Pediatric psychologists

Pediatric psychology developed to address unmet needs for psychological services in the pediatric setting and the field blends together several distinct areas in psychology (such as behavioral medicine, health psychology, developmental psychology, etc.) (Roberts, Maddux, Wurtele, & Wright, 1982 ). Pediatric psychology is an integrated field of science and practice in which the principles of psychology are applied within the environment of pediatric health. The Society of Pediatric Psychology (SPP, Division 54) resides under the American Psychological Association (APA), see http://www.apadivisions.org/division-54/index.aspx. SPP aims to promote health and psychological well-being of children, adolescents, and their families through the promotion of evidence-based science and practice, education, training, and advocacy. The field was founded in 1969 and includes a broad interdisciplinary foundation, drawing on clinical, developmental, social, cognitive, behavioral, counseling, community and school psychology.

Pediatric psychologists work in a variety of settings and fulfill various roles such as (Spirito, 2003 ): (1) Providing psychosocial services for problems related to pediatric health conditions

(2) Psychological services for mental health problems appearing in medical settings—which involves mental issues related to medical conditions or the treatment of them, coping related to chronic and acute illnesses, adherence, quality of life, pain, traumatic medical stress, adjustment related issues on the psycho-social continuum, school reintegration, and behavioral problems

(3) Psychological services for mental health problems without concomitant health condition

(4) Programs for promotion of health/prevention and early intervention

(5) Provide assistance for those with Mental retardation and/or developmental disabilities

(6) Psychological training and consultation for physicians

(7) Public health and public policy. Interventions are not just illness-related, but address behavioral problems as well. The settings that pediatric psychologists work in allows for brief interventions that are economical and time efficient. Collaboration with the health care providers allows for more targeted assessment and interventions.

Pediatric healthcare providers seem to value the work of Pediatric Psychologists (Stancin, Perrin, and Ramirez, 2009): "Recently, a surge of interest by pediatricians on the identification and care of children with mental health problems has resulted from the recognition that:

• Precursors of mental health disorders in adulthood can often be identified in early childhood (e.g. Anda et al., 2007 )

• At least 10% of children and adolescents have functional impairment due to a diagnosed mental health and/or substance abuse disorder (U.S. Department of Health and Human Services, 1999 ), and up to 25% have clinically significant problems that may not (yet) rise to the level of a diagnosable psychiatric disorder (Briggs-Gowan et al., 2003 ).

• There is a shortage of qualified mental health clinicians, especially for children younger than 5, and for families in middle-and-low income groups and/or of minority background.

• Primary care settings provide the most accessible and least stigmatizing resources for many families who have concerns about their children's developmental and/or behavior. "

Areas of Expertise
According to the work of a recent task force commissioned by the Society of Pediatric Psychology, Division 54 of the American Psychological Association, 12 topic areas adapted from Roberts et al. (1998) were identified as important areas of expertise in pediatric psychology:

The field of pediatric psychology recognizes that pediatric conditions have emotional/psychological aspects, the presenting problems require integrated medical-psychological interventions, and traditional pediatric and/or clinical psychology could not meet the needs.
 * 1) lifespan development
 * 2) Lifespan developmental psychopathology: the effects of one's disease and medical regimen on emotional, social, and behavioral development; additionally, normal developmental milestones may be used such that preventative efforts can be created and well-child visits can include a psychological-developmental perspective
 * 3) Child, adolescent, and family assessment: experience with the assessment of health-related concerns such as health promotion, health risk, health outcome, and quality of life
 * 4) Intervention strategies: Exposure to and experience with empirically supported interventions specifically applicable in pediatric psychology and delivered in health care settings
 * 5) Research methods and systems evaluation: Exposure to research design issues especially pertinent to pediatric psychology such as health services research and clinical trials
 * 6) Professional, ethical, and legal issues pertaining to children, adolescents, and families: knowledge and experience with issues such as health care delivery, practice of psychology in medical settings, and rights of caregivers vs. children when making decisions regarding medical care
 * 7) Issues of diversity: Experience with patients from diverse ethnic and cultural backgrounds, as well as sexual orientations, in health care settings and understanding of nonmainstream health practices influenced by a family's cultural or religious beliefs
 * 8) The role of multiple disciplines in service-delivering systems: Experience on multidisciplinary teams delivering health care services
 * 9) Prevention, family support, and health promotion: understanding the principles of behavior change as they relate to healthy development, health-risk behavior, and prevention of disease in adulthood
 * 10) Social issues affecting children, adolescents, and families: exposure to and experience with advocacy in pediatric health care including social issues that affect health care delivery
 * 11) Consultant and liaison roles in health care settings: Exposure to different consultation-liaison models and supervised experience providing consultation
 * 12) Disease process and medical management: A basic understanding of various diseases and their medical management.