From Wikipedia, the free encyclopedia
Health psychology is the study of psychological and behavioral processes in health, illness, and healthcare. The discipline is concerned with understanding how psychological, behavioral, and cultural
factors contribute to physical health and illness. Psychological
factors can affect health directly. For example, chronically occurring
environmental stressors affecting the hypothalamic–pituitary–adrenal axis,
cumulatively, can harm health. Behavioral factors can also affect a
person's health. For example, certain behaviors can, over time, harm
(smoking or consuming excessive amounts of alcohol) or enhance (engaging
in exercise) health. Health psychologists take a biopsychosocial
approach. In other words, health psychologists understand health to be
the product not only of biological processes (e.g., a virus, tumor,
etc.) but also of psychological (e.g., thoughts and beliefs), behavioral
(e.g., habits), and social processes (e.g., socioeconomic status and ethnicity).
By understanding psychological factors that influence health, and
constructively applying that knowledge, health psychologists can
improve health by working directly with individual patients or
indirectly in large-scale public health programs. In addition, health
psychologists can help train other healthcare professionals (e.g.,
physicians and nurses) to apply the knowledge the discipline has
generated, when treating patients. Health psychologists work in a
variety of settings: alongside other medical professionals in hospitals
and clinics, in public health
departments working on large-scale behavior change and health promotion
programs, and in universities and medical schools where they teach and
conduct research.
Although its early beginnings can be traced to the field of clinical psychology, four different divisions within health psychology and one related field, occupational health psychology (OHP), have developed over time. The four divisions include clinical health
psychology, public health psychology, community health psychology, and
critical health psychology. Professional organizations for the field of health psychology include Division 38 of the American Psychological Association (APA), the Division of Health Psychology of the British Psychological Society (BPS),[10] the European Health Psychology Society (EHPS), and the College of Health Psychologists of the Australian Psychological Society (APS). Advanced credentialing in the US as a clinical health psychologist is provided through the American Board of Professional Psychology.
Overview
Recent
advances in psychological, medical, and physiological research have led
to a new way of thinking about health and illness. This
conceptualization, which has been labeled the biopsychosocial model,
views health and illness as the product of a combination of factors
including biological characteristics (e.g., genetic predisposition),
behavioral factors (e.g., lifestyle, stress, health beliefs), and social
conditions (e.g., cultural influences, family relationships, social support).
Psychologists
who strive to understand how biological, behavioral, and social factors
influence health and illness are called health psychologists. Health
psychologists use their knowledge of psychology and health to promote
general well-being and understand physical illness. They are specially trained to help people deal with the psychological
and emotional aspects of health and illness. Health psychologists work
with many different health care professionals (e.g., physicians,
dentists, nurses, physician's assistants, dietitians, social workers,
pharmacists, physical and occupational therapists, and chaplains) to
conduct research and provide clinical assessments and treatment
services. Many health psychologists focus on prevention research and
interventions designed to promote healthier lifestyles and try to find
ways to encourage people to improve their health. For example, they may
help people to lose weight or stop smoking. Health psychologists also use their skills to try to improve the
healthcare system. For example, they may advise doctors about better
ways to communicate with their patients. Health psychologists work in many different settings including the UK's National Health Service
(NHS), private practice, universities, communities, schools and
organizations. While many health psychologists provide clinical services
as part of their duties, others function in non-clinical roles,
primarily involving teaching and research. Leading journals include Health Psychology, the Journal of Health Psychology, the British Journal of Health Psychology, and Applied Psychology: Health and Well-Being. Health psychologists can work with people on a one-to-one basis, in groups, as a family, or at a larger population level.
Health psychology, like other areas of applied psychology, is
both a theoretical and applied field. Health psychologists employ
diverse research methods. These methods include controlled randomized experiments, quasi-experiments, longitudinal studies, time-series designs, cross-sectional studies, case-control studies, qualitative research as well as action research. Health psychologists study a broad range of health phenomena including cardiovascular disease (cardiac psychology), smoking habits, the relation of religious beliefs to health, alcohol
use, social support, living conditions, emotional state, social class,
and more. Some health psychologists treat individuals with sleep
problems, headaches, alcohol problems, etc. Other health psychologists
work to empower community members by helping community members gain
control over their health and improve quality of life of entire
communities.
