Psychology

The year 2020 brought a lot of changes – from saying goodbye to a treasured former colleague, former division chief Barbara Rzepski, PhD, to welcoming new ones, all while standing up in the face of the Covid-19 pandemic. Throughout, members of the Division of Pediatric Psychology remained focused on improving the mental health of all of Connecticut’s children.

DIVISION OVERVIEW

Our division is comprised of 13 pediatric psychologists spread across eight divisions at Connecticut Children’s (Obesity, Pain & Palliative Medicine, GI, Consultation/ Liaison, Rheumatology, Hematology-Oncology, Primary Care, Sleep, and the NICU). We are dedicated to improving treatment options, testing new therapies, being the voice for mental health diagnosis and treatment in the state of Connecticut, and training the next generation of providers. We are committed to increasing access to mental health care for families. Our psychologists in the Division of Pain and Palliative Medicine brought Comfort Ability to Connecticut Children’s. This is a one-day, evidencedbased group intervention designed to increase the accessibility of psychological services for patients who live with chronic pain and for their families, especially those that live far away or are unable to attend frequent appointments. Siddika Mulchan, PhD, in the Sickle Cell Clinic, has created a similar monthly treatment group for youth to overcome transportation barriers. Lynelle Schneeberg, PsyD, created a bedwetting alarm loan program for families that have a child who experiences nocturnal enuresis so these families do not have to purchase this device. Melissa Santos, PhD, interim head of the Division of Pediatric Psychology and clinical director of the Pediatric Obesity Center, uses technology to engage families in treatment through weekly text messaging and by utilizing various forms of social media. Dr. Santos also launched an eight-week Facebook Live series on the Connecticut Children’s Facebook page and discussed creating a coping toolkit while Dr. Schneeberg discussed improving sleep habits in young children.

We are committed to implementing new therapies and guidelines. Amy Signore, PhD, is working on bringing Parent-Child Interaction Therapy (PCIT) treatment to primary care with the goal of preventing and treating disruptive behaviors in an at-risk population. Similarly, Dr. Mulchan is utilizing PCIT in the Hematology-Oncology division as she completes her certification. Brad Jerson, PhD, of the Division of Digestive Diseases, Hepatology and Nutrition, has created a program to support transition of care and increased self-management within families of youth with inflammatory bowel disease as they graduate high school. Timothy LaVigne, PhD, in the Division of Pain and Palliative Medicine, is launching biofeedback services for youth with headaches. In collaboration with Richelle deMayo, MD, division chief of Biomedical Informatics, he is developing a multidisciplinary weekly headache treatment group that will highlight the intersection of psychological and medical approaches to headache management.

Lauren Ayr-Volta, PhD, is developing a new model for transition off oncology therapies to foster a more successful adjustment to life as a cancer survivor. Kelly Maynes, PsyD, works to update all the pathways within the consultation/liaison service to ensure the quality of care we provide. Dr. Santos directs the nationally accredited Adolescent Bariatric Surgery Program at Connecticut Children’s, maintaining all required pathways and quality improvement initiatives.

Dr. Jerson is working with Corey Baker, MD, in the Gastroenterology division, to lead the creation of an interdisciplinary motility specialty clinic within the newly developed Center for Neurogastroenterology and Motility Disorders.

REACHING NEW POPULATIONS & CREATING NEW SERVICES

We are reaching new populations and creating new services. Our pediatric psychologists in Hematology-Oncology are leading efforts to develop a biopsychosocial assessment for adolescents who are seeking fertility preservation – an incredibly important consideration not only for patients in oncology but those with a host of other medical conditions as well as youth in our gender program. Dr. Ayr-Volta is bringing neuropsychology testing to children with brain tumors to identify cognitive risk factors and to ensure that patients are getting the correct supports in school and in the community. Dr. Reiss is creating a care pathway between the Pediatric Obesity Center and Endocrinology to make the Pediatric Obesity Center the medical home for youth with Prader–Willi Syndrome.

ESTABLISHING CONNECTICUT CHILDREN’S AS A NATIONAL LEADER IN PEDIATRIC PSYCHOLOGY

Members of our division are leading national work groups and establishing Connecticut Children’s as a leader in pediatric psychology. Staff members are involved within the American Psychological Association (APA) and our national society, the Society of Pediatric Psychology (SPP). Dr. Signore is working as part of APA’s Division 38’s subcommittee on Addressing the Needs of Underserved Populations through Integrated Primary Care to understand the gaps in primary care providers’ knowledge of assessing and treating behavioral health concerns among underserved populations. Dr. Wakefield is the education chair of the Pain SIG of Division 54. Dr. Mulchan is the policy cochair of the Adolescent and Young Adult SIG of Division 54. Dr. Santos is on the board of directors of the SPP and is the clinical chair of the Obesity SIG of Division 54. She also leads the Anti-Racism work group for SPP. Dr. Jerson is the clinical member-at-large for the Pediatric GI SIG of Division 54.

