An introduction to psychologists treating medically ill patients: Competent practice and seeking credentials in organized health care settings for routine or incidental practice.

Psychology has been recognized as a health care science and profession, and psychologists have been working clinically with medically ill patients and within organized health care settings and hospitals for decades. The potentially daunting environment of organized health care should be seen by psychology as an opportunity to further develop and expand its scope of practice. With knowledge of that environment's rules, regulations, ethics, bylaws, and traditions, the clinically competent psychologist who is first seeking to practice in hospitals should succeed alongside psychologists with busy practices who are already exclusively or occasionally within an organized health care setting or medical facility. This article reviews issues of competency, credentialing, privileges, bylaws, and practice expansion to guide psychologists toward a successful hospital practice with medically ill patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A step in the right direction: A resource for collaboration on health-related issues.

Reviews the book, Health-related disorders in children and adolescents edited by L. Phelps (see record 1998-07780-000). This edited text provides an overview of 96 medical conditions that place children at risk of developing psychological or educational problems. The central feature of this book is that it is intended as a reference tool for professionals who collaborate with medical professionals. Increasingly, there have been many vehicles for school psychologists to collaborate with medical professionals, including comprehensive school health care programs and school-based health clinics, and community-based coordinated services that provide children and youth comprehensive care. In this regard, school psychologists are likely to encounter increasing numbers of children who experience health disorders, along with more traditional areas of practice including mental health and educational issues. Although not a purely medically oriented text, Phelps has taken a perspective that school psychologists work within the context of a multidisciplinary team of professionals who are likely to provide services for these children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emergency medical services for children: Beyond lights and sirens.

This article describes the history of emergency medical services for children and identifies important mental health issues. It discusses the roles of psychologists in such services, including intervening with children and their families during times of crisis, helping others who are providing the physical care of children to mitigate rather than exacerbate children's emotional distress, and attending to the emotional needs of health care providers who treat children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Public policy and the provision of psychological services to older adults.

Public policy shapes who delivers health care, how care is delivered, and how much providers are paid. The impact of public policy will become even more important to psychologists who serve older adults as 76 million members of the so called “baby boom” generation enter their later years. Armed with basic public policy facts, psychologists can better maneuver the systems created by public policy and even change policy. This article reviews how Medicare works since it is the primary payer of mental health services for older adults. The article then turns to the question of how many health care professionals (including psychologists) will be required to meet the needs of a rapidly growing older population and concurrent challenges of training and building that work force. Finally, different policy visions for a better mental health care system for older adults are summarized since they may be roadmaps to what the future of mental health care will look like. The article closes with practical recommendations on how psychologists can influence mental health and aging public policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Linking psychologists and family physicians for collaborative practice.

This article describes a pilot, demonstration project that linked psychologists and family physicians to improve the care of patients with alcohol and other drug abuse problems. The project facilitated collaborative practice between family physicians and psychologists to enhance treatment of patients with alcohol and other drug abuse and other psychosocial problems in rural America. Ten pairs of psychologists and family physicians in rural Texas and Wyoming participated in the project. The training successfully established linkages between psychologists and family physicians for the care of a broad range of medical and psychological problems. This article discusses the linkage training, factors that facilitated and hindered collaboration, as well as implications for future training and collaborative health care practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological consultation with primary care physicians: Obstacles and opportunities in the medical setting.

This article discusses the relationship between psychologists and primary care physicians and describes the training and practice of physicians in the areas of mental and behavioral health care. Issues affecting the relationship between psychologists and primary care physicians are then reviewed. Different models of psychological consultation are discussed, and an integrated behavioral systems model of psychological consultation is presented as a potentially effective model for consultation with primary care physicians. This model provides a framework for psychologists to function as coproviders of primary health care services. Practical strategies to enhance collaboration between psychologists and primary care physicians in private practice are discussed. The need for more research on primary care and for the inclusion of psychologists in managed care and health care reform are also highlighted. (PsycINFO Database Record (c) 2010 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)     

Clinical psychology in general hospital settings: Issues in interprofessional relationships.

We suggest that the involvement of clinical psychologists in health care teams may not necessarily improve health care. The position of clinical psychology with regard to medical theory and practice is examined. Then issues arising from multidisciplinary teamwork, with particular emphasis on consultation–liaison work, are discussed. We conclude that professional power structures in hospital settings have a profound influence on clinical psychological practice and that these issues need to be explicitly addressed before health care can benefit from the expertise of clinical psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Divided No More: Psychology's Role in Integrated Health Care.

