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)     

Some unresolved challenges facing psychology's entrance into the health care field.

Psychology has recently attempted to broaden service, research, and training opportunities. However, major differences between psychology and medicine over paradigms, training approaches, and organizational and professional practice issues may impede psychology's growth in the health science field. The hospital setting for physicians and for university and community training environments for psychologists foster the development of different analytic abilities and attitudes regarding disciplinary primacy and approaches to patient care. As such, total medical authority over all health-related professions is sought. This medical dominance is inimical to the emergence of psychology as an independent health-related discipline. These differences are further magnified at a professional level, as psychology expands the scope of its practice and threatens the economic and organizational control that medicine exerts over health care. Concern is expressed over the ability of psychology to establish itself as a major force in a field that is structurally dominated by the medical profession, which would probably resist any change that is not in its own best interest. (42 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)     

Predoctoral training in collaborative primary care: An exam room built for two.

Psychologists have discovered new training and practice opportunities by collaborating with family physicians. This article describes a collaborative practicum experience in which predoctoral psychology students teamed with family medicine residents to provide care for family medicine outpatients. Psychology students improved their clinical skills and reported learning valuable collaborative skills. Family medicine residents increased their postpracticum mental health diagnoses and their mental health referrals and changed their attitudes about providing mental health care. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Stumbling blocks to the practice of health psychology: A Canadian perspective.

Argues that Canadian provincial legislation regulating the practice of medicine ignores the common goals of medicine and health psychology and therefore may impede the practice of health psychology in Canada. It is suggested that the contributions made by health psychology practitioners in the treatment of physical injuries or diseases be recognized. (French abstract) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Introduction to the Special Section on the Future of Health Psychology.

Following 25 years of landmark progress, health psychology faces even greater change in the foreseeable future. Evolving patterns of health and illness and developments in medicine and related fields will shape the future of health psychology. The articles in this special section discuss these future issues in several areas: the biopsychosocial model, changes in demographics, prevention, clinical health psychology interventions, health care financing, and new technologies. In every case, the future holds a variety of important challenges and opportunities in research, practice, training, and policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rehabilitation Psychology, Medical Psychology, Health Psychology, and Behavioral Medicine.

In their recent article, "The Distinctiveness of Rehabilitation Psychology," Shontz and Wright (see record 1981-26520-001) attempt to differentiate rehabilitation psychology from other areas of applied and professional psychology in health settings. Although the authors' historical recounting of early research and theory in rehabilitation psychology is informative, too little emphasis is placed on the relationship between rehabilitation psychology and "mainstream" professional psychology, particularly with regard to its health-setting applications. There appear to be more similarities than differences. The authors' argument runs full circle, namely, that rehabilitation psychology is distinct because of its philosophy, but its philosophy and "principles are valuable to psychologists in many specialties" (p. 919). The notion of involving a patient in his/her care and treatment planning also is not unique to rehabilitation psychology. Shontz and Wright state that rehabilitation psychology is not medical psychology; however, instead of defining medical psychology, they go on to talk about medical care. Medical care is not medical psychology. Further confusion is added by the statement that medical psychology should be a component of rehabilitation psychology. The authors are using medical psychology, health psychology, and behavioral medicine as if they are synonymous, when they are not. Each discipline is made distinct here. Shontz and Wright do not address what the majority of psychologists in rehabilitation do, that is, provide services. In short, although the authors complain about the unfamiliarity of rehabilitation psychology relative to the profession as a whole, their article does little to promote rehabilitation psychology as an area of interest important to professional psychologists in health care and/or rehabilitation. (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)     

Cost containment in clinical psychology: Critique of Biodyne and the HMO.

Cost containment has become the major theme of the day within health care. The growing "corporatization" of health services has drawn the attention of many clinical psychologists, and a number have expressed deep concern over the incursions of health maintenance organizations into psychologists' practice. They have claimed that the process of corporatization in health care has caused a genuine "crisis" that will destroy the practices of many psychologists, unless practitioners themselves adopt corporate methods and alter their mode of practice to fit a brief-treatment model. In this article, the context of pressures for cost containment is examined, and Cummings's proposed model for American Biodyne Centers is reviewed. Cummings's claim that Biodyne is an alternative to corporatization is questioned, as is the notion of crisis in health care. In the new models of corporate-inspired practice in psychology, the therapeutic relationship is poorly conceptualized, and patient interests are treated as secondary in importance to organizational demands for cost savings. In the absence of clear conceptualization of why, whom, and how clinicians hope to help, the professional status of clinical psychology is placed at serious risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioural science and behavioural medicine revisited.

