Neonatal Intensive Care

Psychology consultation to the neonatal intensive care unit (NICU) is relatively new. However, with growing recognition that both the infant and each part of the vulnerable infant’s support system can be adversely impacted by the NICU course, psychologists are increasingly being called upon to consult to the NICU. Consultation in the NICU requires a diverse skill set for psychologists, including understanding issues related to perinatal functioning, infertility, bereavement, transition to parenting, infant mental health including the parent-infant attachment processes, adult mental health, co-parenting, family systems, and neurodevelopmental functioning of at-risk infants. With more medically complex infants surviving than ever before, families are enduring lengthy infant hospitalizations and being exposed to a greater number of traumatic events. Without intervention, parental distress can persist, and infant development may be further compromised. Psychologists can aid in implementing recent recommendations for screening for parental distress, as well as conducting comprehensive assessments and providing interventions in the NICU setting. Although rigorous empirical studies of NICU-based interventions are limited, psychologists can offer a variety of intervention approaches with promising outcomes. In addition to the impact on infants and families, higher medical acuity in the NICU results in more challenges for the NICU multi-disciplinary team as they strive to provide family-centered care. Therefore, consulting psychologists also have a role in supporting and educating staff, toward the end goal of supporting both staff functioning as well as indirectly supporting families.