Pediatric Psychology Fellowship Training Program

The primary goal of the CHKD postdoctoral fellowship program in pediatric psychology is to help fellows develop the clinical skills necessary to provide care for diverse pediatric populations and to obtain a position in a pediatric healthcare setting or university-based training program.

Goals and Objectives

Fellows will participate in a range of clinical assessment and intervention experiences, supported by ongoing formal and informal didactics. A major emphasis during the training year is developing the clinical and professional skillset required to work in healthcare settings. This includes participation on interdisciplinary teams and providing mental health training to other healthcare professionals. Fellows will also have opportunities to supervise practicum students and other trainees, collaborate in interdisciplinary treatment teams, and participate in care that is coordinated across multiple specialty services. In addition to direct service, which constitutes more than fifty percent of the fellows’ time, fellows are expected to gain exposure to programmatic care along with the development of programs and systems of care.

Curriculum and Training Plan

CHKD’s pediatric psychology postdoctoral fellowship involves year-long core experiences with consult-liaison and outpatient services. This fellowship will provide an opportunity to work with a variety of medical populations, including inpatient pediatric rehabilitation, pain and palliative care, gastroenterology, neurology, hematology/oncology, intensive care, and trauma. The fellow will be responsible for working with interdisciplinary teams and the patients referred to each of these service areas. In addition, fellows may supervise trainees and provide educational opportunities to other professionals in the healthcare system.

The psychology fellow, with their supervisors and the training director, will develop a specific program that addresses the requirements and goals of the training program, the fellow’s individual training needs and interests, and the patient care needs within the service area and hospital. As they demonstrate readiness over time, the fellow is given increasing clinical responsibility, autonomy, and exposure to more challenging treatment cases. All of these experiences are supported and reviewed by supervisors who are active treatment providers and team members in the various service areas. The development of increasing competence is evaluated informally through supervision, and formally through written evaluations every six months. We are committed to promoting the strongest match possible between the fellow’s training needs and goals and our program’s mission and goals.

Consult-Liaison

The fellow will be an integral part of the inpatient consultation-liaison service and work alongside psychiatrists, licensed professional counselors and social workers to deliver comprehensive mental health care to patients admitted to the medical units. As a component of this work, the fellow will participate in daily interdisciplinary rounds to offer consultation and support to our medical teams. We work closely with a variety of inpatient services including the pediatric intensive care, hematology/oncology, gastroenterology, trauma, surgery, rehabilitation, and general hospital medicine. Assessment and interventions on the consult-liaison team will focus on behavioral planning and support during medical inpatient admissions; adjustment to diagnosis, pain, and stress management; and adherence to medical regimens, feeding, and extended hospitalizations.

Outpatient

With respect to outpatient care, the majority of our referrals for outpatient therapy are from physicians in our healthcare network. This provides the unique opportunity to coordinate with a patient’s larger healthcare team through the electronic health record. The fellow will conduct clinical intake evaluations and develop and deliver treatment plans rooted in evidence-based therapies for children with mental health diagnoses and, potentially, co-occurring acute or chronic illness, trauma, or disability. Additionally, the fellow will conduct psychological testing to evaluate domains related to cognitive, achievement, executive functioning, social communication, and emotional/behavioral functioning. Integration of data from various sources, development of diagnostic conceptualizations, and tailored treatment recommendations will culminate in a comprehensive evaluation report and therapeutic delivery of feedback.

Additional Program Information:

Summary of Direct Service Experiences

- Comprehensive psychological evaluation

- Outpatient psychological intervention

  • Cognitive behavioral therapies
  • Dialectical behavior therapy
  • Parent-child interaction therapy
  • Parent management interventions
  • Family-based treatment
  • Exposure and response prevention
  • Habit-reversal therapy
  • Family therapy and family systems work

- Inpatient consultation-liaison

  • Adherence therapies and interventions
  • Adjustment to hospital/disease
  • Management of nutritional deficiency
  • Parent management
  • Parent coaching to support hospitalization goals
  • Educating and coaching staff to support treatment goals
  • Psychological interventions and assessments using methods and protocols similar to those in outpatient

- Professional consultation and team-oriented care

- Examples of populations served

  • Behavioral and emotional problems related to illness
  • Behavioral and emotional problems that complicate course of treatment for illness
  • Illness related to problems in behavior
  • Adherence/compliance with treatment
  • Neurodevelopmental disorders
  • Disruptive behavior and conduct problems
  • Anxiety disorders
  • Obsessive compulsive disorder
  • Compulsive disorders, including trichotillomania and dermatillomania
  • Adjustment after trauma
  • Mood disorders

Electives

Additionally, the fellow may select an elective experience (4-8 hours per week) within a specialty area to cultivate a niche skill set. Previous examples of elective experiences have included rotations with sleep medicine, pain and palliative care, and primary care/General Academic Pediatrics which have involved assessment and consultation of mental health needs and brief treatment, if indicated, integrated with the medical providers.

