Reflections on interdisciplinary collaboration in the new millennium: perspectives and challenges.

The occasion of this presidential address for the Society for Behavioral and Developmental Pediatrics (SDBP) provides a welcomed opportunity for me to reflect on the past and point toward the future concerning a topic I have visited and revisited many times, continues to engage me, and is at the heart of our field, that is, interdisciplinary collaboration. First of all, how does one define collaboration? There are many different definitions and options for collaboration. These can include cooperative work, communication, integration of care, mutual planning, or mutual learning, which take place across a wide spectrum of activities including clinical care, research, and teaching. My interactions with my colleagues in the SDBP over many years, the majority of whom are pediatricians, reflects such interdisciplinary collaboration, as does my current position as chief of a division of behavioral pediatrics and director of a graduate level research training program in pediatric psychology. Although frequent and productive interdisciplinary collaboration is second nature to me at this point in my career, I know it is not necessarily the norm. On the one hand, medical training and fellowship training in our field has become increasingly interdisciplinary. On the other hand, for the most part, professional training in pediatrics, psychology, and other disciplines remains dominated by a single profession-centered model of training and supervision. I recognize that a wide range of training models is currently in operation, at least some of which involve innovative interdisciplinary models. Nevertheless, in many programs, including graduate training programs in psychology, training is still conducted primarily by members of a single professional discipline. Moreover, most professional organizations are also focused on promoting the needs and interests of single professions. The members and officers of SDBP can take pride in the fact that our organization represents a refreshing exception to this rule. Members of other professions, especially psychologists, but also nurses, sociologists, and others now contribute to SDBP in multiple ways, e.g., in committees, in the executive council, on the editorial board of Journal of Developmental and Behavioral Pediatrics (JDBP), and to the annual program. The founders and leaders of SDBP were wise (in my opinion) to envision an interdisciplinary organization from the outset and develop these collaborative values, which have been sustained up to the present. Interdisciplinary collaboration is very much a valuedriven activity. We engage in it because we believe in its worth. As we all know, collaborative work is by no means heavily reimbursed. But in this sense, it fits well with a number of other critical professional activities, such as advocacy, that are very important to the lives of children and families but do not generate significant economic remuneration. But what are the most salient values inherent in interdisciplinary collaboration? First of all, there is the potential for significant mutual enrichment of knowledge and perspectives. This reflects the experience of learning from different professionals’ strengths and experience base. Moreover, there is the value of sharing and mutual support and the satisfaction that is inherent in developing interdisciplinary professional relationships. In this regard, a survey of pediatric psychologists noted that this group regards collaboration with pediatric colleagues as one of the most important aspects of their work-related satisfaction. The values and potential benefits of collaboration are especially critical for the professional development of the next generation of professionals in many fields: behavioral/ developmental pediatrics, psychology, child psychiatry, nursing, and social work, to name a few. These include developing bases of research, clinical, and didactic knowledge that are enriched and informed by multiple professional perspectives, rather than being steeped in the traditions of a single profession. A related value is the facilitation of the development in our trainees of skills that simply could not be developed as effectively were it not for the benefits of collaborative training. For example, for psychologists in a clinical pediatric context, these skills include learning how to conduct diagnosis and management in an expeditious, practical manner. For pediatricians, these skills include behavioral management/parent-training approaches, many of which have been developed by psychologists and supported by research findings. In general, many psychologists benefit from the breadth of pediatricians’ knowledge base and experience in clinical care whereas many pediatricians can benefit from psychologists’ research and related knowledge.