Pediatric Psychology Training Program

Children’s Hospital of Michigan
APA-Accredited Predoctoral Internship Program

Program Requirements
(Numbers below identify rotations described in Rotations Section)

OTHER ROTATIONS AND ELECTIVES

PEDIATRIC PSYCHOLOGY TRAINING PROGRAM

1. ROTATION REQUIREMENTS, GOALS AND DESIRED COMPETENCIES:
   The Pediatric Psychology Internship consists of two six-month rotations: (1) Hospital Based Rotation, and (2) Outpatient Based Rotation. In addition to these six month rotations, the interns maintain a therapy case load of 3-4 cases continuously throughout the entire 12-month internship.

Hospital Based Rotation

Description:

The interns participate in two types of clinical activities:(1) multidisciplinary medical specialty clinics for children with chronic illness; and (2) consultation liaison.

Each multidisciplinary clinic consists of a team comprised by a physician, nurse, dietician, psychologist, and social worker. Children enrolled in these clinics receive a comprehensive annual multidisciplinary evaluation, along with a number of shorter follow-up visits. Each intern is assigned to one primary supervisor for the multidisciplinary clinics, and goes with this supervisor to one of the following blocks of clinics: (1)asthma/allergy, myelomeningocele, and HIV; or (2) nephrology, endocrinology, and adolescent medicine. Interns are assigned to a clinic block based upon a combination of preference, background, and supervisor judgement. The intern conducts comprehensive annual evaluations and writes up reports of the results, participates in the team meetings, and conducts follow-up visits. Follow-up visits are treatment-focused and may include interventions to improve adherence to medical regimens, assist during painful medical procedures, prepare children for surgery, etc.

On the consultation liaison service, the intern responds to requests from the hospital pediatricians to address behavioral/emotional problems of children admitted to Children’s Hospital of Michigan for medical problems. Consultation requests include chronic illness compliance and adjustment issues, differential diagnosis of psychopathology issues, and family/environmental stress issues. Interns at first accompany their supervisor on consults, and are gradually given more autonomy to conduct consultations independently throughout the rotation. Many of these consults are for patients whom the interns have previously seen in the multidisciplinary clinics, allowing them the opportunity to learn about continuity of care from inpatient to outpatient settings.

Desired Competencies and Outcomes:

During this rotation, the intern will accomplish the following goals and objectives and develop the following competencies. Outcome measures which we use to judge attainment of the goals and competencies are also listed:

1. Goal 1- To develop intermediate skills in understanding issues related to children with chronic illness

Objective A: Develop familiarity with models of coping with chronic illness and differentiate normal coping with chronic illness from psychopathology.

Objective B: Demonstrate a basic understanding of specific illnesses and their treatment regimens.

Objective C: Identify the psychological factors which promote and interfere with adherence to medical regimens.

Outcome Measures: Supervisor evaluations, observation in multidisciplinary specialty clinics, review of cases during supervision, and discussion of case examples during seminars.

2. Goal 2- Develop intermediate to advanced skills in working with multidisciplinary teams in a family-centered care model

Objective A: Demonstrate respect for opinions and information provided by other disciplines, such as medicine, social work, dietitians, and nursing staff.

Objective B: Demonstrate the ability to integrate information from other team members.

Objective C: Demonstrate the ability to provide feedback to team members in a constructive manner.

Outcome Measures: Supervisor evaluations, observation in multidisciplinary specialty clinics, review of cases during supervision, discussion of case examples during seminars, written reports and progress notes, and review of feedback from multidisciplinary team members.

3. Goal 3- Develop consultation-liaison skills

Objective A: Demonstrate the ability to review inpatient medical charts and obtain information from nursing and medical staff.

Objective B: Demonstrate the ability to interview children and families efficiently, formulate a working diagnosis and a treatment plan.

Objective C: Communicate diagnostic information and findings to other professionals and parents in a sensitive, respectful and clear manner.

Outcome Measures: Supervisor evaluations, feedback from inpatient medical and nursing staff, discussions with primary supervisor, written consultation forms, and discussion of case examples during seminars.

4. Goal 4- Develop intermediate to advanced competency in assessment and testing of children with chronic illness and behavioral/emotional problems

Objective A: Demonstrate intermediate to advanced skills in selecting, administering, scoring, and interpreting psychological tests suitable for children with chronic illnesses and behavioral/emotional problems.

Objective B: Demonstrate intermediate to advanced skills in making differential diagnoses based upon an integration of tests and interviews of children with chronic illnesses and behavioral/emotional problems.

Objective C: Demonstrate intermediate to advanced skills in communicating the results of such evaluations through written reports and verbal contacts with other professionals.

Outcome Measures: Supervisor evaluations, written testing reports, review of cases during supervision, and discussion of case examples during seminars.

 

Outpatient Based Rotation

Description:

The intern participates in four activities: (1) pediatric neuropsychology, (2) ADHD Clinic,  (3) autism clinic, and (4) consultation liaison.

The intern spends 20 hours per week in pediatric neuropsychology. They learn and administer neuropsychological test batteries to children with various neurologic disorders. They have the opportunity to observe intracarotid amobarbital procedures, language and motor mapping, and participate in multidisciplinary team evaluations of children undergoing epilepsy surgery. They learn to write comprehensive neuropsychological test reports.

The intern spends five hours per week in ADHD Clinic. They participate in evaluations of children and adolescents suspected of having ADHD, learning and behavior problems. They learn to administer and score a variety of rating scales and tests, and conduct differential diagnostic interviews with parents and children. They learn to write comprehensive evaluation reports.

