Marketing Psychology at Academic Health Centers

The administrative structure of academic health centers is reviewed, with a view to understanding the issues of marketing psychological services within that setting. The slow changes at academic health centers to new practice styles requires psychology to formulate a market strategy addressing the traditional specialist model and another plan responsive to the emerging model emphasizing primary care. Market targets for psychologists include administration, physicians, and patients. Presently, the Association of Medical School Psychologists is working with the Association of Academic Health Centers to design a marketing program targeting leaders at academic health centers.     

The Future of Education and Training in Academic Health Centers

National reports have recommended additions to the core competencies that should be required of all health disciplines, including psychology. The recommendations will affect the education and training of health professionals at academic health centers (AHCs). There will be more focus on training for competence in patient-centered care, evidence-based care, interdisciplinary teamwork, informatics, and continuous quality improvement. Other trends that will affect training of psychologists and other health disciplines in AHC settings include emphasis on better ways to assess the quality of clinical skills, support for improvement of teaching and training, and an increase in educators' status.     

Health Psychology in Catalonia in 2000: Current View and Future Perspective

This report describes the current status of health psychology in the nation of Catalonia (Spain). Emphasis is placed upon autonomy and self-governance, which have progressively influenced the structure and functioning of the health care system and the professional colleges. The current university educational model of training and practice in health psychology is reviewed. The most important characteristics of professional psychologists are presented. A critical view of health psychology research in medical settings and future perspectives of health psychology in Catalonia are also discussed.     

The Current State of Medical Psychology in Iran

This paper reviews medical psychology in Iran and describes the two major professional associations representing the profession. The unique role of religion in Iran is stressed, and limitations of the current health care system are described. The paper also addresses human resource issues and the educational requirements for the practice of psychology in Iran.     

Adolescent Health Care Training in Predoctoral Psychology Internship Programs: A Model of Interdisciplinary Training Needs in Health Care

This needs assessment of predoctoral psychology programs in a large southeastern state reveals that although many programs include adolescent health issues and often involve the psychiatry discipline in their curricula, many trainees do not have exposure to medicine, nutrition, or nursing disciplines. Opportunities for greater interdisciplinary adolescent health care training exist in psychology training programs in this southeastern state. Integrating such training into psychology programs may enhance psychology's ability to function as a vital component of adolescent health care teams within academic medical centers across the country.     

The Future of Psychology in Medical Specialities: Introduction to the Special Issue

The continuing evolution of the health care delivery system in the United States presents threats and opportunities to psychologists in medical settings. This special issue explores the future of psychology in psychiatry, family medicine, rehabilitation, geriatric medicine, and pediatric medicine. The challenges facing neuropsychology and pain management are explored also. Finally, the professional issues of ethics in managed care, psychology in the public sector, and training future psychologists are addressed. Each paper summarizes concerns and provides recommendations for clinical practice, research, and training.     

Psychologists in Academic Health Centers: Reflections on Traditions and Innovations in Education,Science, and Practice

In 2007, the Association of Psychologists in Academic Health Centers (APAHC), formerly known as Association of Medical School Psychologists (AMSP), held its first national conference since 1997. At the latter conference, the author of this article [Sheridan (1999) Journal of Clinical Psychology in Medical Settings, 6, 211–218] was asked to present some of the issues that would be important to health care psychologists in the next decade. These issues included the role of psychology in academic health centers, interventions psychologists offer, reimbursements for such treatments, education and training models, and research. This article examines those observations, offers new data, and explores the current challenges and opportunities for psychologists in academic health centers. The presentation also addresses aspirations of psychologists as well as resistances within the profession. Parts of this paper were delivered at the 3rd Conference of the Association of Academic Health Center Psychologists in Minneapolis, Minnesota in 2007.     

Freestanding Psychology: The Only Way in Academic Health Centers

Psychology must assure that its programs, faculty and staff, clinical services, research enterprises, and training programs must be freestanding in Academic Health Science Centers and not organized within any other department except a freestanding Department of Psychology. Without this autonomy, it is argued, Psychology can never reach its full potential as a health care science and profession in hospital and academic health care center settings. This thesis is argued on the basis of issues of finances, credentialing and privileging, role modeling for psychologist trainees, the importance of Psychology's persona within the health science center and in the eyes of the public, and finally, academic freedom.     

Medical Psychology in Australia

Medical psychology in Australia is heavily influenced by British and American thought. The dominant model for clinical training and practice is the scientist–practitioner model, yet a gulf exists between academic and practice settings. Membership of the professional society requires 6 years of university study in psychology. However, registration requires only 4 years training in psychology. Medical psychologists provide a broad range of services in hospital and community settings, often within multidisciplinary teams. Challenges for the future include bridging the divide between university and health settings, increasing qualifications required for registration, making psychology culturally relevant, and demonstrating to funding managers that psychological interventions are both clinically effective and cost effective.     

Medical Psychology in Brazil

In 1962, Psychology was officially accorded professional status in Brazil. Since then the profession has been undergoing continuous development, but the training of psychologists still suffers from flaws that are reflected in the public heath service, SUS (Sistema Único de Saúde). However, SUS itself is also open to criticism: the service is badly distributed, the number of posts for psychologists is limited, and working conditions are poor. Nevertheless, many positive changes are occurring. These include plans to alter academic training to better meet the needs of the Brazilian population, an expansion of the roles played by psychologists in the health service, and increasing research activity. These and many other changes suggest that the progressive evolution of the profession in Brazil will continue.     

Medical Psychology in New Zealand

This paper describes medical psychology and health psychology in New Zealand, particularly in relation to psychologists teaching in medical schools, psychologists working in general medical settings, and health psychologists. It identifies a reasonably slow but continuing consolidation of the discipline, particularly from a research perspective, but also with therapeutic initiatives in the public and private health sector. The potential for increased activity in health promotion and increased psychological analysis and influence in the health system is identified.     