Clinical health psychology (ClHP)
ClHP
is the application of scientific knowledge, derived from the field of
health psychology, to clinical questions that may arise across the
spectrum of health care. ClHP is one of the specialty practice areas
for clinical and health psychologists. It is also a major contributor to
the prevention-focused field of behavioral health and the treatment-oriented field of behavioral medicine. Clinical practice includes education, the techniques of behavior change, and psychotherapy. In some countries, a clinical health psychologist, with additional training, can become a medical psychologist and, thereby, obtain prescription privileges.
Public health psychology (PHP)
PHP
is population-oriented. A major aim of PHP is to investigate potential
causal links between psychosocial factors and health at the population
level. Public health psychologists present research results to
educators, policy makers, and health care providers in order to promote
better public health. PHP is allied to other public health disciplines
including epidemiology, nutrition, genetics and biostatistics.
Some PHP interventions are targeted toward at-risk population groups
(e.g., undereducated, single pregnant women who smoke) and not the
population as a whole (e.g., all pregnant women).[citation needed]
CoHP
investigates community factors that contribute to the health and
well-being of individuals who live in communities. CoHP also develops
community-level interventions that are designed to combat disease and
promote physical and mental health. The community often serves as the
level of analysis, and is frequently sought as a partner in
health-related interventions. A prominent focus of community health psychology is how to promote and
strengthen health systems in communities. By doing so, community health
psychologists hope to improve health across generations in a family.
This comes with a strong focus in maternal and child care to do so.
Critical health psychology (CrHP)
CrHP
is concerned with the distribution of power and the impact of power
differentials on health experience and behavior, health care systems,
and health policy. CrHP prioritizes social justice and the universal right to health
for people of all races, genders, ages, and socioeconomic positions. A
major concern is health inequalities. The critical health psychologist
is an agent of change, not simply an analyst or cataloger. A leading
organization in this area is the International Society of Critical Health Psychology.
Occupational health psychology
Occupational
health psychology brings together aspects of health psychology and
industrial/organizational psychology to protect and improve health and
workalike balance. Two of the main focuses are on occupational stress
and workplace interventions. Pickren and Degni and Sanderson observed that in Europe and North America, occupational health psychology
(OHP) emerged as a specialty with its own organizations. The authors
noted that OHP owes some of that emergence to health psychology as well
as other disciplines (e.g., i/o psychology, occupational medicine).
Sanderson underlined examples in which OHP aligns with health
psychology, including Adkins's research. Adkins documented the application of behavioral principles to improve working
conditions, mitigate job stress, and improve worker health in a complex
organization.
Current occupational health psychology research focuses on
different job fields to more effectively determine how to improve
organizational health. A job field that has received a lot of focus are
nurses. Among nurses, there were two methods to reduce occupational
stress. One method was implementing cognitive-behavioral skills
training. This type of training focuses on emotional regulation,
emotional intelligence, assertiveness, and time management. Another
method to reduce occupational stress among nurses was mindfulness based
intervention. Mindfulness-based intervention were taught to nurses as a
way to stay present and was encourage to use before shifts or during
busy shifts when it was chaotic.
Origins and development
Health psychology developed in different forms in different societies. Psychological factors in health had been studied since the early 20th century by disciplines such as psychosomatic medicine and later behavioral medicine, but these were primarily branches of medicine, not psychology.
United States
In 1969, William Schofield prepared a report for the APA entitled The Role of Psychology in the Delivery of Health Services. While there were exceptions, he found that the psychological research
of the time frequently regarded mental health and physical health as
separate, and devoted very little attention to psychology's impact upon
physical health. One of the few psychologists working in this area at
the time, Schofield proposed new forms of education and training for
future psychologists. The APA, responding to his proposal, in 1973
established a task force to consider how psychologists could (a) help
people to manage their health-related behaviors, (b) help patients
manage their physical health problems, and (c) train healthcare staff to
work more effectively with patients.
