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Pediatric Psychology Postdoctoral Fellowship Program

CHOC Children’s (Children’s Hospital of Orange County) (CHOC) is pleased to offer up to 6 one-year, full time, postdoctoral fellowships in the Department of Pediatric Psychology. The training year begins on August 28, 2017 and ends on August 24, 2018. The postdoctoral fellowships are a part of the Psychology Training Program that includes an APA accredited internship. The postdoctoral fellowships at CHOC offer advanced training in the areas of pediatric and/or child psychology. The goal of the training program is to allow fellows to further their professional development so that they can function independently as a psychologist across a wide variety of settings. The training program is designed to allow for the natural progression from internship training, where a variety of new clinical skills are learned, to a greater focus on the application of these skills with an increasing degree of independence. Along with this emphasis, training increasingly focuses on the development of professional skills necessary for independent functioning (professional development areas include serving as a consultant within specific medical teams, program development,,licensure and/or grant writing). Fellows will receive training in assessment and consultation within a medical/clinical setting as well as additional experiences with more traditional intervention or assessment outpatient cases.

Childhood chronic illness is a significant health concern. As medical treatments improve, more children are living longer with chronic illnesses. It has been estimated that 15 to 18% of children in the US are living with a chronic illness. Of these, about half experience a restriction in their ability to participate in typical activities. Medically fragile children and their families experience a wide range of unique stressors, yet many do not have access to quality mental health services. Uniquely tailored psychological services, such as specialized assessments, psychosocial support, more intensive psychotherapy, and consultation with medical teams can have a very positive effect on quality of life for children and their families. In recognition of these positive effects, children’s hospitals and clinics are increasingly working closely with psychologists and other mental health professionals to provide comprehensive services to their patients. The psychology post-doctoral fellowships at CHOC Children’s seek to train psychologists to work effectively with medically fragile children and their families within the context of hospital based inpatient, clinic, and outpatient services. This is a particularly exciting time to be a part of pediatric psychology as the medical field increasingly understands the critical role of psychological factors in overall health and thus is increasingly involving psychology services into standard health care services. Fellows will apply their knowledge of child development and their skills as a child therapist to children affected by medical illness through a wide variety of experiences, such as inpatient consultation-liaison services to a variety of medical specialty units, more intensive experiences with specific medical specialty teams, and outpatient therapy. In addition to the intensive experiences with children with medical diagnoses, fellows will work with more traditional child outpatient therapy and/or psychological and neuropsychological assessment cases.

In order for the fellow to take a leadership role in program, our fellowships are designed to focus in a primary area.  This focus allows fellows opportunities to work with teams over a year long period and to develop mastery of these skills.

One of the clinical fellowships will primarily work with the oncology program, one-two fellows will primarily work with the CHOC Consultation and Liaison Team, and two will work with our Co-Occurring Clinic offering mental health services to children with co-occurring medical and mental health conditions. Depending on funding, an additional fellowship may be available working with the Neurology Service, with a focus on neuropsychological assessment. Fellows will coordinate with the respective medical teams throughout the year, participating in clinical work, program development and clinical research activities within the teams. Fellows will see more complex cases and be responsible for further developing clinical services with the medical teams. They will participate in outpatient clinics with the multi-disciplinary medical teams, provide inpatient consultation services to patients followed by the medical team, and potentially submit a poster and/ or write a paper within their area of specialization.

Pediatric Psychology Post-Doctoral Fellowship – Clinical Focus (up to 6 positions)

I.  Oncology Track (1 position):

The fellow will work with the Oncology Medical team and the interdisciplinary psychosocial team (which includes psychologists, social workers, child life specialists, teachers, and chaplain) to provide coordinated services to children diagnosed with cancer and their families. Fellows will be involved with the new diagnosis program, which includes initial coping assessments of all newly diagnosed patients and their families. After these individualized initial assessments, the fellow will provide ongoing therapeutic services as needed to each child/family (in both medical inpatient and outpatient settings). Therapeutic services include assisting children and families in the initial adjustment to a new cancer diagnosis and facilitating effective coping, helping parents and/or the medical team with behavioral management issues, psychotherapy to address pre-existing or secondary mental health issues (e.g., depression, anxiety), pain management assistance, and help in dealing with death and dying issues as well as with survivorship issues. In addition, the fellow may assist in school reintegration activities, which includes working with children who are ready to return to the school setting after completing their intensive treatment or who are struggling in school after completing their treatment. Activities might include assessments to determine their particular learning strengthens and challenges, working with schools to develop appropriate educational programs (which might include attending IEP meetings), presenting educational programs in the schools to fellow students and/or teachers, or providing psychotherapy to reduce anxiety or depression.

