Psychology in Medical Settings in Thailand

This article explores the development of psychology as a profession in Thailand, its challenges, and future trends. There are currently very few Thai psychologists who are active in the medical fields in comparison to other health care professions. Being held back by limited education and training, many psychologists see their future career as less than promising. The lack of professional licensing standards and dominance of psychiatry further limit their career advancement. However, tremendous opportunities await those who persevere to expand their roles beyond the traditional assessment, treatment, and research models. A small number of them have ventured out into unexplored territories such as behavioral medicine, AIDS counseling, health promotion, and prevention of mental health problems. There is a strong potential for Thai psychologists to make significant contributions in these areas. It is clear that higher standards of education and more rigorous training are needed if this goal is to be realized in the near future.     

Mindfulness-Based Stress Reduction in Medical Settings

Meditation, as a psychological intervention, has become of increasing interest to psychologists who conduct clinical research with or provide clinical services to medical populations. Mindfulness-based stress reduction (MBSR) is a manualized program which teaches a variety of meditation techniques and has frequently been used in medical settings with mixed medical populations. The following is a review of the literature, which provides preliminary support for the effectiveness of MBSR in specific medical populations, including persons with chronic pain, cancer and heart disease. Despite these encouraging findings, experts agree that continued research is needed, especially controlled studies with more rigorous methodology.     

Groddeckian Interventions In Medical Settings

We present Groddeckian psychoanalytic psychosomatics in practice through two case studies. Groddeck pioneered the application of psychoanalysis to organic diseases, but his ideas have not been explored adequately. It is necessary to reappraise his concepts to develop their potential in psychoanalysis. We aim to demonstrate the efficacy of the Groddeckian approach by presenting two cases: a case of conversion of a boy who entered a semi-comatose state due to unattended emotional experiences and a man who developed a "sick role" resisting all medical interventions. In both histories, it is possible to see how disease and subjectivity intertwine in a complex unity of mind and body.     

Counselling Older Adults Living in Residential Aged Care Settings: Four Illustrative Case Studies

The role of psychologists and other mental health professionals in long‐term care settings is undefined in Australia. Graduate psychology students receive little training in clinical geropsychology, and residential aged care providers do not routinely employ psychologists within such settings. Further, despite high rates of depression, neurocognitive problems, and other mental health problems, residents are rarely referred for evidence‐based psychological treatment. This article presents four case studies showing how psychology services may be employed in such settings within the context of a postgraduate psychology placement programme. These case studies emphasise the importance of engagement, the use of flexible and individualised treatment approaches, and the involvement of family and professional carers in the provision of psychological services. Psychology services in residential settings can have a positive impact on the care of older adults and their families.     

Implementing Cognitive Behavioral Therapy in Specialty Medical Settings

This article is an introduction to the second issue of a two-part special series on integrating cognitive behavioral therapy (CBT) into medical settings. The first issue focused on integrating CBT into primary care, and this issue focuses on implementing CBT in other specialty medical settings, including cancer treatment, HIV care, and specialized pediatric medical clinics. Models for treatment delivery to improve ease of implementation are also discussed, including telehealth and home-delivered treatment. The six articles in this series provide examples of how to transport CBT techniques that are largely designed for implementation in outpatient mental health settings to specialized medical settings, and discuss unique considerations and recommendations for implementation.     

Recognition and Treatment of Late-Life Addictions in Medical Settings

Addictive disorders among the elderly have emerged as a growing public health concern. As the proportion of the elderly population increases, more and more older adults will either develop addictions as a dysfunctional means of coping with the psychosocial consequences of aging, or will carry their long-standing addictive behaviors with them into later life. Among the most common of these addictions are smoking, excess consumption of alcohol, and gambling. This article briefly reviews these three addictive disorders and examines assessment and treatment options. The current cohort of older adults tends not to seek help for addiction problems in specialty mental health or substance abuse treatment. To improve rates of cessation and abstinence, assessment and intervention should be delivered in general medical settings such as primary care. With the addition of a behavioral health specialist, primary care has the potential to offer improved interventions in a cost-effective and time-efficient manner.     

Clinical Geropsychology: Implications for Practice in Medical Settings

Older adults are a rapidly growing segment of the population, who have high rates of chronic illness and who utilize health care resources heavily. Psychologists must become better prepared to work with older patients in geriatric settings, including geriatric assessment units, memory disorders clinics, and nursing homes. In addition, all psychologists will increasingly encounter older patients in environments such as primary care clinics, rehabilitation settings, and disease management programs focusing on problems that are prevalent in older patients (e.g., cancer, diabetes). Suggestions are offered for adaptation of usual clinical practice to address the special needs of older patients and their families, and recommendations made for advancing and expanding the practice of clinical geropsychology.     