Health psychology began to emerge as a distinct discipline of
psychology in the United States in the 1970s. In the mid-20th century
there was a growing understanding in medicine of the effect of behavior
on health. For example, the Alameda County Study,
which began in the 1960s, showed that people who ate regular meals
(e.g., breakfast), maintained a healthy weight, received adequate sleep,
did not smoke, drank little alcohol, and exercised regularly were in
better health and lived longer. In addition, psychologists and other scientists were discovering
relationships between psychological processes and physiological ones. These discoveries include a better understanding of the impact of psychosocial stress on the cardiovascular and immune systems, and the early finding that the functioning of the immune system could be altered by learning.
Led by Joseph Matarazzo,
in 1977, APA added a division devoted to health psychology. At the
first divisional conference, Matarazzo delivered a speech that played an
important role in defining health psychology. He defined the new field
in this way, "Health psychology is the aggregate of the specific
educational, scientific and professional contributions of the discipline
of psychology to the promotion and maintenance of health, the
prevention and treatment of illness, the identification of diagnostic
and etiologic correlates of health, illness and related dysfunction, and
the analysis and improvement of the healthcare system and health policy
formation." Similar organizations were established in other countries, including Australia and Japan.
Europe
In
the 1980s there was increasing interest in many European countries in
researching psychological aspects of health and illness. In 1986, Stan Maes (1947–2018) of Tilburg University
convened a meeting of researchers from Finland, Switzerland, Poland,
Czechoslovakia, Italy, Germany, Belgium, Spain, the UK and the
Netherlands. Out of this meeting emerged the European Health Psychology Society which began to organise regular conferences (e.g. Trier, 1988; Utrecht, 1989; Oxford, 1990; Lausanne, 1991; and Leipzig, 1992) and published proceedings from these meetings. This society also began to develop its own publications.
United Kingdom
Psychologists have been working in medical settings for many years (in the UK sometimes the field was termed medical psychology). Medical psychology, however, was a relatively small field, primarily aimed at helping patients adjust to illness. The BPS's reconsideration of the role of the Medical Section prompted the emergence of health psychology as a distinct field. Marie Johnston and John Weinman argued in a letter to the BPS Bulletin
that there was a great need for a Health Psychology Section. In
December 1986 the section was established at the BPS London Conference,
with Marie Johnston as chair. Annual conferences began to be held and began to map out the areas of interest. At the Annual BPS Conference in 1993 a review of "Current Trends in
Health Psychology" was organized, and a definition of health psychology
as "the study of psychological and behavioural processes in health,
illness and healthcare" was proposed.
The Health Psychology Section became a Special Group in 1993 and
was awarded divisional status within the UK in 1997. The awarding of
divisional status meant that the individual training needs and
professional practice of health psychologists were recognized, and
members were able to obtain chartered status with the BPS. The BPS went
on to regulate training and practice in health psychology until the
regulation of professional standards and qualifications was taken over
by statutory registration with the Health Professions Council in 2010.
Development
A
number of relevant trends coincided with the emergence of health
psychology. One of those trends being the addition of behavioral science
to medical school curricula, with courses often taught by
psychologists. Another trend of the increased knowledge in health psychology is the
training of health professionals in communication skills, with the aim
of improving patient satisfaction and adherence to medical treatment. Another impact of the emergence and focus on health psychology are the
increasing numbers of interventions based on psychological theory (e.g.,
behavior modification) and an increased understanding of the interaction between psychological and physiological factors leading to the emergence of psychophysiology and psychoneuroimmunology (PNI). The health domain has also become a target of research by social
psychologists interested in testing theoretical models linking beliefs,
attitudes, and behavior. Another important impact of the focus on health psychology and its
research is the increase of and funding of research in the emergence of
AIDS/HIV. The emergence of academic /professional bodies to promote research and
practice in health psychology was followed by the publication of a
series of textbooks which began to lay out the interests of the
discipline.
Objectives
Understanding behavioral and contextual factors
Health
psychologists conduct research to identify behaviors and experiences
that promote health, give rise to illness, and influence the
effectiveness of health care. They also recommend ways to improve health
care policy. Health psychologists have worked on developing ways to reduce smoking in order to promote health and prevent illness. They have also studied
the association between illness and individual characteristics. For
example, health psychology has found a relation between the personality
characteristics of thrill seeking, impulsiveness, hostility/anger,
emotional instability, and depression, on one hand, and high-risk
driving, on the other.
Health psychology is also concerned with contextual factors,
including economic, cultural, community, social, and lifestyle factors
that influence health. Physical addiction impedes smoking cessation.
