Advancing Psychology as a Bio-behavioral Science

Concerns for the integrity of psychology as an independent discipline have caused some psychologists to object to introducing any knowledge from the biological sciences into the training of psychologists. However, calls for the greater incorporation of the behavioral sciences in medical education, increased attention to research on the mechanisms of bio-behavioral interaction, and initiatives in translational medical research and clinical care, have prompted increased interest in interdisciplinary research, health care, and teaching. These changes, in turn, are resulting in a re-conceptualization of the structure of academic medicine with increasing emphasis upon multidisciplinary knowledge and interdisciplinary collaboration, and less emphasis upon disciplinary insularity and competitiveness. If clinical health psychology is to play a role in this evolving concept of academic health care, it must adequately prepare its trainees to function in interdisciplinary academic health care settings. This will require not only expertise in the role of behavioral factors relevant to medical disorders, but also some basic familiarity with the biological processes to which those behavioral factors relate. With the evolution of its fund of knowledge, clinical health psychology has the potential to utilize its science to discover, describe, interpret, teach and clinically apply knowledge of the mechanisms of interaction between biological functions and behavioral, learning, cognitive, socio-cultural and environmental processes. By failing to seize this initiative, clinical health psychology risks becoming irrelevant to the evolving model of medical research, education and health care. Presented, in part, to the Association of Psychologists in Academic Health Centers, Minneapolis, MN, May 2007.     

Innovative Methods for Making Behavioral Science Relevant to Medical Education

Thousands of psychologists teach in U.S. medical schools, and these psychologists are responsible for ensuring that the medical students they train are aware of the ways in which research findings from the behavioral and social sciences can enhance the practice of medicine. In addition, it is imperative that physicians appreciate the limits of their own ability to treat psychological and psychiatric problems and know when to refer to mental health professionals. This brief article is based on a talk given by the author at the 2007 American Psychological Association (APA) convention after receiving the Association of Psychologists in Academic Health Centers (APAHC) Ivan Mensh Award for Distinguished Achievement in Teaching. The paper draws on the personal experiences of the author after three decades spent teaching behavioral science to medical students, and it introduces readers to the reasoning behind many of the decisions made in planning and developing each of the author’s four editions of the medical school text Behavior and Medicine.

Psychologists in Academic Health Centers and Medical Centers: Being Visible,Relevant and Integral

Psychologists play key roles in academic health centers. This article is an outgrowth of a presentation at the 2015 Conference of the Association of Psychologists in Academic Health Centers addressing various strategies by which psychologists can effectively adapt to and develop successful careers in medical schools, academic health centers, and teaching hospitals. The authors encourage early career and mid-career psychologists in academic health centers to be active, engaged members of their institutions and to participate in multiple aspects of the research, educational, and clinical missions.     

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

Psychologists, interns, and postdoctoral fellows convened in Minneapolis May 3–5, 2007 for the 3rd National Conference of the Association of Psychologists in Academic Health Centers (APAHC): “Psychologists in Academic Health Centers: Traditions and Innovations in Education, Science, and Practice.” This paper reviews the development and organization of the conference, which built upon the two previous conferences of the Association of Medical School Psychologists. The articles in this special issue are based on a selected number of the 32 conference presentations, covering a range of timely topics that reflect the conference theme. Participants’ positive perceptions and satisfaction with the conference reveal the value of such conferences focused on the activities, interests, opportunities, and challenges of psychologists who work in academic health centers (AHCs) and teaching hospitals. Moreover, the content and success of the conference underscores the importance of APAHC as an organization serving the needs and promoting the interests of psychologists affiliated with AHCs.

Competencies for Psychologists in Academic Health Centers (AHCs)

This paper begins by providing the landscape that undergirds the competency-based movement within professional psychology education, training, credentialing, and performance appraisal. Attention is then paid to the relevance of this culture shift for psychologists working as practitioners, educators, researchers, and administrators in AHCs. In this regard, there is an articulation of the essential subcomponents of each of the core foundational and functional competency domains that are salient for AHC psychologists. Implications of the competency-based movement for professional psychologists in AHCs are offered. This paper is based in part on the first author’s plenary address at the Association of Psychologists in Academic Health Centers Midwinter Meeting in Minneapolis, Minnesota, May 2007.     