Seminars and Other Training Experiences

A variety of serialized and one-off training opportunities such as seminars and didactics are regularly available to the fellow and co-occur with other trainees and other health system staff. Weekly one-hour didactics are held in conjunction with EVMS psychiatry residents regarding a variety of mental health topics presented by faculty from the EVMS departments of pediatrics and psychiatry. Topics are varied and may include presentations regarding social determinants of health, child development, specific evidenced-based interventions and/or medication management approaches, psychological assessment, or specific conditions such as somatoform disorders.

Participation in weekly 30-minute psychology huddles and hour-long divisional staff meetings/case conferences is expected. The department of pediatrics hosts Grand Rounds on a weekly basis that are attended by faculty, community faculty, house staff and residents, trainees, and students. Annual health system trainings with respect to autism, bioethics, and LGBTQ affirming practices (Safe Zone) are offered on an ongoing basis. Examples of past in-house trainings include dialectical behavior therapy, parent-child interaction therapy, cognitive behavioral intervention for tics, risk and trajectory in child/adolescent substance use disorders, family-based integrated care, and cognitive behavioral therapy for pediatric pain. Initial training in parent-child interaction therapy with a within agency/level 1 PCIT trainer may be provided on an elective basis. This intensive training may support application for certification in PCIT.

The fellow may be asked to provide training and demonstration of clinical skills to mental health and non-mental health CHKD staff, including nursing, mental health techs, medical staff, and residents, as well as community stakeholders, such as school systems or non-profit groups, as needed.

Supervision

Our division subscribes to the philosophy that the most effective learning environment for postgraduate psychology trainees is one that allows sufficient freedom for the fellow to share responsibility for decision-making in patient care in collaboration with the faculty supervisor and integrated interdisciplinary team. Provision of this learning environment is supported by the following elements:

  • Goals and objectives have been written for each clinical service area so that both the supervising faculty member and the fellow will be aware of the specific and progressive responsibilities and competencies.
  • Fellows receive at least three hours of face-to-face individual supervision weekly with a licensed clinical psychologist/core supervisor, including the training director. One-hour group supervision is also provided in an interdisciplinary setting supported by a licensed clinical psychologist. Additional supervision and instruction may be received from health system faculty including physicians, nurse practitioners, and master’s-level licensed therapists.
  • The fellow will have access to a therapy room equipped with a one-way mirror and video equipment to allow video recording of sessions and live supervision. Faculty members emphasize observation and review of video for training purposes.
  • The organization and the psychology training faculty are committed to providing the highest standard of care in the field. They utilize a multi-faceted systemic perspective with a biopsychosocial emphasis. As such, use and training in a variety of psychotherapeutic approaches grounded in evidence-based practices to facilitate change occurs within our service line. These approaches include cognitive-behavioral, behavioral, family systems, trauma-focused, as well as integrationist approaches. The fellow will be provided with the opportunity to use all of these approaches, as appropriate to the needs of their patients.

Fellowship Resources

The fellow is provided with an individual or shared office space equipped with a desktop computer with webcam and speakers, and access to a laptop and network printer. An encrypted telehealth account also will be provided. Further, the fellow is provided with support from informatics in the preparation of EMR documentation and other medical records management. Outpatient administrative support staff is available to assist with management of outpatient appointments.

Professional liability insurance covering clinical activities clearly defined within the scope of the pediatric psychology fellowship program is provided by CSG at no cost to the fellow. With respect to assessment materials, the fellow has access to test kits and protocols as well as iPad administration options and online scoring of testing instruments.

Licensure

The postdoctoral fellowship is a full-time, one-calendar-year commitment. Fellows will complete a minimum of 1,500 training hours. Additionally, each fellow will receive three hours per week of individual supervision by a licensed clinical psychologist and one hour per week of group supervision with an interdisciplinary team. The fellow will also participate in didactics curated for trainees and hospital-wide learning opportunities. These activities include, but are not limited to, weekly pediatric grand rounds, weekly psychiatry/psychology seminar series, annual bioethics training, and annual autism training. While there is no licensure requirement for postdoctoral supervised experience in Virginia, this fellowship training experience does meet the standards outlined for postdoctoral fellowship training by the Association of Psychology Postdoctoral and Internship Centers (APPIC).

Program Personnel and Administration

Core Supervisors and Training Director

Division of Psychiatry and Psychology Faculty

Psychology

Psychiatry

    Evaluation

    The evaluation process is an iterative one designed to provide fellows with information that will inform their professional growth. The expectation is that fellows and supervisors will engage in ongoing evaluation of the fellow’s performance, and that the supervisory relationship will support optimal learning and development. At the end of each six-month period, the fellow (via self-evaluation) and supervisor will complete a more formal written evaluation of the fellow. Mutual exchange of feedback between the supervisor and fellow is designed to enhance professional growth of both by identifying strengths, areas needing improvement, and personal goals.

