Learn more about the training opportunities within the core rotation in consultation.

Acquired Autonomic Dysfunction Program (AADP) Clinic

Psychological Intake Evaluations through the Acquired Autonomic Dysfunction Program (AADP) Clinic provides interns with an opportunity to take the lead role in conducting consultative intake evaluations. The AADP Clinic is a multidisciplinary program (Psychology, Psychiatry, Diagnostic Pediatrician and Nurse Practitioners, GI, Cardiology, Neurology, Physical Therapy, Nutrition, and Social Work) that accepts referrals for consultations for adolescents experiencing multisystem symptoms of Autonomic Dysfunction.

Interns will have the opportunity to conduct intake evaluations and consult with the team on best practice recommendations. Interns may have the opportunity to consult with follow-up patients and coordinate care with community mental health providers.

Training objectives

• To understand the Autonomic Nervous System and the reciprocal relationship between stress, mood, and somatic symptoms.
• To increase understanding of the mind-body connection, and be able to share with patients and team members how aspects of CBT and ACT can help patients  increase their repertoire of copies strategies for managing physical symptoms, stress, and mood.
• To learn how to efficiently evaluate the presenting somatic and psychological concerns and relevant background and history.

Behavioral Health Integrated Program (BHIP) - inpatient consultation liaison

Interns will have the opportunity to provide consultation and intervention services to a variety of patients through the Behavioral Health Integrated Program (BHIP).  BHIP is devoted to addressing the behavioral health care concerns of hospitalized children/adolescents and their families.  Interns who participate in BHIP will provide behavioral assessment, consultation, and brief interventions for a wide-range of pediatric subspecialty services including but not limited to adolescent medicine, gastroenterology, hematology, and neurology.  Presenting concerns include problems in patient or family coping and adaptation to illness or injury, psychosomatic presentations, eating disorders, and other mental health disorders (e.g., depression, anxiety).  Opportunities for collaboration will occur with other behavioral health care providers (psychiatry, social work, child life) and nursing and medical providers.  Specific training goals of the intern will be discussed at the start of the rotation. 

Training objectives

• Develop inpatient consultation skills related to the clinical assessment of patients and families with a range of medical diagnoses and behavioral health concerns.
• Develop skills related to the provision of inpatient behavioral health intervention for patients and families, which may include education, individual and family interventions, behavioral interventions, and brief psychotherapy.
• Develop skills as a consultant to members of the treatment team to plan for patient care issues.
• Gain knowledge and skills related to working as a consultant to interdisciplinary inpatient treatment teams.
• Develop skills related to documentation, including inpatient consultation and progress notes, and medical chart review.

Cardiac Psychology Consultation

The rotation will provide interns with the opportunity to conduct consultative intake evaluations and follow-up, typically brief, intervention services in both the inpatient and outpatient setting. This rotation allows for collaboration with multidisciplinary team members (e.g., physicians, advance practice providers, nurses, social workers, child life specialists, and rehab therapists) to provide behavioral health services to patients from infancy through young adulthood. Presenting concerns are varied but typically include adjustment to and coping with diagnosis and associated care, psychological and behavioral concerns impacting medical care, parental distress and coping related to child hospitalization, and concerns related to the neurodevelopmental impacts of cardiac conditions. This rotation is ideal for an intern interested in getting a sampling of the consultative and intervention work done by hospital-based pediatric psychologists as well as those with an interest in cardiology or pediatric psychology.

