Implementation of a Behavioral Intervention in Consultation-Liaison With an International Family

Pediatric psychologists are frequently consulted for inpatient concerns regarding disruptive behaviors (e.g., verbal and physical tantrum, defiance) that impact medical care. The purpose of this case study is to describe the implementation of a behavioral protocol for a young child in an inpatient medical setting. This study describes the application and challenges of utilizing a behavioral management plan to address tantrum behaviors associated with medical care in an Arabic-speaking 4-year-old child from the Middle East hospitalized for a chronic medical condition. Treatment included 32 contacts over the course of a 2-month hospitalization. The focus of these contacts included implementation of behavioral and parenting strategies to decrease tantrum behaviors during routine medical care. Challenges in implementing a behavior plan within a large medical setting are discussed, including issues associated with fidelity to behavioral interventions, psychoeducation about behavioral principles, and cultural factors and barriers relevant to this patient. These factors are highlighted to better examine their impact on the implementation of behavioral interventions for international patients in a tertiary care pediatric hospital. Further research is necessary to better understand cultural differences influencing behavioral management of patients with chronic medical conditions during prolonged medical stays.