Pediatric Psychology Post-Doctoral Fellowship Curriculum 

Pediatric Psychology Postdoctoral fellows gain clinical experience under the supervision of licensed clinical psychologists working across the hospital setting. Fellows receive opportunities to gain additional experience providing outpatient therapy in person and via virtual care, outpatient IQ/Achievement and ADHD testing services, inpatient consultation and liaison; working on multidisciplinary treatment teams; and conducting crisis evaluation and group therapy services. Services provided are short-term and evidenced-based. There also is potential for research collaboration and teaching opportunities, and fellows have regularly scheduled supervision and didactic seminars. Opportunities to attend hospital Grand Rounds and Continuing Education conferences also are available. Career development opportunities, including licensure support, is provided.

Fellows are based on Gundersen's main campus in La Crosse, Wis., and have an office located in Outpatient Behavioral Health, where they see virtual and in-person outpatient therapy cases and testing patients. Work-from-home options may be available during the second half of the fellowship as independence increases and fellows demonstrate competence in a variety of care areas. Fellows also have many opportunities to choose to interact with staff and patients in Gundersen’s Pediatric Unit, Pediatric Intensive Care Unit and Neonatal Intensive Care Unit through our consultation and liaison service. Fellows may elect to participate on multidisciplinary teams in Pediatric Specialties and Pediatric Neurology, including Pediatric Allergy; Pediatric Gastroenterology; Pediatric Endocrinology; Pediatric Cardiology; and Pediatric Hematology/Oncology. Formal participation in the Cystic Fibrosis Clinic and Pediatric Headache Clinic also is possible. Fellows regularly collaborate with Gundersen pediatricians—a significant referral source.

Fellows also receive at least two hours per week of individual supervision through a combination of in-person and virtual supervision. Fellows attend a weekly didactic and weekly professional development seminar and have access to other recurring training activities, such as the Gundersen Expert Lecture Series (GELS) and other virtual on-campus trainings as offered. 

Fellows will meet criteria of the Wisconsin State Statute to be eligible for licensure of having a minimum of two (2) hours of supervision per week of fellowship training. This will amount to at least 100 hours of supervision time upon completion of the 1-year fellowship. 

Fellows will be offered an average of 2 hours of didactic training per week (though some weeks may be more or less) for a total of at least 100 hours of didactic and continuing education participation upon the completion of fellowship. Within this area, fellows are required to complete a minimum of the following:

• Weekly Friday Didactics: Fellows are required to attend a minimum of 80% of the weekly Friday didactic offerings over the course of their training year. These are scheduled from 1:00 – 3:00 pm.
• Gundersen Expert Lecture Series (GELS): Fellows are required to attend a minimum of     12 noon conference GELS opportunities out of the selected topics as identified by their supervisors.
• Peer Collaboration Group: Fellows are required to attend a minimum of 4 collaboration group meetings.
• Ethics: Fellows are strongly encouraged, but not formally required, to use one half of a meeting time day to attend the once annual Ethics conference presented on-site.
• Case Presentation: Fellows will be required to complete two formal case presentations by the completion of their fellowship.
• Journal Club: Fellows will be required to complete and present at two journal clubs by the completion of their fellowship. 

Fellows receive two hours of formal, scheduled, face-to-face or virtual individual supervision by doctoral-level licensed psychologists, with the intent of supervising psychological services rendered directly by the fellow. Fellows attend one hour per week of Professional Development Seminar, as well as one hour per week of regularly scheduled Didactic Training, which may be virtual or in-person. Additional continuing education opportunities are offered throughout the year as available to the hospital staff. 

The training program is directed and managed by Gundersen’s Medical Education Department. The program is assigned a Fellowship Program Administrator who is the go-to person for Fellows regarding attending interviews, accepting an offer, relocating, onboarding, housing, insurance, and benefits. The Program Administrator will also assist Fellows with documentation required for licensure, should this be requested.  

The Fellow has two actively practicing licensed PhD-level Psychologist supervisors who are on-site 5 days/45 hours per week with the exception of illness, vacation days, and holidays. Supervisors are credentialed within the hospital system, are independently practicing, and have clearance for patient care in the inpatient and outpatient settings. Supervising Psychologists have offices located next to the fellow's office, and are available to the Fellow by page, email, phone and/or Teams (instant message) at all times during office hours.  

