Recognizing pediatric psychology

Reflections from Thomas Kenny, PhD, a charter fellow of the Society of Pediatric Psychology.

By Thomas J. Kenny, PhD

My early experience in pediatric psychology was discovering I was a pediatric psychologist. In 1967, I attended the APA Convention in Washington, D.C., and listened to a report by a committee appointed by George Albee, then president of Div. 12 (Clinical). The committee, consisting of Lee Salk of Cornell Presbyterian Hospital, Dorothea Ross of Stanford University and Logan Wright of Oklahoma Medical Center, investigated the prevalence of psychologists working in pediatric settings. The results of their national survey were surprising. They found over 250 names of psychologists working in pediatric, not psychiatric, settings (Routh, 1975). The report led to the organizing of the Society of Pediatric Psychology in 1968. I became a charter member of the society, albeit an affiliate member as I had yet to complete my PhD. In 2000, I was among a group that were elected charter fellows when SPP became a division of APA.

A lot happened between 1968 and 2000. I recall the early years as characterized by a need to survive and stabilize. Finances were a constant challenge. An early effort centered on publishing a newsletter. With limited resources, this was not easy and led to frequent interruptions in its printing. At one point Dorothea Ross from Stanford University made a loan to keep the newsletter going. During my term as secretary/treasurer of SPP, the society was growing and new members helped us achieve a more stable financial base. As a result I contacted Dorothea and informed her that I felt we were in a position to finally repay the loan. She graciously declined payment and asked to have the loan turned into a gift.

When I returned home to the University of Maryland Medical School, Department of Pediatrics, after my election as secretary/treasurer of SPP in 1973, I received a package in the mail. Inside, I found an old shoe box. Upon opening the shoe box, I found the membership and financial records on 3 x 5 index cards with members’

names, addresses and dues status. I also found a year’s worth of bank statements and a check book from a bank in the town of the previous secretary/treasurer. My first job was to transfer the funds from the old bank of a new account in a Baltimore bank and close the old account. The process of enrolling new members was simple. I merely made up another 3 x 5 index card, filed it alphabetically and deposited the check in the new account. The fun came when it was time to send out dues notices. To do this, I had to address all the members’ mailings by hand.

At the mid-year Executive Committee Meeting during my presidency in December 1974, Tom Boll, who was on the faculty of the University of Virginia Medical School, raised the issue of establishing a definition for pediatric psychology. The committee approved the statement that: “The Society of Pediatric Psychology is a professionally oriented group of psychologists who deal with children in interdisciplinary settings such as hospitals, pediatric practices, and developmental centers. The purpose of this group was to exchange information on clinical procedures and research and to define training standards for pediatric psychologists” (Kenny, 1975, p. 8). This was prescience. When we later became part of APA, it was as a section of Div. 12 (Clinical), which already included a section devoted to clinical child psychology. This definition helped us differentiate ourselves from that group. The affiliation also provided other benefits. As part of Div. 12, we were allotted a share of the program time at the national meeting. It was a small amount of time, but we worked at sponsoring joint programs with other groups in Div. 12 and also in Div. 7 (Developmental).

The interests of the early leaders in pediatric psychology played an important role in the growth of the field. Lee Salk was the public face of the organization. His book, What Every Child Wants His Parents to Know (Salk, 1972) was a popular success and got the public’s attention. In addition, Salk had a television program in New York City, during which he answered questions called in by parents about issues of development and behavior. He also wrote a column for McCall’s , a popular women’s magazine.

Logan Wright became involved in the operation of the APA and later became its president. He was our friend in “high places.” Diane Willis of the Oklahoma Medical Center was an early advocate for women and minority rights. Donald Routh was part of a group at the University of North Carolina Medical School that included Carolyn Schroeder, Gary Mesibov and Brian Stabler, all active in pediatric psychology. Donald Routh had the widest range of research interests of anyone I knew. He was also one of those rare people who enjoyed editing a professional journal and he was good at it. These people were not just colleagues, they were friends. It made being involved in the society a pleasure.

