Health psychology concerns itself with understanding how biology, behavior, and social context influence health and illness. Health psychologists generally work alongside other medical professionals in clinical settings, although many also teach and conduct research. Although its early beginnings can be traced to the kindred field of clinical psychology, four different approaches to health psychology have been defined: clinical, public health, community and critical health psychology.
Many researchers believe that physical health may be influenced by psychology through a variety of direct and indirect means. There is some evidence that certain negative mental states (such as depression and anxiety) can directly affect physical immunity through production of stress hormones, such as the catecholamines and glucocorticoids. Although this research is widely debated, there is also some indication that negative psychological states may lead to faster disease progression in certain diseases (such as HIV and heart disease) through these direct biological mechanisms. Negative emotional states may also indirectly affect disease processes through their influence on health behaviors. For example, depression has been related to many risk factors for poor health including overeating, smoking, physical inactivity, and poor medication compliance.
Health psychology is the “…use of psychological principles to promote health and to prevent illness" (Taylor 1990); it is also part of clinical treatment for established illness. This approach considers the biological, cognitive, behavioral, emotional, social, psychosomatic and environmental factors as they relate to health, illness and health care at the level of individuals. This approach has adopted what it calls the biopsychosocial model.
Clinical health psychology (ClHP) adopts a definition reflecting the fact that the field was originally a branch of clinical psychology; it is also a major contributor to the field of behavioral medicine within psychiatry. Clinical practice includes the techniques of education, behavioral change, and psychotherapy; with additional training, a clinical health psychologist can become a medical psychologist in certain countries and, consequently, prescribe medication.
Organizational health psychology (OHP) is the use of health psychology knowledge and techniques as applied to health and illness in the workplace, at the individual and group levels.
Public health psychology (PHP) tries to determine causation between psychological factors and health for the population as a whole, and present this information to educators, policy makers, and health care practitioners for the promotion of better public health. It gives prominence to population-level health outcomes and interventions. It is allied to other disciplines in the fields of global and public health including epidemiology, nutrition, genetics and statistics. Interventions are determined and "targeted" using population health statistics which evaluate health needs of various population groups as perceived by health authorities and policy makers. These interventions are "top-down" and tend to have varying levels of effectiveness across diverse population groups.
Community health psychology (CoHP) approach tries to understand what is happening at a local level. Interventions are generated collaboratively with coalitions of stakeholders and are aimed to facilitate community empowerment to improve the physical and/or mental health of local people outside of any formal involvement of the health care system.
Critical health psychology (CrHP) is concerned with the distribution of power and the impact of power differentials on health experience and behaviour, health care systems and health policy. It prioritises social justice and the universal right to health of peoples of all races, genders, ages, and socioeconomic positions. A major concern is health inequalities. The CrHPist is an agent of change, not simply an analyst or cataloguer. The field was developed through the foundation of the Journal of Health Psychology and the International Society of Critical Health Psychology.
Health psychology is both a theoretical and applied field. Many different methods are employed including questionnaires, interviews, controlled studies, and actions designed to bring about change using "action research". Health psychologists conduct health interviews with clients that aim to construct a more holistic picture of each person’s health, one that includes their genes, religious beliefs, social supports, living conditions, emotional state, and beliefs of health, etc. They use this information to work alongside a person’s physicians and therapists to develop a treatment tailored for individual needs or to develop greater empowerment among the community's members so that the community is able to strengthen and sustain its own quality of life.
What a Health Psychologist Does and How to Become One
Recent advances in psychological, medical, and physiological research have led to a new way of thinking about health and illness. This conceptualization, 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. The term "health psychology" is often interchanged with the terms "behavioral medicine" or "medical psychology". In contemporary research and medical settings, 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 assessment and treatment services. Many health psychologists focus on prevention through research and clinical interventions designed to foster health and reduce the risk of disease. While more than half of health psychologists provide clinical services as part of their duties, many health psychologists function in non-clinical roles primarily involving teaching and research.
The Work Setting of a Health Psychologist: Health psychologists participate in health care in a multitude of settings including primary care programs, inpatient medical units, and specialized health care programs such as pain management, rehabilitation, women's health, oncology, smoking cessation, headache management, and various other programs. They also work in colleges and universities, corporations, and for governmental agencies.
Clinical Activities: Assessment approaches often include cognitive and behavioral assessment, psychophysiological assessment, clinical interviews, demographic surveys, objective and projective personality assessment, and various other clinical and research-oriented protocols. Interventions often include stress management, relaxation therapies, biofeedback, psychoeducation about normal and patho-physiological processes, ways to cope with disease, and cognitive-behavioral and other psychotherapeutic interventions. Healthy people are taught preventive health behaviors. Both individual and group interventions are utilized. Frequently, health psychology interventions focus upon buffering the effect of stress on health by promoting enhanced coping or improved social support utilization.
