Child Community-Pediatrics Track Description 2022-2023
Track Overview: The training emphasis of the Child Community-Pediatrics Track is tri-fold: to develop expertise in working on an inpatient medical floor with the Pediatric Psychology Consultation Liaison team, to develop skills addressing parent and child intergenerational trauma, and to advance psychotherapy skills with an outpatient population of children and adolescents dealing with chronic illness. This position will appeal to an applicant who wants an emphasis on pediatric psychology consultation liaison experience. There are two 6-month major rotations offered: a Pediatric Consultation Liaison rotation in the NC Children’s Hospital and a rotation in the community working at the UNC Horizons residential program with mothers with substance use disorders and trauma histories, as well as their children. Outpatient psychotherapy cases will be followed across the year. The ideal candidate will have a strong interest in both major areas; the intern’s “home base” will be with the Pediatric Consultation Liaison program. The Child Community-Pediatric Intern is strongly encouraged to choose an elective with the TEACCH center for autism; this rotation will also fulfill the program’s requirement for an assessment elective. Other possible assessment rotations include the Carolina Institute for Developmental Disabilities (CIDD), or Physical Medicine and Rehabilitation (PM&R) Neuropsychology.
The inpatient and outpatient settings within the Child Community Pediatrics track serve a diverse patient population, representative of many cultural and linguistic groups. NC Children’s Hospital serves the entire state of North Carolina and offers frequent exposure to rural and Native American communities. Our model is to address cultural influences as a multidimensional combination of age, developmental and acquired disabilities, religion, ethnicity, socioeconomic status, sexual orientation, indigenous heritage, national origin, and gender. Cultural humility, cultural sensitivity, and antiracism are actively practiced and embodied within this track. Supervisors are committed to recruiting a diverse and inclusive class of trainees, who will also have the opportunity to engage in advocacy activities within this track.
Clinical Rotations and Patients:
- Pediatrics Consultation/Liaison (C/L) Service (both inpatient consults and longer term outpatient psychotherapy (Joni McKeeman, PhD; Samantha Pflum, PhD; Mary Beth Prieur, PhD)
Inpatient consultation-liaison services are provided as part of a multidisciplinary team that includes psychology, psychiatry, and social work. The intern will have the opportunity to participate in evidence-based practice with specific populations or problems (e.g., trauma work, anxiety, depression, pain). Evaluation and treatment experiences will include a breadth of strategies and treatment modalities. Interns will collaborate with physicians and interdisciplinary team members, including participating in daily psychology/psychiatry team meetings and occasionally attending inpatient care rounds with the medical teams on the pediatric floors. This rotation may also include time spent in outpatient clinics on days when there are fewer inpatient consults. For more in-depth outpatient clinic experiences, an elective day can be chosen in a specific clinic area. Because of the nature of consultation/liaison psychology, supervision often occurs at the actual practice site, involving continuing dialogue between the trainee and supervisor. In addition, each trainee is free to establish a regular weekly supervision time when more diverse material can be discussed.
Common reasons for inpatient psychology consultation include adjustment to acute or chronic illness, feeding difficulties, organ transplant evaluations, GI concerns, pain, non-accidental trauma, and burn injuries. These are typically short-term interventions (e.g., initial evaluation, 1-3 follow up sessions), but opportunities for longer-term care are also available. There may also be opportunities to participate in consultation and training experiences/lectures with the Children’s Supportive (Palliative) Care Team.
In addition to training in the two major rotations (Pediatric Psychology C& L service and Horizons), the intern will carry 4-6 outpatients across the year, providing evidence-based psychotherapy treatment for children, adolescents, and families, many of whom have comorbid medical diagnoses. Specific patient populations are related to supervisor specialty and include cystic fibrosis, heart and lung transplant (Dr. Prieur), gastroenterology, kidney and liver transplant (Dr. McKeeman), sickle cell disease, and gender diverse youth (Dr. Pflum). Cases will be assigned based on intern interest and training goals. Treatment modalities commonly offered in this clinic include Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, Exposure and Response Prevention, and Dialectical Behavior Therapy.
- Horizons Program (Evette Horton, PhD)
Within the UNC Department of Obstetrics & Gynecology, Horizons is a substance use disorder and trauma treatment program designed for pregnant and/or parenting women through a prenatal clinic, an outpatient treatment program, and two residential treatment programs for women and their children. Interns will co-facilitate parenting groups and mother-child psychotherapy using evidence-based models such as Child Parent Psychotherapy, Parent Child Interaction Therapy, Trauma Focused Cognitive Behavioral Therapy, and Circle of Security Parenting. Over time, interns will be able to lead parenting groups, follow at least one mother-child dyad in the residential program through child-parent psychotherapy, and learn how substance abuse and intergenerational trauma impacts infant/child social and emotional development. Interns may also have some experiences conducting perinatal child psychotherapy and working with infants with neonatal abstinence syndrome.
Supervisors in the Child Community-Pediatrics track are actively engaged in fostering interns’ professional development. Training and professional development goals are set at the beginning of each rotation. Professional development goals may include writing a case report or research manuscript, presenting at an academic conference, attending a workshop to develop a specific skill or technique, or giving a talk to colleagues in the Departments of Psychiatry and/or Pediatrics. Goals for post-doctoral training and ongoing clinical and research activities are also actively discussed throughout the year.
Depending on goals and interest, interns may have the opportunity to engage in clinical research with youth and families impacted by cystic fibrosis.
Supervision Training and Opportunities:
Interns may have opportunities to provide education and training to medical students and residents, particularly in the Departments of Psychiatry and Pediatrics.
Joni McKeeman, PhD
Joni McKeeman, PhD
Samantha (Sam) Pflum, PhD
Mary Beth Prieur, PhD
Evette Horton, PhD