In addition to the experiences working with the medical teams described above, the fellow will also participate in a range of other pediatric psychology experiences described below in the section, “Activities Common to All Tracks.”

II.  Consultation and Liaison Track (1-2 positions):

One to two fellow(s) will work with the Consultation and Liaison Team which provides inpatient consultation to the medical units at Children’s Hospital of Orange County. Common consults include ruling out psychosomatic causes of medical symptoms, assessing depression and anxiety and providing referrals and/or treatment, teaching children and families non-pharmacologic pain control strategies, acute stabilization of children or adolescents with eating disorders, neurologic complications, acute stress reactions, and adjusting to a new medical diagnosis. The fellow will work with interdisciplinary psychosocial teams (social workers and child life specialists) as well as with nurses, medical attendings and house staff (medical residents and fellows) as well as medical students, and case managers. Depending on the diagnosis, physical and/or occupational therapists, dieticians, pharmacists, and other specialists might also be involved. Fellows will attend medical rounds on several floors to provide information to medical professionals. The fellow will have the opportunity to run psychosocial rounds on the Medical-Surigical Floors on a weekly basis. The fellow will also have an opportunity to work closely with the Pediatric Intensive Care Unit (PICU) at CHOC. The PICU team consists of attendings, fellows, medical residents, social work, child life, psychology, nutrition, pharmacists and physical and occupational therapists.

The fellow will have the opportunity to participate in the research activities of the UCI Center on Stress and Health. The UCI Center on Stress and Health is part of the Department of Anesthesiology and Perioperative Care, at the University of California-Irvine (UCI) and Department of Pediatric Psychology at CHOC Children’s (CHOC). The Center on Stress and Health is a collaborative group from diverse areas in medicine, nursing, and psychology. Under the Direction of Dr. Zeev Kain, and Dr. Michelle Fortier, the center conducts cutting edge research on children’s health with particular interests in medical anxiety and pain. The Center on Stress and Health was first established by Dr. Kain under the name, the Center for the Advancement of Perioperative Health (CAPH) which relocated from Yale University to UCI/CHOC in July 2008. The multi-disciplinary research team has a number of ongoing federally funded projects examining perioperative pain and anxiety as well as procedural pain and anxiety. The fellow will have an opportunity to participate in projects and complete a poster and paper.

In addition to the experiences working with the medical teams described above, the fellow(s) will also participate in a range of other pediatric psychology experiences described below in the section, “Activities Common to All Tracks.”

III.  Pediatric Psychology Track (2 positions):

Two fellows will work within our innovative Pediatric Psychology Co-Occurring Clinic. Both fellowship positions focus on working with children and families with a broad range of medical disorders and co-occurring psychological/psychiatric diagnoses. The structure of this clinic allows clinicians to follow families throughout the treatment and in a variety of settings.  Common diagnoses include diabetes, cancer, cystic fibrosis, pain disorders, headaches, epilepsy, and GI conditions. Fellows will work with the medical teams to coordinate psychological services with medical care. The fellows in these positions will provide continuity of care to patients through outpatient and inpatient stays. In these positions, the fellows will provide initial services to families within the medical subspecialty clinics, transitioning families to psychology offices once families have identified their goals. Likewise, the fellows may start working with families while they are on an inpatient medical unit and transition them to follow-ups in medical clinics or through the outpatient clinic.  The co-occurring clinic includes mental health providers from a variety of disciplines such as psychologists, psychiatrists, and licensed clinical social workers. Thre are possibilities to work with the Social Services Agency following children at risk of or who have been removed from the home for non-adherence or in providing psychological services through the child’s school.  The fellows in these positions also will have the opportunity to participate in workshops and evidence based trainings provided by Orange County Behavioral Health.

