Psychology and health care.

Recent advances in health care psychology are noted, especially those involving the conceptualization and treatment of lifestyle and chronic health problems. The contributions to health care psychology of community psychology, brief psychological treatments, behavioral medicine, and health psychology are outlined. The central task of both organized psychology and individual psychologists is to create an underlying structure of clear boundaries and standards for clinical practice and training in health care psychology. Initially, this task should involve an inventory of Canadian psychologists currently providing health care services and the nature and amount of those services. Subsequently, a need exists for the profession to examine and create guidelines in psychological service delivery, professional role models, training, and scientific methods pertaining to general health care. (French abstract) (27 ref) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychology and national health care.

Presents the position of the American Psychological Association concerning the national movement toward a "comprehensive and coordinated system of health services which will be of high quality and equally accessible to all persons." Provisions for recognition and management of emotional and mental disorders and for the optimum use of all qualified health care professionals are urged. Guidelines for the development of a health care program are enumerated and include concern for accessibility of services, patient rights, adequate funding, consumer roles, grievance provisions, program evaluation, and research into the system itself. Criteria for evaluating the adequacy of proposed legislation for a health care system in terms of the mental health provisions and the utilization of psychological services are also presented. It is concluded that "psychologists, by training and experience, have the qualifications to provide independent mental health services and should be permitted to do so." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and primary health care for children.

There is an emerging consensus among those responsible for primary health care to children that such care should not only include medical concerns but also should assist parents with common problems of development and behavior. Psychologists are increasingly included among the personnel of medical groups that provide primary care to children. A model for this relatively new type of practice is described. Such pediatric primary-care settings also offer new research opportunities for psychologists. An important public policy issue concerns how comprehensive primary health care, including psychological services, can be made accessible to all children, and how research to evaluate such services and improve their efficacy can be encouraged. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role functions of pediatric and health psychologists in health care settings.

686 pediatric and health psychologists completed questionnaires requesting background information concerning years of experience, current work settings, graduate training, and professional identification. Ss were also asked to describe services and functions they performed, difficulties they encountered, and general consultation goals. Results suggest that both groups are involved in a wide range of diagnostic, treatment, and consultative activities in health care settings and that there are many similarities in the ways they conceptualize their roles and how they function. However, pediatric psychologists were especially involved in clinical assessment activities, whereas research was a high priority for health psychologists. Other aspects of the roles, functions, and activities of these 2 groups are described. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology in health care: Future directions.

The nature of health care delivery in the U.S. will change radically in the next 5 years, and the nature of psychological services provided will also change. Psychology is evolving into a primary health care profession, at least in terms of "health psychology" broadly defined. Modern clinical health psychology includes, at the minimum, rehabilitation psychology, neuropsychology, and traditional health psychology. The present article represents the views of 20 experts from this evolving area of practice and research on matters of public policy, training, and the future of psychology in health care settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists in health care settings: An introduction.

Summarizes a series of articles that examine such topics as the operation of health maintenance organizations, the training of psychologists for various health care settings, and the legislative and political issues affecting the delivery of health care. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and health.

This article traces the historical development of Canadian medicare and its significant influence on shaping not only the clinical services provided within Canada's public health care system but also its major impact on the nation's overall health research agenda. Particular emphasis is placed on how this has influenced the development and role of psychology in the public health care system. It is argued that all psychologists, whether their work is focused on the applied or experimental areas of the discipline, have much to offer Canadians across the entire health care spectrum. Nevertheless, psychological services in the public health care system, and particularly in hospitals, have mainly developed within and continue to be primarily focused around mental health. Services in nonmental health areas of health have been more limited, although their importance is well recognized. The current situation partly reflects the limited training in general health issues that clinical psychologists-in-training generally receive in many graduate school programs in Canada. However, it also reflects the overall influence of medicare on the development of Canada's health care system. Medicare has tended to focus the activities of Canada's health care system primarily on treating illness rather than on preventing it and/or maintaining health. Also, medicare has oriented Canada's health care system mainly toward delivering medical services rather than providing more comprehensive health services (e.g., the "medically necessary" criterion for funding). However, times are changing. The growing emphasis among health policymakers in Canada on illness prevention and health promotion (e.g., the creation of the federal government Public Health Agency of Canada in 2004) will significantly expand psychology's role across all areas of health. Psychology education and training programs are urged to seriously examine whether psychology practitioners and researchers are being adequately prepared at present for the much broader array of future interdisciplinary professional, research, and educational activities and responsibilities that will emerge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirical support for psychological assessment in clinical health care settings.

