International Development Of Health Psychology

John Weinman, Mary A. Jansen

• Publisher: Routledge
• Year: 2022
• ISBN:
  9781134343935
• Edition: 1
• Topic: Medicine
• Subtopic: General Health

First Published in 1991. With any new area of research, particularly one in which development has been so rapid and influential, it is important to take stock of progress and identify critical issues. Health Psychology shows great potential both as a research area and a profession, and the careful planning of good quality research and of appropriately structured training programs if imperative if this potential is to be realised. this book explores the way in which this discipline has developed internationally and the nature of different types of training programs which have emerged. This book is intended for health psychologists who are interested in the latest developments in their field around the world and will be particularly valuable to those responsible for training programs.

SECTION ONE INTERNATIONAL DEVELOPMENTS OF HEALTH PSYCHOLOGY

DOI: 10.4324/9781315076843-1

CHAPTER 1 AN INTERNATIONAL REVIEW OF THE EMERGENCE AND DEVELOPMENT OF HEALTH PSYCHOLOGY

GEORGE C. STONE

Department of Psychiatry, University of California, Center for the Social and Behavioral Sciences, 1350 Seventh Avenue, CSBS 204, San Francisco, CA 94143, USA

DOI: 10.4324/9781315076843-2

This article presents an historical review of the development of the field of health psychology and traces its progress from its conceptual beginnings until the present. Events are chronicled in most regions of the world and the status of the field is given for these regions with a summary of the current activities taking place.

Three hypotheses are posited regarding the future development of the field with respect to its status in the country:

1. The identification of health psychology as a specific field has led to its expansion and development.
2. The history and status of psychology itself plays a major role in determining a country or region’s receptivity to health psychology.
3. Where psychology is strong and autonomous and where health research and service is not dominated by medicine and psychiatry, health psychology will flourish.

A. INTRODUCTION AND EARLY DEVELOPMENTS

About fifteen years ago, in the United States, a new term was proposed for an emergent sphere of psychological activity. As early as 1974, the term “health psychology” was used in an internal memorandum proposing a new curriculum in psychology at the University of California, San Francisco. Although we felt that we had created a new and, to us at the time, a somewhat awkward sounding term, I have no doubt that others were independently trying out this unfamiliar juxtaposition of words, expressing once more the power of the Zeitgeist.

The first self-conscious use of the term “health psychology” in an organizational context in the United States was probably at a business meeting of the Section on Health Research of the Division of Psychologists in Public Service in 1977, when the choice of a name for a proposed new division of the American Psychological Association was debated. The next September, the Division of Health Psychology came into being. Five years later, in 1982, the Interamerican Congress of Psychology meeting in Quito, Ecuador, devoted a major part of its program to this newly named enterprise and at the meeting established a Task Force on Health Psychology. The First International Symposium of Health Psychology took place in La Habana, Cuba in 1984. Since then, there has been a veritable explosion of interest, worldwide, in the application of the concepts, knowledge, and skills of psychologists to problems of the health system. International and regional conferences have followed upon each other in quick succession.

How did this phenomenal efflorescene of activity come to pass? Does it mark the beginning of a major new field in psychology, or will it be a transient phenomenon, soon absorbed into existing categories of psychological endeavor? We are much too close to the events to give definitive answers to such questions. Yet, we must try to appraise our work and to discern the directions that offer the greatest promise of enduring contributions to human health and well-being. It is in the spirit of such appraisal and discernment that this paper is presented. Many persons in many countries are offering their views in this regard. Although I present here a personal perspective, I have tried to base it not only on my own participation in the process, but to incorporate some of the reflections of others published during these formative years. I attempt to look at the developments that took place just before and just after the crystallization of the concept of health psychology to gain insight into the emergence of this new field. In doing so, I have relied to a large extent on secondary sources—reviews and commentaries by specialists in particular topics and participants in various geographical/cultural areas. †

† I wrote to a number of persons active in promoting international organizations in health psychology asking for their help in identifying the kinds of material I was seeking. Some of them sent me valuable publications. I am particularly indebted to Stan Maes of the Netherlands, Brian Oldenburg, Neville Owens, and Rob Sanson-Fisher of Australia, Andrew Steptoe and John Weinman of Great Britain and Barbara Marin of the USA. Helpful information was also received from Professor A. Appels of the Netherlands, Irmelda Florin of the Federal Republic of Germany, and Stephen Weiss of the USA.

