Becoming a Health Psychologist

Tracey A. Revenson, Patrice G. Saab, Peggy M. Zoccola, Lara N. Traeger

• Publisher: Routledge
• Year: 2019
• ISBN:
  9781351201254
• Edition: 1
• Topic: Psychology
• Subtopic: Applied Psychology
• Index: Psychology

Becoming a Health Psychologist provides an overview of the different training paths students can take to prepare themselves for graduate school and careers in the field of health psychology.

You'll find tips on how to choose and apply for graduate programs as well as numerous practical examples such as emails to potential advisors and questions to ask during interviews. Throughout, the authors provide examples of different health psychology careers, along with references, resources, and first-hand experiences. It details what is involved in becoming a health psychologist, what a health psychology career entails, and how to reach that goal.

The inclusion of tips from a diverse group of successful students, early career, and senior health psychologists makes this book an invaluable resource for anyone looking to start their career or for advisors who are counselling students about career choices. For many readers, this book may serve as "the mentor they never had".

1
What Is a Health Psychologist?

Introduction

When asked at age five what they wanted to be when they grew up, none of the four authors of this book chimed, “I want to be a health psychologist!” To be fair, for half of us, the field of health psychology didn’t exist at that time, but even if it had, we wouldn’t have known what it was, and our parents and teachers wouldn’t have guided us to it.

The field of health psychology does exist now—in fact, it is a thriving area of psychology—and it presents an exciting career choice for those interested in the connections between health and psychology, for those in the helping professions, or for those who want to conduct scientific research (or all three). We presume that is why you have taken this book off the shelf or have pulled it up on your tablet.

Health psychology is an evolving field, boasting many potential job opportunities and predicted growth in the future. In the next ten years, the job outlook for psychologists is expected to grow by 14% (U.S. Bureau of Labor Statistics, 2018). Specifically for health psychologists, evolving healthcare reform is expected to enhance the role of psychologists within the healthcare system in treating behavioral components of health and chronic illness (Norcross, Pfund, & Prochaska, 2013). Additionally, health psychologists can be found in a variety of different professional settings and roles, from clinics and research to teaching, consulting, and government roles. So, pursuing a career in the field of health psychology is not a path to a single destination but a way of gaining skills and knowledge useful for several opportunities and ever-changing environments.

Today nearly 70% of U.S. psychology departments offer an undergraduate course in health psychology (Norcross et al., 2016), compared to only 26% in the 1990s (Panjwani, Gurung, & Revenson, 2017). Health psychology features prominently in many recent introductory psychology textbooks (Griggs, 2014) and is rated as one of the most important topics covered in introductory psychology (McCann, Immel, Kadah-Ammeter, & Adelson, 2016), a course taken by approximately 1.5 million students a year (Gurung et al., 2016). There are now numerous graduate programs that offer doctoral-level training in health psychology (Byrne, Gethin, & Swanson, 2017).

Some of you may have taken an undergraduate course in health psychology or read a chapter on health psychology in a textbook or encyclopedia. For others, a classmate, colleague, or mentor may have suggested that health psychology is the field for you. At the moment, you may think that you want a career in health psychology. But do you really? In this book, we will describe what it means to be a health psychologist and offer information and advice on how to prepare yourself for a career in health psychology regardless of what stage you are in your training or career. We will give you advice on deciding which type of graduate program is best for you, how to apply to health psychology programs and choose among them, and how to prepare for the career ahead while you are in graduate school and beyond.

What Is Health Psychology?

Health psychology is a relatively young field within psychology. In the late 1970s, interest in the contributions of psychological, social, and behavioral factors to physical health led to the emergence of health psychology as an area within the field of psychology. In 1978, this contributed to the founding of the division of Health Psychology (Division 38) within the American Psychological Association (APA), the major membership organization for psychologists in the United States. That division changed its name in 2015 to the Society for Health Psychology (SfHP) and currently boasts 3,237 members, of whom 719 are students in training. Those who would like to read a more detailed history of the field will find it in the writings of Taylor (1990), Pickren and Degni (2011), and Friedman and Adler (2011).