Training Objectives

• To develop an understanding of child and family coping with congenital and acquired heart disease and to identify and treat typical needs during prolonged hospitalizations for surgical management and after acute events
• To develop skills in consultation with medical and nursing teams regarding emotional and behavioral aspects of patient care in both the inpatient and outpatient settings
• To develop skills in providing education and intervention to support child, parent, and sibling coping with illness and hospitalization

Center for Fetal Diagnosis and Treatment

Working with expectant parents with babies with congenital anomalies; offering intake evaluations to determine adult psychopathology and providing short-term individual and couples therapy in anticipation of birth and ICU parenting

Training Objectives

• To understand risks and symptoms of perinatal mood and anxiety disorders
• To learn EBT to address symptoms in expectant and postpartum parents of critically ill fetuses and newborns
• To build language and skills to support grieving parents post-pregnancy and neonatal loss
• Recognize the role of perinatal psychology within a multidisciplinary maternal-fetal medicinal team

Endocrine Psychology Consultation

The Endocrine Psychology Consultation rotation will provide interns with the opportunity to conduct consultative intake evaluations and follow-up intervention services in both the inpatient and outpatient setting. This rotation allows for collaboration with multidisciplinary team members (e.g., physicians, advance practice providers, dieticians, social workers, child life specialists) to provide behavioral health services to patients from infancy through young adulthood. Presenting concerns are varied but typically include adjustment to and coping with diagnosis and associated care, psychological and behavioral concerns impacting medical care, parental distress related to patient's hospitalization, and concerns related to the neurodevelopmental impacts of endocrine conditions.

Interns will have the opportunity to conduct consultations, make recommendations, and develop and implement intervention plans for a caseload of patients with congenital hyperinsulinism, Turners syndrome, Klinefelter syndrome, Differences in Sexual Development (DSD) and other associated adrenal/puberty conditions. Patients will be seen at various stages including outpatient management of chronic illness as well as during hospitalization for congenital hyperinsulinism. This rotation is ideal for an intern interested in getting a sampling of the consultative and intervention work done by hospital-based pediatric psychologists as well as those with an interest in endocrinology. The primary mode of supervision is live individual supervision during the consultation, with opportunities to work toward independent evaluations through a developmental model of supervision and support. Specific rotation days would work best- Monday, Wednesday, or Thursday.

Training Objectives

• Develop an understanding of child and family coping with endocrine conditions
• Develop skills in consultation with medical teams regarding emotional and behavioral aspects of patient care in both the inpatient and outpatient settings
• Develop skills in providing psychoeducation and intervention to support child, parent, and family coping with illness and hospitalization

Healthy Weight

The Healthy Weight Program is an outpatient interdisciplinary team comprised of physicians, nurse practitioners, registered dieticians, physical activity specialists and social workers. Our patient population includes children and adolescents who have a body mass index greater than the 85th percentile. In addition, patients may present with comorbidities associated with elevated BMI, such as, obstructive sleep apnea, dyslipidemia, and Type 2 diabetes. The goal of the clinic is to provide assessment of weight-related medical issues and weight management through a family-based approach that is uniquely tailored for the child and family.

The training goal of this rotation is to provide the intern with direct practice opportunities in providing psychosocial consultation and brief intervention to children with overweight/obesity and their families in the context of a multidisciplinary family-based weight management program.

Training objectives

• To understand the impact of obesity and weight related concerns on child and family caregiver functioning.
• To develop expertise in clinical consultation and brief intervention with children presenting with concerns related to being overweight or obese.
• To acquire skills in motivational interviewing and family systems conceptualization and intervention of cases; specifically addressing health behavior change in the family system.
• To develop collaborative relationships with a multidisciplinary team through conjoint conceptualization and management of cases.

Inpatient rehabilitation

The inpatient rehabilitation program is located in Children’s Seashore House and is an 18-bed unit, providing services to children with a variety of neurorehabilitation and musculoskeletal needs. Psychology interns working with this program will develop skills at providing psychological services for rehabilitation patients within an inpatient interdisciplinary team (including attending physician, resident, clinical nurse manager, PT, OT, SLP, Child life, social worker, and case manager), and will serve as a leader on the treatment team.

The rehabilitation psychology service provides initial assessments, case consultation, behavioral management, patient and family psychotherapy, psychoeducation, co-treatment with other members of the team, and overall team support. Interns on this service will be responsible for the initial assessment and provision of indicated psychological services for a limited caseload of patients with diagnosis that could include traumatic brain injury, brain tumor, stroke, encephalitis, orthopedic injury, and Conversion Disorder. Typical interventions include behavioral and cognitive-behavioral interventions for adapting to new injury and hospitalization, improving motivation for or compliance with medical treatment, improving symptoms of depression or anxiety, and decreasing symptoms of post-traumatic stress.