Recommendations for Research Success: One Investigator’s Perspective

This article is a personal reflection by an investigator with over 25 years of funding from the National Institutes of Health (NIH). The article: (1) highlights research opportunities for psychologists at the NIH outside of the traditional mental health arena; (2) provides specific recommendations to individual investigators to enhance their likelihood of obtaining NIH funding; (3) specifies needed changes in psychology’s research education and training programs to prepare the next generation of psychologists for research success; and (4) asks the Association of Psychologists in Academic Health Centers to play a lead role in both research training and advocacy. This article is based on a presentation given at the 3rd national conference of the Association of Psychologists in Academic Health Centers in May of 2007 in Minneapolis, Minnesota.     

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.     

Preparing Psychologists in Academic Health Centers for the Rapidly Changing Health Care Environment

The Association of Psychologists in Academic Health Centers (APAHC) convened its 5th National APAHC Conference in Boston March 3–5 2011. The conference and its theme, “Preparing Psychologists for a Rapidly Changing Health Care Environment,” brought psychologists from academic health centers together to examine how psychology can adapt to and help lead health care efforts in the face of health care reform. This paper reports on the conference and introduces the special issue of JCPMS that is dedicated to the conference. The conference theme is framed in the historical context of the four national conferences that preceded it. In examining the focus and topics of the preceding conferences, recurrent themes are identified and progress in certain areas is highlighted.     

Changing Educational Needs of Psychologists: Do We Need More Medical Knowledge,Basic Science and More Psychological Science?

Psychologists of the 21st century must be highly skilled and versatile to function effectively in academic health centers (AHCs). Thus, the current paper focuses on the training psychologists receive to prepare them for their diverse roles in AHCs. The paper is framed around the question: Do we need more medical knowledge, basic science and more psychological science? posed to the author by the conference organizers of the 3rd National Association of Psychologists in Academic Health Centers (APAHC) Conference and is based on the perspective of the author.     

The NIH Roadmap: Are Psychologists In or Out?

Psychologists often express concerns about the inclusion of psychology in the National Institutes of Health (NIH) Roadmap initiative. Most Roadmap themes focus on biomedical research, forming the basis for psychologists’ concerns. Although most Roadmap funding goes toward biomedical research, social and behavioral scientists do win support. It is reasonable to ask, however, why the Roadmap is focused so exclusively on medical research. One explanation is that medical interventions are seen as the natural translation of basic biomedical research, whereas psychological interventions are not perceived as following from basic behavioral research. Psychologists working in academic health centers represent the best opportunity for creating such linkages, and therefore the best potential bridge for psychology connecting to the NIH Roadmap. This paper represents the views of the author, and not necessarily those of the American Psychological Association and is based on a presentation given at the 3rd National Conference of the Association of Psychologists in Academic Health Centers in May 2007 in Minneapolis, Minnesota.     

The Difficulty of Making Psychology Research and Clinical Practice Relevant to Medicine: Experiences and Observations

Psychology and medicine research and practice have demonstrated substantial and unique bodies of knowledge designed to both improve patient care and respond to contemporary health care needs for use of evidence and cost consciousness. At their full potential they represent a significant paradigm shift in healthcare. Despite impressive successes, it is clear that we are just on the cusp of such a change. These findings have had limited impact and penetration into medical practice, particularly outside of academic medicine and large, organized systems of health care, and there are multiple examples of such limitations in various arenas of health care. There also appear to be common themes to such examples which provide us opportunities to consider how psychologists might move things ahead. They also suggest how our unique position in academic medicine can both limit our impact and provide ways of creating continued shifts in the healthcare paradigm. This paper is based in part on the author’s presentation at the Association of Psychologists in Academic Health Centers 3rd National Conference in Minneapolis, Minnesota, May 2007.     

Introduction to the Special Section from Recent Association of Psychologists in Academic Health Centers (APAHC) Programs

The Association of Psychologists in Academic Health Centers (APAHC) offers programming at the annual American Psychological Association (APA) conventions as well as periodic APAHC conferences. Participants from academic health centers across the country convened in St. Louis, Missouri, October 15–17, 2009, for the 4th National Conference of the Association of Psychologists in Academic Health Centers (APAHC). The title of the conference was ‘‘Psychologists in Academic Health Centers: Facing Tomorrow’s Challenges to AHC Programs and Careers.’’ Efforts were made to include topics relevant to academic health center (AHC) practice including the unique challenges of working in AHCs and issues pertinent to the different stages of AHC careers. To facilitate networking, opportunities for discussion among conferees and presenters with shared interests and concerns were provided throughout the conference. This paper introduces the special section of JCPMS dedicated to the conference and provides a brief overview of its development and organization. Articles selected for inclusion represent a sampling of the four conference themes: (1) challenges to AHC programs, (2) staying current in critical clinical areas, (3) professional issues and challenges, and (4) challenges to developing careers. Post-conference evaluation data are presented as evidence of the need for further conferences with similar foci. The programming offered by APAHC at the APA convention in San Diego in 2010 built on the themes offered at the 2009 APAHC conference.     