In addition to the experiences working with medical teams described above, the fellows will also participate in a range of other pediatric psychology experiences described below in the section, “Activities Common to All Tracks.”

IV.  Epilepsy Track (1 position, contingent on funding):

The fellow in this position will work closely with the Neurology service, with a focus on patients with epilepsy.  CHOC has a Level IV Epilepsy Center and has a busy EEG monitoring program and also conducts epilepsy surgeries.  The fellow in this position will work closely with our board certified neuropsychologists in performing assessments, with a focus on pre-surgery epilepsy evaluations.  In addition, the fellow may have the opportunity to participate in a specialized neurology clinic with a focus on epilepsy.  The fellow will provide consultation to the EMU (EEG Monitoring Unit) to assist the medical team in managing patients and addressing psychological symptoms.  The medical team is intradisciplinary in nature, including epileptologists, other neurologists, hospitalists, nurses, nurse practitioners, social workers, child life specialists and pharmacists.  Fellows in this position may not follow outpatient cases, but will participate in the Behavioral Emergencies On Call, Supervision Experiences and Seminars.  The fellow in this position will also serve as a teaching assistant for the Neuropsychological Assessment Seminar which is a weekly, year long teaching seminar.  Finally, the fellow in this position will also participate in a biweekly journal club focused on neuropsychological literature.

Activities Common to All Tracks:

Outpatient Therapy:

The fellows in the co-occurring track will see a larger outpatient caseload (see types of cases described above in the co-occurring clinic description), while the fellows in the oncology, consultation-liaison, and neurology tracks will see a limited number of child outpatient cases. The focus will be more on children with medical diagnoses and many cases may be referred from the primary medical team placement (oncology or consultation and liaison). Referrals may include children and families coping with a medical diagnosis, noncompliance with medical treatment recommendations, and pain control. Fellows may also follow children with more traditional outpatient referrals, including depression, attention and behavior problems, anxiety, and family conflict.

Behavioral Emergencies On Call:

A distinctive feature of our program is that all trainees receive training in managing behavioral emergencies through the provision of consultation services to the CHOC Emergency Department and hospital inpatient medical units. Interns and post-doctoral fellows rotate taking after hours call throughout the year for high risk consults. Trainees are always paired with a faculty member for this coverage. High risk consults include assessment of suicide risk or acute mental status changes. Trainees will conduct a brief clinical interview, provide crisis intervention and immediate disposition plans for the suicidal patient, the potentially aggressive patient, and the psychotic patient. The Post-doctoral fellows will participate in no more than 10 weeks of call per year.

Supervision Experiences:

Postdoctoral fellows will be provided with an opportunity to supervise interns and/or practicum students. Training in the provision of supervision will be provided. Supervision and responsibility for the patients will ultimately be the responsibility of a licensed clinical psychologist on staff. Depending on the specialty track, fellows will either supervise therapy cases, assessments, or inpatient consult cases.

Supervision:

Fellows receive a combination of individual and group supervision (a minimum of four hours) per week. Supervision occurs on an individual basis, during group rounds, within clinic settings, and within the Training Program seminars. All supervision is performed by departmental staff who meet the California Board of Psychology requirements and CHOC Hospital’s Medical Staff qualifications.

Fellows are offered at least two hours of individual supervision per week for ongoing therapy cases and rotational experiences. Supervision of consults is handled with both individual supervision and via group supervision (rounds). Rounds are co-led by a board certified child and adolescent psychiatrist/ pediatrician and a licensed psychologist. The amount and frequency of this supervision will vary depending on the complexity and number of consults received. Typically, consultation supervision occurs for 1 to 2 hours weekly. Additionally, consultation services are often provided using co-therapy, especially for high risk and complex consults. Therefore, fellows are able to observe their supervisors providing psychological services. They are also able to do co-therapy and receive immediate feedback based on direct observation of clinical skills. Supervision is also provided informally during medical rounds. Fellows will be assigned one outpatient therapy and/or assessment supervisor who will work with them throughout the year on more long term outpatient therapy cases.

