This rotation is required and restricted to interns within the Behavioral Health Integrated Care track. Interns will work in CHOP pediatric primary care, providing consultation and intervention services within a primary care team, including pediatrician, pediatric resident, clinical nurse practitioner, child psychologist, amongst others. The patient population is generally low income and resides in medically underserved urban communities. Some interns will also provide consultation and intervention services within an urban middle school utilizing a multidisciplinary team, including child psychologist and child and adolescent psychiatry fellows. Interns will acquire skills necessary to effectively provide community-based services to underserved children and their families.
The training goal of this 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 rotation.
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 grieving, posttraumatic stress. Interns may also co-lead a bi-monthly parent group for parents of inpatients, and may have the opportunity to co-lead other groups for survivors and their families.
Interns are expected to attend patient care meetings and didactics within the Division of Oncology, including Psychosocial Rounds, Journal Club and Tumor Board. Specific training objectives of the rotation will be tailored to each intern’s training needs, goals and objectives.
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 neurorehabilitation patients within an interdisciplinary team (including attending physician, resident, clinical nurse manager, PT, OT, SLP, Child life, social worker, and case manager). The rehabilitation psychology service provides initial assessments, case consultation, behavioral management, individual psychotherapy, family therapy, education, cognitive screening, and 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 traumatic brain injury, brain tumors, encephalitis, and so forth. Trainees may also have the opportunity to participate in the Minimally Responsive Evaluation Program if appropriate patients are entered in this program during the rotation.
This rotation provides the opportunity to participate in a multidisciplinary 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: most of the providers are clinical trainees under supervision, and there are frequent trainee observers (LEND fellows and pediatric residents).
The intern will take an active role in helping create a team documentation summary, because the current format will not be compatible with EPIC in the future. Documentation of consultation is currently in the form of a brief summary of ADOS testing, impressions, and recommendations, but will move toward a more integrated team summary. Completed documentation must be posted in EPIC within one week, so as to be available to families when they return for their feedback appointment.
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:
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.
Required training activities include:
The Pediatric Feeding and Swallowing Center assesses and treats children typically between 2 months to 5 years 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, outpatient consultation and feeding therapy in a day hospital setting. Limited inpatient consultations and feeding therapy in outpatient setting may also be available.
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.
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.
Patients (ages: birth to 21 years) with a variety of medical concerns, including:
This is an outpatient rotation, although opportunities for inpatient consultation may be available (e.g., when patients are hospitalized for surgical procedures). Common referrals include:
Interns who elect to complete this rotation will participate in the following activities:
Opportunities to participate in several ongoing research projects are available.
Interns will be responsible for writing consultation notes, initial evaluations, and progress notes. Consultation and progress notes should be completed on the day of the patient visit. Initial evaluations (including treatment plan) should be completed within three sessions. Samples of consultation notes, initial evaluations, and progress notes will be provided.
Integrated Ccare track
The Primary Care rotation fulfills requirements in the 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, and pediatric residents.
This rotation is based at the Karabots and Cobbs-Creek Primary Care centers, located at 48th and Market Street (Karabots) and 63rd and Market (Cobbs Creek). Psychology interns at Karabots will work with licensed providers from our community partner, Child Guidance Resource Centers, physically co-located within the primary care center. Children, ages 2 through 18 years, are referred by the primary care pediatrician to Child Guidance because of a wide variety of mental health concerns, including behavioral difficulties, attention difficulties, relationship concerns, developmental concerns, mood concerns, and anxiety concerns.
In conjunction with their psychologist supervisor, psychology interns participate in the initial clinical assessment, which focuses on an assessment of the child in the context of their family, school, and community. Clinical assessment 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.
Interns will spend approximately one to two days per week on site, including supervision time. They will see approximately four to eight patients/week, and will document their clinical activities in accordance with the policies in effect through Child Guidance or CHOP.
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
Specific training objectives of the rotation will be tailored to each intern’s training needs, goals and objectives.