In the Department of Behavioral Health, the Fellow has their own office, computer, printer, furniture, phone and panic alarm system. The Fellow has access to the DSM-5, testing kits and manuals, as well as online scoring systems (e.g., Q-Global) within the department and/or their office. They are supplied with business cards and office supplies. They also are assigned a secretary to assist with any clerical needs and are assigned a Patient Liaison to assist with patient scheduling, check-in, and general management of their schedules.  

The fellow is provided with $1,000 allowance to assist with purchasing any continuing education related materials which may include books, EPPP study materials, journal subscriptions, professional memberships and/or licensing fees. The Fellow also has access to the hospital's journal subscriptions both in print in the Medical Library as well as online using the hospital's intranet for any research needs. 

Multidisciplinary teams occur throughout the hospital system. The Cystic Fibrosis clinic is within Gundersen Pediatric Specialties on the La Crosse Campus. During these clinics, supervisors and fellows do not have their own office space but rather meet with the team in a reserved conference room setting and then rotate in to see patients in exam rooms. The Pediatric Headache Clinic is within Gundersen Neurology on the La Crosse Campus. Fellows and supervisors meet with team members in Neurology to engage in warm handoffs. Patients are then seen in exam rooms and rounding occurs in a reserved conference room space. Computers with Epic for charting are available in the exam rooms of each department. The department hosting the multidisciplinary clinics is in charge of scheduling, rooming and collecting necessary insurance paperwork for patients seen. Fellows and supervisors then return to their offices in Behavioral Health for charting/dictation These departments are within the La Crosse Campus and fellows do not need to walk outside to access these departments. 

Due Process

Grievance 

*This is an optional but encouraged rotation

Faculty: Erin L. Beinborn, PsyD, LP, ABPP

Time Commitment (number of hours/week): 5 to 10 hours per week.  

The expectation is one testing case, report writing and feedback session per week. Fellows will have the option to do more as desired.

Goal of Rotation: To become proficient utilizing cognitive, achievement and executive functioning psychological testing measures; to integrate data to provide diagnoses and recommendations in a user-friendly report and communicate findings with caregivers.

Description of Patient Population: Children and adolescents (ages 3-18). Patients are typically referred from therapists, psychologists, psychiatrists, integrated care teams, and/or pediatricians looking for diagnostic clarification and assistance with treatment recommendations

Setting: Outpatient Behavioral Health, with occasional consultation to Inpatient Adolescent Psychiatric Unit. Testing is being conducted in-person. Feedback sessions occur in-person and virtually, depending on the state of patient residency.

Opportunities for Program Development: There are opportunities to expand testing and to integrate new tests to current protocols.

If yes, current projects: n/a

Opportunities for Research: No projects currently

If yes, current projects: N/A

Objectives:

At the end of this rotation you will be able to:

• Utilize standardized objective assessment measures following standardized protocols
• Score and interpret data findings and utilize in diagnostic decision making
• Write succinct, user-friendly reports, including practical recommendations tailored to the patient needs
• Conduct feedback sessions with caregivers answering questions and providing recommendations
• Provide feedback to referring clinicians. 

*This is an optional rotation

Faculty: Erin L. Beinborn, PsyD, LP, ABPP

Time Commitment (number of hours/week): 5 hours every other week.

Goal of Rotation: To become proficient with evaluating for headache and co-morbid concerns; to work collaboratively with multiple clinicians; to communicate behavioral health concerns; to develop an integrated treatment plan; and to teach pain management strategies to children, adolescents and their families to assist with management of headaches.

Description of Patient Population: Children and adolescents (ages 10-18) referred from across the hospital system, presenting with a variety of headache concerns.

Setting: Outpatient Neurology. Patients attend appointments in-person.  

Opportunities for Program Development: Yes. We have in the past run a headache pain management group. This is an option for interested fellows to conduct as is or to modify and improve. This group would be provided via telehealth.  

If yes, current projects: n/a

Opportunities for Research: Yes.

If yes, current projects: We recently concluded collecting data of numerous patients that received care in the headache clinic, as well as those who received standard care. We have significant data that can be utilized to investigate a wide range of research questions. Opportunities are available to an interested fellow.

