This externship has opportunities in a variety of clinics to provide trainees with a breadth of experiences in multidisciplinary clinics including medical team consultation, psychosocial assessments, short-term therapy, and outpatient therapy for youth/caregivers with chronic medical conditions. As such the extern will be exposed to diverse team-based models of care in hospital settings. All rotations include collaboration with physicians, nursing team, social work and other allied team members. Each rotation emphasizes increasing access to culturally responsive care and addressing health equity in medical settings. All rotations offer unique opportunities for program development. The extern will work under the direct clinical supervision of Julie Heier, Ph.D.
Potential experiences are as follows:
- Pediatric Dermatology. (Thursdays tentatively) At the main hospital, externs will provide psychological services to a diverse population of children and adolescents diagnosed with a breadth of skin and related conditions including acne vulgaris, atopic dermatitis, alopecia areata, psoriasis, vulvar dermatitis, and hidradenitis suppurative. Many youths live throughout the D.C., MD, and VA area. This clinic provides care for youth who hold marginalized identities and over 50% are Spanish speaking families. The extern will provide screening for comorbid mental health conditions, psychosocial assessments using the biopsychosocial model framework, procedural support and needle phobia intervention, and short-term intervention. This clinic provides short-term treatment for a large variety of presenting concerns including depression and anxiety related to skin disease, coping with chronic illness, treatment adherence, skin picking using habit reversal therapy, and sleep interventions. Some opportunities for telehealth and group interventions may be available. Cognitive-behavioral therapy, behavioral health psychology, acceptance and commitment therapy, and interpersonal frameworks utilized.
- Colorectal and Pelvic Reconstruction Clinic. (Tuesdays) This clinic provides consultation/liaison and short-term therapy for youth diagnosed with Hirschsprung Disease, anorectal malformations, and idiopathic constipation that greatly interfere with quality of life. At the main hospital the psychologist is part of a collaborative team comprised of colorectal surgery, gastroenterology, urology, gynecology, nursing, child life and social work. The extern will be part of the multidisciplinary clinic day providing brief psychosocial screening for families traveling to clinic from across the world before they undergo colorectal surgery or procedural testing. The psychologist also supports families adjust to post-surgery care and identifying psychological factors that are contributing urinary and bowel incontinence. Families identified in the multidisciplinary clinic who would benefit from additional support are seen as outpatient therapy patients. Opportunities in program for parent support and youth groups may also be available. Extern will also attend team meetings and division-wide educational seminars.
- Colorectal Bowel Management. (Day of week varies) This clinic provides consultation/liaison for youth who attend bowel management bootcamp following their colorectal surgery. Provides consultation in conjunction with their medical appointment to identify and provide recommendations for psychosocial, family and behavioral factors barriers to bowel continence. Common presenting concerns including adjusting to taking new medications or enemas, anxiety/behavioral resistance related to colorectal home care plan, and treatment adherence.
- Complex Care Program. (Mondays tentatively) The Complex Care Program at Children’s National is located within Primary Care at our Shepherd Park location in Washington, D.C. Youth in the Complex Care Program have multifaceted, systemic, medical problems and are followed by three or more medical subspecialties (e.g., neurology, cardiology, endocrinology, gastroenterology). Patients in the complex care program have frequent or prolonged hospitalizations and use mechanical devices to treat their conditions. Our team strives to optimize quality of life and the patient experience by providing continuity, coordination, and consistency of care for patients and families. This clinic provides both same-day visits with families when they attend their medical appointment, targeted co-located psychosocial assessments from medical provider referrals, and short-term therapy. Primary presenting concerns include caregiver interventions, behavior and sleep challenges secondary to developmental delays and genetic conditions, transition for youth with disabilities and neurological conditions, school advocacy, and social determinants of health. This program works collaboratively with medical attendings, advanced practice nurses and case management.