Although many descriptions of the field have been offered over the past 40 years, the SfHP description captures the breadth of and diversity of activities in which health psychologists engage:

Health psychology is “[t]he field of psychology that addresses the interactions of psychological, social, cultural, and biological influences, mechanisms, and consequences as they relate to the development, prevention, treatment and management of illness and disability and the promotion of health and wellbeing. The field of health psychology produces and evaluates rigorous health research, products, and services, and translates the research for the purpose of enriching empirical knowledge, public understanding, clinical practice, program design, and policy across diverse populations and settings”.

(Block, 2015)

Figure 1.1 Biopsychosocial Model

There is a lot to unpack in that definition. First, it states that the field of health psychology is based on the biopsychosocial model, first developed by a psychiatrist, George Engel, in 1977 and adopted in psychology soon after (Schwartz, 1982). In the biopsychosocial model (see Figure 1.1), health and disease outcomes are not the result of some single cause-single effect pathway, but the results of multiple interacting influences, some biological, some psychological, and some from individuals’ social environments. Second, health psychology is relevant along the entire continuum of health to illness—from promoting health and wellness to the prevention of disease (e.g., cancer screening, smoking cessation programs) to making difficult medical decisions and adhering to medical treatment and to living with chronic illness. Third, health psychology is research-based. This involves conducting original research to determine the causes and consequences of health conditions and using evidence-based treatment approaches (that is, those based on research evidence) in clinical practice. Fourth, health psychology is a field that serves the public interest by producing research findings that can improve health and quality of life for all people (not just those who have easy access to healthcare).

During the past four decades, health psychologists have worked to understand the biological, psychological, and social factors that affect health, health behavior, and illness. They have worked to turn those answers into help for people faced with illness or for those who might benefit from changing their health behavior. Recently, the first author of this book suggested that we move toward a biopsychosociocultural model in order to address important questions of health disparities and inequities (Revenson & Gurung, 2019). As you read the following research examples, consider the breadth of topics that health psychology comprises, from the study of biobehavioral mechanisms of stress and illness, to the study of social justice concerns such as the impact of economic and social disparities on health. Researchers continue to grapple with probing questions that examine the bidirectional nature of mind and body, such as:

How does depression contribute to the pathophysiology of cardiovascular disease?

How do inflammatory processes influence depressive symptoms?

How can we convince more people to engage in regular cancer screening?

How can we increase uptake and adherence rates for pre-exposure prophylaxis, or PrEP, the first biomedical prevention strategy for HIV?

How do perceived racism and daily microaggressions lead to greater cardiovascular risk for African-Americans?

How can we use the research evidence in health psychology to develop more effective and cost-effective behavioral interventions for those living with chronic illness?

These questions (among many others) are the terra firma of health psychology. Addressing such questions offers the potential for research evidence to be translated into clinical practice and health policy.

“Growing up, I always envisioned that I would become a physician since I liked science, I did well in school, and I wanted to help people. I completed all the pre-med requisite courses as an undergraduate, studied for the medical school entrance exams, and volunteered in the local emergency department to prepare for my future. Through my undergraduate coursework and experience as a research assistant in psychology, as well as personal experiences, I came to realize that my true interest was in resilience, particularly how people manage illness and injury. My journey to becoming a health psychologist began when I recognized that my passion was in the intersection of the biological, psychological, and social factors that affect health”.

—Laura Forsythe, Ph.D., M.P.H., Director of Evaluation and Analysis, Patient-Centered Outcomes Research Institute

The Difference Between Health Psychology and Behavioral Medicine

Interest in the contributions of biological, psychological, social, cultural, and behavioral factors to physical health and well-being is a hallmark of health psychology, but it is not unique to health psychology. This emphasis also characterizes the broader field of behavioral medicine, which coincidently came on the scene at the same time as health psychology in the late 1970s. And, if you browse through research journals in the two fields, you won’t see much of a difference in the content. Health psychology can be viewed as a sub-discipline of behavioral medicine, which is part of the broader public health, healthcare, and medical domains (Freed-land, 2017).

