Service Development and Healthcare Policy

Health psychology interventions can be carried out within primary or secondary prevention services (Hallas, 2007). Health psychologists design and carry out cognitive-behavioural interventions with individual patients and groups for changing health behaviours. Health behaviours refer to the actions and behaviours of an individual person, a group or/and an organization. For example, when someone is stressed at work it could be attributed to the person’s coping strategies, but it could also be related with the manager’s decision-making behaviour, which would be the organization in this case (Kok & Schaalma, 2007). Within the category of health behaviours, there are included the use of medical services, the adherence to medical diets, and the self directed behaviours such as nutrition, physical activity, smoking and consuming alcohol (Marks, et al., 2015). All these behaviours are usually divided between health-enhancing and health-impairing behaviours (Bennett, Conner & Godin, 2007). The way in which an individual behaves in relation to health may determine the outcome of the illness.

Moreover, behaviour management is a key factor for preventing and dealing with chronic diseases (Matarazzto, 1982). Chronic patients’ behaviours contribute to their adjustment to the outcomes of the illness and to manage pain (Stanton, Revensons & Tennen, 2007). This highlights the relevance of behaviour management and change in someone’s health and well-being.

Health psychologists need to understand and to intervene to changes in both psychological and behavioural processes on illness and healthcare. Changing behaviour of patients and health professionals can be advantageous for the healthcare system (Kaplan, 1990) and should be one of the main goals of health psychology.

Health psychology training to healthcare professionals HPs are also employed to train other healthcare professionals so they can better understand de psychological impact of illness and treatment and improve the professional – patient communication (Gatchel & Oort, 2003).

The fields of knowledge that HPs could teach may include the Biopsychosocial Model of health, statistics and methods of research and theories and techniques of behaviour change (Winefield, 2007). They may as well use their expertise in intervention design and implementation to support other healthcare professionals in delivering interventions and developing their own design (Hallas, 2007). In more applied contexts, health psychologists may train on skills such as communication and interview, adherence to treatment, promotion of a healthy lifestyle and handling work stress for health professionals.

Another important part when it comes to professionals’ education is the supervision from professional health psychologists to other people training for being one of them (Horn, 2007). Supervision implicates an exchange of information between the supervisor and the trainee. The supervisor must identify what the trainee needs and guide him or her in the right way for understanding, experiencing and reflecting over the acquired knowledge (Miville et al., 2014).

Health psychologists can also use their knowledge on statistics and research for participating on research projects. During the healthcare practice, many questions and difficulties arise that need further research to provide evidence-based practice (Hallas, 2007). This allows HPs to have an influence on the standards of practice as a result of their research skills.

Service development and Healthcare Policy

Health psychologists work within public health and primary care departments based in both national health authorities or in national agencies.

Polices on service and standards are often revised for health service managers due to the Department of Health studies and guidelines (Hallas, 2007). HPs may be asked to assist the revision of this polices, which sometimes implies the evaluation of the policy, or providing professional advice (DeLeon, Frank & Wedding, 1995). Health psychologist roles in these cases may include the development and assessment of health promotion throughout health education and perhaps community-based interventions (Hallas, 2007). Thinking about the organizational implications for psychological services and for the psychological wellbeing of staff and patients should be one of the main concerns of HPs working in healthcare services.

After briefly describing the settings in which health psychologists’ work, these suggests that most of the time health psychologists’ work takes place within multi-professional teams. This means that they usually work closely with other health professionals such as doctors, nurses, physiotherapists and even professionals from other fields, as can be the social workers. Whilst working in multidisciplinary teams, the health psychologist provides can conduct research, provide a service or offer some consultancy; without depending on the role they have within the team, they need to be aware of other disciplines’ theories, practice and ethics, and respect every point of view even if not agreeing with them (Michie, 2007). Work in multidisciplinary teams might be an advantage when it comes to research practice as it may provides more resources and results will be more reliable.

Constraints

Health psychology is a relatively new discipline and a developing field. It is for this reason that there are some issues that health psychologists must take into account.

Starting with the area of teaching and education, health psychologists may not have complete independence when choosing what, how and to whom to teach. However, they always need to make sure of the information the learners want and need to know and adapt themselves to the environment in which they are teaching (Winefield, 2007).

Something similar occurs in their consultancy role. When treating patients directly, health psychologists need to identify patients’ personality and needs and work under such conditions (Suls & Rittenhouse, 1990; Stone and McCrae, 2007). Moving into wider issues in health, HPs must take into account social aspects of psychological functioning at a deeper societal level (Abraham, 2007). Findings suggest that socioeconomic status (SES) is an important factor when talking about life expectancy (Marmot & Wilkinson, 1999). Several studies show how SES can be more powerful than someone’s health behaviour when determining health outcomes (Lynch, Kaplan, Salonen, 1997; Kennedy, Kawachi, Glass & Prothrow-Stith, 1998). In 2005, Fukuda, Nakamura and Takano found that individual lower socioeconomic status was a strong predictor of risk behaviour in both sexes even when controlling personal characteristics.