Domestic Violence Screening in Medical and Mental Health Care Settings

ABSTRACT

Health care providers and patients agree that domestic violence presents a serious health issue that falls within the purview of medical care. The patient-physician encounter has the potential to assist domestic violence victims in considering their options of living without violence and playing a critical role in preventing future violence. Despite this possibility, many persons evaluated in the health care system do not experience the benefits of such interactions. This article reviews current research that evaluates physician, patient, and systems barriers to providing care to patients experiencing domestic violence as well as gaps in the current research and suggestions for how these barriers might be overcome. Educational initiatives, implementation of protocols, and increasing environmental cues that prompt patients and physicians to discuss domestic violence may all increase the likelihood of screening and the success of interventions.     

Primary Care and Clinical Psychology: Assessment Strategies in Medical Settings

There is ample evidence regarding medical-psychological comorbidity to consider clinical psychology as a viable component of health care services in medical settings. Psychologists can become valuable assets to primary care physicians who treat a high number of primary psychiatric cases as well as medical cases with secondary psychological symptoms. Psychologists who function in hospital-based clinics as well as affiliates with primary care (PC) offices can provide empirically supported assessment services that can make treatment more effective and efficient. Multiple studies indicate high prevalence rates of psychiatric patients in PC settings using various instruments. This paper reviews selected assessment tools that have established diagnostic validity and reliability that can be both strategic for patient care and useful to reinforce psychologist collaboration with primary care physicians (PCP).     

Introduction to the Special Issue on Personality Assessment in Medical Settings

Rouse, Greene, Butcher, Nichols, and Williams (2008) Sellbom, M., Ben-Porath, Y. S. and Bagby, R. M. 2008a. On the hierarchical structure of mood and anxiety disorders: Confirmatory evidence and an elaboration of a model of temperament markers. Journal of Abnormal Psychology, 117: 576–590. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] repeat two claims about the MMPI–2 Restructured (RC) scales. One asserts that the correlations of RC scales with parent Clinical scales are modest compared to the correlations with other existing MMPI–2 scales. In response, we reiterate that the RC scales were not meant to emulate the divergent and overlapping content of the Clinical scales. Instead, each represents a distinctive Clinical scale component. Although individually focused, the RC scales span collectively a wide range of content and used as multivariate predictors, account for most of the variance of each Clinical scale. Rouse et al. also claim that most RC scales are redundant with existing MMPI–2 scales, which they propose as substitutes (“proxies”). However, our analyses of Rouse et al.'s database and of our own data show that several of their proposed proxies are far less mutually distinguishable than are the RC scale counterparts. Furthermore, several Clinical scales are more successfully, and none are less successfully, accounted for by RC scales than by proxies. In response to Rouse et al.'s neglect of a body of empirical findings supporting the construct validity of the RC scales, we also review the relevant research literature.     

Implications of Healthcare Payment Reform for Clinical Psychologists in Medical Settings

Health reform, post the passing of the Patient Protection and Affordable Care Act, has highlighted the need to better address critical issues such as primary care, behavioral health, and payment reform. Much of this need is subsequent to robust data showing the seemingly uncontrollable growth of healthcare costs, and the exacerbation of these costs for patients with comorbid behavioral health and medical conditions. There is increasing recognition that incorporating behavioral health in primary care leads to improved outcomes and better care. To address these problems, primary care will play critical roles across the healthcare system, especially in the delivery of behavioral health services. Psychologists are uniquely positioned to take advantage of this propitious moment and can help facilitate the integration of behavioral and primary care by developing competencies in integrated care, training a capable workforce, and advocating for integrated care as the status quo.     

Counselling in dyslexia

This paper is basically a report of personal experiences. In Part one I shall describe and comment on some of the things which are said and done when parents bring their children to me to be assessed for dyslexia; in Part Two I shall consider what conclusions, if any, can be drawn which are relevant to counselling in general.     

Transformation in Counselling

The view is put forward that counselling appears to be undergoing a transformation which renders the old distinction between counselling and therapy no longer meaningful or practical. This transformation reflects the psychic backdrop of our times; it has come about because the needs of people seeking help, as well as the needs of those counselling, have altered and developed. Increasingly, clients are acknowledging the need for radical change which involves exploration of all levels of their being. This transformative work, a moving across inner barriers and coming into wholeness, necessarily involves active awareness of spirit. Thus it is no longer possible to be a client-centred counsellor without being willing to address the spiritual dimension ofhuman-beingness.     