Although health psychologists play a central role in behavioral medicine as valued members of interdisciplinary research and clinical teams, behavioral medicine careers are not limited to health psychologists. Rather, behavioral medicine careers include any profession that “promote[s] healthy behaviors to improve health and well-being” (Society of Behavioral Medicine, n.d.). As such, other fields like medicine, nursing, public health, pharmacy, social work, nutrition, exercise, dentistry, physical therapy, and health education offer many excellent options for those interested in health and behavior.

“There are many positives of interdisciplinary collaboration, including a broader perspective and a deeper understanding of the biological, psychological, and social forces that combine to shape health-related behavior. For example, my work on the development of chronic low back pain is informed by both basic learning principles (e.g., after an acute back injury, restriction of spinal motion is negatively reinforced by avoidance of pain) and physiological processes (e.g., over time, continued restriction of spinal motion promotes muscle tissue changes that increase risk for re-injury). In my experience, the challenges of interdisciplinary collaboration, which include differences in knowledge bases, settings, job descriptions, and reward structures, are overcome by mutual respect and a commitment to good communication”.

—Chris France, Ph.D., Distinguished Professor of Psychology, Ohio University

“As a physician, I would not be able to do the meaningful research work I am currently doing if it wasn’t for my close collaborations with psychologists who share the common interests and goals of improving the quality of life and reducing distress of patients living with cancer and their care-givers. Our research projects are built on our interdisciplinary strength and require close collaboration. For example, I have worked closely with several of my psychology colleagues to develop and test a psychological intervention to promote effective coping for caregivers of patients undergoing hematopoietic stem cell transplantation. My clinical expertise in this population coupled with the psychological training that my colleagues bring has allowed us to build innovative models of healthcare delivery for patients with cancer and their families. Importantly, throughout these experiences, my psychology colleagues have helped me become a better clinician, capable of recognizing patients’ various coping strategies and helping them think about how to strengthen their resilience and ability to deal with the challenges of a life-threatening illness. I often say that by working with psychologists, I wish I had chosen their career path given their immense contribution to my thinking and perspective on illness and medicine”.

—Areej El-Jawahri, M.D., Assistant Professor of Medicine, Massachusetts General Hospital

What Is a Health Psychologist?

The multiple facets of health psychology hint at the diverse opportunities for specialization. Although there are many types of health psychologists, the two most common types are clinical health psychologists (who are trained both to provide health services and conduct research) and health psychologists (who are trained to conduct research but are not trained to be health service providers).

While all health psychologists address some aspect of health, well-being, or illness in their work, clinical health psychologists are distinct in that they receive specialized training to engage in the clinical practice of health psychology. Clinical health psychologists might be part of a multidisciplinary team working with doctors, nurses, dieticians, and other healthcare providers treating patients in a medical setting or they might work to promote well-being in otherwise healthy clients.

Health psychologists who do not have clinical expertise are a broad group with diverse training. For example, there are health psychologists with expertise in statistics, psychophysiological methods, brain imaging, neuroendocrine and immunological assessment, social relationships, developmental processes, or population health. Many health psychologists “work the hyphen” within psychology and call themselves social-health psychologists, developmental-health psychologists, or health neuroscientists. For example, social-health psychologists address the influence of social processes and the social environment on health-related processes. As such, they might work to understand how attitudes contribute to health behavior change or how the social environment contributes to health and illness by affecting immune processes (Taylor & Broffman, 2011). Health psychologists also may refer to themselves by the methods they use: experimental health psychologists or, for those who use qualitative methods, critical health psychologists.

“A social-health psychologist can do ma...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Dedication
• CONTENTS
• List of Illustrations
• Foreword
• Preface
• 1 What Is Health Psychology?
• 2 Training Options for Health Psychologists
• 3 Preparing for Graduate School in Health Psychology
• 4 Applying to Graduate Programs in Health Psychology
• 5 What to Expect in Graduate School in Health Psychology
• 6 Managing the Stresses and Challenges of Graduate School in Health Psychology
• 7 Professional Development
• 8 The Clinical Predoctoral Internship
• 9 Planning for Your Career in Health Psychology After Graduate School
• Appendix
• Index