Clinical Child Psychology

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The Mayo Clinic Clinical Child/Pediatric Psychology Postdoctoral Fellowship is a two-year program accredited by the APA-Commission on Accreditation. The program is well suited to learners seeking comprehensive, personalized training to prepare them for the highest level of certification in clinical child/pediatric psychology and for a trajectory of leadership in academic medicine.

The program is highly flexible to allow you personalized training across clinical, research, educational, and other professional activities. Fellows typically engage in activities across clinical child and pediatric psychology, with integration of complex mental health and medical concerns frequently present in practice.

Personalized training plans and progress review are guided by specialty competencies as defined by Council of Specialties in Professional Psychology and the Clinical Child Psychology Specialty Council and the American Board of Clinical Child and Adolescent Psychology. As such, fellows’ training has both breadth and depth. You develop broad advanced-level competencies, facility with evidence-based practices across common psychiatric and health problems presenting in childhood and adolescence, and the ability to work with children and families facing complex, multi-diagnostic concerns. As for depth, fellows also develop expertise in an area of interest through targeted selection of clinical, research, and other professional activities.

Our faculty have diverse interests and expertise. Areas of faculty expertise include:

Intensive Group-Based Treatments (Whiteside, Biggs, Harbeck-Weber, Sim, Matthews)
Anxiety Disorders and OCD (Whiteside, Biggs)
Mood Disorders (Matthews)
Chronic Pain and other Somatic Symptom Disorders (Harbeck-Weber, Sim, Hilliker, Biggs, Weiss)
Consultation-Liaison Services (Hilliker, McCarthy)
Health Promotion and Weight Management (Biggs)
Psychiatric Inpatient Consultation (Matthews)
Disordered Eating and Feeding-Related Concerns (Sim, Lebow, Hilliker, Matthews)
Coping with and Management of Chronic Illness and Treatment Demands (Hilliker, McCarthy, McTate)
Integrated Behavioral Health in Primary Care (Lebow, Cassidy)

Personalized training plan

As a fellow, you work with the specialty director, primary clinical supervisor, and primary research supervisor to develop your overarching training plan, which includes selection of rotations, types of outpatient therapy cases, research projects, and other professional activities linked to your training needs and interests. Training plans are flexible and responsive. You review your training plan with the program and specialty directors and your primary supervisor every 6 months.

While the fellowship is primarily clinical, the 30 percent protected time for supervised research makes it well-suited for those pursuing academic practice. Clinical activities include carrying an ongoing outpatient therapy caseload (20 percent time) and rotations in specialty services (40 percent time).

Rotation descriptions

The following are brief overviews of clinical rotations within the Child Psychology track.

Pediatric Psychology Consultation and Liaison (CL) Service within the Inpatient Medical Hospital

Fellows work alongside CL providers to field consult requests from the general pediatric hospital service and a wide range of pediatric subspecialties (gastroenterology, neurology, hematology/oncology, endocrinology, etc.), as well as surgery, critical care, physical medicine and rehabilitation, and palliative care. Consultations often focus on child and family adaptation to chronic illness or acute injuries, differential diagnosis within the context of medically unexplained symptoms, and development of behavioral plans to assist with treatment optimization. Fellows interact closely with our colleagues in pediatrics, nursing, social work, child life, and chaplain services. Opportunities exist for the fellow to participate in the intensive behavioral feeding program.

Pediatric Pain Rehabilitation Center (PPRC)

The PPRC is a three-week intensive outpatient interdisciplinary program for adolescents and young adults, ages 13 to 21 years, with chronic pain, autonomic dysfunction, and other chronic symptoms which negatively affect functioning. Treatment consists of psychoeducational and cognitive behavioral groups focused on pain and stress management skills, as well as physical, occupational, and recreational therapy. Parents attend parenting groups on how to support their child’s treatment plan. Fellows have the opportunity to conduct evaluations and brief psychoeducational assessments, lead both teen and parent groups, attend medical rounds, and see patients for individual and family consultations.