The intern spends ten hours per week in autism clinic. The intern participates on a multidisciplinary team which consists of a pediatric neurologist, a Ph.D. level speech/language pathologist, and a psychologist. They participate in the screening and evaluation of children for autism and other pervasive developmental disorders, and then give referrals for treatment and educational interventions.

The intern will continue to participate in inpatient consultation liaison, with a maximum of one consultation per week.

Desired Competencies and Outcomes:

1. Goal 1- Develop competency in assessment

Objective A: Demonstrate intermediate to advanced skills in selecting, administering, scoring, and interpreting the following types of psychological tests: intelligence tests, tests of academic achievement, empirical measures of child behavior problems, tests of visual-motor skills, measures of attention, measures of adaptive behavior, rating scales of child development, and tests of personality.

Objective B: Demonstrate beginning to intermediate skills in selecting, administering, scoring, and interpreting tests of neuropsychological abilities.

Objective C: Demonstrate intermediate to advanced skills in writing reports of testing batteries.

Outcome Measures: Observation of test administration, review of test protocols by supervisors, discussion of case examples during seminars, review of test reports, supervisor evaluations.

2. Goal 2- To develop intermediate to advanced competency in making differential diagnostic decisions

Objective A: Demonstrate intermediate to advanced skills in conducting differential diagnostic interviews with children and parents.

Objective B: Demonstrate intermediate to advanced skills in using rating scales, questionnaires, and observational measures to make differential diagnostic decisions.

Outcome Measures: Observation of interviews, supervisor evaluations, discussion of case examples during seminars, review of cases during supervision.

3. Goal 3- To identify appropriate assessment methods and techniques for diverse populations and different types of psychopathology, incorporating cultural and individual diversity in this process

Outcome Measures: Review of test reports and case summaries, discussion of case examples during seminars, observation of testing and interviewing.

During the clinic rotation, the intern may elect to do a rotation for 20 hours per week at another site, by arrangement with the Director of Pediatric Psychology Training and the Director of Training at the elected site. This 20 hour elective will result in a decrease in the amount of pediatric neuropsychology clinical time. The intern will still attend autism and ADHD Lifespan Clinic as outlined above.

 

Therapy Activities

The intern carries a minimum of three therapy cases throughout the entire 12 month internship, across the two six-month rotations. These must include at least one play, one family, and one pediatric/individual case. The three cases may be of the intern’s choosing, depending upon interest. Below are the goals, objectives, competencies, and outcomes for the therapy activities:

1. Goal 1- To develop intermediate to advanced competency in psychotherapy

Objective A: Display intermediate to advanced skills in individual psychotherapy, including play therapy, dynamic therapy, supportive therapy, and cognitive/behavioral therapy.

Objective B: Display intermediate to advanced skills in family therapy.

Outcome Measures: Supervisor evaluations, observation (live, video, audio), review of cases during supervision, chart review of treatment plans and progress notes, input from co-therapist for family therapy, discussion of case examples during seminars, approval of treatment plans by CARF review teams.

2. Goal 2- To identify appropriate treatment methods and techniques for diverse populations and different types of psychopathology, incorporating cultural and individual diversity in this process.

Outcome Measures: Review of treatment plans and progress notes and case summaries, discussion of case examples during seminars, observation of therapy.

 

2. PROGRAM SEMINAR REQUIREMENTS:

Interns in the Pediatric Psychology Program will be required to attend the seminars listed below, in addition to the Core Seminar requirements.

1. Pediatric Psychology Didactic Seminar - this weekly seminar involves presentations by faculty members and outside speakers on a variety of topics related to chronic illness and
pediatric psychology issues. The format includes both lectures and case presentations.

2. Pediatric Psychology Supervision Seminar - this seminar is a group supervision and case discussion of the interns' pediatric psychology therapy cases, and also includes a small amount of didactic presentation.

3. Pediatric Neuropsychology Seminar and Case Conference - this weekly seminar focuses on developing skills in the interpretation of cognitive deficiency patterns from test data (including WISC-III and neuropsychological tests). The format is to practice blind interpretation of data derived from a library of cases collected by the supervisor.

4. Family Therapy Supervision Seminar - this seminar is a group supervision and case discussion of the interns’ family therapy cases, and also includes a small amount of didactic presentation. Interns and supervisor also take turns doing brief presentations on the application of family therapy to diverse ethnic and cultural groups.

5. Play Therapy Supervision Seminar - this seminar is a group supervision and case discussion of the interns’ play therapy cases.

 

3. ADMINISTRATIVE REQUIREMENT:

In order to learn about the role of the psychologist in health care and hospital administration, each intern participates in a small number of meetings of committees throughout the year: (1) the Children’s Hospital Child Protection Team; (2) the Children’s Hospital Ethics Committee; (3) the Children’s Hospital Parent Advocacy Committee; and (4) the Child Psychiatry and Psychology Department Chart Review Committee.

4. EVALUATION PROCEDURES:

At the end of the third, sixth, ninth and twelfth months of the internship, each supervisor completes a written evaluation of each intern. This evaluation is reviewed by the supervisor with the intern, signed by both the intern and the supervisor, and forwarded to the Director of Training. The Director of Training sends feedback letters to the interns’ graduate programs at the end of six and twelve months. Each intern anonymously evaluates each supervisor at the same time intervals, and also evaluates the program at the end of six and twelve months. These intern evaluations are submitted to the Director of Training. The Director of Training calls meetings of the Training Committee to review all intern and supervisor evaluations on a quarterly basis. The Training Committee also reviews the six month and twelve month program evaluations when they have been completed, and uses these evaluations as the basis for making adjustments in the program.

Psychology Training Program

General Clinical Psychology Training Program

Child/Adolescent Clinical Psychology Training Program

Psychology Seminar Schedule

Rotations and Electives

Training Faculty

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