Training Program Seminars

Required

Postdoctoral Fellow Seminar (weekly, year-long))
Multicultural Seminar (weekly, 5 months)
Ethics Seminar (weekly, 3 – 4 months)
Pediatric Psychology Seminar (occurs weekly, fellows serve as a teaching assistants and assist in coordinating the seminar and fellows rotate attending the seminar throughout the year, attend at least 5 weekly sessions to address any training gaps and all trainee presentations)

Optional

Neuropsychology Seminar (occurs weekly,the neurology fellow would serve as a teaching assistant, other fellows may attend any sessions to address any training gaps)

Chispa (weekly)
Pediatrics Grand Rounds (weekly)
Hematology Teaching Rounds (monthly)

Content of required seminars is biased in the direction of material needed for CHOC clinical activities. A didactic element is included in all seminars. Professional issues are addressed throughout the training year. Outside speakers with a particular area of expertise are invited to present several of the seminars. Trainees may also attend the CHOC Grand Rounds as time permits.

Postdoctoral Fellowship Seminar:

This seminar is held weekly throughout the year. The seminar focuses on professional development and also provides training in supervision. The seminar is informal in nature and covers topics relevant to your own training interests and needs.

Multicultural Seminar:

This seminar is designed to focus on learning and applying an approach to your clinical work that supports increased cultural competency. The seminar is interactive in nature and consists of self-exploration activities, exploration of the surrounding community (through research and an experiential activity), presentations from professionals, as well as trainee case presentations. While we expect multicultural awareness to permeate all of your work throughout the year, this seminar is designed to help you develop your model of learning and practice.

Ethics Seminar:

Cases in medical settings can bring a multitude of ethical challenges, which don’t always offer clear directions for change. In this seminar faculty present cases they have worked on that have presented ethical challenges. In these interactive presentations, faculty, postdoctoral fellows, and interns discuss systems and strategies to assess ethical dilemmas and determine courses of action.

Pediatric Psychology Seminar:

This weekly seminar focuses on topics relevant to the practice of Pediatric Psychology. Presenters include physicians and other medical staff as well as psychologists experienced in particular areas. Topics include medical treatments for common medical problems, as well as psychological problems associated with those disorders. Special topics include issues such as pain control, acupuncture and traditional Chinese medicine, helping children and families cope with death and dying, and feeding issues, etc. Postdoctoral fellows serve as teaching assistants for this seminar and help to coordinate the seminar. They alternate attending the seminar throughout the year and all fellows attend all trainee presentations at the end of the year.

Neuropsychological Assessment Seminar:

This weekly seminar focuses initially on learning assessment instruments commonly used at CHOC. From there the seminar reviews the areas of function assessed in the neuropsychological evaluation, and then focuses on specific illnesses and disorders that are typically seen at CHOC, including epilepsy, traumatic brain injuries, and infant and developmental problems. The fellows may select to attend seminars with topics that address specific training needs.
Postdoctoral fellows make formal case presentations in the Pediatric Psychology Seminar (one therapy case), as well as more information presentations/consultations in Multicultural Seminar (case presentation), Postdoctoral Fellowship Seminar (supervision consultation), Ethics (case presentation), and Chispa (case consultation).

Pediatric Psychology Fellowship Training

Training Model
Our training model is that of scholar-practitioner. All current staff members were trained in the scientist-practitioner model and see the inclusion of empirical work as necessary for the competent treatment of psychological problems. We strive to provide trainees with a breadth and depth of training experiences in the context of utilizing innovative scientific information to guide their treatment planning, conceptualization, and delivery. All staff members remain actively involved in scientific associations, continuing education, and reviewing the relevant literature, in order to constantly improve the quality of their work and supervision.

Licensure in the state of California requires 1500 Pre-doctoral and 1500 Postdoctoral hours of Supervised Practice, as well as successful completion of the national written exam (EPPP) and a written exam in Jurisprudence (CPLEE). Satisfactory completion of the post-doctoral fellowship at CHOC exceeds this requirement and provides at least 2000 hours of post-doctoral supervised practice. CHOC fellows in all tracks can anticipate that their weekly responsibilities will be approximately 45 – 50 hours per week. This time estimate includes clinical service, supervision, seminars, administration, scoring, and write-ups of psychological assessments.