Some research suggests that seductive advertising also contributes to
psychological dependency on tobacco, although other research has found no relationship between media exposure and smoking in youth. OHP research indicates that people in jobs that combine little decision
latitude with a high psychological workload are at increased risk for cardiovascular disease. Other research reveals a relation between unemployment and elevations in blood pressure. Epidemiologic research documents a relation between social class and cardiovascular disease.
Health psychologists also aim to change health behaviors for the
dual purpose of helping people stay healthy and helping patients adhere
to disease treatment regimens (also see health action process approach). Health psychologists employ cognitive behavioral therapy and applied behavior analysis (also see behavior modification) for that purpose.
Preventing illness
Health
psychologists promote health through behavioral change, as mentioned
above; however, they attempt to prevent illness in other ways as well.
Health psychologists try to help people to lead a healthy life by
developing and running programmes which can help people to make changes
in their lives such as stopping smoking, reducing the amount of alcohol
they consume, eating more healthily, and exercising regularly. Campaigns informed by health psychology have targeted tobacco use.
Those least able to afford tobacco products consume them most. Tobacco
provides individuals with a way of controlling aversive emotional states accompanying daily experiences of stress that characterize the lives of deprived and vulnerable individuals. Practitioners emphasize education and effective communication as a part
of illness prevention because many people do not recognize, or
minimize, the risk of illness present in their lives. Moreover, many
individuals are often unable to apply their knowledge of health
practices owing to everyday pressures and stresses. A common example of
population-based attempts to motivate the smoking public to reduce its
dependence on cigarettes is anti-smoking campaigns.
Health psychologists help to promote health and well-being by preventing illness. Some illnesses can be more effectively treated if caught early. Health
psychologists have worked to understand why some people do not seek
early screenings or immunizations, and have used that knowledge to
develop ways to encourage people to have early health checks for
illnesses such as cancer and heart disease. Health psychologists are also finding ways to help people to avoid
risky behaviors (e.g., engaging in unprotected sex) and encourage
health-enhancing behaviors (e.g., regular tooth brushing or hand
washing).
Health psychologists also aim at educating health professionals,
including physicians and nurses, in communicating effectively with
patients in ways that overcome barriers to understanding, remembering,
and implementing effective strategies for reducing exposures to risk
factors and making health-enhancing behavior changes.
There is also evidence from OHP that stress-reduction
interventions at the workplace can be effective. For example, Kompier
and his colleagues have shown that a number of interventions aimed at reducing stress in
bus drivers has had beneficial effects for employees and bus companies.
Illness, disabilities and long-term conditions
Health
psychologists investigate how disease affects individuals'
psychological well-being. An individual who becomes seriously ill or
injured faces many different practical stressors. These stressors
include problems meeting medical and other bills, problems obtaining
proper care when home from the hospital, obstacles to caring for
dependents, the experience of having one's sense of self-reliance
compromised, gaining a new, unwanted identity as that of a sick person,
and so on. These stressors can lead to depression, reduced self-esteem,
etc.
The use of medications can alter the microbiome and potentially impact overall health and the development of diseases. It has been discovered that the metabolites
produced by intestinal microorganisms can influence one's health. For
instance, antidepressants can modify the composition of the intestinal microbiota,
which can then affect the course of the disease through changes in
specific metabolites produced by certain intestinal microorganisms. This
has significant implications, particularly in the context of
depression, as it offers new insights into how to approach and treat the
condition at hand.
Health psychologists can support people living with long-term
conditions to improve or maintain quality of life, self-manage their
conditions, and adjust to life with an illness, disability or long-term
condition.
Health psychology also concerns itself with bettering the lives of individuals with terminal illness. When there is little hope of recovery, health psychologist therapists can work within a multi-disciplinary palliative care
team to improve the quality of life of the patient by helping the
patient recover at least some of his or her psychological well-being.
A form of therapy shown in recent studies is psychotherapy.
It is used as a mode of intervention due to the inconsistency and
issues that may arise from pharmacological interventions. It ensures the
use of evidence-based practices and helps in facilitating adherence to
medication regimens that may be impacted by psychiatric symptoms, such
as low motivation or depressive symptoms. When using psychotherapeutic
strategies, clinicians can choose from three modes: individual,
family/couples, and group psychotherapy.
