The Clinical Child and Pediatric Psychology Program
The faculty of the Northwestern University Medical School accepts one student per year to receive clinical and research training in child and pediatric psychology. The goals of this program are to enable the student to develop the clinical skills necessary to function as a clinical child psychologist, and to develop critical research skills in the areas of child psychopathology and child mental health services. Graduates of this program will be well prepared to pursue a career as a clinical scholar in an academic medical center.
Fundamental to training in the program is the development of clinical skills with both adults and children. A broad and sophisticated knowledge in clinical psychology is developed through departmental coursework and mentored clinical and research experience. Typically, students in this concentration participate in a year-long training sequence at Children’s Memorial Hospital in psychological and neuropsychological testing. This is followed by an additional year in the evaluation and treatment practicum at Children’s Memorial Hospital. This may be supplemented by additional supervised training at the Warren Wright Adolescent Center, along with the required adult practica.
The research activities of this program involve the following:
* To improve the clinical services provided by practicing child clinicians in mental health settings: The gap in the outcomes of child treatment in randomized clinical trails versus clinical settings is well-known. Our research team is engaged in an examination of psychological treatments in mental health settings, what treatments work with what patients, and what factors are associated with successful, clinic-based treatment.
* To extend empirically supported treatments beyond the tertiary care mental health services system: Over the past 15 years, our research team has been examining the role of psychology and psychological services in primary care pediatrics. This has included NIMH-funded studies of pediatricians' ability to identify children with behavior problems, and the study of interventions in primary care for the treatment of oppositional defiant disorder in young children. We have completed studies of the treatment of Oppositional Defiant Disorder in young children in primary care, and plan to conduct further studies examining a stepped care procedure for treating ODD in primary care (two reports currently in press). Presently, an NIMH-funded study is being conducted to determine whether specialized training in the use of guidelines for pharmacologic treatment of ADHD improves the quality of care compared to community treatment as usual. Another project, with which graduate students are very involved, examines the factors associated with positive outcomes of children receiving "real world" psycholotherapy, including patterns of change and predictors of patient responsiveness. A paper resulting from that project, examining the predictors and consequences early gains in child psychotherapy, is currently in press. We view the process of understanding "what works" as an important complement to efforts to translate the results of randomized controlled trials to clinical practices through the use of manuals, etc.
* To increase our understanding of the psychopathology of children in order to improve the quality of services being provided: NIMH-funded studies have examined the prevalence and stability of young children's behavior problems. Presently, an NIMH-funded study examining factors associated with the onset and stability of oppositional defiant disorder and depression, as well as the comorbidity of these two disorders.
The guiding principles underlying this
program are:
* Advances in psychological treatments for children will occur most rapidly through a process involving the development of empirically supported treatment through efficacy and process studies.
* To influence public policy and public mental health practices, it is essential to translate the results of those efficacy studies into treatments that can be used by practicing clinicians (effectiveness studies).
* The translation of efficacy research into clinical practice should be supplemented by a reciprocal process involving the examination of the current practices of clinicians and improving those practices through continuous quality improvement practices and patient-focused research.
* Traditional service delivery through the mental health services system is not sufficient to reach the many children who need psychological services. Epidemiologic and services studies have demonstrated that large numbers of children with psychiatric disorders are not served in the mental health services system. As a consequence, extending services into other areas, such as schools and primary care health systems, is necessary. As a medical school/hospital-based training program, one of our priorities is to study the process of integrating psychological services into primary care pediatrics.
References (since 2001):
Cromley, T. & Lavigne, J. V. (2008). Predictors and consequences of early gains in child psychotherapy. Psychotherapy: Theory, Research, and Practice, 45(1), 42-60.
Lavigne, J. V., LeBailly, S. A., Gouze, K. R., Cicchetti, C., Jessup, B. W., Arend, R., Pochyly, J., & Binns, H. J. (2008). Predictor and moderator effects in the treatment of Oppositional Defiant Disorder in pediatric primary care. Journal of Pediatric Psychology, 33(5), 462-472.
Lavigne, J. V., LeBailly, S. A., Gouze, K. R., Cicchetti, C., Pochyly, J., Arend, R., Jessup, B. W., & Binns, H. J. (2008). Treating Oppositional Defiant Disorder in Primary Care: A comparison of three models. Journal of Pediatric Psychology, 33(5), 449-461.
Soriano LeBovidge, J., Lavigne, J.V., & Miller, M. L. (2005). Adjustment to chronic arthritis in childhood: The roles of illness-related stress and attitude toward illness. Journal of Pediatric Psychology, 30, 273-287.
Soriano LeBovidge, J., Lavigne, J.V., Donenberg, G.R., Miller, M. L. (2003). Psychological adjustment of children and adolescents with chronic arthritis: a meta-analytic review. Journal of Pediatric Psychology, 28:1 , 29-39.
Lavigne, J.V., Cicchetti, C., Gibbons, R.D., Binns, H.J., Larsen, L., and DeVito, C. (2001). Oppositional defiant disorder with onset in preschool years: Longitudinal stability and pathways to other disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 40:12 , 1393-1400.
Karen Gouze, Ph.D.
Children’s Memorial Hospital faculty (clinical training)