Psychologists in health care settings today find it increasingly difficult to obtain authorization and appropriate reimbursement for psychological assessments from 3rd party payers. Authorization and reimbursement denials often are based on allegations that empirical support for the utility and validity of psychological tests is nonexistent or limited. This article reviews a sample of the considerable empirical support that exists for the utility and validity of a variety of psychological tests for a wide range of clinical health care applications. Informed by data such as these, psychologists should become more effective in their abilities to seek authorization and reimbursement for assessment and overturning denials. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Day care and early childhood settings. Fostering mental health in young children

The authors, with research supporting the relationship between experience and the developing brain, envision a new and innovative model of child care in which principles of child development and mental health play an integral role. The School of the Twenty-first Century, although housed in existing school buildings, will be far more than a traditional 8:00 AM-to-3:00 PM educational facility. It will become a hub of child and family life in the community and provide institutional and outreach services for children from birth to 12 years of age. Active developmental and mental health programs that provide education for parents, primary caretakers, and other providers are central to the model. These programs will include preventive, evaluative, and treatment services for children. The child psychiatrist is viewed as an important member of the mental health team, who helps identify, assess, and treat children with developmental and psychiatric difficulties.     

Communication and records: Hippa issues when working in health care settings.

To refocus awareness on the original mandate of the Health Insurance Portability and Accountability Act (HIPPA) regulations, this article will review record keeping requirements and examine patient-doctor and interdisciplinary communication as a way to improve the health care consumer's trust in the privacy of their personal information while facilitating integrated and fluid health care delivery systems. The HIPPA rules especially important in medical settings are discussed with a special emphasis on issues confronting psychologists who practice outside of medical institutions and hospitals. The article also examines important implications for practice activities when psychologists attend patients who are hospitalized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and public policy in the "health care revolution."

In this article we give a brief overview of the rapid changes taking place in health care delivery in this country, focusing particularly on cost-containment efforts, organizational restructuring of the medical-industrial complex, and this decade's procompetitive market. Psychologists need to be aware of current policy trends and potential future changes in health and to consider alternative roles in emerging health care systems. Further, mental health policy is heavily influenced by the form and context of health policy. We argue that a top-down analysis of resource allocation is necessary for responsible public policy in health and mental health care. We discuss opportunities and challenges for psychology within this framework in service, research, and education. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology can be indispensable to health care reform and the patient-centered medical home.

The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March 2010, making health care reform a reality. Perhaps the most well-developed model of primary care that aligns with the PPACA's agenda is the patient-centered medical home (PCMH). Integrated care, as defined by collaborative care between mental health and primary care providers and systems, will undoubtedly play a critical role in the success of the PCMH. The role of psychology and integrated care in the PCMH as well as training implications for psychologists are discussed. This article is intended to challenge our discipline to embrace psychology as a health care profession that must prepare for and solidify its added value in the health care delivery models of the future. Requisite skill sets for primary care psychologists and existing training opportunities are presented. Finally, possible mechanisms for training psychologists in integrated care and the professional roles primary care psychologists can expect to fill are proposed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychology and the health systems agencies.

Criticizes H. Silverman's (see record 1980-30929-001) report on activities as a psychologist involved in health planning because Silverman focuses attention on examples of planning for medical health rather than for mental health. Silverman also does not identify the particular problems, needs, challenges, and opportunities for psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and the mental health movement.

