Psychiatrist

Volume 39, Number 1

An experience from the Pediatric Inpatient Psychotherapy Squad

Samantha Hayes, MD (they/them)

Psychiatry Resident, Maimonides Health, Brooklyn NY

In 2016, the average hospital cost for pediatric stays unrelated to birth was $13,400, more than half of which is covered by Medicaid (Moore 2019). One innovative way to reduce costs and length of stays for these patients is through psychological interventions (Bujoreanu 2015). In addition, preliminary research shows that children may develop post-traumatic stress disorder symptoms secondary to their medical trauma (Marsac 2014) and have a high chance of meeting criteria or carrying a diagnosis of another psychiatric condition unrelated to medical trauma (Doupnik 2017).

As recognition grows regarding the benefit of psychological and psychiatric care for children on medical units, so must services provided by these hospitals. At Maimonides Health- a community mental health center in Brooklyn, NY, a psychiatric resident-driven group known as the Pediatric Inpatient Psychotherapy Squad (PIPS) was developed to meet this need. PIPS is an elective rotation for residents interested in child and adolescent psychiatry, which offers the opportunity to engage patients noted by the pediatric inpatient team and approved by the child psychiatry consult-liaison team as appropriate and willing to take part in therapy. Residents visit these patients 2-3 times a week, usually after regular clinic hours, to help them cope with medical diagnoses, the hospital stay and other psychological needs identified. The residents are receiving supervision from a trained child psychologist as well as other resources.

As a second year psychiatry resident, the PIPS service was my first opportunity to develop a therapy-driven relationship with a child and was invaluable in shaping skills I will continue to hone for the rest of my career.

The below reflection highlights one child whose lived experience and therapeutic relationship educated me on the power of holding space, and shows the value of providing psychological support to those dealing with acute medical trauma (all potentially identifiable details have been changed to protect their privacy).

Spring 2023

Volume 39, Number 1