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Psychology Internship Multidisciplinary Medical Teams Rotation
Psychology Internship Multidisciplinary Medical Teams Rotation

The Multidisciplinary Medical Teams Rotation at Children's Mercy Hospitals and Clinics will provide the intern experience with outpatient interdisciplinary consultation and brief intervention, outpatient therapy as an adjunct to medical care, and assessment of psychological functioning within outpatient medical clinic populations. Details on the options available within the Multidisciplinary Medical Teams rotation are provided below:

(1) Eating Disorders Center
Supervisors: Kathryn Pieper, Ph.D., and Sara Gould, Ph.D.
Days Offered: Monday is preferred due to interns being able to work with both supervisors. Tuesdays and Wednesdays are also available, with the intern working with Dr. Pieper on Tuesdays or with Dr. Gould on Wednesdays.

The Eating Disorders Center provides outpatient services to children and adolescents with diagnoses of Anorexia, Bulimia, and Eating Disorder Not Otherwise Specified. Common comorbidities include anxiety disorders, depression, substance use/abuse, and characteristics consistent with Borderline Personality Disorder. Treatment modalities used include cognitive-behavioral therapy, family-based treatment, motivational interviewing, dialectical behavioral therapy skills and mindfulness. Interns working in the EDC have the opportunity to participate in cotherapy with established and new patients, with increasing involvement as they become more familiar with the eating disorder population and with individual families. Interns will also be able to observe appointments with other EDC Team providers, including nutrition, medical, and family therapy, and to participate in care coordination. No comprehensive evaluations are conducted in the EDC, but initial appointments include in-depth interviews with parents and teenagers and standardized instruments, which are then re-administered throughout the treatment process. Interns will also learn about the levels of care available to children and adolescents with eating disorders and how providers work together to consider multiple facets of the illness when setting treatment goals, including what level of care is appropriate for an individual. Finally, interns will learn to communicate effectively with families and in a multidisciplinary team.

(2) Endocrine/Diabetes
Supervisor: Anna Egan, Ph.D.
Days Offered: Monday, Wednesday, or Thursday

The rotation option in endocrine/diabetes allows the intern to work with an outpatient pediatric multidisciplinary team treating patients with endocrine-related medical diagnoses (e.g., Type I and Type II diabetes, Insulin Resistance, Turners syndrome) and associated psychosocial concerns (e.g., adjustment to diagnosis, nonadherence, depression, anxiety, and parent-child conflict). Multidisciplinary collaboration occurs with physicians, nurse practitioners, social workers, dieticians, certified diabetes educators (CDEs), etc. Patients referred range in age from 2-18, with most referrals being youth in their teens. There is a focus on utilizing technology (e.g., insulin pumps, glucose meters) for monitoring and implementing interventions and setting goals through modalities such as MI and CBT.

(3) Weight Management
Supervisors: Amy Beck, Ph.D. (primary), Meredith Dreyer Gillette, Ph.D.
Days Offered: Wednesday, Thursday

Specific experiences in this rotation option may differ somewhat depending on what days the intern is available. These may include observation and direct clinical contact with patients and families referred to the general weight management clinic for obesity. Interns will gain experience in addressing behavioral components of making healthy lifestyle changes with the goal of stabilizing or losing weight. This will include consultation with the rest of the team (MD/PNP, PT, RD, and SW). Another potential experience is initial observation and then direct clinical contact in individual outpatient therapy for patients from the weight management clinic who have been referred for behavioral or emotional concerns (primarily depression, anxiety, and externalizing/disruptive behavior disorders), and who need to stabilize or lose weight. Interns will gain experience in both general treatment of common presenting concerns, as well as more specific eating related issues (emotional eating, sneaking food, etc.), and adherence concerns. Patients may range from ages 5-17, are typically complex, and often exist within chaotic family systems with many barriers. These will be long-term patients who will provide the opportunity for follow-up through the training year. Lastly, weight management offers evening intervention groups throughout the week. Monday evenings is the 6 week long Zoom to Health for young children (ages 2-8), and Tuesday/Thursdays evenings are the 12 or 24 weeks long PHIT Kids program. The intern will have an opportunity to flex his/her schedule and stay late once or twice to observe these treatment groups. This will promote experience in multidisciplinary weight management treatment that is non-clinic based, and is in a group format.

(4) Abdominal Pain Clinic
Supervisors: Amanda Deacy, Ph.D. (primary), Jennifer Schurman, Ph.D.
Days Offered: 1st, 2nd, and 3rd Wednesday afternoons of each month, Thursdays
**Early in the rotation, we ask that interns spend 1-2 half days on Monday or Tuesday mornings shadowing new patient visits.