Pediatric Anxiety Disorders Clinic (PADC)

The PADC offers assessment services and both individual and group-based treatment either through a once-weekly or intensive outpatient format to families of youth who are struggling with significant anxiety. Through the PADC, fellows gain experience administering structured diagnostic interviews, integrating assessment information from multiple sources (clinical interview, parent and child report forms) into a treatment plan, and working in a multidisciplinary clinic. Fellows work alongside PADC providers to facilitate parent-coached exposure therapy through the weekly groups and intensive treatment program. Fellows are encouraged to participate in a weekly PADC Team Meeting during which the maintenance of the anxiety clinic practice, research projects, and case consultation is discussed.

Psychology Consultation Service within the Inpatient Psychiatric Hospital

Fellows gain familiarity with acute inpatient psychiatric care as a member of a multidisciplinary team. Fellows gain experience with providing consultation services regarding behavioral interventions that may be beneficial to patients while on the unit or in aftercare planning. Fellows work with the rotation supervisor as a multidisciplinary team member, participate in treatment rounds, and provide consultation services as part of the treatment team. Fellows shadow the designated supervisor, psychiatrists, and nurses in clinical duties and, once they have a foundation of treatment principles and skills relevant to this context, begin to take the lead on provision of psychological consultation services including brief consultation with parents and patients regarding follow-up care approaches, behavioral management strategies, communication and problem-solving skills as well as behavioral activation and safety planning.

*Note: Activities on this rotation are typically less than the 16-20 hours/week allocated to rotations and are typically combined with the Pediatric Mood Disorders Clinic.

Pediatric Behavioral Weight Management Clinic

In this multidisciplinary rotation, fellows gain experience conducting structured functional behavioral assessments of eating and physical activity habits, assessing for psychological comorbidities and obtaining psychosocial history via interview and standardized assessment battery, and developing treatment plans. Fellows also have the opportunity to follow patients for family-based behavioral weight management intervention, and to participate in psychological evaluations and behavioral interventions with adolescents interested in bariatric surgery. Opportunities also exist for fellows to observe participate in program development, evaluation, and research related to pediatric weight management and health promotion.

*Note: Activities on this rotation are typically less than the 16-20 hours/week allocated to rotations and are typically combined with other rotation experiences.

Pediatric Behavior Medicine Clinic (PBMC)

Patients often present to this consultation-based clinic with complex and sometimes rare medical issues, including autonomic dysfunction or unexplained pain, nausea, vomiting, diarrhea, and dizziness. Other frequent conditions include somatoform disorders and conversion disorders. Fellows develop proficiency in conducting diagnostic interviews to identify comorbidities in need of psychological intervention, as well as in formulating and delivering brief feedback to youth and their families. Fellows also build experience discussing the rehabilitative approach to managing symptoms, including connections among physical symptoms, thoughts, and feelings. Furthermore, fellows are able to shadow physicians and medical teams working with these complex patients.

Pediatric Integrated Behavioral Health (Primary Care)

Fellows on this rotation have the opportunity to provide psychological care within an active interdisciplinary primary care center. Fellows gain experience conducting brief evidence-based assessments and interventions, participating in warm hand-offs and case triage, and providing consultation for pediatric and family medicine providers. Fellows are encouraged to attend weekly multidisciplinary case consultation meetings, as well as attend and potentially help run monthly didactic trainings on the provision of evidence-based psychological interventions. Opportunities for program development also exist, with an emphasis on population-based care (groups, care coordination programs etc.).

*Note: This rotation is typically offered in Year 2 after demonstration of relevant competencies and foundational experiences.

Pediatric Neuropsychology

Rotations in pediatric neuropsychology are tailored to the fellow’s level of experience and interests, and thus range from primarily observation-based experiences to conducting brief psychosocial interviews and contributing to testing reports and feedback sessions. Opportunities exist to engage with the pediatric neuropsychology service through three main areas of practice: (1) assessment of current functioning in children with complex medical presentations (traumatic brain injury, seizure disorder, brain tumors, etc.) on referral from medical specialties, (2) evaluation for developmental concerns (autism spectrum disorder, pragmatic communication disorder, etc.) in young and school-aged children presenting to the Dana Clinic (a multidisciplinary team comprised of pediatric neuropsychology, developmental and behavioral pediatrics, and speech and language clinicians), and (3) assessment of developmental disabilities, learning issues, and social-emotional functioning in children followed in the multidisciplinary Craniofacial Clinic.

