Tim and Kay Flesch Postdoctoral Fellowship Program
Pediatric Consultation-Liaison (CL) describes a dynamic form of collaboration between pediatric psychologists and health care specialists aiming to alleviate distress, attend to disease management issues, and facilitate patient and family coping in childhood illness.
CL psychologists in the role of a consultant become involved in patient care upon the request of the referring physician and, while in the role of a liaison, CL psychologists are more involved in the daily workings of a particular hospital service (e.g. attending rounds) and suggest systems-level changes that improve coping and adjustment of all patients, family, and staff.
Our pediatric CL program is led by Dr. Sandy Bowersox, and our service provides multifaceted interventions that address a myriad of issues, including:
- Adherence/Compliance: Given adherence to treatment regimens within pediatric populations is about 50% (Litt & Cusky, 1980), CL psychologists are frequently called upon to increase supervision, feedback, incentives, social support, problem-solving, and education to enhance compliance with treatment recommendations (La Greca & Bearman, 2003).
- Behavioral Management: CL psychologists can provide guidance for medical staff and parents on how to respond to a patient's aggressive, defiant or unmanageable behavior during hospitalization while also assessing whether this behavior should be further targeted following discharge.
- Communication: CL psychologists can assist in providing explanations of illness and treatment in language that is appropriate for a child's age as well as facilitating communication between patients, families and medical personnel.
- Coping and Adjustment: Adjusting to functional limitations as well as coping with emotional distress in forms such as anxiety, worry and hopelessness are often addressed.
- Pain Management: Strategies implemented by CL psychologists address children's perception of pain and aim to change environmental influences that maintain pain behaviors.
- Somatization Issues: CL psychologists often assess for psychological contributions to somatic complaints with unknown organic etiology and provide treatment to reduce somatic manifestations of emotional distress.
- School Re-entry: CL psychologists serve as liaisons by recommending school accommodations and preparing children for reintegration into the school setting after an absence.
- Triage: Identifying diagnosable psychological disorders, assessing patient safety and linking children with appropriate psychological treatment providers are important tasks of CL psychologists.