Speaking of Education

At the time of this writing it is Thanksgiving, and I have been pondering those things for which I am particularly thankful this year: family and friends, new colleagues at APA and a touching farewell from the University of Florida students. In addition I am especially thankful to have received the inaugural Timothy B. Jeffrey Award in Clinical Health Psychology from the American Psychological Foundation. Receiving such an award is not only an honor, but an impetus for reflection on this growing area in our diverse discipline.

Some reflections

Tim Jeffrey died prematurely, but not before he had made his own outstanding contributions to the profession. In 1990, I was president of the American Board of Health Psychology and Tim was vice president. We sat together on a very hard bench in Santa Fe, N.M.--anxiously awaiting word from the American Board of Professional Psychology as to whether our petition for recognition as a specialty would succeed. It did, and Tim went on to lead the development of the board certification process; his untimely death was a loss for us all.

Although its conceptual foundations are as old as human history, health psychology has not been "mainstream" until more recently. A landmark event in organized psychology was the 1969 report, "The Role of Psychology in the Delivery of Health Services," prepared for the APA Board of Directors by William Schofield. Members' interests grew, and by 1978 Div. 38 (Health Psychology) had been founded.

Education and training in health psychology developed concurrently with the synergism between science and practice. Approximately 40 doctoral programs were identified in 1980, and by 1990, surveys revealed that health psychology had become a central component in both clinical and research training in professional psychology. In 1997 APA's Council of Representatives formally recognized Clinical Health Psychology as a specialty, and by 2000 the journal Health Psychology had more individual subscriptions than any APA journal, other than American Psychologist and the Monitor.

At the first national conference to address education and training in health psychology (Arden House, 1983), participants defined core domains of knowledge that today's education, training and professional groups continue to adopt. Key program components include faculty role models for working with other disciplines, access to health-care settings, participation by faculty from other health-care disciplines and exposure to diverse problems and populations. We have also recognized the need for already trained practitioners to obtain relevant knowledge and skills; in fact, Professional Psychology will soon publish an article describing a self-assessment model for practitioners who wish to expand their practices in health care.

Looking forward

An exciting aspect of health psychology is that it is ever-changing. After reviewing current trends, participants in the recent Div. 38 conference on the future of health psychology identified areas for increased attention in future curricula: genetics, telehealth, pharmacology, organ/tissue transplantation, health informatics, diagnostic and treatment medical technologies, changes in population demographics, cultural diversity, primary care, health-care economics and primary prevention.

In related efforts, the Education Directorate has developed two major education and training reports for federal agencies: one on preparing psychologists for changes in the health-care delivery system, and one on preparation for interprofessional services in primary care. We are also collaborating on efforts to develop more in-depth, programmatic, continuing education offerings in health. And on the horizon is the publication of a detailed curriculum for training in primary-care psychology, an interdivisional initiative in which the Board of Education Affairs (BEA) participated. Moreover, the directorate and BEA have made a commitment to advocacy for the establishment of a psychology training program in the Bureau of Health Professions.

The directorate also promotes the teaching of psychology and the application of psychology to the schools. Health initiatives under way in these areas include the development of a health psychology unit plan for high school teachers, and the Healthy Lesbian, Gay, Bisexual Students Project, a program to promote healthy school environments for adolescents.

A real harbinger of things to come is president Norine Johnson's commitment to bringing psychology's contribution to health to the foreground. The initiatives she has chosen are now well under way. In fact, it is my opinion that we are on the brink of witnessing a figure-ground reversal with respect to our perceptions of psychology's role in health research and health care. I believe that mental health research and practice will no longer be recognized as the domain of psychology's contribution to health. Instead, mental health will be recognized as one (but no less important) subset in the much-expanded domain of psychology's contribution to health research and practice. Stay tuned.

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