Ethics and Changing Mental Health Care: Concerns and Recommendations for Practice

Recent developments in health care delivery in the United States have left many professionals baffled by the continuing changes in practice sparked by the relatively new managed care environment. Psychologists who practice in medical settings are struggling to balance the seemingly competing needs to deliver quality care to clients and patients, while meeting the demands of third-party payers and trying to remain true to their ethical responsibilities. Critical elements of managed care, which many suggest compromise the ethical provision of quality care, include utilization review, financial incentives, and threats to confidentiality. Recommendations are proposed so that mental health professionals may be proactive in protecting their ethical responsibilities in this changing environment.     

The Future of Psychology in Departments of Psychiatry

Health care reform has put increasing pressure on faculty of medical schools to become self-supporting. Opportunities for clinical revenue will decrease, but psychologists who are able to generate research funding will become increasingly competitive, albeit as mercenaries, i.e., capable of paying their own way plus generating a profit to support departmental operations and educational programs. Changes in the health care system signal an end to psychiatry's paternalistic relationship to psychology and present opportunities for psychology proactively to influence its future role in health care. Research, political action, and revised scientific mission, models, and roles represent important strategies in the redefining of psychology as a basic science and major profession in health care.     

The Future of Psychology in Family Medicine

Psychology has been integral to the field of family medicine since its inception as a medical specialty in the 1960s. Psychologists and other behavioral scientists contribute to family medicine in teaching clinical skills, in defining research questions, in developing research methodology, and in creating integrated physical/mental health care delivery systems. Future developments in the field of psychology in family medicine are likely to emphasize development and evaluation of screening measures which identify mental health problems in primary care, development of early intervention for those mental health problems, and more precise measurement of process and quality of care and health outcomes. Psychologists have an important role to fulfill in educating physicians on alternatives to pharmacologic and medical interventions for common presenting problems in primary care. However, current economic forces shaping the practice of medicine may work against further enhancing the efficacy of the physician in dealing with psychosocial issues. The future role of psychology in family medicine is not yet delineated, and while the move toward parity of reimbursement for mental and physical health care delivery may enhance this collaboration, there is a need to continue to evaluate how the psychological well-being of patients is influenced in the evolution of new models of care delivery.     

Psychology Internships in the Treatment of Severe Mental Illness: Implications for Training in Academic Medical Centers

Despite an increasing focus over the past 2 decades by federal and state governments on the care of persons with severe mental illness, psychologists remain underrepresented among behavioral health professionals working with this population. Within the discipline there is growing concern about the need to adequately train, recruit, and retain psychologists in this specialty. This is a particular concern in academic medical settings where the overall severity of illness among those receiving psychiatric services continues to increase. The purpose of this qualitative research study was to intensively examine the experience of predoctoral interns engaged in treating individuals with severe mental illness in an academic medical center in order to identify the professional developmental experiences and training needs of those learning to care for this population. This analysis, conducted with semistructured interviews at four points during the internship year, yielded a series of recommendations for improving internship training and recruiting psychologists to this specialty.     

Interdivisional Healthcare Committee: Speaking with One Voice on Cross-Cutting Issues in Health Care Psychology

One of the greatest challenges facing psychology in health settings today is the need for unification on critical issues of client access, workforce oversupply, education and training, and outcomes evalutions. Health care psychology specialty areas can no longer afford to operate in parallel. A unified vision is needed to overcome threats to the viability of the profession and to maximize the potential for achieving common goals. The current paper describes the formation of the Interdivisional Healthcare Committee (IHC), whose purpose is to establish a common agenda for promoting the professional, educational, and scientific goals of health care psychology. The IHC's initiative to develop new CPT codes for increasing access to psychologists' services in health care settings is outlined.     

Stress in Clinical Psychology Trainees: Current Research Status and Future Directions

The purpose of this article is to present the current status of the literature related to stress in clinical psychology trainees (CPTs), and to offer research directions for investigating stress in this population and ways to enhance self‐care in these individuals. The following conclusions emerge from the review: (1) CPTs are vulnerable to elevated stress; (2) undue stress can negatively impact CPTs' personal and professional functioning and, in turn, result in less than optimal standards of care for clients; (3) there is a dearth of studies on stress in this population and no published intervention studies; (4) incorporating self‐care strategies into clinical psychology training is recommended; and (5) “third‐wave” cognitive behaviour therapy stress management interventions have been efficacious in comparable populations. In view of the potential costs of elevated stress to trainees themselves and their clients, research on stress and stress management in this population is of a high priority. Broad research agendas are proposed for these two domains. Modifications to clinical training programmes to reduce trainee stress are required and should be evidence‐based and systematically revaluated.     

A Model for Primary Care Psychology With General Thoracic Surgical Patients

This study examined a model for brief psychological assessment for providing primary psychological care to patients within a surgical, specialty outpatient clinic to provide early and accurate detection of psychological distress in patients to increase compassionate care. Questionnaires were completed by 351 outpatients and 227 of these outpatients were provided a model of primary care (brief psychological intervention). Patients were assessed and provided coping strategies, patient education, and a brief evaluation of anxiety and depressive symptoms. Psychologists, in a brief interview (mean = 12 min) identified individuals experiencing significant psychological distress. The ratings of emotional status also predicted health quality of life and anxiety. Younger individuals presenting for medical care appear to be more vulnerable to psychological distress. Brief psychological interventions provide accurate, efficient assessment of psychological distress and can be an effective way of increasing compassionate care. The results support the use of primary care psychology and brief psychological interventions in the management of medical patient care.