Presents a retrospective view of the relations between behavioral science and behavioral medicine that shows that the concept of "behavioral medicine" has wider and deeper roots than are usually recognized by those who date its inception from the 1970's. Its premises and procedures are also best seen as being broader than those involved in, for example, behavior modification and biofeedback. It is suggested that even the use of the term "health psychology" may divert appreciation from the contribution of the behavioral sciences in general to the problems of health and illness. Three main forces at work in the behavioral sciences are discussed: psychiatry's expanding role in medical education, social change and innovation, and the involvement of social scientists in health care. J. D. Matarazzo's (see record 1980-31050-001) definition of health psychology as the aggregate of the specific educational, scientific, and professional contribution of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, and the identification of etiologic and diagnostic correlates of health, illness, and related dysfunction, is proposed as a more encompassing definition. (French abstract) (24 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)     

Clinical cross-training: Compatibility of sport and family systems psychology.

Sport psychology offers unique opportunities for (a) expanding one's practice beyond areas regulated by managed care and (b) using one's knowledge of psychology to cultivate health, wellness, and positive aspects of life. This article describes how developing expertise in sport psychology may benefit a practitioner, with special attention to family systems psychologists evaluating their own suitability for working in the sport and exercise area. In addition to expanding one's practice, ways in which sport psychofogy expertise may enhance overall clinical skills are noted. The article concludes with a checklist to evaluate suitability for "cross-training" in sport psychology and recommendations for initiating the process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Psychology and Medicine: Psychobiological Dimensions of Health and Illness.

Reviews the book, Psychology and Medicine: Psychobiological Dimensions by Donald Bakal (1979). Bakal believes that psychology "is rapidly becoming an integral part of modern health care delivery systems" and directs his book toward developing this interest by showing the theoretical and practical relevance of psychological concepts to major health problems. In the first section, which has the inclusive title "Medicine: Mind and Body", he describes a "paradigm shift" in medicine, away from an emphasis on the physiological and biochemical systems as basic to understanding disease toward a "psychobiological" approach to illness which focuses on the inter-relationships between the social, psychological, and physiological determinants of health and disease. He amplifies this point by discussing such matters as personality-disease relationships, psychomatic medicine, a cross-cultural variation in models of health and illness and the implications of the split brain research for states of consciousness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counseling psychology in clinical health psychology: The impact of specialty perspective.

Not all clinical health psychologists are trained as clinical psychologists. A significant minority is trained and identifies as counseling psychologists. As a field, it is important to understand how the specialty-specific values, training context, scholarship, and parameters of practice of counseling psychology contribute to clinical health psychology. In this article, we (a) identify the core values and training context of counseling psychology, (b) review the scholarly history of clinical health psychology by counseling psychologists, (c) present the parameters of practice of clinical health psychology as identified from the extant counseling psychology literature, and (d) examine American Psychological Association membership status to investigate joint membership in the Division of Health Psychology and the Society of Counseling Psychology. Conclusions indicate that (a) an identifiable set of core values guides the training of counseling psychologists, (b) scholarly literature by counseling psychologists has contributed to the growth and development of clinical health psychology, and (c) parameters of practice reflect the specialty-specific perspective of counseling psychology. As professional psychology continues to grow as a health care profession, clinical health psychology will benefit from the knowledge, values, attitudes, competencies, and practice parameters of counseling psychology, and counseling psychology will benefit from recognizing what it brings to the practice of clinical health psychology. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Provider profiling: What works for medicine works for mental health?