Objectives:

At the end of this rotation you will be able to:

• Complete brief and focused initial evaluation of pediatric headache and co-morbid concerns
• Understand and integrate information and recommendations obtained from other clinicians (e.g., neurologists, nurse practitioners and nutritionists) to enhance case
• Conceptualization, diagnosis, and the development of treatment recommendations
• Provide effective, evidence-based interventions to address headache and pain management concerns; Common interventions include relaxation strategies; assistance with modification of daily life habits; problem solving strategies; behavioral reward plans to improve school attendance; recommendations for parents and positive self-talk.
• Collaborate with interdisciplinary team members; efficiently communicate treatment recommendations; and introduce/reinforce the benefits of behavioral and psychological interventions to address headache concerns
• Independently present information on the assessment and treatment of headache concerns to other clinicians and/or families at hospital or in the community 

*This is an optional rotation

Faculty: Erin L. Beinborn, PsyD, LP, ABPP

Time Commitment (number of hours/week): 12 hours per month.  

Goal of Rotation: To describe and explain the disease cystic fibrosis, as well as the challenges that lead to less than ideal management of the illness; To assess for mental and behavioral health concerns and provide intervention and recommendations to manage these concerns as they arise.

Description of Patient Population: Patients in the clinic are all ages. Patients are followed birth to death.  

Setting: Outpatient Pediatric Specialties

Opportunities for Program Development: Yes.  

If yes, current projects: We have current quality improvement projects regarding mental health screening as well as transition from dependent to independent care that fellows could participate or modify, if interested.

Opportunities for Research: Yes.

If yes, current projects: We currently do not have any projects but opportunities are available.  

Objectives:

• At the end of this rotation you will be able to:
• Define and explain the disease cystic fibrosis
• Identify barriers to care for patients with cystic fibrosis along the lifespan
• Assess for anxiety and depression in patients, communicate findings and provide recommendations as needed to manage these concerns 

*This is an optional rotation

Faculty: Sarah Long, PhD, LP

Time Commitment (number of hours/week): 10 hours per week

Goal of Rotation: To competently provide inpatient consultation/liaison services to Gundersen Pediatrics, Neonatal Intensive Care Unit and Pediatric Intensive Care Unit, joining with various medical teams to offer needed psychological services to children and teens with a variety of complex medical and mental health presentations.

Description of Patient Population: Children and adolescents (birth to 18 years) admitted to the hospital presenting with a variety of medical and psychological concerns including, but not limited to, psychogenic non-epileptic seizures; functional abdominal pain; uncontrolled diabetes mellitus; and chronic pain. A major component of the rotation is assessing safety after self-harm attempts. Family support is also provided in the NICU, including brief management of maternal mood concerns and difficulty coping with the stressors of their child's medical condition.

Setting: Inpatient

Opportunities for Program Development: Yes

If yes, current projects: Opportunity for refinement of the C/L service always exists. Examples of possible quality improvement projects include standardizing assessment procedures and developing treatment protocols for specific patient groups.

Opportunities for Research: No projects currently, but opportunities exist for interested fellows.

If yes, current projects: N/A

Objectives:

At the end of this rotation you will be able to:

• Complete a comprehensive inpatient consultation with children and their families that identifies emotional and behavioral comorbidities that are impacting a patient's medical care, barriers to treatment adherence and other psychosocial factors contributing to a patient's presentation.
• Utilize evidence-based interventions including behavioral therapy, cognitive-behavioral therapy and motivational interviewing to address acute psychological concerns associated with a hospitalization, treatment and/or adjustment to medical condition.
• Interact competently with inpatient and outpatient interdisciplinary team members, including physicians, nurses, physical therapists, speech therapists, occupational therapists, child life specialists, social workers and dieticians to promote the benefits of psychological services on the inpatient units of the hospital for children with acute and chronic medical conditions.
• Understand the medical recommendations/considerations for children hospitalized with a variety of chronic conditions (e.g., chronic pain, diabetes mellitus, and psychogenic non-epileptic seizures) and incorporate them into treatment planning and interventions.
• Provide clear and concise conceptualizations and recommendations to patients, families and the medical teams that identify present concerns/comorbidities, ongoing outpatient treatment needs and resources provided to the patient. 

