Handbook of Clinical Psychology in Medical Settings

For two decades, I have been responding to questions about the nature of health psychology and how it differs from medical psychology, behavioral medicine, and clinical psychology. From the beginning, I have taken the position that any applica tion of psychological theory or practice to problems and issues of the health system is health psychology. I have repeatedly used an analogy to Newell and Simon's "General Problem Solver" program of the late 1950s and early 1960s, which had two major functional parts, in addition to the "executive" component. One was the "problem-solving core" (the procedural competence); the other was the representa tion of the "problem environment. " In the analogy, the concepts, knowledge, and techniques of psychology constitute the core competence; the health system in all its complexity is the problem environment. A health psychologist is one whose basic competence in psychology is augmented by a working knowledge of some aspect of the health system. Quite apparently, there are functionally distinct aspects of health psychology to the degree that there are meaningful subdivisions in psychological competence and significantly different microenvironments within the health system. I hesitate to refer to them as areas of specialization, as the man who gave health psychology its formal definition, Joseph Matarazzo, has said that there are no specialties in psychology (cited in the editors' preface to this book).

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I. Introduction.- 1 Clinical Psychology in Medical Settings: Past and Present.- 2 Psychology and the Health Care System: Characteristics and Transactions.- 3 The Structure and Authority of Hospitals.- II. Professional Issues.- 4 Educational Preparation and Clinical Training within a Medical Setting.- 5 Psychologists, Politics, and Hospitals.- 6 Professionalism in Medical Settings.- III. Practical Issues: Practice Management.- 7 Quality Assurance and the Clinical Health Psychologist: A Programmatic Approach.- 8 Arguments for the Financial Efficacy of Psychological Services in Health Care Settings.- 9 Marketing Psychological Services in Hospitals.- 10 Computers in Psychological Practice: Historical and Current Uses.- IV Practical Issues: General Clinical Issues.- 11 Critical Issues in Consultation and Liaison: Pediatrics.- 12 Critical Issues in Consultation and Liaison: Adults.- 13 Emerging Issues in Women's Health.- 14 Emerging Issues in the Care of the Elderly.- 15 Adherence to Self-Care Regimens: The Patient's Perspective.- V. Practical Issues: Research.- 16 Research in the Medical Setting: Implementing the Scientist-Practitioner Model.- VI. Templates for Program Development.- 17 Toward Program Development: An Integration of Science and Service in Medical Settings.- 18 Psychological Evaluation and Testing Services in Medical Settings.- 19 Development of an Eating-Disorder Program.- 20 Integration of Clinical Psychology into Adult and Pediatric Oncology Programs.- 21 Cardiovascular Disorders: Hypertension and Coronary Heart Disease.- 22 Psychological Components of Rehabilitation Programs for Brain-Injured and Spinal-Cord-Injured Patients.- 23 Chronic Pain: Psychological Assessment and Treatment.- 24 Program for Behavioral and Learning Disorders in Children.- 25 Development of a Program for Sleep Disorders.- 26 Diabetes: Clinical Issues and Management.- 27 Psychological Theory, Assessment, and Interventions for Adult and Childhood Asthma.- 28 Psychological Characteristics and Treatment of Patients with Gastrointestinal Disorders.- 29 Programs for the Treatment of Dental Disorders: Dental Anxiety and Temporomandibular Disorders.- 30 Integration of Clinical Psychology into Hemodialysis Programs.- 31 Psychosocial Services for Persons with Human Immunodeficiency Virus Disease.- VII. Future Directions.- 32 Challenge of the Future: Psychologists in Medical Settings.- Afterword.- About the Contributors.