Medical Settings as a Context for Research on Cognitive Development

Medical contexts provide a rich opportunity to study important theoretical questions in cognitive development and to investigate the influence of a range of interacting factors relating to the child, the experience, and the broader social context on children's cognition. In the context of examples of research investigating these issues, we consider several specific advantages of conducting research in medical settings: the diverse range of participants, experiences, and potential research paradigms and the opportunities for student training. We discuss the benefits and challenges of conducting research within medical contexts and consider ways of attempting to maximize the former and of addressing the latter.     

Gender Differences in Employment and Salaries of Psychologists Within Medical School Settings

A survey of 3,894 psychologists employed within medical schools and academic health centers was conducted in 1997 by the Research Office of the American Psychological Association (APA) in collaboration with the Association of Medical School Psychologists (AMSP). This survey, published as the 1997 Employment Characteristics and Salaries of Medical School Psychologists, included inquiries about various aspects of employment (e.g., academic rank, tenure status, employment activities, appointment characteristics, department affiliations, demographic characteristics) and earnings. Employment characteristics and salary information were compared by gender. The findings indicated that men had more favorable employment circumstances and higher base salaries than their female counterparts. These differences existed across all academic ranks and were found at each level of experience. This article discusses these findings and their implications.     

Implementing Trauma-Informed Care in Primary Medical Settings: Evidence-Based Rationale and Approaches

ABSTRACT

Chronic stress stemming from trauma exposure and posttraumatic stress disorder (PTSD) leads to many health problems that are typically seen by primary care providers. Unfortunately, providers rarely identify trauma as the root cause of patient difficulties. The present paper provides an evidence-based rationale for implementing trauma-informed care principles and processes into medical primary care systems. Beginning with a review of prevalence of trauma exposure and PTSD in primary care clinics, this article elucidates relationships between trauma exposure and behavioral and medical health problems, as well as clinical and physiological pathways that lead from trauma exposure to illness. The article concludes with exposition of trauma-informed interventions that can be implemented in primary care clinics, and discussion of future directions.     

Pastoral Counselling

The beginnings of the modern pastoral-care and counselling movement in the 1960s are reviewed, in particular, the attempt to integrate theology with the behavioural sciences, and the theories born of that integration with the practice of pastors and religious leaders. The developments of the last ten years are explored and the tensions of the movement analysed. Pastoral counsellors' contribution to counselling in general in the United Kingdom, and to pastoral ministry both here and overseas, is assessed.     

Spiritual Experiences in Counselling

Three questions are addressed. First, what are spiritual experiences? The one-two-three-infinity theory of spirituality is questioned, and it is suggested that there are at least nine distinguishable spiritual experiences. Second, how do we use such experiences in counselling? Examples are given of how this approach is useful in counselling. and particularly in dream work. The importance of intuition is stressed, and group work is discussed. Third, what are the implications for the training of counsellors? The issues of ego inflation and psychosis are raised, and it is suggested that the training of future counsellors needs to include the coverage of such issues, as well as the more general material dealt with in this paper.     

Counselling Psychology in Japan

Les caractéristiques du conseil psychologique au Japon ont été passées en revue selon les points-de-vues suivants: (1) l'histoire du conseil psychologique. (2) le conseil psychologique aujourd'hui, (3) le conseil psychologique comparé au psychologue clinicien. (4) l'avenir du conseil psychologique, et (5) le conseil psychologique appliqué au, conseil d'etudiants. Au Japon, le conseil psychologique est encore jeune, si Ton en juge par sa familiarité chez les professionnels comme chez les non-professionnels, probablement autant à cause des caractéristiques nationales des japonais que du système scolaire. Il semble important que le conseil psychologique sauvegarde son identitéà I'intérieur des disciplines de la psychologie appliquée et/ou de la psychologie de la santé.
The outlook for counselling psychology in Japan has been reviewed from the following viewpoints: (1) the history of counselling psychology, (2) counselling psychology today, (3) counselling psychology compared with clinical psychology, (4) the future of counselling psychology, and (5) counselling psychology applied to student counselling. It is found that counselling psychology in Japan is still young in terms of its familiarity to both professionals and non-professionals, probably because of the national characteristics of the Japanese as well as the certification system. It seems to be important for counselling psychology to secure its identity within the discipline of applied psychology and/or health psychology.