Texas Children's Hospital-Pediatric Psychology Track
Location: Texas Children's Hospital
Training experiences occur through the Psychiatry Service at Texas Children’s Hospital’s main campus. Texas Children’s Hospital provides inpatient acute and outpatient subspecialty care and is the largest children’s hospital in the country. Psychologists in Texas Children's Hospital's Psychiatry Service treat children whose complicated medical problems have psychological and behavioral components. These children and families are referred as inpatients or outpatients, for assessment and treatment of psychological issues related to physical conditions or symptoms, or for behavioral problems that interfere with optimal medical care and adaptation to illness. Common referral issues include noncompliance with medical treatment, pain management, management of physical symptoms without identified organic etiology, school avoidance, conditioned anxiety reactions to medical procedures, and feeding and elimination disorders.
Treatment issues encompass the full range of pediatric psychology concerns from a wide array of subspecialties. The tertiary care nature of our patient population frequently necessitates referral to the empirical literature and application of evidenced-based principles for use with new or complex problems. As such, interns in this track gain experience in inpatient consultation and outpatient treatment for a remarkably broad spectrum of complex pediatric issues with many different populations.
Assessment and Consultation
Inpatient: Interns participate in inpatient consultation to pediatric units at Texas Children's Hospital: Psychology consultation questions include the full range of pediatric psychology issues, including differential diagnosis of psychological versus medical etiology of symptoms. The role of psychological issues in medical presentation or adjustment, and optimal participation in the rehabilitation or medical treatment..
Outpatient: Formalized outpatient assessment is limited and is primarily conducted to assess psychological adjustment or to facilitate treatment planning and evaluation of treatment progress. The Service provides psychological evaluations of children (and their families) who are being evaluated for lung transplantation or surgical intervention for headaches. Brief consultation to trainees and staff in the pediatric specialty clinics regarding psychological issues related to patient care, such as self-management-enhancing strategies, effective communication, effective discipline, recognition and referral of mental health problems, etc., also may occur. Occasional outpatient consultation work with patients in pediatric specialty clinics may also occur.
Inpatient: Inpatient interventions also span the range of pediatric psychology issues, including assisting children and families in coping with prolonged hospitalization and serious illness, adherence with medical care, and pain and behavior management.
Outpatient: Psychology provides outpatient treatment of psychological concomitants of medical illness. Families are referred from multiple primary pediatricians as well as subspecialties, including but not limited to Pulmonary and lung transplant, Pain, Gastroenterology/Nutrition, Cardiology and heart transplant, Rheumatology, Dermatology, and Neurology. Common presenting concerns include pain or other symptom management, elimination disorders, self-management of long-term medical regimens, infant and childhood feeding disorders, anxiety associated with medical procedures and family adjustment to chronic illness. Outpatients who do not have significant medical involvement but have conditions best treated with cognitive behavioral interventions, such as anxiety disorders, are occasionally seen for psychotherapy and sometimes co-managed with a psychiatrist in the Psychiatry Service.
Access to Diverse Populations
Due to its national reputation, Texas Children’s Hospital provides services not only to local children but also children and families from other regions, states, and countries. Interns in this track have access to a remarkably broad spectrum of patients with respect to demographics and medical diagnoses, at times including very rare conditions or atypical medical presentations. Interns gain experience with patients with a wide range of ages (typically 1-22 years), as well as economic, cultural, and linguistic backgrounds (with frequent work with Spanish-speaking patients but also at times Vietnamese, Cantonese, Urdu, American Sign Language, etc.). .
Both supervisors are collaborators on NIH-funded research related to children with functional gastrointestinal disorders and also participate in various other collaborative research studies in the hospital. Interns may have the opportunity to gain experience on these studies, or development of a short-term research project related to ongoing services or established populations may also be an option.
Supervision: Supervision is provided by Danita Czyzewski, Ph.D., and Mariella Self, Ph.D. Interns work with both supervisors throughout the year.
Didactics: Interns participate in a pediatric psychology journal club meeting and an interdisciplinary inpatient consultation case conference with psychiatry. Interns have the opportunity to attend pediatric grand rounds or other didactic seminars offered within the hospital.