Adolescent health care: A public policy perspective.

Focuses on the importance of psychosocial and behavioral components of health care in the area of adolescent health care. The authors contend that it will ultimately be as a direct result of psychology's tangible (and visual) successes in areas such as adolescent health that will lead to psychological services becoming fully accepted within the overall health care system. The underlying policy notion is that if psychology addresses society's perceived needs, society (i.e., the nation's public policy/political leadership) will strive to meet the mental health profession's needs. The majority of problems adolescents face, regardless of apparent physical symptomatology, are essentially behavioral (psychosocial) in nature. The symptom distress model provides for a school-based integration of psychological knowledge with clinical and educational expertise. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Behavioral medicine, clinical health psychology, and cost offset.

The use of medical services is a function of several interacting psychological and social variables as well as a function of physical malfunction. The clinical significance of addressing patients' psychosocial issues has only occasionally been considered. However, the shift in health care economics toward health care maintenance is responsible for the increased interest in interventions in the domain of behavioral medicine and health psychology. Evidence is reviewed for 6 mechanistic pathways by which behavioral interventions can maximize clinical care and result in significant economic benefits. The rationale for further integration of behavioral and biomedicine interventions is also reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benefits of comprehensive health care for improving health outcomes in women.

The American Psychological Association Health Care for the Whole Person Task Force was formulated to provide a rationale for integrating behavioral health services in primary care. Collectively, the task force called for a transformation of the biomedical system into one based on the biopsychosocial model. This article is a summary of the Women's Health Committee position paper that reviewed contextual factors in women's health, provided recommendations for clinical service action, and recommended an integrated primary health care system to address women's health needs. This article provides a vision of integrated care and a practical guide for psychology practitioners as they collaborate with other health care providers and health policy groups to improve health outcomes for women over the life course. (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)     

Journals relevant to health psychology.

This article describes journals of interest to health psychologists. People have long studied the psychological factors of physical health and illness, so one can find articles relevant to health psychology in all but the most narrow of psychological, medical, and psychiatric journals. A complete list, mentioning every journal which might be relevant to health psychology, would be useless. The list presented here has been selected very carefully. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investing in our future: Unrealized opportunities for funding graduate psychology training.

Purpose: Changes in the health care environment have brought challenges and opportunities to the field of psychology. Practitioners have been successful in modifying service models to absorb losses of financial support for behavioral health care, due to managed care and public policy changes, while simultaneously managing the growing need for these services. However, in this reactive mode of responding to evolutions in the health care system, the field of psychology has at times lost sight of the long-term vision required to promote psychology's inclusion in the health care system of the future. In particular, a focus on training psychologists and ensuring the availability of funding to support these activities must be a priority in planning for the future. This article provides an overview of federal programs that currently offer funding for psychology training, as well as other opportunities for federal funding that have been unrealized. Details regarding advocacy efforts that were required to secure available sources of funding are given, followed by consideration of strategies for taking advantage of existing resources and prioritizing advocacy for additional funding. Conclusion: Funding for psychology training provides an avenue for increasing the number of well-trained psychologists who can serve patients' mental and behavioral health needs and thereby improve health outcomes. Moreover, capitalizing on available funding opportunities for psychology training and promoting efforts to expand these opportunities will help ensure that the field of psychology is positioned to remain an important contributor to the health care system of the future. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical health psychology: A health care specialty in professional psychology.

Clinical health psychology is a specialty recognized by both the American Board of Professional Psychology and the American Psychological Association. Clinical health psychology focuses on psychological and behavioral components of illness and health and promotes the understanding of psychology as a health profession. In this article the author reviews its definition, provides a brief overview of practice in the specialty, addresses its relevance for practitioners, and notes sample resources for further study. (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)     

Introduction.

The development of effective interventions that focus on the manipulation and utilization of behavioral and psychological variables to influence health outcomes is an important component of health psychology. Investigators in clinical health psychology make important contributions to our basic understanding of the role of behavioral and psychological factors in disease and contribute to improved patient care in primary, secondary, and tertiary prevention programs. The purpose of the present series of Health Psychology articles is to provide readers who may not be familiar with research in clinical health psychology with a sample of research in this area and to emphasize that the journal is an outlet for research in clinical health psychology. This series of articles represents some of the diversity and strengths of research in clinical health psychology. The investigations range from controlled laboratory investigations to worksite field interventions. The scope of outcome and process measures encompasses behavioral, subjective, and physiological changes. The studies utilize both hypothetico-deductive and inductive theoretical models to generate hypotheses. Finally, several of the studies provide outcomes that clinically benefit the study participants. It is hoped that identification of Health Psychology as a resource for clinical health psychology research will stimulate the submission of more high-quality articles in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nursing and Psychological Treatments.

Presents a comment on "Psychological Treatments" (see record 2004-21168-001) by D. H. Barlow. In his article, Barlow pointed to the need "to solidify the identification of psychology as a health care profession" by changing the terminology of practice in the health care context from psychotherapy to psychological treatments and suggested that the only persons qualified to carry out such interventions are doctoral-level psychologists. Unfortunately, there was no discussion of the health care professionals who already provide psychological treatments in health care settings and their contribution to the evidence base supporting such treatment. The authors find several aspects of the article to be problematic. Overall, the authors feel that suggesting that psychology should claim treatment of psychological disorders and psychological components of physical disorders in health care settings as exclusively its own domain ignores the research and clinical contributions of others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of public/private health care insurance parameters for independent psychological practice.