Training objectives

• Develop knowledge related to the unique sequelae and biopsychosocial needs of children with neurorehabilitation issues, and their families.
• Develop inpatient consultation skills related to the clinical assessment of patients and families with rehabilitation issues.
• Develop skills related to the provision of services to patients and families with inpatient rehabilitation issues, which will include individual and family interventions, education, behavioral interventions, and psychotherapy as indicated.
• Gain knowledge and skills related to working within a interdisciplinary inpatient treatment team.
• Develop skills as a consultant to members of the treatment team to plan for patient care issues.
• Develop skills related to documentation, including inpatient consultation and progress notes, and medical chart review.
• Participate in team meetings, family meetings, and school re-entry meetings.
• Participate in monthly Psychosocial Rounds.

Newborn/Infant Intensive Care Unit

The training goal of this consultation rotation is to provide clinical experience with infants and their families in an inpatient intensive care setting. This rotation involves consultation and collaboration with multiple disciplines, including nursing, developmental therapies (physical, occupational, speech, music, and child life), social work and neonatology. This rotation complements the Neonatal Follow-up Program rotation and provides a foundation for understanding the needs of the population referred to that program. This rotation is generally completed as an 8-hour/week rotation.

Training objectives

• Become knowledgeable about preterm and term infant development, including the role parents in this process 
• Learn how the intensive care environment and infant medical complications impacts infants’ developmental progress
• Observe/assist with standardized developmental assessments 
• Develop consultative working relationships with multidisciplinary colleagues through participation in developmental rounds 
• Work in conjunction with other developmental disciplines to provide developmental intervention for infants
• Learn how parent-infant relationships can be affected by birth complications and the intensive care environment, and develop strategies for intervention 
• Assess family needs for additional supports, and use consultation and individualized intervention strategies to promote parent-infant relationships

Oncology Survivorship Clinic

Interns completing the Survivorship Clinic rotation will provide outpatient consultation and intervention services for children, adolescents, and young adults and their families who have survived cancer. Interns will respond to outpatient consultation requests, refer patients for outside services and/or provide outpatient therapy. Common referral issues include: adjustment to survivorship, issues of loss and guilt, posttraumatic stress and anxiety, depression, dealing with cognitive late effects and school issues, social isolation. 

Training objectives

• Develop consultation skills as the psychosocial member of an interdisciplinary team providing care to survivors and their families.
• Gain family-systems and cognitive behavioral psychotherapy skills for a wide range of issues related to childhood cancer and its treatment, with children, adolescents and young adult survivors and their families.
• Become familiar with long-term cognitive, emotional, and medical late effects of childhood cancer treatment, and the effect of these late effects on the development of the survivor and his/her family.
• Gain competence with assessment and treatment issues unique to adolescent and young adults such as sexual and health risk behaviors, identity development, and transition to adulthood.

Pediatric Feeding and Swallowing Center

The Pediatric Feeding and Swallowing Center assesses and treats children typically between 2 months to school age with a variety of complex feeding and swallowing problems. These children may present with limited intake of food and/or fluid, limited variety of foods accepted, dependence on tube feedings, and failure to advance from smooth to textured foods.

Comprehensive services are provided by an interdisciplinary team, comprised of a pediatrician, nurse practitioner, psychologist, dietitian, speech and language pathologist, and occupational therapist. Services offered include evaluation of feeding problems within outpatient consultation.

Training objectives

• To increase knowledge about assessment of complex feeding disorders
• To become familiar with behavioral strategies as these relate to feeding difficulties
• To understand the role of the pediatric psychologist as consultant to a multidisciplinary team

Pediatric Primary Care

Integrated care track

The Primary Care rotation fulfills partial requirements in the core areas of intervention and consultation and includes individual and family therapy, parent training in behavior management, clinical assessment, and consultation with families, primary care pediatricians, school personnel, child psychiatry fellows and pediatric residents.