Research: Health psychologists are on the leading edge of research focusing on the biopsychosocial model in areas such as HIV, oncology, psychosomatic illness, compliance with medical regimens, health promotion, and the effect of psychological, social, and cultural factors on numerous specific disease processes (e.g., diabetes, cancer, hypertension and coronary artery disease, chronic pain, and sleep disorders). Research in health psychology examines: the causes and development of illness, methods to help individuals develop healthy lifestyles to promote good health and prevent illness, the treatment people get for their medical problems, the effectiveness with which people cope with and reduce stress and pain, biopsychosocial connections with immune functioning, and factors in the recovery, rehabilitation, and psychosocial adjustment of patients with serious health problems.
Career Opportunities: The opportunities for careers in health psychology in the United States are quite good. Medical settings, particularly medical centers, have greatly expanded their employment of psychologists. Aside from medical centers, health psychologists often work in colleges and universities, medical schools, health maintenance organizations, rehabilitation centers, pain management centers, public health agencies, hospitals, and private consultation/practice offices. In addition to the specific content skills which psychologists offer to patients and staff in the medical community, psychologists' unique training often makes the health psychologist an asset to the medical team with regard to quality assurance methods (making certain that health care is helpful and cost-effective), research, writing, grant-writing, statistical, communication, and team development skills.
Training for Health Psychology Careers: Health psychologists typically hold a doctoral degree (Ph.D. or Psy.D.) in psychology. Applied health psychologists are licensed for the independent practice of psychology in areas such as clinical and counseling psychology, and board certification is available in health psychology through the American Board of Professional Psychology.
Often, psychologists preparing for a career in health psychology obtain general psychology training at the undergraduate and doctoral levels, but then receive specialty training at the postdoctoral or internship level. Some programs have been developed which offer specialized training in health psychology at undergraduate and graduate levels. Here are some specifics of training in health psychology at various levels:
Undergraduate: Health psychology courses are available at about a third of North American colleges and universities. Because of the field's biopsychosocial orientation, students are also encouraged to take courses focusing on abnormal and social psychology, learning processes and behavior therapies, psychophysiology, anatomy and physiology, psychopharmacology, community psychology, and public health.
Graduate: Many doctoral programs in clinical, counseling, social, or experimental psychology have specialized tracks or preceptorships in health psychology. A number of programs now exist in the United States and other countries specifically for doctoral training in health psychology. These programs are quite diverse: some specialize in training students either for research careers or for direct clinical service to patients.
Predoctoral Internships: Clinical and counseling psychologists are required to complete a one-year internship/residency before obtaining their doctorates. Many of these programs offer some training in health psychology. A number of internship programs provide specialized training in health psychology in which at least half of the trainee's time is spent in supervised health psychology activities.
Postdoctoral Fellowships: Many university medical centers, universities, health centers, and health psychology programs offer specialized research and/or clinical training in different areas of health psychology.
Many researchers believe that physical health may be influenced by psychology through a variety of direct and indirect means. There is some evidence that certain negative mental states (such as depression and anxiety) can directly affect physical immunity through production of stress hormones, such as the catecholamines and glucocorticoids. Although this research is widely debated, there is also some indication that negative psychological states may lead to faster disease progression in certain diseases (such as HIV and heart disease) through these direct biological mechanisms. Negative emotional states may also indirectly affect disease processes through their influence on health behaviors. For example, depression has been related to many risk factors for poor health including overeating, smoking, physical inactivity, and poor medication compliance.
Health psychology is the “…use of psychological principles to promote health and to prevent illness" (Taylor 1990); it is also part of clinical treatment for established illness. This approach considers the biological, cognitive, behavioral, emotional, social, psychosomatic and environmental factors as they relate to health, illness and health care at the level of individuals. This approach has adopted what it calls the biopsychosocial model.
Clinical health psychology (ClHP) adopts a definition reflecting the fact that the field was originally a branch of clinical psychology; it is also a major contributor to the field of behavioral medicine within psychiatry. Clinical practice includes the techniques of education, behavioral change, and psychotherapy; with additional training, a clinical health psychologist can become a medical psychologist in certain countries and, consequently, prescribe medication.
Organizational health psychology (OHP) is the use of health psychology knowledge and techniques as applied to health and illness in the workplace, at the individual and group levels.
Public health psychology (PHP) tries to determine causation between psychological factors and health for the population as a whole, and present this information to educators, policy makers, and health care practitioners for the promotion of better public health. It gives prominence to population-level health outcomes and interventions. It is allied to other disciplines in the fields of global and public health including epidemiology, nutrition, genetics and statistics. Interventions are determined and "targeted" using population health statistics which evaluate health needs of various population groups as perceived by health authorities and policy makers. These interventions are "top-down" and tend to have varying levels of effectiveness across diverse population groups.
Community health psychology (CoHP) approach tries to understand what is happening at a local level. Interventions are generated collaboratively with coalitions of stakeholders and are aimed to facilitate community empowerment to improve the physical and/or mental health of local people outside of any formal involvement of the health care system.
