Health Psychology: History, Definition And Areas Of Application
There are a large number of disciplines within psychology. While some of them focus on research, group settings or clinical practice, Health Psychology focuses on health promotion and in the psychological treatment of physical illness.
In this article we will review the history of this branch of the profession, contextualize it, define it and describe its objectives.
In the preamble to its Constitution, written in 1948, the World Health Organization defined health as “a state of complete physical, mental and social well-beingand not the mere absence of illness or disability.”
The definition itself emphasizes making a distinction with the old conception of health as the simple absence of physical problems; Currently, the term “health” is used to also refer to psychosocial variables that influence biology human, which gives a key role to Health Psychology.
Other definitions place health and illness on a continuum. Thus, at one end we would find total health, while at the other we would find premature death due to the absence of health.
Likewise, more and more importance is given to the understanding of health as a state and as resource that allows achieving goals and meet the needs of individuals and social groups in relation to their environment.
History of Health Psychology
The functions currently performed by Health Psychology have traditionally been the subject of attention of various disciplines.
We can consider that the emergence of Health Psychology was a slow and progressive process. In this we find several key moments and contributions that need to be mentioned in order to understand the development of this field.
The biomedical model and the biopsychosocial model
Traditionally it has been understood health from a dualistic perspective that separates the body and the mind. This point of view would be included in what we know as the “biomedical model”, which became popular in the West during the Renaissance, a period in which there was a reunion with science and reason, overcoming the religious explanations that prevailed at that time.
At the end of the 19th century and the beginning of the 20th, progress in medicine caused a change of direction in this field and other related ones. In addition to the improvement in medical interventions and quality of life In general, infectious diseases, which until then had been the main focus of medicine, could be treated more effectively. This shifted the focus of medicine toward chronic lifestyle diseases such as cardiovascular disorders and cancer.
The biopsychosocial model proposed by Engel ended up replacing the biomedical model. Unlike this one, the biopsychosocial model highlights the relevance and interaction of psychological and social factors along with biological ones. This perspective raises the need for personalized and interdisciplinary treatments, since the intervention must address the three types of variables.
Influences and background
Johnson, Weinman and Chater (2011) point out several fundamental close antecedents in the emergence of Health Psychology as an independent discipline.
These include obtaining epidemiological data that relate behavior to healththe emergence of Psychophysiology and Psychoneuroimmunology, and the addition of behavioral science and communication skills (to improve relationships with patients) to medical training.
The development of disciplines such as Psychosomatic Medicine and Behavioral Medicine. Both focus on the treatment of physical illness through psychological intervention techniques, although Psychosomatics emerged from psychodynamic approaches and Behavioral Medicine from behaviorism.
Currently the term “Behavioral Medicine” is used to name an interdisciplinary field that encompasses contributions from psychology but also from other sciences, such as pharmacology, nutrition, sociology or immunology. This gives it a broader scope of action than that of Health Psychology.
The emergence of Health Psychology as a discipline
In 1978 the American Psychological Association created its 38th Division: that belonging to Health Psychology. Joseph D. Matarazzo was named its president and Division 38 soon after launched its first manual (“Health Psychology. A handbook”) and an official magazine.
Since then, Health Psychology has specialized in treatment of physical and psychological illnesseslike depression. However, the advance of this branch of psychology has been faster in some countries than in others due to its relationship with public health; For example, in Spain the low government investment in psychology makes Health Psychology a relatively uncommon specialization.
Although Health Psychology does not have an official definition, Matarazzo (1982) described it as a field that encompasses diverse contributions from psychology in relation to education, science and profession, applied to health and illness.
The American Psychological Association proposes that Health Psychology is an interdisciplinary field that applies the knowledge obtained by psychology to health and disease in health programs. These interventions are applied in primary care or in medical units.
Thielke and others (2011) describe four subdisciplines within Health Psychology: Clinical Health Psychology, Public Health Psychology, Community Health Psychology and Critical Health Psychology, aimed at social inequalities. related to health.
Differences with Clinical Psychology
What, exactly, are the differences between Health Psychology and Clinical Psychology? In the Spanish context, it is easy to confuse these two branches of psychology, given that both fit with the idea of intervention in patients with problems that make them suffer or that limit their autonomy. However, they don’t deal with exactly the same thing.
Clinical Psychology aims to diagnose and offer psychotherapy to people who could have developed a psychological disorder, that is, one that focuses on mental health in the face of cognitive, emotional or behavioral alterations whose severity sometimes exceeds the clinical threshold. and damages mental health. On the other hand, Health Psychology does not focus its efforts on psychotherapy carried out to reverse the symptoms of OCD, bipolar disorder or other similar complications, but instead tries to promote the patient’s healthy habits in a broad sense, as well as seeking who is informed and knows how to prevent and mitigate the discomfort caused by a certain physical or mental illness.
However, it must be taken into account that This difference in categories depends on the regulations of each countryand in certain places Clinical Psychology could be practically a synonym for Health Psychology.
Goals
For Matarazzo, Health Psychology has several specific goals that we will describe below.
1. Health promotion
This is one of the most characteristic aspects of Health Psychology. Traditionally, medicine has been insufficient in the treatment of a good number of diseases, especially those that are chronic and require a change in habits, such as cardiovascular diseases or respiratory problems due to tobacco consumption.
Psychology has a greater number of resources to improve adherence to treatment and relationship between the professional and the patient. Both variables have been shown to be fundamental in the effectiveness of medical treatments.
2. Prevention and treatment of diseases
Both Medicine and Clinical Psychology have historically focused on the treatment of illness (physical and mental, respectively). However, both have neglected disease prevention, an unavoidable aspect for achieving full health.
Health Psychology has been applied to a large number of physical illnesses. Are include cardiovascular disorders, cancerasthma, irritable bowel syndrome, diabetes and chronic pain, such as that derived from fibromyalgia or headaches.
Likewise, Health Psychology is key in the prevention of problems derived from habits unhealthy, such as those produced by smoking or obesity.
3. Identification of etiological and diagnostic correlates
Health Psychology should not be dedicated simply to applied tasks of prevention and treatment of diseases, but also to actively investigate what factors influence in its appearance and its course.
In this sense, Health Psychology would include contributions from epidemiology, Basic Psychology and other fields of research useful for various disciplines related to health.
4. Analysis and improvement of the health system
This aspect of Health Psychology is key and implies a political component, in the sense that the health measures recommended by Health Psychology professionals must be implemented through the public health system to reach a greater number of people.
However, as we have previously said, depending on the country in which we find ourselves, this objective is still somewhat utopian.
Perspectives in this area
There are two main perspectives regarding the direction that Health Psychology should take, which currently remains a very young field.
One of them suggests that the discipline should specialize in providing the knowledge of psychology to physical illness; Health Psychology would be conceived, therefore, as an equivalent for the physical health of What Clinical Psychology is to mental health. However, this entails a return to the dualistic conception of the human being, with the separation of the body and the mind as independent entities.
The other point of view rather proposes that Clinical Psychology and Health Psychology actually belong to the same field of action. The biggest difference between the two would be the emphasis on prevention by Health Psychology, compared to the traditional focus of the Clinic on pathology.