Training Purpose and Objectives
The purpose of our Pediatric Psychology Training Program is to provide a training experience to post graduate psychology students within a multi-disciplinary setting that allows for the professional development of child and/or pediatric psychologists and meets the licensing requirements for the Board of Psychology of the State of California (as well as those of other states).

Through our program, fellows will further develop their expertise in assessing and intervening on the psychosocial impact of acute and chronic illness in children and their families by providing hospital consultation and liaison services and outpatient therapy. Through these experiences fellows continue to grow and develop their own unique professional identities.

Our program is designed to provide more structure at the beginning of the year, and for you to play an increasingly independent role towards the end of the year. During this year of critical transition from an intern to a professional psychologist, we encourage you to coalesce your unique  professional identity, professional values, and a professional demeanor.

We fully anticipate that fellows graduating from our program will be prepared to function as an entry level pediatric psychologist in a medical setting. Many of our graduates go on to work in hospital based settings (both clinical and research), while others go on to assistant professorship positions, and others become private practitioners.

Evaluations
Informal evaluations are conducted throughout the year; formal evaluations are conducted at 3 months, at mid-training year (6 months), and at the end of the training year (12 months) by training teams consisting of the fellows’ supervisors. These evaluations look at the trainees’ strengths in a variety of areas including diagnostic skills, interventions, testing, ethics, professional development, multicultural awareness and response to supervision. Evaluation results are shared with the fellows so that goals can be defined and planned for and refinements in performance can occur. Fellows are also asked to evaluate their supervisors and the Training Program annually. Supervisor and Training Program evaluations are used to review and clarify rotation strengths and weaknesses, supervisor performance, and program efficacy.

Educational Services
Fellows can use Burlew Medical Library, located on the CHOC/St. Joseph Hospital campus. A selection of professional books, journals, and audiovisual materials are available. Literature searches are free. Professional databases include the National Library of Medicine MEDLINE, HEALTH and CINAHL. Access can be accomplished remotely.
The Department of Pediatric Psychology has an assortment of professional books and journals, germane to professional work at CHOC.

Copying and multi-media services are available for presentations.

Benefits

Fellowship Location

CHOC is located in central Orange County, placing it less than an hour drive from the City of Los Angeles and about 30 minutes from the Pacific Ocean. Mountain resorts and the California desert are less than two hours away. The Southern California climate is very moderate all year round. Housing costs in Orange County tend to be on the average to high average side, but are often more affordable than in other major metropolitan areas. Orange County offers great diversity in terms of its population, with significant Latino, Vietnamese, Indian, and Filipino populations.

Salary and Benefits

Fellows: $42,536/year
Medical and Dental Insurance (after first full month of employment)
Paid time off (total of 22 days) for educational/vacation/sick leave (14 days) and departmental holidays (8 days)
Paid sick leave (total of 3 days per fiscal year)
An additional 3 days of educational leave (for conferences or licensure classes).
Each fellow is assigned a desktop or laptop computer.
Video cameras are available on site to enhance the supervision experience, including facilitating supervision of more challenging cases
Postdoctoral Fellows receive free parking

How to Apply

Application ProcedureThe application deadline for fellows is January 6, 2017, to begin training on August 28, 2017.
Please utilize APPIC’s centralized postdoctoral application system (APPA CAS; https://portal.appicpostdoc.org) to apply.

Specific to our site, please upload the following in your application:

Selection Procedures
At times, CHOC will make offers early to internal candidates. In cases where a CHOC intern is interested in staying for a postdoctoral fellowship at CHOC, we will review his/her application early and will make offers in December, 2016 to those who fit well with fellowship positions. We will notify all applicants of any positions that have been filled prior to the application deadline (01/06/2017). While we often fill some fellowship positions with internal candidates, we also fill positions with external candidates as we often have more fellowship positions available than CHOC interns.

For external candidates, on site interviews will be held in late January and early February and are by invitation only. If an on site interview is not feasible or affordable for an invited candidate, a telephone interview will be arranged. The interview process includes a semi-structured interview.  This format allows all applicants the same opportunity to show all of the skills and knowledge they have gained over the course of their graduate training.  It also ensures that we ask you about all important areas. Time is also scheduled for more open-ended discussions where you can ask questions about our internship site. We also schedule time for you to talk to with current trainees. With applicants’ permission, we would like to take a picture at the interview in order to assist the memory of the selection committee. This is a totally voluntary process, and all applicants are welcome to opt out of the photograph. In the past we have had applicants bring a camera and take pictures of us as well. We invite you to do the same as we know how helpful that can be as a memory aide. We do ask that you respect the privacy of our patients and not take pictures that would include them.