Faculty: Sarah Long, PhD, LP and Erin Beinborn, PsyD, LP, ABPP

Time Commitment (number of hours/week): 15-20 hours per week

*This is a required rotation

The expectation is that the fellow is in Gundersen Behavioral Health conducting individual outpatient evaluations and psychotherapy under the supervision of Drs. Long and Beinborn during this time. The fellow conducts two to five new patient evaluations (varies depending on active caseload) during this time; 10 to 15 time slots are reserved for ongoing psychotherapy. Services are provided in-person and through telehealth. Approximately 75 percent of outpatient therapy services are provided via telehealth.

Goal of Rotation: Fellows will provide specialized outpatient pediatric psychology care to patients with chronic or acute medical conditions, as well as other general mental health concerns. Fellows will competently provide individual pediatric psychology evaluations and psychotherapy on an outpatient basis.

Description of Patient Population: Children and adolescents (birth to 18), generally with co-occurring medical and psychological concerns.

Setting: Outpatient within Gundersen Behavioral Health

Opportunities for Program Development: Yes

If yes, current projects: Opportunity for refinement of the outpatient service always exists. Examples of possible quality improvement projects include standardizing assessment procedures and developing treatment protocols for specific patient groups.

Opportunities for Research: No projects currently, but opportunities exist for interested fellows.

If yes, current projects: N/A

Objectives:

At the end of this rotation you will be able to:

• Complete a comprehensive outpatient evaluation with patients that identifies emotional and behavioral comorbidities that are impacting a patient's medical care, barriers to treatment adherence, and other psychosocial factors contributing to a patient's presentation
• Develop and implement a treatment plan with patients that include specific goals that address the physical and psychological health of patients
• Implement evidence-based interventions including behavioral therapy and cognitive-behavioral therapy with children and teens diagnosed with a chronic or acute medical condition, as well as mental health concerns
• Understand the medical recommendations/considerations for patients and incorporate these medical considerations into treatment planning and interventions; Function effectively and independently providing outpatient psychological services for children with chronic and acute medical conditions while communicating successfully with the medical team also involved in the patient's care.
• Collaborate with interdisciplinary team members to coordinate patient care; efficiently communicate treatment recommendations; and introduce/reinforce the benefits of behavioral and psychological interventions to address relevant concerns. 

*This is an optional, but encouraged, rotation

Faculty: Sarah Long, PhD, LP

Time Commitment (number of hours/week): 2-8 hours per week plus 1 hour for weekly Eating Disorder Team staffing

Goal of Rotation: To competently provide psychological evaluation and therapy for outpatients with eating disorder concerns. Fellows also attend the Eating Disorder staffing meeting and collaboration group, currently held virtually.  

Description of Patient Population: Children and adolescents (up to age 18), presenting with eating and feeding related concerns (e.g., Anorexia Nervosa, Bulimia Nervosa, ARFID)  

Setting: Outpatient within Gundersen Behavioral Health. Services are provided in-person and through telehealth, though most services are typically provided virtually.

Opportunities for Program Development: Yes

If yes, current projects: n/a

Objectives:

At the end of this rotation you will be able to:

• Complete psychological evaluations with individuals referred for eating disorders
• Utilize evidence-based interventions including behavioral therapy, cognitive-behavioral therapy and motivational interviewing to address behavioral and psychological symptoms.
• Attend and participate in multidisciplinary team staffing and make recommendations/collaborate with the team, as appropriate. 

*This is an optional rotation

Faculty: Sarah Long, PhD, LP

Time Commitment (number of hours/week): Two to four hours per week plus one hour for monthly team staffing

Goal of Rotation: To competently provide psychological evaluation and therapy for outpatients with gender identity concerns; Fellows also attend the monthly transgender team staffing meeting (either in person or virtually)

Description of Patient Population: Children and adolescents (up to age 18) who present with gender identity concerns

Setting: Outpatient within Gundersen Behavioral Health; all evaluations completed in person with opportunities for virtual visits with ongoing follow up

Opportunities for Program Development: Yes

If yes, current projects: n/a

Objectives: At the end of this rotation, fellows will be able to:

• Complete psychological evaluations with individuals referred for gender evaluations prior to medical intervention
• Utilize evidence-based interventions, including behavioral therapy and cognitive-behavioral therapy, to address psychological symptoms related to gender identity concerns and other underlying psychological concerns, as needed
• Attend and participate in multidisciplinary team staffing and make recommendations/collaborate with the team, as appropriate