Feature

Psychologist Susan Folkman, PhD, has noticed an unintended trend in her post-college life: About every 12 years her career path shifts. The latest change came earlier this year when she accepted an offer to direct the University of California at San Francisco (UCSF) Osher Center for Integrative Medicine.

The move represents not only a significant milestone for her personally, but also for psychology as a discipline: It brings to three the number of psychologists heading centers at UCSF, one of the nation's leading medical schools.

Ten years ago not only would there not have been a center for integrative medicine at a major medical university, but it would have been difficult to find a single psychologist in a leadership position, let alone three at one university.

Even today, UCSF stands out as a dramatic example of the increasing acceptance of the integral role behavioral and social science plays in medical research, says Thomas Coates, PhD, director of UCSF's Center for AIDS Prevention Studies (CAPS).

Coates, Folkman and psychologist Nancy Adler, PhD, who directs the Center for Health and Community Sciences, believe they are fortunate to work for a dean--Haile Debas, MD--who has a broad vision of health and health care and who doesn't recognize the traditional barriers among disciplines.

Folkman, who's conducted seminal research on stress and coping and co-directed CAPS with Coates for 12 years, embodies UCSF's tradition with her ability "to bring people together and get them to think creatively about a problem," says Coates. "She's got the skills to form a scientific agenda that will advance the field of integrative medicine. It's a field that has a lot of gurus but very little of substance. Our niche at UCSF will be to add science to the discussion and make it an evidence-based endeavor."

Folkman is excited about the prospects of helping to shape a research field. Although her career has taken an untraditional path--she started with an undergraduate degree in history--each move has been a logical progression.

After spending her first 12 post-college years raising her four children, she returned to school, choosing the counseling psychology program at her local university because it fit best into her child-care schedule. But she was much less interested in counseling people than in understanding what underlay their need for counseling, she recalls. It was the 1970s, when many women in their 30s were re-entering school to start careers and, Folkman noticed, some coped well while others floundered. She wanted to know why, and thus began her career studying stress and coping.

After Folkman finished her master's at the University of Missouri, her husband took a job in San Francisco and she began working toward her PhD at the University of California at Berkeley. Although she'd been accepted into the educational psychology program within the school of education, her research interests took her to the psychology department where she found a home with stress and coping researcher Richard Lazarus, PhD, who became her longtime mentor.

Folkman stayed at Berkeley to teach and conduct what is now considered critical work in the area of stress and coping research. Her research naturally evolved to study how people cope with the stress of chronic illness. In 1988 she met Coates, who interested her in studying people with HIV/AIDS. That's when she moved to UCSF, where she built a research program focused on stress and coping in the context of HIV/AIDS and other chronic illness, with a particular emphasis on caregiving and bereavement.

In 1994, she joined Coates to co-direct CAPS. Then, early in 2001, to her surprise, university administrators approached her to become the first full-time director of its Osher Center for Integrative Medicine (OCIM), formed in 1997 to coordinate UCSF's research agenda into alternative and holistic medicine.

"I was happy where I was," says Folkman. "It had never occurred to me to move. But as I looked into it, I realized that it represented a new kind of challenge that built on what I'd been doing."

Indeed, heading up OCIM seemed like a natural progression to Folkman. Not only has her research moved toward an integrated medical model of stress and coping, but her work at CAPS prepared her for the job of shaping a research agenda in a field that is largely fueled by demands from the general public.

To begin, Folkman will focus on research areas that capitalize on UCSF's strengths. In particular, she hopes to get the school's top-notch pharmacy school working on studies of herbal medicines and its reknowned neuroscientists looking into mind-body research. In addition, she'd like to see studies that investigate different models of care, including the patient-physician relationship and end-of-life care.

"I want our focus to reflect the important shift in this field toward rigorous research," she says. "That will include seeking most of our funding from the National Institutes of Health, where we'll go through the rigor of its peer-review process."

Folkman's wisdom, broad view of medical as well as social and behavioral research, and her ability to think outside the box make her an ideal choice for the job, says Adler, whose center coordinates the social and behavioral sciences at UCSF. It also helps that Folkman is a scientist and not an advocate for alternative medicine. "She's interested in mechanisms and processes," says Adler. "That's what's needed to bring a sense of legitimacy to this newly emerging field."



Beth Azar is a writer in Portland, Ore.