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PEDIATRIC PSYCHOLOGY HOSPITAL CONSULTATION-LIAISON SERVICE Children who are diagnosed with significant physical illness are at risk for associated developmental, behavioral, and emotional problems. Staff in the Section of Pediatric Psychology at The Children's Hospital at The Cleveland Clinic provide psychological consultation services to children who are hospitalized for a wide range of acute and chronic illnesses. The pediatric psychologist functions as an active part of a collaborative, multidisciplinary approach to patient care, with the goal of providing your child with the best and most comprehensive care possible. Diagnosis with and treatment for an acute or chronic illness can result in significant psychological and social consequences for a child and his or her family. Sudden and significant lifestyle change is often required, including extensive hospitalization and medical intervention. Some medical interventions are accompanied by physical changes (such as weight gain, hair loss, and growth limitations) or cognitive changes (such as learning difficulties and memory problems), which can exacerbate the emotional and social challenges faced by these children, as well as their families. The experience of a significant illness can interfere with the development of a child's independence, self-confidence, social skills, and sense of security within his or her environment. If your child is hospitalized at The Children's Hospital and there are concerns regarding his or her developmental, behavioral, or emotional functioning, your primary physician may request a consultation with a pediatric psychologist. Consultations are typically requested for patients who are newly diagnosed with a chronic or critical medical condition, for patients who are candidates for organ transplantation, and when there are concerns regarding the impact of psychological factors on physical symptoms (such as headache, abdominal pain, and tremors). Pediatric psychologists are also active members of the Helping Hands Team, The Children's Hospital's pediatric palliative medicine service. Common psychological interventions include: Supportive psychotherapy with the child and family; assessment and treatment of mood disorders (e.g., depressive and anxiety disorders), particularly as they relate to/ impact the child's physical illness; assistance with procedure-related anxiety management; guidance in the use of cognitive-behavioral (non-pharmacological) strategies for symptom (e.g., pain, nausea) management; interventions to help promote compliance with medical/ dietary regimens; parental guidance regarding management of the child's behavior, emotions, and illness-related academic concerns; and for the most significantly ill patients, psychological support around the many aspects of end-of-life decision-making and care. The pediatric psychologist also acts as a liaison between your family and the care team. If your child is seen by a pediatric psychologist during his or her stay at The Children's Hospital, your psychologist will typically be able to see you as an outpatient, if outpatient follow-up treatment is indicated. This is not always possible, however, depending upon the nature of your child's difficulties and treatment needs and also depending upon your insurance, for example. Families who have traveled a long distance to receive care are referred to providers closer to their homes for follow-up outpatient care, if appropriate and preferred by the family. Alternatively, your child might first be seen as an outpatient by one of our staff, who will then continue to work with your child during his or her hospitalization, as warranted. Psychology fellows (i.e., individuals who have achieved their doctoral degree but are further training and not yet licensed to practice independently) are an active part of our service and are supervised by our attending-level pediatric psychologists. Information regarding insurance coverage As with all psychological services, insurance coverage for the costs associated with the consultation services varies. Pre-authorization for inpatient psychological services does not automatically take place when a consultation is requested. Depending upon the clinical findings during your child's assessment, services will be billed using either of two sets of billing codes, as appropriate. Services are either billed using traditional psychiatric billing codes (which require a psychiatric/ psychological diagnosis and are paid out of your mental health benefits) or using health and behavior codes (which require a medical rather than psychiatric diagnosis and are paid out of your medical benefits). There may be a required deductible or co-pay, for which you are financially responsible. If you would like information regarding the fees for services, please contact the financial coordinator at 216/444-1184. If you would like more information regarding your benefits, you should contact your insurance company directly. For more information, contact: Dunya T. Yaldoo-Poltorak, Ph.D. Directions to the Cleveland Clinic Main Campus
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