An Overview of Health Psychology
According to the American Psychological Association, health psychologists “help patients manage chronic disease and avoid preventable diseases” by “incorporating psychological theory and research to develop methods to assist patients in maintaining healthy lifestyles.”
If you haven’t yet heard of health psychology, you will soon. Clinical health psychologist Amanda Withrow, Ph.D., who has spent over a decade working with patients with chronic illnesses, says health psychology has seen significant growth in the last 30 years.
This could reflect the shift that’s occurring in the way we perceive our health. According to Withrow, 50 to 60 years ago, “physicians had the final word [and] everybody respected that. You did what the doctor said. You didn’t argue. And you didn’t do your own research. Today, patients advocate for their own health. They do their own research. They challenge doctors. They make choices about what they want their quality of life to be.” And although we are still trying to understand the body, “there are certain things that are within our control.”
In a sentence, that is what health psychologists strive to do — educate and inform patients so that they can take control of their health. But what exactly is health psychology? Can a health psychologist potentially help you? Read on to get a detailed look at this burgeoning field from two health psychologists.
What Is Health Psychology? How Can It Help You?
“Health psychology really comes from where medicine and psychology can work symbiotically,” Withrow said. It is taking our knowledge of mind and body and using it to understand and help individuals cope better, manage their pain and essentially learn to empower themselves.
Health psychology encompasses a wide range of issues — from chronic pain to terminal illness — with the goals of helping people improve their quality of life and addressing specific health issues. Maureen Lyon, Ph.D., clinical health psychologist and associate research professor in pediatrics at George Washington University, said, “Health psychologists do a lot of prevention work around a range of issues from preventing obesity, maintaining a positive outlook in life, preventing anxiety and depression and trying to enhance the quality of life of individuals.”
Health psychologists also play a big role in the military, helping soldiers and veterans with post-traumatic stress disorder (PTSD), life adjustment and suicide prevention.
They also promote healthy behaviors and deal with underlying psychological issues such as stress, depression and anxiety. Unlike other clinical psychologists, Withrow explained that health psychologists are trained to know about the “disease processes and physiology and how the mind and body can work together on what’s going on with a specific illness in order to help that person deal with whatever issues they are being presented with.”
A person who has insomnia, for example, may work with a health psychologist on creating a regular bedtime routine, limiting their caffeine intake and participating in relaxation activities before bed. Someone who is suffering from chronic pain could also benefit from seeing a health psychologist. While health psychologists do not solely advocate patients to stop taking their medication, Withrow said, “there are a lot of things we can do behaviorally, things we can do using your mind and behavior to better manage pain without needing to rely on medication or on the same dosage of medication.” For example, stress management tools and relaxation techniques can help chronic pain patients cope more effectively with stress. This is important, she said, since stress often exacerbates pain.
Understanding the Thoughts Behind Behavior
One of the ways health psychologists help patients is through education. They inform patients on a basic level about their body and their illness. If patients can understand why their body is acting or reacting a certain way, then they will be able to understand how things like stress management, for example, can help.
Another part of patient education is learning about the relationship between thought and behavior. Withrow gives an example of a person with chronic pain. On a good day, this person may overcompensate by doing too much. As a result, stress and fatigue may cause an increase in pain. A health psychologist would then work with this patient on trying to find ways to “keep a consistent level of activity.”
She also uses cognitive tools to help patients. “If you’re really, really worried about something, if you really think there’s going to be a flareup, you may think yourself into a flareup instead of being able to step back and taking a more objective look.” Using cognitive-behavioral techniques can help patients reduce their pain and anxiety and could potentially reduce their dependency on medication.
Health Psychology’s Holistic Approach
Health psychology provides a holistic perspective to health. It takes into account not only a person’s physical illness and symptoms but also their life experience. According to Withrow, this means that patients should be seen in context, “not just what’s going on physically and emotionally, but what their relationships are like, how much support they have, their community and how all that fits together to present the person we’re seeing in front of us.” The information they collect about a patient includes biological characteristics (e.g., genetic predisposition to illness), behavior (stress, negative thoughts, values) and social factors (social support, relationships).
In the case of a diabetic, Withrow explained that it is important to consider a patient’s resources. Is walking around their neighborhood something they can comfortably and safely do? Are they able to afford fresh fruits and vegetables? If you can understand, for example, what resources are available for that person, you can work with them where they are and with what they have. A full assessment of a person’s situation can better serve the needs of the individual.
How Health Psychologists Empower Patients
Health psychologists provide tools and teach their patients new skills so that they can learn to help themselves. “The nice thing about learning these tools is it puts people in the driver’s seat of their pain and they’re not reliant on their doctors for prescriptions and the pharmacy for filling it or, you know, the insurance company for authorizing it.”
A health psychologist’s role is to provide information so that patients can ultimately make their own informed and conscious decision. “Things we do, what we eat, how we behave, what we think and the medications we take have consequences…I talk about this a lot with pain patients, in that narcotics, opiate medications can be really useful for controlling pain, but they have a lot of side effects and they have a lot of long-term consequences. And being able to consciously make a decision of how much they are going to use, what their limits are, whether they want to use it or not is far better when they can weigh the costs and benefits and consequences and make that conscious decision rather than just taking a passive role and say, ‘Okay, I’m just going to take this for the rest of my life.’”
What You Might Not Know About Health Psychology
According to Lyon, health psychologists work on multidisciplinary teams in integrated care settings including working with physicians, nutritionists, dieticians, and physical therapists. Withrow also adds that they work side by side with physicians so they can discuss and share relevant information to best serve their patient.
In addition to helping doctors with patient compliance and personality conflict between physicians and their patients, they also help doctors and nurses and other health care staff deal with burnout. “Health psychologists working alongside with these providers on a regular basis in these settings have a unique opportunity and potential to really help the providers as much as they do the patients,” said Withrow.
Should You See a Health Psychologist?
Health psychologists see people with a wide range of issues, including cancer, sexual dysfunction, obesity, chronic pain, depression and anxiety. In deciding on whether you should see a health psychologist, Withrow said to ask yourself these three questions:
- Is there a physical illness or chronic illness that’s underlying my depression or anxiety or other issues that I’m seeking help with?
- Am I looking to treat a specific symptom (e.g. insomnia, migraines)?
- Do I want somebody who will work closely with my physician?
If you answered “yes” to any of the above, you might want to consider consulting a health psychologist. Although she receives the majority of her patients through doctor referrals, it’s perfectly fine to seek a health psychologist on your own.
How To Find a Health Psychologist
When looking for a health psychologist, Lyon advises interested individuals to find someone who has been certified by the American Board of Professional Psychology (ABPP). Most health psychologists are board certified and to find one you can ask your doctor for a referral or go to the APA website. When searching in their database under “psychological locator” look for things like behavioral change, stress management, chronic illness and sexual dysfunction since these are key areas of expertise for a health psychologist.
What You Should Know if You’re Working with a Health Psychologist
Withrow reminds patients that the path toward health and healing takes time. Patients need both determination and patience to be successful. “Sometimes they’ll get a lot of symptom relief or make improvements in a couple of sessions, but sometimes they may not really see the true, full benefit for awhile and it takes a lot of hard work and perseverance to actually get to that point.” But she says it’s worth it. “I’ve had patients who have felt really empowered and have had really amazing, life-changing experiences from doing the work.”
Uyemura, B. (2015). An Overview of Health Psychology. Psych Central. Retrieved on July 31, 2016, from http://psychcentral.com/lib/an-overview-of-health-psychology/