Managed care cost-cutting strategies are more prevalent in the private (employer provided) than public (Medicare/Medicaid) health care sectors. The main organizational managed care strategy pertaining to the independent practice of psychology has been the separation of the administration of mental from medical health care though behavioral health carve-outs. These organizations typically offer lower reimbursement rates and have greater preauthorization requirements than non-managed care public plans for the same psychological service. Dispute resolution in the private sector involves lawsuits and state consumer protection programs while public plans utilize internal review and are subject to investigations of provider billing fraud and abuse. Behavioral health carve-outs have reduced mental health care utilization rates with unknown effects upon outcome. There is some evidence that psychologists have chosen to limit practice within the private sector, but national data on the overall effect is lacking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some thoughts on health promotion.

Defines health promotion as the planned use of resources to encourage the maintenance and enhancement of health and prevention of disease. A study by G. J. Botvin (1980) is described in which the psychological factors affecting cigarette smoking in adolescents were examined. The study illustrated the relationship between psychological knowledge and health promotion. It is suggested that health promotion is an area in behavioral medicine with applications for applied social psychology and for applied psychological research. (French abstract) (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managed mental health care and independent practice: A challenge to psychology.

Suggests that the rapid development of managed mental health care systems has created serious problems for psychology. Addressed are several issues that are inherent in the manner in which psychology responds to the development of these systems, particularly whether effective psychological treatment must be compromised in such systems. A model of managed mental health care is described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evolution of challenges to researchers in health psychology.

Provides a historical review of current challenges for researchers in health psychology. Current challenges include a) creation of physical pathology, b) physical symptoms of physical pathology in the absence of true pathology, c) increased or decreased vulnerability to infectious disease, d) intensify, prolong, or diminish existing pathology, e) individuals' preoccupation with illness, f) voluntarily engaging in risky behavior, g) engaging in health-enhancing lifestyle behaviors, and h) involuntarily becoming the victim of toxic agents. The shift in public policy as related to psychological research--from mental health to physical illness--reflects societal support for such areas of research by health psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care reform: The 1993–1994 evolution.

Health care costs in the US continue to increase, as does the number of individuals who lack health care coverage. The magnitude of these critical problems assures that reform of the health care system will continue to be debated over the next decade. Increasing health care costs are associated with increased complexity of services and a greater number of health care providers. As health costs increase and the number of individuals covered by private insurance decreases, states will face increasing pressure to develop effective methods of providing coverage for those without health insurance. Employer mandates will be viewed as one method of extending health coverage. Psychologists must be involved in policy issues so as to ensure the utilization of psychological knowledge and attention to psychological and behavioral health needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How psychology can improve effectiveness and reduce costs of health services.

Contends that psychology can be used to prevent heart disease, cancer, accidents and violence, and respiratory disease through programs such as those designed to eliminate smoking, control obesity, reduce stress, and intervene when multiple risk factors are present. Psychological techniques—as useful and cost-saving companions to traditional medical treatments—can increase checkup visits and participation in health screening, improve adherence to medication schedules, aid recovery from surgery, and facilitate outpatient medical service delivery. Since 40–60% of physician visits are for nonmedical reasons that are psychological and behavioral in nature, psychologists can reduce medical care overutilization and unnecessary medical expenditures by offering less costly and more appropriate alternatives. Psychological interventions for health disorders include treatment for pain, asthma attacks not responsive to medical treatment, heart rate variability, gastrointestinal problems, skin disorders, and self-destructive behaviors. It is concluded that psychological procedures offer a means of reducing health care expenditures reliably. (4 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comprehensive program for mental health and behavioral medicine in a large children's hospital.

Primary health care services are differentiated from secondary or tertiary levels of care. Problems of illness-related psychopathology, sometimes called psychosomatic or behavioral medicine, are differentiated from traditional forms of emotional disturbances such as neurosis, psychosis, and personality disorders. It is shown how primary mental health care and behavioral medicine combine to form a special branch of child psychology known as pediatric, medical, or health care psychology. A program for work of this type in a large children's hospital is outlined. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology practice: Design for tomorrow.

This article offers a blueprint for modernizing the delivery of high-quality behavioral health care and for improving access to care by a public sorely in need of psychological services. The blueprint brings together disparate elements of psychology practice into a more unified structure, an updated house, based upon advances in the essential building blocks: evidence-based practice, treatment guidelines, technology, classifications of function, diagnostic systems, outcomes measurement, and integrated health care. The goal is twofold: to make psychological services more accessible to the public and to position psychology for an increasingly major role in health care in order to serve the public weal in diverse communities. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychological Treatments.

Psychology has recently identified itself as a health care profession and codified this change in the bylaws of the American Psychological Association. Although psychologists make a number of contributions to the nation's health-and mental health-the most identifiable activity focuses on treating physical or psychological pathology with psychological interventions. Recently, health care policymakers have established that evidence supporting the efficacy of these interventions is more than sufficient for their inclusion in health care systems around the world. To promote faster and more widespread dissemination of these interventions specifically targeting problems severe enough to be included in health care systems and to solidify the identification of psychology as a health care profession, perhaps it is time for a change in terminology. It is proposed that psychologists label these procedures psychological treatments so as to differentiate them from more generic psychotherapy, which is often used outside of the scope of health care systems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)