Provider profiling is a growing practice in organizations that supply or pay for health care, and escalating health care costs are likely to accelerate this trend. First developed for general medical settings, profiling systems now challenge practicing psychologists to meet ostensibly objective, scientific standards of care. The most advanced approaches compare providers on a "level playing field" statistically adjusted for variations in the "illness burden" of their patients. Profiling psychological practice, however, requires specialized new tools and more sophisticated analytical methods than have typically been used. This article provides a practical overview of provider profiling, emphasizing related developments in health care policy that are perhaps less familiar to practicing psychologists. Potential pitfalls confronting professional psychology are discussed, and points for advocacy are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practicing psychology in the era of managed care: Implications for practice and training.

Beginning with the HMO Act of 1973, managed care, a system for controlling health care costs, rapidly expanded and gained influence as the main vehicle for health care delivery in the United States. Implementation of managed care principles in the mental health arena has generated much debate, particularly with respect to issues of quality of care. The authors briefly trace the development of managed care and evaluate its impact on the practice of psychology. The extant literature is reviewed with specific attention to issues of quality of care, confidentiality of patient information, and shifting practice patterns of clinicians. Finally, the future of professional psychology within the context of managed care is examined, and the implications of newly created mental health roles for practitioners, training programs, and organized psychology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care psychology: Prospects for the well-being of children.

Reviews historical as well as recent developments in the area of health care psychology for children. This area is contrasted with both behavioral medicine for adults and the traditional areas of child psychology. Certain unique characteristics of psychodiagnosis and psychotherapy in health care psychology are pointed out. Promising areas for future research are described, and implications for the wellbeing of children are drawn. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rehabilitation: Psychology's greatest opportunity?

Rehabilitation (RHB) is one of the fastest growing areas in the health industry. Supported by several key pieces of legislation, psychologists have established themselves as integral health care providers in RHB. Although psychologists have benefited from legislated membership in RHB, most individual psychologists and the psychological associations have not recognized the importance of public policy for the practice of psychology. Escalating health care costs have resulted in major revisions in the manner in which health insurers reimburse treatment. Medicare, the major federal health insurance provider, increasingly has been viewed as a model for the provision of all health care. The historic exclusion of psychologists from Medicare has limited the scope of psychologists' practice and the growth of professional psychology. The recent inclusion of psychologists in Medicare improves but does not solve practice and policy issues confronting psychology. Knowledge of national health policy formulation and greater participation by psychologists in health policy are necessary to secure the scope of professional practice most psychologists expect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Viability and recovery of peripheral blood mononuclear cells cryopreserved for up to 12 years in a multicenter study

Polish physicians-philosophers tried to find a compromise between medicine as a science and medicine as a healing art. They stated that clinical practice should be transformed into science, bearing in mind that there would be no medicine without the existence of the sick. A perfect physician is a good and wise person and not exclusively a proficient expert. Polish physicians exercised a science that they called philosophy of medicine. It included logic, psychology, and medical ethics. The Polish school claimed that the history of medicine and philosophy of medicine are necessary for future doctors. The historical and philosophical approach makes it possible to recognize the subject of medicine (health, disease, and the sick) and its aim (treatment, restoration of health or just alleviation of suffering). The ethics teaches what values are pursued by medicine, what moral duties a doctor has, and what role model to follow to become a good physician. Placing the sick in the focus of medical interest, the Polish school taught future physicians to see in them suffering fellow men who should be embraced with care, compassion, and Christian charity. Such an approach to the ethical aspect of medical philosophy became incorporated into an education towards humane values, responsibility for ones' life and health in the spirit of the ethics of care.     

Testing the biopsychosocial model: The ultimate challenge facing behavioral medicine?

Proposes that the ultimate challenge facing behavioral medicine is the empirical testing of the biopsychosocial model. Drawing upon S. C. Pepper's (1942) philosophy of science writings, the author illustrates the formistic, mechanistic, contextual, and organistic ways of thinking about health and illness. It is suggested that single-category, single-cause, single-effect models of health and illness are being replaced by multicategory, multicause, multieffect models and that this reflects a major paradigm shift in science in general. Basic aspects of systems theory are applied to the 4 major definitions of behavioral medicine and the 4 major stages of clinical research. The Patient Evaluation Grid is used to highlight how clinical data can be collected biopsychosocially. The emerging roles of psychology as the "middle" discipline and medicine as a biopsychosocial profession are considered in relation to medical education and the practice of behavioral medicine. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)