The lack of opportunities in psychology graduate programs was probably a major factor in most pediatric psychologists taking positions in medical schools or pediatric clinics. It allowed them to experience real situations and guidance by doctors and nurses. They conducted research, taught and did patient service. Eventually some medical schools began to offer internships in pediatric psychology. My colleague, Rudy Bauer, and I (Kenny & Bauer, 1975), published a report on the intern program we set up in the Pediatric Department at the University of Maryland School of Medicine.

APA requirements for accreditation were an obstacle, especially to potential PhD training programs. At the time, the APA only had criteria for accrediting clinical, counseling and school psychology. At a training conference sponsored by the National Institute of Mental Health, I was chairing a discussion group aimed at training psychologists to work in public programs in state institutions (Wohlford & Magrab, 1990). We were discussing course work to prepare psychologists for this field even though APA requirements for accreditation left room for only two electives in a four-year program. I recall remarking that if we discovered a cure for mental illness, we would not find room to teach it in the programs. However, things change – even APA requirements.

An important change during my career was the end of the concept of a mind/body dichotomy whereby problems were either the result of physical or emotional issues. This concept severely limited the understanding of mental illness and limited treatment options. The change to a biopsychosocial model held that problems had components of physical, emotional and environmental elements. This idea broadens understanding and treatment. Hypnotherapy was another modality finding increasing use, especially in pain management. Children whose treatment involved repeated blood drawing, bone marrow aspirations and spinal taps were taught to use hypnosis to manage discomfort. It was even used to help children take bad-tasting medicines. The head of pediatric surgery at the Maryland Medical School during my time here described himself as “a closet hypnotherapist.” He used it to reduce anxiety in children prior to surgery.

In conclusion, pediatric psychology is now a well-established and successful field. I am proud of my work in the field and take great pleasure in seeing so many accomplishments resulting from the work of many colleagues over the past 40 years. I am confident of continued growth as we expand in new areas.

Thomas Kenny, PhD, is a pediatric psychologist who was a faculty member in the Department of Pediatrics at the University of Maryland from 1961 until his retirement in 1995. Tom received a master’s degree in psychology from George Peabody College (Vanderbilt University) and worked for a number of years as a psychologist in Maryland. He completed an internship at Springfield State Hospital in Sykesville, Md., and received his PhD in 1969 from The Catholic University of America in 1969. Tom served as president of SPP in 1975-1976. He authored articles that cover many issues that remain critical to the field today such as measurement in developmental and behavioral pediatrics (Kenny, Holden, & Santilli, 1991), developmental screening (Kenny, Hebel, Sexton, & Fox, 1987) and child advocacy (Kenny, 1977) and pharmacologic treatment of behavior problems (Kenny, Badie, & Baldwin, 1968), among others.

 

References

Kenny, T. (1975). Pediatric psychology: A reflective approach. Pediatric Psychology , 3 (4), 8.

Kenny, T. (1977). Should the six year old have the vote? Journal of Pediatric Psychology, 2 , 4-8.

Kenny, T., Badie, D, & Baldwin, R. (1968). The effectiveness of a new drug, mesoridazine, and chlorpromazine with behavior problems in children. Journal of Nervous and Mental Disease 147, 316-321.

Kenny, T., & Bauer, R. (1975). Training the pediatric psychologist: A look at an internship program. Journal of Clinical Child Psychology , 4, 50-52.

Kenny, T., Hebel, J., Sexton, M., & Fox, N. (1987). Developmental screening using parent report. Journal of Developmental and Behavioral Pediatrics, 8 , 355-360.

Kenny, T., Holden, E.W., & Santilli, L. (1991). The meaning of measures: Pitfalls in behavioral and developmental research. Journal of Developmental and Behavioral Pediatrics,12 , 355-360.

Routh, D. (1975). The short history of pediatric psychology. Journal of Clinical Child Psychology , 4 , 6-8.

Salk, L. (1972). What every child would like his parents to know. New York: David McKay.

Wohlford, P., & Magrab, P. (1990). Improving psychological services for children and adolescents with severe mental disorders: Clinical training in psychology . Washington, DC: American Psychological Association.