Table 1.
Core Competencies in PCLP
| Patient Care: |
| Psychiatrists practicing in the PCLP setting should be able to: |
| 1. Clarify the chief complaint and consult question |
| 2. *Assess adjustment to medical illness in the child and family members |
| 3. *Assess the functional impact of medical illness and the response of children and family members to illness and medical treatment |
| 4. *Assess the role of family factors in the triggering and amplifying physical and psychological symptoms |
| 5. *Work effectively with parents with psychiatric illness and personality disorders |
| 6. *Conduct a developmentally appropriate mental status examination |
| 7. Recognize signs and symptoms of drug intoxication and withdrawal, polypharmacy and drug-drug interaction |
| 8. Assess and manage suicide risk and suicidal behaviors |
| 9. *Assess for potential neglect or abuse and make appropriate referrals to Child Protective Services |
| 10. Assess for nonadherence with medical treatment |
| 11. *Develop a developmentally appropriate case formulation |
| 12. *Develop a developmentally appropriate diagnostic plan |
| 13. Recognize the need for and utilize medical consultation |
| 14. *Identify and use appropriate pharmacological treatments for medically ill children and adolescents |
| 15. *Identify and use appropriate psychotherapeutic treatments for medically ill children and adolescents, including psychodynamic, CBT, guided imagery/hypnosis |
| 16. *Develop and help implement developmentally appropriate behavioral plans |
| 17. *Utilize techniques to help children and adolescents cope with stressful medical and surgical procedures |
| 18. *Provide guidance to caregivers of medically ill children and adolescents after discharge |
| Medical Knowledge: |
| Psychiatrists practicing in PCLP settings should demonstrate knowledge of: |
| 1. *Nature and prevalence of psychiatric illness in medically ill children and adolescents |
| 2. Impact of psychological factors and psychiatric illness on the course of medical illness |
| 3. Psychiatric complications of medical illness |
| 4. *Role of developmental factors and their relationship with medical illness and coping |
| 5. *Psychiatric and neurodevelopmental effects of toxins, medical/surgical treatment and medications |
| 6. *Indications for the use of psychiatric medications in medically ill children and adolescents |
| 7. Impact of medical illnesses on pharmacology and appropriate adjustments to prescribing |
| 8. Adjustment Disorders |
| 9. Acute Stress Disorders/Medical PTSD |
| 10. Delirium |
| 11. Catatonia |
| 12. Neuroleptic Malignant Syndrome |
| 13. Serotonin Syndrome |
| 14. Anti NMDA Encephalitis (Autoimmune encephalitis) |
| 15. Psychiatric Disorders Due to a General Medical Condition or Toxic Substance |
| 16. Somatoform Disorders |
| 17. Pain Assessment and Management including the use of psychiatric medications and nonpharmacological interventions |
| 18. *Factitious Disorders and Factitious Disorder by Proxy |
| 19. Psychological Factors that Affect Physical Illness |
| 20. Eating Disorders |
| Professionalism |
| Psychiatrists practicing in the PCLP setting should consistently: |
| 1. Respond to communications from patients and health care professionals in a timely manner |
| 2. Document encounters and treatment recommendations promptly and comprehensively in the patient medical record |
| 3. Coordinate care with other members of the multidisciplinary team |
| 4. Arrange for back up coverage when necessary |
| 5. Ensure continuity of care for patients |
| 6. Manage countertransference reactions of the medical team |
| Interpersonal and Communication Skills: |
| Psychiatrists practicing in the PCLP setting should be able to: |
| 1. *Establish rapport with a culturally diverse population of medically ill children and adolescents and their families |
| 2. Communicate effectively and collaborate with consulting providers |
| 3. Use clear written and verbal skills to communicate information to referring providers and family members |
| 4. Provide guidance to the referring multidisciplinary team regarding the implementation of the recommended treatment interventions |
| 5. Abide by HIPAA regulations and state laws to protect patient privacy |
| 6. Lead a multidisciplinary treatment meeting to facilitate patient care |
| Practice Based Learning and Improvement: |
| Psychiatrists practicing in the PCLP setting should consistently: |
| 1. Locate and critically appraise the medical literature for questions applicable to patient care |
| 2. Use medical libraries and information technology to identify resources to facilitate patient care |
| 3. Maintain current knowledge base in the literature specific to the practice of consultation-liaison psychiatry |
| Systems-Based Practice: |
| Psychiatrists practicing in the PCLP setting should have a working understanding of: |
| 1. Insurance benefits and limits |
| 2. System resources |
| 3. Healthcare economics and financing |
| 4. *Contexts of care provision in the pediatric setting |
| 5. *Impact of parental and child mental health issues on the pediatric team |
| 6. Impact of consultation recommendations on the larger hospital system |
| 7. Effective liaison with outside agencies |
*
indicates pediatric-specific competencies