Transcript Role of Psychology in Health Care Setting

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 patientcentered 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.
malingering
chronic fatigue syndrome
o stress & anxiety
o
o
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, 59-64.
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
http://www.apa.org/about/gr/issues/chc.psychologists-role.aspx
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 www.apa.org
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). 316-318.
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).
341-344.
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). 19-24.
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). 627-629.
References
American Psychological Association. (2010). The role of psychologists in health centers. Retrieved from http://www.apa.org/about/gr/issues/chc.psychologistsrole.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 www.apa.org
Eisenberg, Daniel, Golberstein, Ezra, Gollust, Sarah. (2007). Help-seeking and access to mental health care in a university student population. Medical
Care. 45: 594-601.
Health Service Psycholgoy Education Collaborative. (2013). Professional psychology in health care service. American Psychologist. 68(6). 412.
Johnson, S. (2013). Increasing psychology’s role in health research and health care. APA Presidential Address. 68(5). 316-318.
Johnstone, B. et. al. (1995). Psychology in health care: future directions. Professional Psychology: Research and Practice. 26(4). 341-344.
Karademas. (2009). Counselling psychology in medical settings: the promising role of counseling health psychology. Counselling Psychology in Medical Settings,
1(1). 19-24.
Kwilosz, et. al. (2003). Role of psychologists in end of life care: emerging models of practice. Professional Psychology: Research and Practice, 34(6). 627-629.
Thielke, S., Thompson, A., and Stuart, R. (2011). Health psychology in primary care: recent research and future directions. Psychology Research and