C. Training Components
Figure 1 below provides an overview of the program’s training component.
The following competencies reflect the program’s training emphasis. These training requirements are not specific to any specialized training track, but rather constitute the internship program’s core training components.
Assessment. Interns will acquire the full range of skills necessary to evaluate children’s developmental, intellectual, academic, emotional and behavioral needs. Interns will conduct clinical interviews, administer and interpret test batteries consisting of intellectual, processing, academic, and emotional/behavioral components and produce integrated written reports. Children are referred from other departments in the hospital as well as from schools, community agencies, and private referral sources. Children with neurological (e.g., Tics, Tourette’s) and neurodevelopmental (e.g., PDD, Autism, Epilepsy, Rett’s Disorder) concerns are routinely seen through the Program’s affiliation with the Department of Neurology. Evaluations are also conducted to address learning/academic difficulties and emotional adjustment problems and to monitor overall development and specific intellectual functioning due to chronic and acute medical conditions. Evaluations include behavioral observations, and consultation with other professionals in the hospital as well as in the community. Community outreach includes consultation with private and public school personnel in an effort to facilitate social and academic adjustment. Interns complete a minimum of 2-3 comprehensive evaluations every month during the course of the internship year. Neuropsychological assessments are completed by the interns in the Neuropsychology Track.
Treatment. Interns receive training in individual, family and group modalities and will be able to apply psychotherapeutic techniques. They acquire experience with children, adolescents and family members utilizing both long term and short-term modalities. They will be able to develop and implement therapeutic interventions for children experiencing emotional psychopathology, behavioral disruption and family systems dysfunction. They will also develop and implement interventions for behavioral/emotional problems associated with chronic and acute medical conditions. Children and adolescents who are presenting with or are at risk for emotional and behavioral problems are seen. Children from preschool age through adolescence and their families are seen in consultation. Emphasis is on the assessment and treatment of common behavior problems including attention deficit hyperactivity disorders, mood and anxiety disorders, oppositional defiant and conduct disorders, eating and elimination disorders, trauma and developmental spectrum disorders. Children and adolescents with difficulties and disorders related to acute and chronic surgical and/or medical conditions are also seen. Collaboration with other disciplines (e.g., medicine, social work, physical therapy, nutrition) and the referral source is a key component of the treatment process. Cognitive-behavioral, psychodynamic, developmental and family systems perspectives are emphasized in understanding psychopathology and developing intervention strategies. Interns typically carry 5-10 therapy cases per week.
Consultation Liaison. Interns serve as consultants to physicians, medical residents, child life specialists, nutritionists and nursing personnel involving patients experiencing behavioral and emotional problems associated with a medical condition. They learn rapid assessment and differential diagnosis of psychological factors affecting a wide variety of medical conditions. The focus is on children and adolescents who have acute or chronic medical problems and prevention of medical conditions in children and adolescents. Services are provided to patients on the following inpatient/outpatient units: Neurology, Hematology/Oncology, Bone Marrow Transplant, Diabetes/Endocrinology, Pediatric Intensive Care, Gastroenterology and Cardiovascular Intensive Care, among others. This training experience focuses on the behavioral aspects of chronic illness (e.g., diabetes, sickle cell disease, cystic fibrosis, asthma, etc.), adherence with treatment regimes and problems with disease management (e.g., diabetes), behavioral and emotional difficulties associated with recurrent somatic problems, the promotion of child and family coping with pediatric conditions (e.g., stress management during medical procedures), and supportive interventions for adolescents with chronic diseases. Cases range from pain management to complex family dysfunction and provide training experiences in behavioral intervention and prevention of psychological adjustment problems. Training opportunities include individual and family based intervention. Training is provided in consultation, assessment, and treatment before, during and after medical interventions. Interns participate as members of multi-disciplinary teams providing comprehensive health care. Multidisciplinary teams consist of physicians, nurses, social workers, speech/language pathologists, occupational and physical therapists, and patient advocates. Team meetings and case conferences provide a forum for clinical discussions and training across services. Interns typically complete 5-8 consults per week.