Outside the APA and SPP, Mike Reiss, PsyD, is participating in a national work group to examine the effects of trauma in patients being seen at pediatric obesity clinics. Dr. Santos is on the governance board of the Pediatric Obesity Weight Evaluation Registry (POWER), the national registry for pediatric obesity, and is leading the committee writing the psychological guidelines for adolescents undergoing bariatric surgery. She serves on the Integrated Health Committee for the American Society of Bariatric and Metabolic Surgery. Dr. Jerson is the co-leader of the Patient and Family Education Committee of the Connecticut Chapter Medical Advisory Committee for the Crohn’s and Colitis Foundation.

MENTORING THE NEXT GENERATION OF PEDIATRIC PROVIDERS

Our staff is actively involved in training the next generation of pediatric providers. Connecticut Children’s Division of Pediatric Psychology is the training site for pediatric trainees at the Institute of Living. Dr. Signore focuses on measuring resident’s knowledge/attitudes of treating behavioral health in primary care and training pediatric residents to assess and treat behavioral and mental health problems in primary care. Dr. Reiss provides training for medical students in motivational interviewing. Emily Wakefield, PsyD, provides mentoring for future pain researchers under the Pain in Child Health (PICH) Initiative. Dr. Schneeberg provides clinical and didactic training as part of the Behavioral Sleep Medicine rotation to residents of the UConn School of Medicine. Dr. Jerson participates in the GI Fellowship Training program by providing training on psychogastroenterology and conducting biopsychosocial assessments within medical evaluations.

THE VOICE OF PEDIATRIC PSYCHOLOGY IN CONNECTICUT

As part of the mission of the Division of Pediatric Psychology, our members strive to give voice to the needs of pediatric patients on both local and national levels, and we are committed to serving as a resource for a variety of news outlets and publications. Dr. Schneeberg is frequently viewed as an expert for her work in sleep. She has contributed to the New York Times Parenting section and Psychology Today, and is regularly featured on local television and quoted in national publications including the Wall Street Journal and Parade. Dr. Santos was featured on Connecticut Children’s webinar series Ask the Experts to discuss the mental health impact of Covid-19.

ACADEMIC OUTPUT

Our staff is actively involved in soliciting grants, authoring publications, and presenting our work to show the value of psychology in terms of its relationship to the overall well-being of children, and the positive effects of medical care that integrates psychological assessment and therapy into treatment plans.

THE FUTURE

As we look forward to 2021, we do it in appreciation of the many years of service contributed by Dr. Barbara Rzepski, whose efforts were crucial to the formation and development of the Division of Pediatric Psychology. She built the foundation that we continue to use and expand on in servicing the many needs of Connecticut’s children.

PUBLICATIONS

LaVigne T, Laake L, Ibeziako P. Somatic symptom and related disorders in pediatric patients: Associations with parent psychiatric and substance use history. Clin Child Psychol Psychiatry. 2020 Oct; 25(4):932-944. doi: 10.1177/1359104520931579. Epub 2020 Jun 9.

Mulchan SS. Where we should go from here: a brief commentary on the role of pediatric psychology in changing racial inequality. Progress Notes, Soc P ediatri Psychol. 2020; 44(3).

Guite J, Reiss M. Psychotherapy and cognitive behavioral therapy. In: Starkweather A, McCauley P, editors. Pain management for advanced practice: multimodal approaches. Philadelphia: Wolters Kluwer; 2020. pp. 61-81.

Santos M. The offspring of parents undergoing a weight loss surgery: a systematic review. [invited commentary] SOARD. 2020.

Santos M, Gorin A, Thaker S, Zempsky W. Pain and obesity: relationships and initial tool validation. Clin Pract Pediatr Psychol. 2020. Epub ahead of print. https://doi.org/10.1037/cpp0000376.

Santos M. The inclusion of mental health factors into the resumption of bariatric surgery. [commentary] Lancet Diabetes Endocrinol. 2020.

Santos M. [Co-guest editor] J Pediatr Psychol: Special Issue Addressing Health Disparities in Pediatric Psychology. 2020.

Santos M, Mackey E, Gaffka B, Ward W, Burton ET. Bariatric and metabolic surgery during and after the Covid-19 pandemic. Lancet Diabetes Endocrinol. 2020;8(9):742-743. https://doi-org.online.uchc. edu/10.1016/S2213-8587(20)30278-3.

Santos M. [Comment] The offspring of parents undergoing a weight loss surgery: a systematic review. Surg Obes Relat Dis. 2020;16(6), 815–816. https:// doi-org.online.uchc.edu/10.1016/ j.soard.2020.03.018.

Valrie C, Thurston I, Santos M. Introduction to the Special Issue: Addressing health disparities in pediatric psychology. J Pediatr Psychol. 2020;45(8), 833–838. https://doi-org.online.uchc.edu/10.1093/ jpepsy/jsaa066.

STAFF

Melissa Santos, PhD, Interim Division Chief Barbara Rzepski, PhD, retired, June 2020 Timothy LaVigne, PhD Emily Wakefield, PsyD Mike Reiss, PsyD Kelly Maynes, PsyD Bradley Jerson, PhD Lauren Ayr-Volta, PhD Siddika Mulchan, PhD Lynelle Schneeberg, PsyD Lisa Backus, PhD Amy Signore, PhD Christine Chew, PhD Preeti Sandhu, PsyD Vanessa Laurent, PhD