The purpose of this study was to examine the safety, feasibility, acceptability, and preliminary efficacy of a cross-age peer mentoring program created to improve adherence and psychosocial outcomes for pediatric liver transplant recipients. Twenty-two participants were assigned to a "mentor now" or "mentor later" waitlist control group. Tacrolimus SD, a validated measure of adherence, was assessed for six months pre- and post-intervention for both groups. Self-report measures of self-management and HRQOL were completed at recruitment and three months after training. Participant report indicated the acceptability of the intervention. Clinically significant improvement in adherence was detected. No significant changes on the psychosocial outcome measures at follow-up were observed. This study demonstrated that an outpatient-based mentoring program is a safe, feasible, and acceptable option to incorporate within a pediatric liver transplant program with potential for promising application in other transplantation populations as well. These results also suggest that the program may have been associated with meaningful improvement in adherence, although further evaluation is warranted.

A large proportion of pediatric solid organ transplant recipients are young children, yet dedicated studies on the challenges faced by these patients are sparse. The present article aims to provide a summary of key considerations for pediatric solid organ transplant teams, describing what challenges are more likely for younger patients and how they might identify and address these circumstances. Our findings suggest that the mental health of patients and caregivers, issues at school, neurocognitive difficulties, and self-management are areas of particular relevance for children. We offer several recommendations that stem from these identified areas of concern. Dedicated focus on the well-being of younger patients could in the long-term stave off adverse events that are often associated with adolescence. In the short-term, certainly intervening in any of these domains could lead to improved quality of life during childhood.

Prior to listing for transplantation, patients participate in a comprehensive, multidisciplinary evaluation. One component of this process, incorporated by the vast majority of transplant centers, is a psychosocial assessment conducted by a mental health professional. The primary objectives of a pre-transplant psychosocial assessment are to identify risk factors for difficulty adjusting post-transplant as well as behaviors that may compromise transplantation outcomes. This paper aims to provide a summary of key considerations for pediatric transplant teams describing what this assessment might include, when it should be performed, training requirements for the evaluators, how results of the evaluation might best be utilized and suggestions for optimal patient preparation. Our findings suggest that the evaluation, which can be conducted by a variety of professionals, should include assessment of patient knowledge and motivation for transplant, mental health and substance abuse history, presence or absence of family and social support, availability of financial resources, past history of treatment adherence, and the quality of the family's relationship with the transplant team. Repeat assessments and utilizing the initial evaluation for outcome assessment should be considered. Finally, the evaluation offers a unique opportunity for better preparing patients and families for transplantation.

The Yale Child Study Center offers a 2-year integrated predoctoral internship and postdoctoral fellowship training sequence that emphasizes both child and adolescent generalist and pediatric specialty training. In this article, we outline how the various elements of the Yale Child Study Center Psychology Fellowship link directly to recommended core competencies recently published by the Society for Pediatric Psychology's (SPP) Task Force on Competencies and Best Training Practices in Pediatric Psychology (Palermo et al., 2014). We review the manner in which our trainees are evaluated for achievement of these competencies and discuss how the 2-year developmental model enables graduating trainees to thrive as highly competent pediatric psychologists within a complex and constantly changing health care environment.

The aim of this study was to examine the mental health of cardiac patients with diabetes and whether symptoms varied by gender and/or age. Screening for depression and posttraumatic stress symptoms was conducted on 1003 patients with cardiovascular disease. Correspondence analysis was utilized to identify clinical core profiles. Results suggested that cardiovascular disease patients with diabetes, particularly males, experience high rates of depression, suicide ideation, and posttraumatic stress symptoms. Clinical implications of these findings include targeted mental health screening options as well as offering a closer look at the specific concerns of cardiovascular disease patients with diabetes.