Critical analysis of health policy
Critical health psychologists explore how health policy can influence inequities, inequalities and social injustice. These avenues of research expand the scope of health psychology beyond
the level of individual health to an examination of the social and
economic determinants of health both within and between regions and
nations. The individualism of mainstream health psychology has been
critiqued and deconstructed by critical health psychologists using
qualitative methods that zero in on the health experience.
Conducting research
Like
psychologists in the other main psychology disciplines, health
psychologists have advanced knowledge of research methods. Health
psychologists apply this knowledge to conduct research on a variety of
questions. For example, health psychologists carry out research to answer questions such as:
- What influences healthy eating?
- How is stress linked to heart disease?
- What are the emotional effects of genetic testing?
- How can we change people's health behavior to improve their health?
Teaching and communication
Health psychologists can also be responsible for training other
health professionals on how to deliver interventions to help promote
healthy eating, stopping smoking, weight loss, etc. Health psychologists
also train other health professionals in communication skills such as
how to break bad news or support behavior change for the purpose of
improving adherence to treatment.
Applications
Improving doctor–patient communication
Health
psychologists aid the process of communication between physicians and
patients during medical consultations. There are many problems in this
process, with patients showing a considerable lack of understanding of
many medical terms, particularly anatomical terms (e.g., intestines). One area of research on this topic involves "doctor-centered" or
"patient-centered" consultations. Doctor-centered consultations are
generally directive, with the patient answering questions and playing
less of a role in decision-making. Although this style is preferred by
elderly people and others, many people dislike the sense of hierarchy or
ignorance that it inspires. They prefer patient-centered consultations,
which focus on the patient's needs, involve the doctor listening to the
patient completely before making a decision, and involving the patient
in the process of choosing treatment and finding a diagnosis.
Improving adherence to medical advice
Health
psychologists engage in research and practice aimed at getting people
to follow medical advice and adhere to their treatment regimens.
Patients often forget to take their pills or consciously opt not to take
their prescribed medications because of side effects. Failing to take
prescribed medication is costly and wastes millions of usable medicines
that could otherwise help other people. Estimated adherence rates are
difficult to measure (see below); there is, however, evidence that
adherence could be improved by tailoring treatment programs to
individuals' daily lives. Additionally, traditional cognitive-behavioural therapies have been
adapted for people with chronic illnesses and comorbid psychological
distress to include modules that encourage, support and reinforce
adherence to medical advice as part of the larger treatment approach.
Ways of measuring adherence
Health psychologists have identified a number of ways of measuring patients' adherence to medical regimens:
- Counting the number of pills in the medicine bottle
- Using self-reports
- Using "Trackcap" bottles, which track the number of times the bottle is opened.
Managing pain
Health
psychology attempts to find treatments to reduce or eliminate pain, as
well as understand pain anomalies such as episodic analgesia, causalgia, neuralgia, and phantom limb pain. Although the task of measuring and describing pain has been problematic, the development of the McGill Pain Questionnaire has helped make progress in this area. Treatments for pain involve patient-administered analgesia, acupuncture (found to be effective in reducing pain for osteoarthritis of the knee), biofeedback, and cognitive behavior therapy.
Current research
MIDUS
Midlife
in the United States, also known as MIDUS, has sent out numerous
surveys since its start in 1995. The goal of MIDUS was to collect data
on the role of behavioral, social, and psychological factors on
age-related outcomes on health and well-being. Since its start, MIDUS
has sent out a variety of surveys and done an extensive amount of
research pertaining to health psychology. Many researchers often refer
back to MIDUS data for their own research as the MIDUS data is extensive
and longitudinal.
MIDUS 1: National Survey of Midlife Development in the United States.
Done
in 1995 to 1996, the MIDUS 1 project surveyed 7,108 individuals ages 25
to 75 years old. This sample also included the national sample of twins
and siblings as a large sample of their participants. This survey was
done through self-administered questionnaires and phone interviews.
Participants were asked to provide information on their physical and
mental health as well as insight on their lifestyle choices, demands of
their career, substance use, sense of control over their health, and
what their decision making process is.
