Introduction to Pediatric Psychology - Public Health and Psychology - Lecture Slides, Slides of Public Health

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Introduction to Pediatric Psychology Docsity.com What is Pediatric Psychology?  Concerned with physical health and illness of children and the relationship between psychological/behavioral factors and health, illness, and disease.  “Pediatric Psychology” first coined in 1967 by Logan Wright, “dealing primarily with children in a medical setting which is nonpsychiatric in nature” (p. 323) Docsity.com Clinical Activities: Settings  Specialty clinics – Physical rehabilitation centers, Child study centers  Camps or groups – Camps for children with chronic illness Docsity.com Types of Issues  Problems related to pediatric conditions – Adjustment to disease – Adherence – Coping with procedural pain  Mental health problems arising in medical units – Behavior problems while hospitalized – Bereavement – Reintegration into school after hospitalization Docsity.com Types of Issues  General mental health concerns  Programs for health promotion and early intervention – Programs to increase physical activity – Early intervention with high-risk infants  Mental retardation and developmental disabilities – Assess, train, and educate parents and professionals  Education/consultation for physicians  Public health and public policy Docsity.com Somatization Disorder  History of many physical complaints that occur over a period of years and result in treatment being sought or significant impairment in functioning.  Following symptoms have been displayed – Four pain symptoms – Two GI symptoms – One sexual symptom – One psuedoneurological symptom  Symptoms cannot be fully explained by known medical condition or substance use.  If medical condition is present, symptoms are beyond that expected for condition. Docsity.com Conversion Disorder  One or more symptoms or deficits affecting voluntary, motor or sensory functions that suggest a neurological or other general medical condition (and causes distress or impairment).  Psychological factors are judged to be associated with the symptom or deficit because the initiation or exacerbation of the symptoms or deficit is preceded by conflicts or other stressors.  Symptom not fully explained by a general medical condition or substance or culture. Docsity.com Psychological Factor Affecting Medical Condition  A general medical condition is present.  Psychological factors adversely affect the medical condition in one of the following ways: – The factors have influenced the course of the medical condition - as shown by a close temporal relationship between psychological factors and the development or exacerbation, or delayed recovery from the condition. Docsity.com Things to Look For  Do psychologically relevant factors (eg., trauma, stress, life disruptions, etc.) precede onset.  Do these factors exacerbate “medical” symptoms.  Is it possible to find evidence for secondary gain resulting from the “medical symptom” or “disorder”.  Be cautions of “as yet undiagnosed” medical conditions that may really account for symptoms.  Cases referred for evaluation often turn out to have some sort of physical problem. The Case of Dr. X’s Patient Docsity.com Psych Problems Due to Medical Conditions  Depression, anxiety or other psychological issues can result from dealing with chronic illnesses or stressful medical conditions – coping with disorders such as cancer, cystic fibrosis, craniofacial disorders – having to undergo painful treatments such as burn patients  These child may often benefit from therapy  Parents of these children may also need help in coping with these types of conditions in their children Docsity.com Examples of Peds Psych. Practice  Transplant Evaluations  Diabetes Clinic  Craniofacial Clinic Docsity.com Pediatric Endocrinology Clinic  Outpatient tertiary care clinic  Psychologist serves as a consultant in a multidisciplinary team – Pediatric endocrinologist – Nurses, nurse practitioners – Diabetes educators – Nutritionists – Residents, fellows Docsity.com Pediatric Endocrinology Clinic  Most patients have type 1 diabetes (but also type 2 and other endocrine disorders)  Physician refers patients for: – Adjustment difficulties – Poor functioning (academic, behavioral, family, emotional) – Poor adherence/diabetes control Docsity.com Pediatric Endocrinology Clinic  Psychologist conducts brief assessments (15-30 minutes) and provides feedback to the family and physician  Family feedback – Referrals – Behavioral recommendations – Problem solving  Physician feedback – Referrals – Prognosis – Treatment regimen change? Docsity.com Craniofacial Clinic  Clinic for children with genetic craniofacial abnormalities – Cleft lip and/or palate, craniosynostosis, hemifacial microsomia  Psychologist is a member of an interdisciplinary team including: – Physicians, general surgeons, plastic surgeons, dentists, oral surgeons, nurse, social worker, insurance representative, orthodontists Docsity.com Craniofacial Clinic  Psychologist conducts a brief assessment of every patient  Issues assessed: – Medical issues – Social functioning – Development – Academic, psychological, and behavioral functioning Docsity.com Major Developments in Pediatric Psychology  APA Division Status – 2001: The Society of Pediatric Psychology became Division 54 in APA – http://apa.org/divisions/div54/ – Differentiated from clinical child, clinical, and health psychology – Made the field more recognized and viable – Led to collaborations with the American Academy of Pediatrics Docsity.com Major Developments  Primary Care – Pediatric psychologists are moving away from university-based hospitals – Focusing more on primary care intervention and prevention activities Docsity.com Major Developments  Empirically supported treatments – Disciplines of medicine and psychology are placing more emphasis on ESTs – Journal of Pediatric Psychology EST reviews:  Regimen adherence  Nocturnal enuresis  Feeding problems  Pain Docsity.com EST criteria  Reports detailed info about participants  Randomized or single-case design  Detailed description of treatment approach (usually with a treatment manual)  Replication by independent researchers  Goal: the determine the most effective treatment for specific mental disorders Docsity.com