Clinical approaches to address health disparities in pediatric psychology

Guest editors Elizabeth McQuaid and Robin Everhart share key takeaways from the June 2020 special issue of Clinical Practice in Pediatric Psychologyopens in new window, which focuses on clinical approaches to consider in ensuring access to and effective delivery of services for children and adolescents of diverse backgrounds.

What is the special issue about?

There continue to be persistent disparities in health care outcomes between children of color and White children. This special issue focuses on clinical approaches to consider in ensuring access to and effective delivery of services for children and adolescents from diverse racial/ethnic and low-income backgrounds. Articles in this special issue are focused on factors affecting use among diverse families, novel approaches to engage and treat diverse youth and families, and the use of paraprofessionals to improve treatment delivery and increase access to services.

What is the significance of the issue?

The demographics of the patient populations that pediatric psychologists see are becoming increasingly diverse in terms of race, ethnicity, gender identity, socioeconomic status, and family composition. There can be a big gap between traditional evidence-based individual and group therapy and what is acceptable to and meets the needs of families from different cultural backgrounds. It is really exciting to see, in the articles in this special issue, how clinical practices are evolving to meet the needs of pediatric patients by adapting channels of delivery, using paraprofessionals, and engaging families in unique ways.

Tell us about a few key takeaways.

It is clear that when developing interventions, clinicians must consider how unmet social needs, processes specific to socioeconomic status, and high levels of stress can affect access to and use of services. The articles in this issue also illustrate the need to be flexible in strategies to access treatment for and provide treatment to youth and families most in need of behavioral health services. Standard delivery systems and modalities, such as face-to-face clinic sessions, were changing even as this issue was going to press. Solutions such as incorporating paraprofessionals and using video-based interventions may ultimately be more feasible and acceptable in delivering behavioral health services to families, especially in the context of the COVID-19 pandemic.

What are some practical implications of the articles featured in the issue?

It is really important to consider how many barriers some families face in accessing behavioral health services and how challenging it can be for families to get the services they need. Making services accessible by integrating them into pediatric practices and having them available during inpatient hospitalizations may improve service use and outcomes for a wide range of families. Moreover, it is becoming clear that psychologists can play an important role in supervising and training paraprofessionals to extend the reach of behavioral health care.

Note: This article is in the Clinical Psychology topic area. View more articles in the Clinical Psychology topic area.

McQuaid, E. L., & Everhart, R. S. (2020). Introduction to the special issue: Clinical approaches to address health disparities in pediatric psychology. Clinical Practice in Pediatric Psychology, 8(2), 97–102. https://doi.org/10.1037/cpp0000325opens in new window

Elizabeth L. McQuaid, PhD, ABPP is professor and vice chair of Psychiatry and Human Behavior and director of the Division of Clinical Psychology at Alpert Medical School, Brown University. Dr. McQuaid’s research addresses determinants of health inequities and delivery of evidence-based interventions for family management of pediatric chronic illnesses to culturally diverse communities. Her work is supported by the National Heart, Lung, and Blood Institute and the Hassenfeld Child Health Innovation Institute of Brown University.

Robin S. Everhart, PhD is an associate professor in the Department of Psychology at Virginia Commonwealth University and a licensed clinical psychologist. Dr. Everhart’s program of research is focused on understanding childhood chronic disease management from a family systems perspective, particularly within the context of factors related to culture and community. Her work is currently funded by the National Institutes of Health, the Cystic Fibrosis Foundation, and the Virginia Foundation for Healthy Youth.