Pediatrie en Pediatrische psychologie – Literatuur
2018 – 2019
Tessa Faber
,Algemene inleiding
Chapter 1 – Historical Developments and Trend in Pediatric Psychology
Pediatric psychology = a multifaceted and integrated field of both scientific research and
clinical practice that focuses on addressing a wide range of physical and psychological issues
related to promoting the health and development of children, adolescents, and their
families, with an emphasis on evidence-based methods.
Founded in 1969, the field has broad interdisciplinary theoretical underpinnings and draws
from clinical, developmental, social, cognitive, behavioral, counseling, community and school
psychology.
History of Pediatric Psychology
The beginnings of pediatric psychology can be linked to the late 19th century, when Lightner
Witmer established the first psychological clinic in the United States.
Early in the 20th century, several psychologists and pediatricians began to perceive the
importance of recognizing the link between psychology and medicine.
The 1911 American Psychological Association (APA) Committee on the Relations between
Psychology and Medical Education served as one of the earliest efforts in collaborative
teaching.
After World War II, a significant increase occurred in the number of psychologists working in
medical school departments.
Despite the early recognition of the benefits of a working relationship between pediatrics
and psychology, progress toward more collaboration did not occur until the mid-1960s. At
about this time, pediatricians were being aced with a large number of problems in
development, behavior, education, and child management when treating patients in their
clinics. For example, Duff, Rowe, and Anderson (1973) found that only 12% of all patients in
a pediatric practice presented with purely physical problems, whereas 36% had primarily
psychological issues, and 52% had issues that were both physical and psychological in
nature.
Thus, the growing need for collaboration between psychology and medicine was becoming
apparent.
In response to these ongoing needs, developmental psychologist and researcher Jerome
Kagan (1965) called for a “new marriage” between psychology and pediatrics.
Some of his suggested benefits included early detection of severe psychopathology an
psychosocial problems, as well as the study of the relationship between prenatal and
perinatal factors to psychological problems.
Development in the field moved forward, and the term “pediatric psychology” was first
coined by Logan Wright in 1967. He defined pediatric psychology as “dealing primarily with
children in a medical setting which is non-psychiatric in nature”.
Wright was the first to recognize the important clinical role of pediatric psychologists in the
medical setting.
,To further ensure the future of pediatric psychology, Wright called for:
(1) A group identity for the field through a formal organization and distribution of a
newsletter.
This group identity was primarily formed through the Society of Pediatric Psychology
(SSP). It focused on the delivery of psychological services to children in medical
settings and research in child health psychology. At the Executive Committee
meeting in December 1874, SPP was defined as a group whose purpose is “to
exchange information on clinical procedures and research and to define training
standards for the pediatric psychologist”. The first newsletter of the society was
Pediatric Psychology, eventually transformed into the Journal of Pediatric Psychology
(JPP).
(2) More specific training for future pediatric psychologists.
(3) An accumulation of a body of knowledge though applied research.
Research in Pediatric Psychology
Various medical and psychological journals published early research in the field, which
centered on examining the psychological impact of medical disorders and the outcomes of
effective intervention.
Early scientific research in the field of pediatric psychology included: developmental
disabilities (e.g. autism); infant development; noncompliance; toilet training; the
development of self-help skills in preschool children; parental neglect and child abuse;
failure to thrive; psychological aspects of physical illness in children; death and
bereavement; hospitalization; and child neuropsychology.
Today, much of the research published in JPP has an interest in a range of chronic illnesses,
primarily cancer, diabetes, and sickle cell disease; however, other conditions (e.g., obesity,
asthma, and pediatric sleep) are now seen more frequently in the journal.
The research efforts of scientists can provide the field with increased understanding of the
relationship between psychological and medical issues and with more effective prevention
and intervention systems, thereby aiding practitioners in providing more adequate services
to children and their families.
Training in Pediatric Psychology
Logan Wright stressed the importance of developing specialized professional training as
integral to the development of the field.
Training in the field of pediatric psychology has undergone substantial expansion, and the
formal organization of the field, SPP, accommodates a variety of diverse activities and
backgrounds.
Early Practice and Training
In 1966, the first formal doctoral training program in pediatric psychology was started by the
Departments of Pediatrics and Psychology at the University of Iowa under the direction of
pediatrician Gerald Solomons. The program aid in the career development of several
psychologists, involving them in clinical training in an interdisciplinary clinical setting.
, Current Trends in Training
Specialized training was not formalized early in the field’s development; however, training
opportunities in pediatric psychology are becoming more abundant.
The development and refinement of several sets of training recommendations, targeting
professionals who work with children, adolescents, and their families in general, provided a
groundwork for understanding part of the professional development of pediatric
psychologists.
A SPP Task Force on training utilized previous recommendations to develop a list of 12 basic
training domains pertinent to developing a specialty in pediatric psychology:
1. Lifespan development;
2. Lifespan developmental psychopathology;
3. Child, adolescent, and family assessment;
4. Intervention strategies;
5. Research methods and systems evaluation;
6. Professional, ethical, and legal issues pertaining to children, adolescents, and
families;
7. Diversity issues and multicultural competence;
8. The role of multiple disciplines in service delivery systems;
9. Prevention, family support, and health promotion;
10. Social issues affecting children, adolescents, and families;
11. Consultation-liaison (CL) roles;
12. Disease process and medical management.
In addition to providing guidelines for training in pediatric psychology, the SPP Task Force
defined three levels of training.
• First, “exposure” refers primarily to didactic training, such as classes and
observations;
• Second, “experience” refers to the practice of newly acquired skills;
• Third, “expertise” involves mastery and the ability to practice skills and apply
knowledge independently.
Training Sequence for Pediatric Psychologists
It is important that members of the field work to foster undergraduate interest by providing
opportunities for exposure.
Over the approximately 4-6 years that students are obtaining training onsite, the primary
focus is to teach the general clinical child competencies outlined by the SPP Task Force
through a combination of exposure and experience.
The Future of Pediatric Psychology
Although there has been progress in some areas, several issues still remain ongoing priorities
for guiding the field. The future will require:
(1) Adjustment to changing reimbursement patterns;
(2) Continual proof of the “worth” or value added by pediatric psychology services;