Mentoring Interns and Postdoctoral Residents in Academic Health Sciences Center

This article was co-authored by a senior mentor and one of her students who worked with her as both an intern and a postdoctoral fellow. It is an expanded version of a presentation given by the first author after receiving the Association of Psychologists in Academic Health Centers (APAHC) Distinguished Achievement in Teaching Award. The article offers a historical view on mentoring, defines and describes the term, and delineates the characteristics of good mentors and mentees. The significant impact of mentoring on the professional and personal development of psychology interns and postdoctoral residents and their mentors in academic health centers is explored. Techniques for developing, maintaining, and promoting effective mentoring relationships are provided and the ethical considerations related to mentoring are examined. This article is based upon an invited address, “Mentoring of Predoctoral Interns and Postdoctoral Fellows in an Academic Health Sciences Center” given by the first author in recognition of the author’s receipt of the Association of Psychologists in Academic Health Centers 2005 Award for Distinguished Achievement in Teaching. The address was presented at the Annual meeting of the American Psychological Association, New Orleans, LA, August, 2006.     

Interprofessional Education: Preparing Psychologists for Success in Integrated Primary Care

Rapidly occurring changes in the healthcare arena mean time is of the essence for psychology to formalize a strategic plan for training in primary care settings. The current article articulates factors affecting models of integrated care in Academic Health Centers (AHCs) and describes ways to identify and utilize resources at AHCs to develop interprofessional educational and clinical integrated care opportunities. The paper asserts that interprofessional educational experiences between psychology and other healthcare providers are vital to insure professionals value one another’s disciplines in health care reform endeavors, most notably the patient-centered initiatives. The paper highlights ways to create shared values and common goals between primary care providers and psychologists, which are needed for trainee internalization of integrated care precepts. A developmental perspective to training from pre-doctoral, internship and postdoctoral levels for psychologists in integrated care is described. Lastly, a call to action is given for the field to develop more opportunities for psychology trainees to receive education and training within practica, internships and postdoctoral fellowships in primary care settings to address the reality that most patients seek their mental health treatment in primary care settings.     

Integrating Behavioral and Social Sciences in the Medical School Curriculum: Opportunities and Challenges for Psychology

The Institute of Medicine has reviewed and made recommendations concerning current teaching approaches, content, and barriers to the incorporation of behavioral/social sciences in medical school curricula (Cuff & Vanselow, 2004). This paper discusses those recommendations, the history of medical education reform, the barriers to and evolution of behavioral/social sciences’ inclusion, and the implications for psychology’s future role in academic medicine. Psychological concepts and technology permeate medical practice, but little progress has been made in integrating psychological and biological sciences. Looking to its basic science domains (e.g. cognition, learning, development, neuroscience), psychology can take scientific leadership in illuminating the mechanisms by which behavioral/social processes interact with biological functions in health, thereby providing the empirical basis for a truly integrated bio-behavioral curriculum. This article is based upon a symposium, “IOM Report on Enhancing Behavioral & Social Science in Medical Education: Impact and Opportunities for Psychology,” presented at the Annual meeting of the American Psychological Association, Washington, D.C., August 21, 2005. Suzanne Bennett Johnson, Chair; Elena Reyes, John E. Carr, and Anthony Errichetti, participants; Eugene K. Emory, Discussant.     

Integrating Mental Health and Primary Care Services in the Department of Veterans Affairs Health Care System

Integrating mental health care in the primary care setting has been identified in the literature as a model for increasing access to mental health services and has been associated with enhanced clinical and functional patient outcomes and higher patient satisfaction. The Department of Veterans Affairs (VA), which operates the nation’s largest integrated health care system, has taken a leadership role in creating a health care system in which mental health care is provided in the primary care setting. This article examines VA’s efforts and progress to date in implementing evidence-based models of integrated mental health services nationally in community based outpatient clinics, home based primary care, and outpatient primary clinics at medical facilities. Psychology plays an important role in this progress, as part of an overall interdisciplinary effort, in which all professions are crucially important and work together to promote the overall well-being of patients. This article is based in part on a presentation by the first author at the 3rd National Conference of the Association of Psychologists in Academic Health Centers (APAHC) in May of 2007 in Minneapolis, Minnesota.     