The following points are elaborated: "1. Among many other things, mental health is a vast social movement which, for better or for worse, will carry us all along with it. 2. Psychologists, for a number of reasons, have not been enthusiastic participators in this social movement. 3. Psychologists have a great deal to contribute to the mental health movement, and they can contribute mightily without loss of identity." Mental health as a social movement seems due to three factors: (a) The tendency to conceive human behavior in naturalistic terms. (b) The American belief in the almost infinite improvability of almost anything. (c) The rising level of aspiration for health and well-being. The scientific humility of the psychologist "can become maladaptive diffidence, and diffidence sometimes becomes irresponsibility." 6 suggestions for dealing with diffidence are indicated. The psychologists perceptions of mental health, the orientation of the movement toward the "pathological," and the focus on the clinical may have discouraged the interests of psychologists in mental health. The unique contribution of the psychologist to mental health is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Historical, current, and future models of schools as health care delivery settings.

Explores existing models of the school as a health care service delivery setting and considers the implications of these models for the practice of psychology in schools. Since the delivery of health services in schools in the present has emerged in response to social needs from the past, the issue of schools as health care settings is examined from both a historical and contemporary perspective. Emphasis is limited in scope to the school as a bureaucratic structure in which models of health service delivery are situated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Youth psychotherapy change trajectories and outcomes in usual care: Community mental health versus managed care settings.

Objective: The authors compared symptom change trajectories and treatment outcome categories in children and adolescents receiving routine outpatient mental health services in a public community mental health system and a private managed care organization. Method: Archival longitudinal outcome data from parents completing the Youth Outcome Questionnaire (Y-OQ) were retrieved for children and adolescents (4–17 years old) served in a community mental health system (n = 936, mean age = 12 years, 40% girls or young women, 28% from families of color) and a managed care organization (n = 3,075, mean age = 13 years, 45% girls or young women, race and ethnicity not reported). The authors analyzed Y-OQ data using multilevel modeling and partial proportional odds modeling to test for differences in change trajectories and final outcomes across the 2 service settings. Results: Although initial symptom level was comparable across the 2 settings, the rate of change was significantly steeper for cases in the managed care setting. In addition, 24% of cases in the community mental health setting demonstrated a significant increase in symptoms over the course of treatment, compared with 14% of cases in the managed care setting. Conclusions: These results emphasize the need for increased attention to negative outcomes in routine mental health services and provide a stronger foundation for identifying youth cases at risk for treatment failure. In addition, given the overall differences observed across treatment settings for average rate of change and deterioration rates, results suggest that setting-specific model heuristics should be used for identifying cases at risk for negative outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Professional transition: Psychology internships in rehabilitation settings.

The professional literature is limited in its coverage of the challenges of clinical and counseling internship training in rehabilitation settings. The characteristics of the patient population, the goals of rehabilitation, and the team approach require the development of professional role behaviors appropriate to these facilities. The present article explores relevant issues and presents suggestions for augmenting training programs to make them congruent with the distinctive aspects of rehabilitation. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suggestions for psychologists working with Mexican American individuals and families in health care settings.

The number of Mexican Americans in the United States continues to grow at a rapid rate. As these numbers increase, so does the likelihood that Mexican Americans will eventually come into direct contact with the health care system. Mexican Americans with traditional Mexican attitudes, values, and behaviors encounter barriers as they attempt to access medical and rehabilitative care. Issues such as acculturation, language, family, interdependence, attitudes toward authority, and time orientation are some of the areas that may present challenges to rehabilitation staff. Psychologists working in health care facilities who have the cultural competence to intervene effectively with the Mexican American patient can play an important role in helping to remove some of these barriers. Specific suggestions for working with Mexican American patients are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Geropsychology in long-term care settings.

Discusses services trained psychologists can offer in long-term care settings for the aged, including individual assessment, psychotherapy, staff training, program consultation, and development. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology in the current mental health marketplace.

The market forces that have shaped the practice of psychology in recent years have occurred within the context of broader changes in the U.S. health care system over several decades. This article reviews important trends in the mental health marketplace and considers the opportunities that these trends may present for professional psychology. There now appears to be more opportunity to balance cost and quality considerations within an increasingly competitive and regulated managed care market with increasingly sophisticated purchasers. Several emerging payment models may provide additional opportunities for psychologists with the requisite knowledge and business strategy to assume the risk involved. (PsycINFO Database Record (c) 2010 APA, all rights reserved)