Consistent with postdoctoral specialty training, fellows’ training plans include at least 90 percent of activities within the clinical child/pediatric psychology specialty, with up to 10 percent time afforded for exposure to pediatric neuropsychology, adult health psychology, and other areas (e.g., Sleep Medicine, Transgender and Intersex Clinic, etc.).

These example training plans demonstrate how various experiences can be combined to support individual goals:

Chronic pain training plan

Highlighted aspects of training opportunities geared towards a fellow interested in developing expertise in chronic pain could include:

Rotations:
- Pediatric Pain Rehabilitation Center to work with patients doing the intensive multidisciplinary program and to gain with curriculum development experience
- Pediatric Behavior Medicine Clinic to provide consultation related to chronic symptom management
- Briefer rotation in Consultation/Liaison to provide consultation to patients with chronic symptoms in the inpatient environment
- Briefer rotation in Pediatric Anxiety Clinic and/or Pediatric Mood Clinic to round out skills in clinical child assessment and evidence-based treatments
Outpatient caseload: Focus on referrals to therapy for chronic pain management and/or coping with illness or treatment demands
Research:
- Supervision and mentorship from Drs. Harbeck-Weber and Sim
- Projects involving investigating parenting factors related to chronic pain presentation and response to treatment
- Participation in quarterly meetings of an interdisciplinary workgroup focused on research to understand autonomic dysfunction in adolescents
Observational/Exposure experiences: Shadowing medical providers in pediatric pain medicine, neurology, the Mayo Clinic autonomic dysfunction clinic, and Adult Pain Rehabilitation Program
Educational experiences: Mentored experience teaching a course on chronic pain for medical students

Anxiety disorders and obsessive compulsive disorders training plan

For a fellow interested in childhood anxiety disorders and obsessive compulsive disorders, the training plan could include:

Rotations:
- Pediatric Anxiety Disorders Clinic to gain experience in evidence-based assessment of anxiety disorders and OCD and in parent-coached group-based exposure-focused therapy (weekly groups and 5-day intensive program)
- Pediatric Mood Clinic and Pediatric Pain Rehabilitation Center to gain familiarity with assessment and intervention for conditions commonly comorbid with anxiety disorders
Outpatient caseload: Focus on referrals for anxiety-related concerns for additional opportunities to provide exposure-focused therapy to individual youth and their families, with additional referrals for mood disorders including some with complex medical presentations, as well as some behavior management-focused cases to round out clinical child skills
Research:
- Supervision and mentorship from Drs. Whiteside and Biggs
- Projects involving evaluating clinic outcomes and/or technology-facilitated delivery of exposure therapy
Educational Experiences: Umbrella supervision of a psychiatry resident or fellow in the delivery of exposure therapy

Supervision and mentorship

You will choose an outpatient therapy supervisor (one for each year of the fellowship) who serves as your primary clinical supervisor, as well as a lead research supervisor for the duration of fellowship (though opportunities exist to engage in collaborative research endeavors with multiple faculty).

Each week, fellows engage in an hour of supervision with their primary clinical supervisor, focused largely on your outpatient therapy caseload and professional development goals.

Faculty approach supervision and training from a developmental model. Fellows work alongside faculty as apprentice junior colleagues and transition from observing to co-facilitating to operating independently with supervision. Opportunities for learning and mentorship exist across the broader psychiatry and psychology faculty, as well as faculty from other specialties (pediatrics, endocrinology, neurology, etc.).

Less formal learning and mentoring opportunities are abundant. For example, fellows have gained experience in program development by supporting faculty in revamping a clinical program, gained insight into interdisciplinary practice through observing team members and referring providers from other specialties, learned about the peer review process by co-reviewing journal submissions with faculty, and learned about grant writing through writing mentored proposals.