MIDUS 2
MIDUS
2 was completed in 2009 and was a longitudinal follow-up on all of the
participants in the MIDUS 1 survey. Within MIDUS 2, there were five
projects. Project 1 was a follow up on all of the questions asked in
MIDUS 1 pertaining to psychosocial, sociodemographic, and health
variables. Project 2 was a follow up of the daily diary in MIDUS 1.
Project 3 was a new assessment of cognition in this sample and also
included a follow up for the previous cognitive subsample from MIDUS 1.
Project 4 was a biomarkers assessment on the participants. Project 5 was
a neuroscience assessment on a subsample of those who participated in
the biomarker study.
MIDUS Refresher
The
MIDUS Refresher study was done in 2011 through 2014. This study
recruited a new sample of 3,577 adults between the ages of 25-74 and was
designed to replenish the original MIDUS 1 sample in order to parallel
the original survey. The MIDUS Refresher survey had the same assessments
that were done with the existing MIDUS sample, but included additional
questions about the effects of the economic recession that took place in
2008 through 2009. The MIDUS Refresher survey also included five
projects. Project 1 was a 30 minute phone interview as well as a two 50
page self-administered questionnaires that were mailed to each
participant. This was done to analyze the mental and physical effects
related to the economic recession. Projects two through five followed
the same pattern as the MIDUS 2 survey with daily diary, cognitive,
biomarker, and neuroscience assessments respectively.
MIDUS 3
A
third wave of surveys were sent in 2013 to collect longitudinal data on
the MIDUS Refresher participants. This survey followed the same
structure as the MIDUS Refresher survey with the addition of questions
about optimism and coping, stressful life events, and caregiving.
MIDJA: Midlife in Japan
MIDJA
looks at 1,027 adults ages 30 to 79 in Japan, specifically the Tokyo
metropolitan area, in 2008. This survey collected baseline data on
sociodemographic characteristics, psychosocial characteristics, and
mental and physical health. In 2009, biomarker data was taken from these
cases. This survey and the collection of biomarker data mirrored the
longitudinal studies of MIDUS to analyze differences between the United
States and Japan. In 2012, a longitudinal follow up was completed on
MIDJA participants. This repeated the baseline assessments to further
look at the differences between MIDUS and MIDJA data.
Uses of MIDUS Data
One
study used MIDUS 1 through 3 data to complete a longitudinal study.
This study was looking at cognitive reappraisal, affective reactivity,
and health. From the MIDUS data, they used the cognitive reappraisal,
sociodemographics, daily stressors, daily negative affect, mental health
scales, reported chronic conditions, and physical health data
throughout these studies. What they found was that cognitive reappraisal
was significantly associated with future health and well-being
outcomes.
Another study looked at daily stressors, positive events, and
depression, specifically the difference in affect between groups with
and without major depressive disorder. This study used MIDUS 1 and 2
data as well as the National Study of Daily Experiences (NSDE) which is a
subset of the MIDUS data also knows and the daily diary project. The
data taken from these surveys were reports of daily affect, daily
stressors, daily positive events, and major depressive disorder. What
was found was that those who had major depressive disorder and
experiences at least one positive event that day reported a greater
decrease of positive affect and greater increase of negative affect
compared to groups without major depressive disorder.
Another study looked at affective reactivity, heart rate, and
marital quality. This study looked at the NSDE, Biomarker Project, and
MIDUS 2 and 3 data. Within this, the variables of interest were daily
stressors, affective reactivity, marital quality, and resting heart
rate. What was found were greater affective reactivity to daily
stressors predicted lower marital satisfaction and higher marital risk.
In addition to that, resting heart rate moderated these associations.
High levels of resting heart rate offset the negative relationship
between affective reactivity and marital quality.
MIDUS data is very important to and applicable in health
psychology research. Since it looks at such a wide variety of variables,
there are many different ways for researchers to analyze the data. It
allows for a variety of different combinations of variables to compare, a
large amount of longitudinal data, and so much research to build off
of. The different variables allow for an intersection of data to present
in health psychology because of the variety in physical health and
mental health variables.
Health psychologist roles
Below
are some examples of the types of positions held by health
psychologists within applied settings such as the UK's NHS and private
practice.