Three propositions appear to be supported by events of the past twenty years:

1. Although some of the activities now classifiable as health psychology have been practiced since long before the term came into use, its adoption has provided a major stimulus to the expansion and development of the field.
2. Receptivity to the idea of a field of health psychology is greatly influenced by the history and current status of the field of psychology in each sociocultural region where it is presented. Where it takes root, its development and the topics and activities it stresses are shaped by the existing forms of psychology.
3. In particular, vigorous growth occurs where there is a strong and autonomous psychology whose access to health research and services is not dominated by medicine or psychiatry.

B. RECOGNITION THAT THERE IS A FIELD OF HEALTH PSYCHOLOGY

Engaging in an activity, recognizing that we are doing so, and naming the activity are often separated by long time spans in the lives of individuals and in the history of humankind. One uses subjects and predicates long before one knows what they are. A search of Psychological Abstracts using subject headings and title words for articles about health psychology, (however labelled) turned up an average of three per year for the period from 1968-1978. In the six million volume library of the University of California, the number of books with publication dates in that period averaged eight. But suddenly, in 1979, the year after the formation of the Division of Health Psychology and the second year following the seminal Yale Conference on Behavioral Medicine, the number of publications increased dramatically. From 1980 through 1987 the number of articles averaged 19 and the number of books, 24. It is my aim to give an overview of how this change came about and to see if we can discern from the trends of these two decades what may lie ahead. In order to achieve this, we must consider the relationships between the new field called “health psychology” and several closely related domains.

C. SOME DEFINITIONS

We begin with a definition of the field of “health psychology” proposed by Joseph Matarazzo and adopted with minor revisions by the Division of Health Psychology of the American Psychological Association in 1980. As revised, the definition reads:

Health psychology is the aggregate of the specific educational, scientific, and professional contributions of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, the identification of etiologic and diagnostic correlates of health, illness and related dysfunction, and the analysis and improvement of the health care system and health policy formation.

Interpretation of this definition requires definitions of psychology and its contributions. An earlier historical reflection proposed that psychology meant “the scientific study of the nature and determinants of human experience and behavior and the application of the knowledge thus gained in professional practice.” (Rodin and Stone, 1987, p. 15). Based upon that definition, the task here can be defined as tracing the recent development of ideas about the ways in which human behavior and experience influence health and are influenced by it and of interventions based upon those ideas.

Some of these developments have appeared under the explicit label of “health psychology”, and some in closely related rubrics, such as “clinical psychology”, “medical psychology”, “behavioral medicine”, or “psychosomatics”. As others have noted (Agras, 1982; Dahme and Scheer, 1984; Rodriguez, 1988; Wisocki, et al, 1982) it isn’t possible to give a precise description of the relationships among these several categories, since definitions vary from place to place and from time to time. Nevertheless, I venture here some broadly brushed distinctions that provide a basis for bounding the phenomenon that this paper attempts to describe.

Clinical Psychology

The field first to establish itself as a domain of research and practice was clinical psychology. Throughout most of its history, clinical psychology has concerned itself almost entirely with a limited class of problems—those in which the behavior of the patient was in some sense the essence of the problem. Garfield’s authoritative definition of clinical psychology as “that branch of psychology which is concerned with problems of personality adjustment and modification” (Garfield, 1965, p. 125), sounds almost as broad as those of health psychology and behavioral medicine. published more that a decade later. But almost all of the actual work performed concerned such “mental health” problems as psychosis, neurosis, and the like, problems of intellectual and emotional development, and those of alcoholism and other drugs that produced serious behavioral consequences. Mastery of techniques of assessment and treatment appropriate for these problems achieved the status of definitional characteristics of the clinical psychologist.

What now appears to have been a kind of overspecialization was pointed out in 1969 in a landmark paper (Schofield, 1969) that was a turning point for health psychology. At first, those associated with the newly identified field of health research, as it was called during the first formative years, made much of the distinction of their new endeavor from the traditional problems of Clinical Psychology, even though many of the participants were clinical psychologists by training. In recent years, with the concept of a health psychology firmly established, this sharp distinction is, quite properly, being softened and much of the present growth in health psychology is occurring as an expansion and broadening of long-standing programs in clinical psychology. As this process continues, a major region of health psychology will be oriented to work with emotional and intellectual problems of persons in the health care phase of the health system.

Psychosomatics

Even earl...

Table of contents

• Cover Page
• Half-Title Page
• Title Page
• Copyright Page
• Table of Contents
• Introduction
• Section 1: International Developments of Health Psychology
• Section 2: Training Within Health Psychology
• Section 3: Health Psychology Training for Other Health Professionals
• Section 4: Concluding Overviews
• Index