This rotation is based at the South Philadelphia, Karabots or Cobbs Creek Primary Care locations.

In conjunction with their psychologist supervisor, psychology interns participate in a brief initial clinical consultation, which focuses on the presenting concern and need for follow-up behavioral health concerns. Clinical consultation results are shared with the referring pediatrician, as well as parent(s). Based on the level of the concerns, short-term, evidenced-based treatment plans are developed. The child and parent(s) are seen for follow-up mental health intervention by the psychology intern at the primary care office location. If necessary, children and families are referred for longer-term community-based care. For these cases, psychology interns work in conjunction with the practice-based social workers to encourage engagement in longer-term care.

Training objectives

• To learn about strategies for providing integrated mental health services in pediatric primary care.
• To learn strategies for conducting brief consultations to develop evidence-informed treatment plans.
• To provide individual and family EBPs to children and families in a primary care setting.
• To learn effective techniques for interviewing parents and children.
• To learn how to conduct behavioral consultation with other primary care providers.
• To become an effective consultant on empirically supported interventions to primary care providers.
• To collaborate with trainees from other disciplines in a primary care setting.

Pediatric Sleep Center

Psychology trainees will join the multidisciplinary team, including pulmonary, neurology, and psychology, of the Sleep Disorders Center in the Division of Pulmonary. Approximately 500 new patients are seen each year. The focus of this rotation includes both assessment and treatment of sleep disorders in children and adolescents, with follow-up of individual patients. As part of this rotation you will participate in a weekly didactic series.

Training

• To understand normal sleep patterns in children and adolescents and the symptoms and treatment of common pediatric sleep disorders, including sleep apnea, narcolepsy, parasomnias (e.g., sleepwalking, sleep terrors), rhythmic movement disorder, bedtime problems, and night waking.
• To gain training in assessment of pediatric sleep problems, including subjective (e.g., history taking, sleep diaries) and objective (e.g., overnight polysomnography) measures of sleep and sleep disorders.
• To develop treatment programs for behaviorally based sleep problems and consult with team members on medically-based sleep issues.
• To expand skills in working within a multidisciplinary team.

Pediatric Stroke Program

The Pediatric Stroke Program is a multidisciplinary clinic that provides comprehensive treatment and assessment of children who have suffered from strokes or other vascular conditions. The team consists of individuals from nursing, neurology, physical therapy, occupational therapy, speech-language therapy, social work, school intervention and neuropsychology.

Interns in the pediatric stroke clinic will see patients in the multi-disciplinary clinic who are referred for various emotional, behavioral and cognitive concerns. Interns work closely with the other team members and provide integrated assessment, consultation, or brief intervention services within the clinic setting. Supervision involves shadowing and individual supervision.
Interns are expected to attend weekly Stroke Conferences, pre-clinic rounds and stroke clinics

Training objectives

• Increase understanding of pediatric stroke and related medical conditions
• Develop consultation and assessment skills as a member of an interdisciplinary team providing care to stroke patients and their families.
• Develop skills working within an interdisciplinary treatment team, including providing feedback and consultation to the team.

Perinatal Mental Health and Bereavement

The training goal of this rotation is to provide the intern with direct practice opportunities with an interdisciplinary team in the assessment of pregnant women and families where the pregnancy has been complicated by a birth defect. Utilizing a unique embedded care model, interns will have the opportunity to engage with families in moments of crisis, provide assessment for perinatal mood and anxiety disorders, explore birth planning and pregnancy options counseling, and offer bereavement support following an intrauterine or neonatal loss. In addition to weekly participation in the psychosocial support team rounds which include: social workers, child life specialist, chaplain, and a psychiatrist, collaboration with other team members will include maternal fetal medicine physicians, advanced practice nurses, certified nurse midwives, obstetricians, and obstetric nurses.

