Role of Psychology in Health Care Setting By: Denise McCoy, Jennifer Allen, and Brittany Price

Collaborative Care ● Also known as integrative care ● The combined efforts of physicians, psychologists, and other health care individuals join forces to improve patient- centered care.

Illness Representations Definition : Our personal views of health and illness including its label and symptoms, perceived causes, consequences, and controllability. Affect our health in at least 2 ways 1.Influencing our preventive health behaviors 2.Affecting how we react when symptoms appear.

Components of How We Represent Illness ● Identity of illness; Label and symptoms ● Causes; Attributing symptoms to external factors ● Timeline; Duration and rate of the disease’s development ● Consequences; the physical, social, and economic impact of illness and disease. ● Controllability; beliefs regarding whether the illness can be prevented, controlled, and/or cured.

Psychosocial Factors Attentional focus influences our awareness of physical symptoms (van Laarhoven and others, 2010). Sensitizers actively monitor the event and their reactions to it. Repressors tend to ignore or deny health-related information. People distance themselves or ignore stressful information.

Statistics National Center for Health Statistics (2006) revealed that… ● More than ⅓ of the men wouldn’t go to a doctor immediately, even if experiencing severe chest pains or shortness of breath. ● In the past year, 55 % of the women had undergone a cancer screening, while only 32 % of the men had checked for cancer Why do you think that men seem to be more reluctant when seeking medical care when compared to women?

Delay Behavior The tendency to avoid seeking medical care because: ● appraisal delay ● illness delay ● behavioral delay ● scheduling delay ● treatment delay ● Eisenburg, et al. (2007) found that college students who screened positive for depression, 37-84%, depending on the disorder, did not receive treatment.

Overusing Medical Services ● Illness anxiety disorder refers to the condition of of experiencing abnormal anxiety over one’s health, often including imaginary symptoms. o malingering o chronic fatigue syndrome o stress & anxiety

Complying with treatment ● Adherence & nonadherence o only 20-40% of particpants in treatment programs for smoking, alcohol, or drug abuse stayed with it ● Patient-provider relationship ● Treatment plan being realistic

Health Psychology and Models ❏ From American Psychologist Association (APA): health psychologist participate in health care in a various of settings including primary care programs, inpatient medical units and specialized health care programs (pain management, rehabilitation, women’s health, oncology, smoking cessation, headache management) ❏ Models in which health psychology use in primary care settings: ❏ Colocation ❏ Coordinated Care ❏ Enhanced Referral ❏ Collaborative Care ❏ Integrated Care ❏ Health psychologist work within public health care systems, managed care, or in private settings Thielke, S., Thompson, A., and Stuart, R. (2011). Health psychology in primary care: recent research and future directions. Psychology Research and Behavior Management:4,

Psychologists Role ❏ Psychologist provide mental and behavioral health services ❏ Often work in health and social care settings ❏ Work with people of all ages who experiences mental health disorders ❏ Assist with diagnosing and treating patients with chronic illness ❏ Primary Prevention ❏ Secondary Prevention American Psychological Association. (2010). The role of psychologists in health centers. Retrieved from

Integrated Health Care ❏ Integrated health care is characterized by collaboration and communication, along with shared leadership and decision making authority. ❏ Goal: develop and implement a comprehensive treatment plan to address the overall health care needs of a patient. ★ How can Psychologists contribute? American Psychological Association. (2014). Briefing series on the role of psychology in health care integrated health care. APA Center for Psychology and Health. Retrieved from

Biopsychosocial Model ❏ Patient-centered integrated care ❏ Changes the concern of evidence-based medicine from a narrow focus on disease to a wide array of potential patient outcomes ❏ Able to use psychological and behavioral treatment ❏ 3 out of 4 directors of Office of Behavioral and Social Sciences Research at the NIH have been psychologists: Norman Anderson, David Abrams, and Robert Kaplan Johnson, S. (2013). Increasing psychology’s role in health research and health care. APA Presidential Address. 68(5)

In the Future ❏ What will be the role of psychology in health care settings in the future? ❏ Lawrence J. Siegel ❏ Importance of Psychology rehabilitation ❏ Psychologists play a role in developing and using preventive interventions ❏ Function less within independent practice model and more within organized health care settings Johnstone, B. et. al. (1995). Psychology in health care: future directions. Professional Psychology: Research and Practice. 26(4)

Issues Regarding Psychology ❏ Training regarding health service psychologists there are around 7 issues ❏ Competencies… ❏ Guidelines… ❏ Focus on Assessment ❏ The Future… ❏ Self-Regulation… ❏ More Research ❏ Levels of Education Health Service Psychology Education Collaborative. (2013). Professional psychology in health care service. American Psychologist. 68(6). 412.

Studies and Importance of Counseling ❏ Rief (2004) reported that about 20% of visits to a physician involve symptoms that cannot be explained by a typical medical disorder ❏ Study done by Ansseau in 2004 ❏ In a sample of 2316 adults patients found that 42.5% of them are met with some type of psychological difficulty (emotional, anxiety, and somatoform symptom) ❏ Counseling Psychologist ❏ Models May Work Under ❏ Collocated Clinics ❏ Independent Provider ❏ Behavioral Health Consultant ❏ Staff Advisor Karademas. (2009). Counselling psychology in medical settings: the promising role of counseling health psychology. Counselling Psychology in Medical Settings, 1(1)

Role for Psychologists in End of Life Care ❏ Disease prevention and health promotion ❏ Provide support and psychosocial interventions ❏ Cognitive Coping Skills ❏ Improve Care of Dying Kwilosz, et. al. (2003). Role of psychologists in end of life care: emerging models of practice. Professional Psychology: Research and Practice, 34(6)

References American Psychological Association. (2010). The role of psychologists in health centers. Retrieved from role.aspx role.aspx American Psychological Association. (2014). Briefing series on the role of psychology in health care integrated health care. APA Center for Psychology and Health. Retrieved from Eisenberg, Daniel, Golberstein, Ezra, Gollust, Sarah. (2007). Help-seeking and access to mental health care in a university student population. Medical Care. 45: Health Service Psycholgoy Education Collaborative. (2013). Professional psychology in health care service. American Psychologist. 68(6) Johnson, S. (2013). Increasing psychology’s role in health research and health care. APA Presidential Address. 68(5) Johnstone, B. et. al. (1995). Psychology in health care: future directions. Professional Psychology: Research and Practice. 26(4) Karademas. (2009). Counselling psychology in medical settings: the promising role of counseling health psychology. Counselling Psychology in Medical Settings, 1(1) Kwilosz, et. al. (2003). Role of psychologists in end of life care: emerging models of practice. Professional Psychology: Research and Practice, 34(6) Thielke, S., Thompson, A., and Stuart, R. (2011). Health psychology in primary care: recent research and future directions. Psychology Research and Behavior Management:4,