of Common Problems in Behavioral Pediatrics:Pediatric Psychology interns consult and collaborate with pediatricians in the application of behavioral principles in the assessment and management of behavioral and familial problems. Such problems include failure to thrive, recurrent pain, enuresis, encopresis, child abuse, sleeping disorders, obesity, anxiety, depression, and fears. Common behavioral techniques used in the management of such problems include behavioral contracts in modifying maladaptive behavior, direct reinforcement, cognitive restructuring, behavioral rehearsal, biofeedback, relaxation training, and self-hypnosis. Family therapy modalities may also be used.
Parent Counseling and Developmental Guidance:In primary care settings pediatricians and nurse practitioners have estimated spending approximately 70% of their time counseling parents on developmental and behavioral issues. Because pediatricians see more people during critical developmental phases than do other professionals, they are in unique positions to provide early detection and intervention. The Pediatric Psychology service provides consultation to health practitioners and parents in regard to behavioral management and parent/child relationship issues.
Preparation for Medical Procedures and Hospitalization for Young Children:Children s experience in the hospital environment can cause transient behavioral disturbances in ranging from mild to severe levels. Hospitalization and illness can result in fears and stress including those related to separation from parents, unfamiliar surroundings and professionals, painful or complicated diagnostic or surgical procedures, medication effects and complex treatment regimens, discomfort related to injury or illness, lengthy recovery periods, and so forth. Behavioral disturbances can include increased dependency, loss of toilet training, excessive fears, sleeping and eating disorders, and a range of regressive behaviors. On a referral basis, interns may assist children and families to adjust to the hospital environment and health problems.

Interns on the Pediatric Psychology rotation are required to attend a variety of conferences:

Monday:	Case supervision in FAS Clinic. 1st and 3rd Mondays, 8:00 A.M. to 9:00 A.M. Gateway Suite 160.
	Collaborative Office Rounds, a joint meeting of pediatricians and psychiatrists from the community and the University occur on the 2nd and 4th Mondays of the Month from 7:45 A.M 9:00 A.M.in the Gateway Suite 160. These meetings are funded by the National Institute of Maternal and Child Health to facilitate communication between Psychiatry and Pediatrics and to inform community pediatricians and trainees about psychosocial matters.
	FAS Case Conference. 12:00 noon to 1:00 P.M. Gateway.
Wednesday:	Journal Club- 8:00-9:00 A.M. in Gateway.
	Grand Rounds, Department of Pediatrics-12:00 noon to 1:00 P.M.
Thursday:	General Pediatrics Psychosocial Rounds-9:30-10:30 A.M. (Intern B attends) on Patient Care Unit 5A or 5C Conference Room.
	Inpatient Pediatric "Walking" Psychology Rounds-11:00 A.M. to 12:00 noon. Start on Patient Care Unit 5A, except for second Tuesday of each month.
Friday:	Supervision and Case Management-8:00-9:00 A.M. in Room 10 of the Pediatrics Clinic (PWB).
	Pediatric Renal Dialysis/Transplant Team Rounds-1:00 P.M. to 2:00 P.M. 13th floor Unit A (Moos Tower).

Feedback | Notice of Privacy Practices

©2002-2008 Regents of the University of Minnesota. All rights reserved.	Trouble seeing the text? \| Contact U of M \| Privacy
The University of Minnesota is an equal opportunity educator and employer.	Last modified on Wednesday Nov 10, 2004