Health-care providers increasingly recognize the need to address behavioural and emotional influences on physical health in order to provide quality and cost-effective services. As behaviour change experts, psychologists can be critically important in new models of integrated care that focus on both physical and psychological health. However, to be effective, psychologists must be prepared to address the major issues facing health-care systems today and be willing to re-examine and modify current modes of education and practice. This article describes important trends affecting health care and the ways in which psychologists could contribute. Lastly, two psychologists involved in new models of integrated care describe their training and the challenges and rewards of their current activities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health psychology practice with asthmatics.

Behavioral and psychological problems associated with physical diseases can be most effectively and efficiently cared for by health psychologists/clinical psychologists who specialize in the care of such problems and who practice as independent professionals sharing responsibility for patient care with physicians treating the disease itself. If the optimum care of independent health psychology practice is to be realized, however, there must exist well-defined spheres of responsibility for each profession. The present article suggests 9 area divisions of responsibility (e.g., medication overuse, malingering, and noncompliance) in caring for asthmatics. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mobility for industrial-organizational and consulting psychologists.

This article addresses an important aspect of professional mobility: the need for industrial-organizational (I/O) and other psychologists who provide consultation to businesses and who are licensed in one jurisdiction to be able to practice for a short term in another. A growing number of these psychologists have national practices. Current laws and regulations, typically designed for clinicians providing direct mental health services, make such practice difficult. The article provides an analysis of state laws and regulations dealing with short-term cross-state practice and describes the challenges confronted by I/O and consulting psychologists in working across jurisdictional lines. Recommendations for rectifying this issue are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attaining medical staff membership and privileges for psychologists: A case study.

The profession of psychology has grown substantially over the last 20 years, yet throughout the United States, there are disparities in practice expansion. One notable disparity is in the domain of hospital practice. Why do psychologists lack parity in various hospital settings? The purpose of this article is to draw attention to the issue of professional inequities psychologists face in inpatient medical facilities, and to question why more has not been achieved. The article provides a theoretical foundation in support of full medical staff membership for psychologists, key principles or “how to” guide for obtaining medical staff membership, and a case example that describes an innovative, primary care solution that worked in a large hospital system. The article concludes with a frank look at obstacles that psychologists continue to face and discussion regarding how to navigate these barriers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How Changes in Population Demographics Will Impact Health Psychology: Incorporating a Broader Notion of Cultural Competence Into the Field.

U.S. population demographics are undergoing striking changes that will impact health care and the research and practice of health psychology. An increase in the number of people who are older; belong to an ethnic minority group; have disabilities; identify as lesbian, gay, bisexual, or transgendered; or live in poverty will influence definitions of aging, health, and illness, and will challenge current psychological and medical treatment models. The authors argue that health psychologists need to become context competent for the field to be relevant and viable over the course of this new century. Health psychologists need to become aware of the multiple, overlapping contexts in which people live and apply this knowledge on a regular basis to research, practice, education and training, and policy in health psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interdisciplinary collaboration in outpatient practice.

Psychology has had a long history of collaboration with the medical profession. This collaboration has been greatly enhanced over the past decade or more as an increasing number of psychologists have become successful in applying the science and practice of psychology to the problems of health and illness. This article reviews and summarizes salient aspects of professional issues in practice that contribute to successful collaboration with physicians in primary and tertiary ambulatory health care settings. Practical strategies to enhance collaboration in independent practice are discussed. (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)     

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)     

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)     

The hospital practice of psychology.

Outlines California laws that enable clinical psycholgists to practice in hospitals and residential health care facilities. Survey data indicate that when projected nationally, the number of licensed psychologists who hold appointments to the organized medical staff of a hospital is approximately 6,800. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists in geriatric medicine: Results of a national survey.

51 physician directors of geriatric medicine fellowship programs were surveyed on their current and desired involvement with psychologists, perceived areas of expertise of psychologists, comparisons of psychologists with overlapping health care professions, and factors limiting involvement of psychologists in geriatric medicine. Results indicate that psychologists are quite involved in most geriatric medicine training programs and that directors of these programs welcome their greater involvement. Significantly, psychologists and psychiatrists are rated as similar in expertise in most areas of clinical practice. Neuropsychological assessment and family therapy are areas of psychologist expertise that are seen as especially valuable. Factors that may increase psychologist involvement in geriatric medical settings and the special importance of medical settings for the care of older patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Moving behavioral medicine to the front line: A model for the integration of behavioral and medical sciences in primary care.

Psychologists have an unprecedented opportunity to influence primary medical care systems where chronic conditions, somatic symptoms, and health-threatening behaviors are prevalent. The authors developed a new model to incorporate behavioral medicine expertise into existing primary care practice with the purpose of delivering integrated, comprehensive, and efficient health care through physician training and direct patient care services. This model moves psychologists from isolated referral settings to the front line of medical care, where a broader impact on the outcomes and costs of health care can be achieved. (PsycINFO Database Record (c) 2010 APA, all rights reserved)