The Forgotten Faculty: Challenges for Ph.D.s in Clinical Medical School Departments

The data and discussion contained in this invited paper are based on the opening plenary by the first author whose paper titled “The Status of Ph.D.s in US Medical Schools” was presented at the 3rd national conference of the Association of Psychologists in Academic Health Centers, Minneapolis, MN, May 2007. The significant growth of the number of Ph.D.s in clinical departments is described, as is their distribution. The roles they play; the barriers they face in terms of leadership opportunities, promotion and tenure; and the concerns they voice that are specific to this population are also discussed. Salary differentials between Ph.D.s on main and medical school campuses are provided. Recommendations for future investigation of disparate treatment and for faculty development opportunities specifically aimed at this group are found at the conclusion of the paper.     

TOWARDS AN INTERNATIONAL PROFESSION OF CLINICAL PSYCHOLOGY: AN ANGLO-SWEDISH PERSPECTIVE

Previous reviews of the international trends in the development of clinical psychology as a profession have identified the United Kingdom and the Nordic States as countries where the role of the psychologist is approximating that in North America. The article presents a review of the historical and current influences on the development of clinical psychology in the United Kingdom and in Sweden. In Europe, where clinical psychology is mainly a Health Service profession rather than a private practice, independence of the management and medical responsibility of the psychiatrist has become more of a key issue. Of the two major ‘schools’ of clinical psychology, identified in Britain with the behavioral approach of the Maudsley Institute of Psychiatry and the psychodynamic approach of the Tavistock Clinic, the behavioral school tended to dominate in Britain until the 1970s. In Sweden, the psychodynamic approach importing many of the aspects of British Object Relations Theory, gained ascendence. This resulted in a split between the more academic form of clinical psychology in Sweden, which had produced research of international importance (e.g. the role of psychological factors in stress-related illness), and professional education in psychology with its emphasis on psychotherapeutic training. Whereas in Britain, during the 1970s, clinical psychology broke away from psychiatry, became more eclectic, and entered the general medical and health areas, these changes failed to take place in Sweden. On the other hand, private practice amongst psychologists in Sweden has shown a dramatic increase during recent years and there are now some clear trends towards eclecticism in the education of psychologists. The issue of medical responsibility remains unresolved in Sweden. That British clinical psychology has reached more progressive and cordial professional relationships in this respect may be, in part, due to the status of the scientist-practitioner role that the initial behavioral emphasis achieved. The major contributions of and trends in British and Swedish clinical psychology are discussed with a view to identifying international trends.     

Psychology in Academic Health Centers: A True Healthcare Home

This article is based on the invited presentation by the author at the American Psychological Association??s Annual Convention, August 4?C7, 2011, upon his receipt of the Joseph D. Matarazzo Award for Distinguished Contributions to Psychology in Academic Health Centers presented by the Association of Psychologists in Academic Health Centers. This article relates the history, roles, and responsibilities of psychologists in academic health centers to the ultimate survival and success of professional psychology. It describes implications of the Patient Protection and Affordable Care Act (ACA) on the institutional practice of psychology including how psychology??s place in academic health centers positions the field well for the future of healthcare reform. The article provides several recommendations to help professional psychology prepare for that future of integrated, interprofessional healthcare.     

Do Father-Friendly Policies Promote Father-Friendly Child-Rearing Practices? A Review of Swedish Parental Leave and Child Health Centers

By reviewing the literature, we looked at how parental leave policies in Sweden have influenced two well-defined areas of early father involvement: participating in parental leave and at visits/activities at the Child Health Centers. Sweden has one of the most comprehensive and egalitarian parental leave policies in the world, permitting parents to take 480 days off of work, receive 80% of their pay for the first 15 months, and divide their leave however they see fit, barring that both parents receive 2 months of parental leave that is exclusive to them. Additionally, fathers are permitted to take the first ten working days off to be at home with his family. Most parents, especially mothers, use parental leave throughout their infant’s first year. During the parents’ time off from work, nearly all Swedish parents (95–99%) utilize the Child Health Centers between 11 and 13 times during the infant’s first year of life. The Child Health Centers help to monitor a child’s growth and development, provide parenting support, immunizations, health education, health screenings, and provide referral sources if the child has any special needs. However, fathers only use 22% of all parental leave days. Studies have pointed out that fathers may not use parental leave because of corporate, maternal, and financial attitudes. Despite the Child Health Centers’ policy of including both parents, fathers do not utilize the Child Health Centers to the same extent as mothers. Research has shown that fathers may not use Child Health Centers as they are mainly only open during normal working hours, they are dominated by females (staff and mothers), and many conversations during the child’s first year are directed towards mothers. Barriers for why father involvement is lower than mothers are discussed.