Healthcare professionals who treat individuals with mental health
conditions prefer medications that provide energy and have fewer side
effects. When prescribing psychiatric drugs, it is essential to consider
individual needs, safety, and anti-doping policies. Psychologists
patients prefer specific medications like escitalopram for anxiety, melatonin for insomnia, lamotrigine for bipolar disorders, and aripiprazole for psychotic disorders. This emphasizes the importance of personalized prescribing individuals.
- Consultant health psychologist: A consultant health
psychologist will take a lead for health psychology within public
health, including managing tobacco control and smoking cessation
services and providing professional leadership in the management of
health trainers.
- Principal health psychologist: A principal health
psychologist could, for example lead the health psychology service
within one of the leading heart and lung hospitals, providing a clinical
service to patients and advising all members of the multidisciplinary
team.
- Health psychologist: An example of a health psychologist's
role would be to provide health psychology input to a center for weight
management. Psychological assessment of treatment, development and
delivery of a tailored weight management program, and advising on
approaches to improve adherence to health advice and medical treatment.
- Research psychologist: Research health psychologists carry
out health psychology research, for example, exploring the psychological
impact of receiving a diagnosis of dementia, or evaluating ways of
providing psychological support for people with burn injuries. Research
can also be in the area of health promotion, for example investigating
the determinants of healthy eating or physical activity or understanding
why people misuse substances.
- Health psychologist in training/assistant health psychologist:
As an assistant/in training, a health psychologist will gain experience
assessing patients, delivering psychological interventions to change
health behaviors, and conducting research, whilst being supervised by a
qualified health psychologist.
Training
United States
Universities
began to develop doctoral-level training programs in health psychology.
In the US, post-doctoral level health psychology training programs were
established for individuals who completed a doctoral degree in clinical
psychology.
United Kingdom
The term "health psychologist" is a protected title, with health psychologists required to register with the Health Professions Council (HPC) and have trained to a level to be eligible for full membership of the Division of Health Psychology within the BPS. Registered health psychologists who are chartered with the BPS will
have undertaken a minimum of six years of training, with three of those
years dedicated to health psychology training. Following the completion of a BPS-accredited undergraduate degree in
Psychology, aspiring health psychologists must first complete a
BPS-accredited masters in health psychology (Stage 1 training). Once the
trainee has completed Stage 1 training, they can either choose to
complete the BPS' independent Stage 2 training route or sign up to an
accredited health psychology doctorate program at a UK university
(DHealthPsy). Both training routes require trainees to demonstrate they
meet the core competencies of:
- professional skills (including implementing ethical and legal standards, communication, and teamwork),
- research skills (including designing, conducting, and analyzing psychological research in numerous areas),
- consultancy skills (including planning and evaluation),
- teaching and training skills (including knowledge of designing,
delivering, and evaluating large and small scale training program),
- intervention skills (including delivery and evaluation of behavior change interventions).
At present, there are limited opportunities for trainees to receive
fully funded training. The NHS Education Scotland (NES) Stage 2 program
funds several trainee health psychologists each year, providing trainees
with fixed-term posts within NHS Boards across Scotland. In 2022, a pilot scheme was launched by Health Education England (HEE)
to provide similar opportunities to aspiring health psychologists across
England.
Once qualified, health psychologists can work in a range of
settings, for example the NHS, universities, schools, private
healthcare, and research and charitable organizations. A health psychologist in training might be working within applied
settings while working towards registration and chartered status. All qualified health psychologists must also engage in and record their continuing professional development (CPD) for psychology each year throughout their career.
Australia
Health psychologists are registered by the Psychology Board of Australia. The standard pathway to becoming an endorsed health psychologists
involves a minimum of six years training and a two-year registrar
program. Health psychologists must also undertake continuing professional development (CPD) each year.
New Zealand
Health psychologists are registered by the New Zealand Psychologists Board within the psychologist scope of practice. The training pathway to becoming a registered health psychologist
requires a Masters in Health Psychology and a two-year registration
Postgraduate Diploma in Health Psychology at the University of Auckland. Outside of clinical work in primary, secondary and tertiary healthcare
settings, graduates may choose careers in research and health promotion
in universities and private settings. Health psychologists are able to join the Institute of Health Psychology (IHP), an institute of the
New Zealand Psychological Society, as a practitioner, academic or student affiliate.
