**Please note that all rotation opportunities may vary year to year depending on service volume as well as individualized training needs.

Required Clinical Activities  

  • Outpatient Pediatric Psychology Clinic (12 months):  Fellow’s will manage a small caseload of outpatients to continue to build a strong foundation of general child clinical diagnostic, interview, and intervention skills while allowing the fellow to focus on areas of clinical interest or need.  The fellow’s outpatient psychotherapy clinic will consist of patients that have been referred from medical rotations or from community pediatricians. Supervision is typically provided in cognitive-behavioral and family systems intervention strategies with special attention to evidence based techniques.  Case supervisors are selected based on their area of expertise relative to the patient’s presenting problem. Supervisors:  Drs.
    Foster, Klein, Mayersohn, Richter, Shelton, and Thompson.
  • Craniofacial/Cleft-Palate Clinic (12 months): Fellows will participate in this weekly multidisciplinary clinic conducting brief psychosocial assessments with children with cleft palate and other craniofacial anomalies and providing anticipatory guidance. The multidisciplinary team consists of representatives from surgery, speech pathology, audiology, genetics, ENT, orthodontics, and dentistry. The fellow will participate in rounds at the end of clinic, reporting relevant findings and assisting in determining treatment recommendations. Fellows will also provide clinical supervision to graduate students who participate in this clinic.  Fellows may follow children from this clinic in their outpatient psychotherapy clinic for assistance with presurgical preparation, behavioral/emotional adjustment, and peer issues. Supervisor: Dr. Cradock.

Primary Specialization (year-long)

The fellow will select one of the following:

  • Solid organ transplant: St. Louis Children’s Hospital is one of the pioneers in pediatric organ transplantation and remains one of the most active transplant programs in the world. The goal of this rotation is to introduce the fellow to the unique issues facing families with end stage organ disease and who are preparing for solid organ transplant.   They will learn protective factors for transplant success and intervention strategies to address potential psychosocial risk factors for future graft failure.  The fellow will conduct 2-4 pre-transplant evaluations per month with families whose children are preparing for lung, heart, liver, kidney or multi-organ transplant. The fellow will have the opportunity to follow the family through the transplant process, both inpatient and outpatient.
    Additionally, fellows will have the opportunity to work with patients on dialysis prior to transplant referral. Typical issues addressed include coping with diagnosis, illness adjustment, behavioral concerns, anxiety, adherence, and palliative care. Fellows will participate in monthly multidisciplinary cardiac neurodevelopment clinic. Consultation with the transplant teams and attendance at multidisciplinary team meetings are integral parts of this rotation. Supervisor: Dr. Mayersohn.
  • Hematology/Oncology:  The pediatric hematology/oncology program at St. Louis Children’s Hospital is the largest comprehensive program for children with blood diseases or cancer in the region. The fellow will follow children who have received a cancer diagnosis through inpatient and outpatient evaluation and treatment.  The fellow will play an active role in weekly psychosocial oncology rounds. There is an opportunity to do pre-bone marrow transplant (BMT) evaluations and follow families through the BMT process to address adherence and adjustment issues as needed.  Typical issues addressed include coping with a new diagnosis, illness adjustment, behavioral concerns, anxiety, and palliative care. Supervisor:  Dr. Foster.
  • Medical Consultation/Liaison: The fellow will provide inpatient consultation/liaison services at St. Louis Children’s Hospital.  This service will include diagnostic interviews, ongoing inpatient psychotherapy, consultation with medical teams, attendance at care conferences, and multidisciplinary rounds. The variety of inpatient consults seen is typical of a pediatric psychology consultation/liaison service in a tertiary care center. We also are able to tailor assignment of cases to training needs and interests of the fellow. Appropriate inpatient cases will transition to the fellow’s outpatient psychotherapy clinic. Supervisors: Dr. Skedgell.

Elective Clinical Focus:

The fellow can elect to choose a minor area of clinical focus.

  • Pain:  The fellow will have the opportunity to work with children and adolescents with acute or chronic pain.  The fellow will work closely with The Division of Pediatric Gastroenterology, Hepatology, and Nutrition for treatment of abdominal pain and Pediatric Neurology Services for treatment of headache pain.  Additionally, the fellow will participate in treatment of complex pain issues through the St. Louis Children’s Hospital Multidisciplinary Pain Management Clinic.  The fellow has access to and will utilize biofeedback in treatment of pain in addition to gaining experience with assessment techniques and cognitive behavioral pain interventions.  Supervisors: Drs. Shelton & Thompson.
  • Other areas of clinical focus may be available throughout the training dependent upon fellow interest and experience, supervisor availability, and service line availability. Some previous (potential) clinic areas may include, but are not limited to: Adherence, Pre-Surgical Evaluations, Working with Gender Diverse Youth, Sleep.