Consultation-liaison services
The consultation-liaison
psychiatry service is designed to respond rapidly to the clinical needs of both
the outpatient clinics and the
inpatient units of the hospital. Clinical activities include evaluation
and treatment of medical patients and consultation with physicians, nurses,
and allied health care
personnel within the hospital. Interns participate in the service during a four-month
rotation.
Physicians frequently request psychological assessment
of children both pre- and post-surgery, consultation regarding the psychological
factors contributing to a child’s physical condition, assistance in helping a
child deal with difficult medical treatments, planning a program to help a child
comply with medical
treatment after an illness or surgery, consultation regarding
treatment for a child admitted after a suicide
attempt, or treating such psychophysiologic disorders as abdominal pain, headache, psychogenic vomiting,
enuresis or encopresis.
Presently, the consultation-liaison ervice provides regular coverage to
several of the major pediatric services, including general medical
outpatient services, neurology, neurosurgery, urology, endocrinology,
hematology-oncology, the pain program and to all services on the inpatient
floors.
A variety of assessment and treatment approaches are used by
the service, but behavioral interventions are most often employed because of the
unique problems that present in the medical setting. Psychological assessments of all kinds
are also very useful within the medical setting, and assessment plays a vital
role in the work of the psychologists and interns on this service.
After the initial evaluation and treatment, the psychologist may provide
outpatient services on a long-term basis, including individual, behavioral, or
family therapy as needed. Other
outpatient medical psychology services, which consist of outpatient psychiatric
services to patients with medical complications, fall under the auspices of the
outpatient services team. Interns devote
three to four hours per week for the entire year to outpatient medical
psychology.
Other opportunities to work with particular illnesses or clinics are
available in medical psychology and are arranged on an individual basis, often
in conjunction with research interests and opportunities. Examples of such opportunities include
work with the HIV team, the
renal transplant team, or the Neonatal Intensive Care Unit.