Training objectives/activities

• Develop expertise in clinical assessment and short-term treatment interventions with adult patients and families in crisis
• Recognize prenatal and postpartum mental health risks that may impact maternal/paternal-infant attachment
• Understand the impact of a life-limiting fetal diagnosis on individual and family functioning and offer grief support prior to and following the death of a child
• Learn skills to manage parental stressors while supporting the interpersonal dynamics within a couple and family
• Co-facilitate weekly mindfulness based skills group intervention
• Possible shadowing opportunities in the N/IICU and CICU to experience the continuity of care provided to babies and their families post-birth

Plastic & Reconstructive Surgery

Interns will predominantly work with our Cleft Palate and Craniofacial Team patients, all of whom have congenital conditions affecting the structure and function of the face. There may be opportunities to work with patients with additional conditions affecting appearance (e.g., acquired differences resulting from medical intervention, injury or trauma; breast anomalies). The patient population includes children (age 0-21) with a variety of medical conditions. Interns work 4-8 hours on Thursdays. Cleft Palate Clinic is held three times a month; Craniofacial Clinic is held on the third Thursday of each month. Each clinic day concludes with a one hour multidisciplinary team meeting. 

Training objectives

• Conduct brief health and behavior assessments for patients with craniofacial conditions and their families presenting for their annual multidisciplinary team evaluation.
• Provide consultation to multidisciplinary craniofacial and cleft palate teams, which include specialists from plastic surgery, ophthalmology, speech pathology, audiology, nursing, neurosurgery, psychology, social work, orthodontics, pediatrics, genetics, growth and otolaryngology.
• Provide follow-up care (e.g., therapy, brief interventions, care coordination) for children/families with acquired and congenital conditions.

Regional Autism Clinic

This rotation provides the opportunity to participate in an interdisciplinary evaluation of young children (age 2-6 years) for possible autism spectrum disorders (ASDs). Disciplines include developmental behavioral pediatrics, psychology, speech and language pathology, occupational therapy, and social work. This is a training clinic, so most of the providers are clinical trainees under supervision, and there are frequent trainee observers from many disciplines, including physician trainees and allied health professionals. The evaluations, case discussions, and feedbacks are conducted with trainees present, which helps the trainees become comfortable with teaching and facilitating clinical training.

The Regional Autism Clinic rotation fulfills a requirement in the core area of consultation.

Training

• Administer the ADOS as part of an interdisciplinary evaluation.
• Provide consultation to the team about observed behaviors, diagnostic impressions, and recommendations.
• Describe the testing and behavioral observations made to visiting trainee observers.
• Provide written and oral feedback to families with the developmental pediatrician.

Solid Organ Transplant Program

The training goal of this rotation is to provide the intern with exposure and direct practice opportunities in providing psychological services as a member of interdisciplinary heart, lung, heart/lung, liver, and kidney transplant teams. These teams serve children who are experiencing organ failures, and who are at various stages in the pre- and post-transplant process.

Psychology services provided include:

• Pre-transplant psychosocial assessment of children and families;
• Inpatient/outpatient consultation/intervention services for children and adolescents awaiting transplant and their families; and
• Consultation with the transplant medical teams around patient and parent coping and parent-staff interaction.

Common referral issues include adjustment to illness, prolonged hospitalization, and transplant; grief and loss; parent/team communication; and adherence to medical regimen pre- and post-transplant.

This rotation is generally completed as an eight-hour rotation. However, other arrangements may be made to accommodate needs of a particular intern’s training interests/schedule.

Training objectives

• To develop an understanding of child and family coping with organ failure and the need for transplant and prolonged hospitalization, as impacted by individual, situational and systemic factors.
• To develop skills in the conduct of the pre-transplant psychological evaluation.
• To develop an understanding of factors impacting the pre-transplant evaluation process, including psychological, social, medical and ethical.
• To develop skills in intervening to support child, parent and sibling coping with illness and hospitalization.
• To develop skills in consultation with medical and nursing staff to support patient and family coping.