We will be following the 2017-2018 APPIC Postdoctoral Selection Guidelines, which include a universal notification date for postdoctoral fellowships, and as such will be making offers to external candidates on February 27, 2017. In accordance with the APPIC postdoctoral selection guidelines, CHOC will utilize the reciprocal offer option prior to February 27, 2017. If an applicant receives a bona fide offer from another postdoctoral training program prior to February 27. 2017 and would like to consider a fellowship position here at CHOC, please contact Dr. Marni Nagel as soon as possible to inquire about your application status and the possibility of a reciprocal offer.

Applicants offered positions with our program should understand that prior to beginning the fellowship they will be required to successfully pass a required brief medical examination, which includes a drug test. Applicants will also undergo a required background test which CHOC requires of all employees in order to ensure the safety of our pediatric patients.

Application Requirements
Admission requirements for fellows include a doctoral degree in psychology from an APA accredited program; anticipated completion of a 1-year clinical internship (APA accredited is preferred); one year of experience providing clinical services to children, preferably in a medical setting; a background in basic psychological testing measures (e.g. IQ, achievement, objective and projective personality measures); and finally, exposure to and interest in pediatric health psychology through coursework, clinical placement, or research.

Questions
Programmatic Questions: Please email or call with any questions about the program.

Please direct any questions about programmatic issues to:
Marni Nagel, Ph.D., Senior Psychologist Training Leader
Department of Pediatric Psychology
Children’s Hospital of Orange County
1201 W La Veta Ave
Orange, CA 92868-3874
Phone: 714-509-8481
Fax: 714-509-8756
Email: mnagel@choc.org

Questions about application status: If you have questions regarding the status of your application (e.g. is it complete or what is missing), please email Graciela Cisneros at gcisneros@choc.org or call 714-509-8481 and ask for Graciela.

Pediatric Psychology Department Faculty:

Heather Huszti, Ph.D., Chief Psychologist, Director of Training, Licensed Psychologist

Julie Moghal, Ph.D., Director, Department of Psychology, Licensed Psychologist

Marni Switkin Nagel, Ph.D., Senior Psychologist Training Leader, Licensed Psychologist

Adrianne Alpern, Ph.D., Registered Psychologist

Marissa Corona, Ph.D., Licensed Psychologist

Nadia Torres-Eaton, Psy.D., ABPP, Licensed Psychologist

Caroline Grantz, Ph.D., Neuropsychologist

Sharonne Herbert, Ph.D., Licensed Psychologist

Cindy S. Kim, Ph.D., ABPP, Licensed Psychologist

Carlos Konishi, Ph.D., Licensed Psychologist

Jonathan Romain, Ph.D.,ABPP-CN, Neuropsychologist

Chris Min, Ph.D., Licensed Psychologist

Grace Mucci, Ph.D., ABPdN, Coordinator, Neuropsychology Program, Neuropsychologist

Wayne Nguyen, M.D., Board Certified Child/Adolescent Psychiatrist, Pediatrics and Psychosomatic Medicine
Medical School, Texas A & M Health Science Center, Internship and Residency, University of Utah Medical Center

Michele Ocen, Ph.D., Licensed Psychologist

Mery Macaluso Taylor, Ph.D., Licensed Psychologist

Amy Veenstra, Ph.D., Neuropsychologist

Carolina Eberhard Veira, LCSW, Licensed Social Worker

Nicole Vincent, Ph.D., Licensed Psychologist

Alejandra Suzuki, M.D., Board Certified Psychiatrist and Child and Adolescent Psychiatrist
Medical School, Universidad de Buenos Aires Facultad de Ciencias Médicas, Argentina

Elisa Corrales, Ph.D., Licensed Psychologist

Michelle Fortier, Ph.D., Licensed Psychologist

Brett Patterson, Ph.D., Licensed Psychologist

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