    Fellows may have live supervision or videotaped review during each evaluation period to enhance the learning process. The formal written evaluation process will be augmented by more frequent and informal feedback during weekly supervision and curbside consultation, which is designed to provide timely feedback to fellows regarding their progress on their clinical training experiences.

    The training director meets regularly with the fellows to monitor achievement of training goals and to facilitate professional development. Fellows are welcome to provide feedback and recommendations to the training director via formal and informal interactions. The training director also maintains regular contact with all supervising psychologists regarding the progress and functioning of the fellows under their supervision.

    By the end of the fellowship training year, it is expected that Fellow completes a minimum of 1500 hours, adheres to the CSG Corporate Compliance Code of Conduct (see CSG Employee Handbook) and is evaluated as proficient to meet the minimum level of achievement in all profession wide competencies in order to adequately complete the fellowship training program. These competencies include:

    • Research (scientific mindedness, scientific foundation of psychology, scientific foundations of professional practice, scientific approach to knowledge generation, application of scientific method to practice)
    • Ethical/Legal Standards (knowledge of ethical, legal and professional standards and guidelines; awareness and application of ethical decision making (assess, plan, implement and evaluate); ethical conduct)
    • Cultural Diversity (self; others; self and others; applications based on individual and cultural contexts)
    • Professional Values and Attitudes (integrity, deportment, accountability, concern for the welfare of others, professional identity)
    • Communication and Interpersonal Skills (interpersonal relationships, affective skills, expressive skills)
    • Assessment (knowledge and application of evidence-based practice, diagnostic interviewing techniques, evaluation/measurement/assessment tools; case conceptualization and diagnosis; communication of assessment findings) Intervention (knowledge and application of evidence-based practice; planning; skills; implementation)
    • Supervision (processes and procedures; practices) Consultation and Interdisciplinary Skills (role of a consultant, addressing referral question, communication of consultation findings, application of consultation methods)

    Fellows who successfully complete the training program will receive a signed certificate of completion.

    Application and Selection Process

    To apply to the CHKD pediatric psychology postdoctoral fellowship, please submit application materials to Lynn.Page@CHKD.org. The absolute deadline for acceptance of the completed electronic application materials is December 8, 2024 and the following information should be included in each candidate's completed application package:

    1.) Vita.

    2.) Letter of interest.

    3.) Three letters of recommendation.

    4.) De-identified sample treatment summary or psychological evaluation demonstrating the integration of multiple sources of data.

    Questions regarding the program not answered here should be directed to the training director Lynn Page, PhD, ABPP, via email at Lynn.Page@CHKD.org or by phone to (757)-668-8023.

    After the initial review of the application materials, we will contact selected applicants, usually prior to January 1, to schedule an interview in January or early February. The interview day runs from 8 a.m. to 2 p.m. and provides an important opportunity for applicants to become more familiar with the medical center facilities via an orientation to gain a greater understanding of the fellowship program. In addition, the interview day offers the applicant an opportunity to become better acquainted with the types of clinical experiences available at CHKD. Each candidate will be scheduled for three 45-minute interviews with at least one faculty/interdisciplinary team members. A brief closing will address additional questions and universal notification date procedures.

    Selection of postdoctoral fellows is based upon comparative evaluation. Equal-opportunity guidelines play an important role in the selection of fellows. The pediatric psychology postdoctoral fellowship training program at CHKD is prohibited from discrimination with regard to gender, race, age, religion, color, national origin, disability, or veteran status.

    Following the interview, applications from all candidates under consideration are rank-ordered as a result of this process. This fellowship site agrees to abide by the APPIC policy that no person at this training facility will solicit, accept, or use any ranking-related information from any fellowship applicant.

    The fellowship follows APPIC Postdoctoral Selection Standards with Common Hold Date. 

    The fellowship will notify applicants as soon as they are no longer under consideration and when our position is filled.  


    Our Location

    CHKD is a 206-bed teaching hospital and the only freestanding children’s hospital in Virginia. The hospital is home to over 200 pediatric physicians and subspecialists from all disciplines. This fellowship position is located within the department of pediatrics’ division of psychiatry and psychology.

    All training locations for the postdoctoral fellowship are on the Eastern Virginia Medical Campus, which includes Children’s Hospital of The King’s Daughters, Sentara Norfolk General Hospital, Eastern Virginia Medical School, and a variety of adjacent outpatient care facilities. Fellows and supervisors operate in multiple locations on this campus with inpatient services being delivered in the main CHKD hospital location. Because of our location and the breadth of services offered, our service area stretches into central Virginia and northeast North Carolina. Patients served are diverse and represent a wide range of incomes, socioeconomic statuses, and urbanicities.