Inpatient Pediatric Psychology Consultation-Liaison: A 10-Year Update

Objective: Pediatric consultation-liaison (CL) psychologists have unique roles in hospitals, providing both direct clinical care to patients and families, and support and education to medical colleagues. A survey published in 2015 was the first to comprehensively describe the roles and challenges of inpatient pediatric CL psychology, and 10 years later, there is a need to identify where these have shifted to provide more accurate data for advocacy. Methods: A 78-item survey was distributed, containing items from the original 2015 survey and new items for additional detail, and 182 current and previous CL psychologists and trainees responded. Items included characteristics of their institutions, requirements of their positions, CL service activity, practice characteristics, training, billing and funding, and outcomes and research, as well as qualitative comments about role challenges. Results: Response patterns were examined, and where applicable, compared with those from the 2015 survey. Most respondents worked or trained in academic medical centers (81.5%) and standalone pediatric hospitals (63%). Consults were typically triaged by an attending psychologist (68.9%). Most services reportedly run Monday through Friday during business hours (82%). Most respondents received training in CL psychology during predoctoral internship (68.1%) or postdoctoral fellowship (64.8%). Qualitative responses reflected challenges in mismatch between productivity expectations and the reality of the CL role. Conclusions: Compared to the 2015 survey, respondents indicated fewer billing barriers to patient care, fewer evening and weekend coverage responsibilities, continued challenges with reimbursement and productivity requirements, and ongoing heterogeneity with training models. Suggestions for advocacy based on these findings are included. Implications for Impact Statement Over the past decade, pediatric consultation-liaison psychology has faced increasing clinical and institutional demands, alongside broader social and policy pressures on pediatric care. This 10-year follow-up study provides an updated perspective on the lived experience and practice parameters of inpatient pediatric consultation-liaison psychology, comparing current trends to those reported a decade ago. Findings provide actionable insights to guide advocacy efforts related to training, reimbursement, and service delivery, supporting the continued advancement of the field.