Handbook of Psychological Services for Children and Adolescents

By Jan N. Hughes; Annette M. La Greca et al. | Go to book overview

5
Providing Psychological Services in
Pediatric Settings in an
Era of Managed Care

Challenges and Opportunities
DENNIS DROTAR
LYNN ZAGORSKI

Psychologists in pediatric settings provide services to a great many children, adolescents, and their families in primary care settings and in acute and chronic care hospitals (Drotar, 1995; Singer & Drotar, 1989). Relevant clinical issues in providing such services have been described in a number of publications (Drotar, 1993, 1995; Schroeder & Mann, 1991). On the other hand, there have been few, if any, comprehensive descriptions of the programmatic and professional issues that arise in providing psychological services to children and families in pediatric settings, especially in an era of managed care. The purpose of this chapter is to provide an overview of the challenges and opportunities of implementing a program of pediatric psychological services to children and their families in an academic medical setting. Based on the senior author's (Drotar) 27 years of clinical experience and the junior author's (Zagorski) time and energy-intensive experience as a clinical services coordinator, this chapter describes key issues in the development, management, and administration of psychological services in pediatric settings.


What Clinical Problems Are Typically Seen in Pediatric Settings?

The specific psychological and behavioral problems that are seen by psychologists in pediatric settings vary widely as a function of the type of setting in which such care is provided. In primary care settings, pediatric psychologists see an extraordinary range of behavioral and developmental problems (Schroeder & Mann, 1991). For example, Charlop, Parrish, Fenton, and Cataldo (1987) described the referral problems of 100 patients who received outpatient behavioral treatment during a one-

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