The APC rotation will provide the intern with the opportunity for three distinct training experiences: 1) outpatient interdisciplinary consultation and brief intervention; 2) biofeedback-assisted relaxation training (BART); and, on rare occasion, 3) outpatient therapy as an adjunct to patients' medical care. Outpatient interdisciplinary consultation and brief intervention will take place as part of APC patients' outpatient follow-up. Interns will collaborate with clinic nursing staff, as well as an advanced practice nurse (APN), to determine ongoing psychosocial treatment needs and/or barriers to adhering to previously prescribed treatments. Clinic visits will occur during approximately 30-minute appointment slots and include face-to-face time with patients, as well as consultation with APNs. Interns also will have the opportunity to gain exposure to the rationale for and techniques contained within the practice of BART. Biofeedback modalities covered will include: EMG, Thermal, GSR, HRV, and respiration training. Interns will shadow providers certified by the Biofeedback Certification International Alliance. Visits may include those of initial evaluation (including administration of the stress profile), as well as follow-ups. Finally, there will be an opportunity for interns to independently follow therapy cases referred from within the APC. Cases typically will involve targeted intervention in the areas of coping with chronic pain, anxiety/depression, and behavior management/parent training. Therapy cases will be seen during a portion of the designated interdisciplinary APC day(s).

(5) Integrative Pain Management
Supervisors: Mark Connelly, Ph.D., Dustin Wallace, Ph.D.
Days Offered: Monday-Friday (Headache-specific clinic Wednesdays and Thursday afternoons)

The pain clinic is on the main campus and consists of a group of physicians (pediatrician, neurologist, rheumatologist), nurse practitioners, psychologists, social workers, massage therapists, and clinic nurses. Interns will have the opportunity to observe and participate in evaluations of new patients presenting with a variety of idiopathic and disease-related chronic pain conditions (e.g. headache, complex regional pain, juvenile fibromyalgia, arthritis, scoliosis). Interns can also participate in individual or multidisciplinary follow-up appointments and take on individual therapy cases if desired. Specific supervision is available in cognitive-behavioral therapy, acceptance and commitment therapy, and relaxation-based treatments such as biofeedback and self-hypnosis. Interns will also gain valuable experience from working within a multidisciplinary team. This clinic is available as a 2-day, 1-day, or mini medical rotation.

MULTIDISCIPLINARY MINI-MEDICAL OPTIONS

In addition to each of the Multidisciplinary Teams options described above being available as "mini-med" rotations for interns interested in getting some exposure to interdisciplinary teams without completing a more in-depth rotation, the following multidisciplinary teams are available as "mini-med" opportunities:

Special Care Clinic Feeding Clinic
Supervisor: Hilary Boorstein, Ph.D.
Days Offered: 2nd and 4th Wednesday mornings each month.
Summary: Clinic typically begins with a new patient, continuing with follow-up appointments for children previously seen in the clinic. The team consists of an SCC pediatrician, OT feeding specialist, nutritionist, and psychologist. The SCC social worker is also included as necessary. Patients range in age from young babies through elementary school. Patients tend to be very young and more medically complex (less behavioral in nature) than those in the South Feeding Clinic. Many patients have g- or g-j tubes, tracheotomies, oxygen, etc. Medical diagnoses include genetic syndromes, premature infants with complications, significant developmental/motor delays, CP, congenital GI disorders, complicated cleft lip/palate, neurological conditions, and many others.

The GUIDE Clinic
Supervisor: Anna Egan, Ph.D.
Days Offered: 4th Wednesday of Jan, March, May, July, Sept, Nov
Summary: The GUIDE clinic is a multidisciplinary clinic made up of Gynecology, Genetics, Urology, Psychology, Social Work, Nursing, and Endocrinology that treats youth with disorders of sexual development (e.g., Mixed Gonadal Dysgenesis, Androgen Insensitivity Syndrome). Patients range from 1 month old to mid-20s. Common presenting concerns addressed by psychology and social work include adjustment to diagnosis and coping (family and child), coping with medical procedures (e.g., surgery, dilation), sexual identity and development, peer and romantic relationships

Sleep Disorders Clinic
Supervisor: Kevin C. Smith, Ph.D.
Days Offered: Main: Thursday afternoon. South: Mondays and Tuesdays (choose ½ day)
Summary: The Sleep Disorders Clinic team consists of a pulmonologist, nurse practitioner, nurses, and a pediatric psychologist. The team also consults with a neurologist and a social worker on a regular basis. Patients range in ages from 1 month-early 20s. Presenting issues can include compliance with medical regimens such as for narcolepsy and sleep apnea; and medical diagnoses such as sleep onset and maintenance insomnia, restless leg syndrome/periodic limb movement disorder, parasomnias (nightmares, sleep terrors, sleepwalking), REM behavioral disorder, and behavioral insomnia of childhood. Depending on scheduling, the intern may have the opportunity to shadow other members of the Sleep Disorders Clinic team as well.


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