Critical health psychology (CrHP) is concerned with the distribution of power and the impact of power differentials on health experience and behaviour, health care systems and health policy. It prioritises social justice and the universal right to health of peoples of all races, genders, ages, and socioeconomic positions. A major concern is health inequalities. The CrHPist is an agent of change, not simply an analyst or cataloguer. The field was developed through the foundation of the Journal of Health Psychology and the International Society of Critical Health Psychology.
Health psychology is both a theoretical and applied field. Many different methods are employed including questionnaires, interviews, controlled studies, and actions designed to bring about change using "action research". Health psychologists conduct health interviews with clients that aim to construct a more holistic picture of each person’s health, one that includes their genes, religious beliefs, social supports, living conditions, emotional state, and beliefs of health, etc. They use this information to work alongside a person’s physicians and therapists to develop a treatment tailored for individual needs or to develop greater empowerment among the community's members so that the community is able to strengthen and sustain its own quality of life.
What a Health Psychologist Does and How to Become One
Recent advances in psychological, medical, and physiological research have led to a new way of thinking about health and illness. This conceptualization, 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. The term "health psychology" is often interchanged with the terms "behavioral medicine" or "medical psychology". In contemporary research and medical settings, 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 assessment and treatment services. Many health psychologists focus on prevention through research and clinical interventions designed to foster health and reduce the risk of disease. While more than half of health psychologists provide clinical services as part of their duties, many health psychologists function in non-clinical roles primarily involving teaching and research.
The Work Setting of a Health Psychologist: Health psychologists participate in health care in a multitude of settings including primary care programs, inpatient medical units, and specialized health care programs such as pain management, rehabilitation, women's health, oncology, smoking cessation, headache management, and various other programs. They also work in colleges and universities, corporations, and for governmental agencies.
Clinical Activities: Assessment approaches often include cognitive and behavioral assessment, psychophysiological assessment, clinical interviews, demographic surveys, objective and projective personality assessment, and various other clinical and research-oriented protocols. Interventions often include stress management, relaxation therapies, biofeedback, psychoeducation about normal and patho-physiological processes, ways to cope with disease, and cognitive-behavioral and other psychotherapeutic interventions. Healthy people are taught preventive health behaviors. Both individual and group interventions are utilized. Frequently, health psychology interventions focus upon buffering the effect of stress on health by promoting enhanced coping or improved social support utilization.
Research: Health psychologists are on the leading edge of research focusing on the biopsychosocial model in areas such as HIV, oncology, psychosomatic illness, compliance with medical regimens, health promotion, and the effect of psychological, social, and cultural factors on numerous specific disease processes (e.g., diabetes, cancer, hypertension and coronary artery disease, chronic pain, and sleep disorders). Research in health psychology examines: the causes and development of illness, methods to help individuals develop healthy lifestyles to promote good health and prevent illness, the treatment people get for their medical problems, the effectiveness with which people cope with and reduce stress and pain, biopsychosocial connections with immune functioning, and factors in the recovery, rehabilitation, and psychosocial adjustment of patients with serious health problems.
Career Opportunities: The opportunities for careers in health psychology in the United States are quite good. Medical settings, particularly medical centers, have greatly expanded their employment of psychologists. Aside from medical centers, health psychologists often work in colleges and universities, medical schools, health maintenance organizations, rehabilitation centers, pain management centers, public health agencies, hospitals, and private consultation/practice offices. In addition to the specific content skills which psychologists offer to patients and staff in the medical community, psychologists' unique training often makes the health psychologist an asset to the medical team with regard to quality assurance methods (making certain that health care is helpful and cost-effective), research, writing, grant-writing, statistical, communication, and team development skills.
Training for Health Psychology Careers: Health psychologists typically hold a doctoral degree (Ph.D. or Psy.D.) in psychology. Applied health psychologists are licensed for the independent practice of psychology in areas such as clinical and counseling psychology, and board certification is available in health psychology through the American Board of Professional Psychology.
Often, psychologists preparing for a career in health psychology obtain general psychology training at the undergraduate and doctoral levels, but then receive specialty training at the postdoctoral or internship level. Some programs have been developed which offer specialized training in health psychology at undergraduate and graduate levels. Here are some specifics of training in health psychology at various levels:
Undergraduate: Health psychology courses are available at about a third of North American colleges and universities. Because of the field's biopsychosocial orientation, students are also encouraged to take courses focusing on abnormal and social psychology, learning processes and behavior therapies, psychophysiology, anatomy and physiology, psychopharmacology, community psychology, and public health.
Graduate: Many doctoral programs in clinical, counseling, social, or experimental psychology have specialized tracks or preceptorships in health psychology. A number of programs now exist in the United States and other countries specifically for doctoral training in health psychology. These programs are quite diverse: some specialize in training students either for research careers or for direct clinical service to patients.
Predoctoral Internships: Clinical and counseling psychologists are required to complete a one-year internship/residency before obtaining their doctorates. Many of these programs offer some training in health psychology. A number of internship programs provide specialized training in health psychology in which at least half of the trainee's time is spent in supervised health psychology activities.
Postdoctoral Fellowships: Many university medical centers, universities, health centers, and health psychology programs offer specialized research and/or clinical training in different areas of health psychology.
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