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The Texas Abuse Hotline is staffed 24 hours a day, seven days a week. The toll-free number is (800) 252-5400.

Recent advances in psychological, medical, and physiological research have led to a new way of thinking about health and illness. This conceptualization, labeled the Biopsychosocial Model, views health and illness as the product of a combination of factors including biological characteristics (e.g., genetic predisposition), behaviors (e.g., lifestyle, stress, health beliefs), and social conditions (e.g., cultural influences, family relationships, social support).

Psychologists who strive to understand how biological, behavioral, and social factors influence health and illness are called Health Psychologists. In contemporary research and medical settings, health psychologists work with many different health care professionals (e.g., physicians, dentists, nurses, physician's assistants, dietitians, social workers, pharmacists, physical and occupational therapists, and chaplains) to conduct research and provide clinical assessment and treatment services. Many health psychologists focus on prevention through research and clinical interventions designed to foster health and reduce the risk of disease. In North America, the term "health psychology" is often interchanged with the terms "behavioral medicine" or "medical psychology".

The Work Setting of a Health Psychologist: Health psychologists participate in health care in a multitude of settings including primary care programs, inpatient medical units, and specialized health care programs such as pain management, rehabilitation, women's health, oncology, smoking cessation, headache management, and various other programs.

Clinical Activities: Assessment approaches often include cognitive and behavioral assessment, psychophysiological assessment, clinical interviews, demographic surveys, objective and projective personality assessment, and various other clinical and research-oriented protocols. Interventions often include stress management, relaxation therapies, biofeedback, psychoeducation about normal and patho-physiological processes, ways to cope with disease, and cognitive-behavioral and other psychotherapeutic interventions. Individual and group interventions are utilized. Frequently, health psychology interventions focus upon buffering the effect of stress on health by promoting enhanced coping or improved social support utilization.

Research: Health psychologists are on the leading edge of research focusing on the biopsychosocial model in areas such as HIV, oncology, psychosomatic illness, compliance with medical regimens, health promotion, and numerous specific disease processes (e.g., diabetes, cancer, hypertension and coronary artery disease, chronic pain, and sleep disorders). Research in health psychology examines: the causes and Development of illness, methods to help individuals develop healthy lifestyles to promote good health and prevent illness, the treatment people get for their medical problems, the effectiveness with which people cope with and reduce stress and pain, biopsychosocial connections with immune functioning, and factors in the recovery, rehabilitation, and psychosocial adjustment of patients with serious health problems.

Career Opportunities: The opportunities for careers in health psychology in the United States are quite good. Medical settings, particularly medical centers, have greatly expanded their employment of psychologists. Aside from medical centers, health psychologists often work in colleges and universities, medical schools, health maintenance organizations, rehabilitation centers, pain management centers, public health agencies, hospitals, and private consultation/practice offices. In addition to the specific content skills which psychologists offer to patients and staff in the medical community, psychologists' unique training often makes the health psychologist an asset to the medical team with regard to quality assurance methods (making certain that health care is helpful and cost-effective), research, writing, grant-writing, statistical, communication, and team development skills.

Training for Health Psychology Careers

Health psychologists typically hold a doctoral degree (PhD or PsyD) in psychology. Applied health psychologists are licensed for the independent practice of psychology in areas such as clinical and counseling psychology, and board certification is available in health psychology, through the American Board of Professional Psychology.

Often, psychologists preparing for a career in health psychology obtain general psychology training at the undergraduate and doctoral levels, but then receive specialty training at the postdoctoral or internship level. Some programs have been developed which offer specialized training in health psychology at undergraduate and graduate levels. Here are some specifics of training in health psychology at various levels:

Undergraduate: Health psychology courses are available at about a third of North American colleges and universities. Because of the field's biopsychosocial orientation, students are also encouraged to take courses focusing on abnormal and social psychology, learning processes and behavior therapies, psychophysiology, anatomy and physiology, and psychopharmacology.

Graduate: Many doctoral programs in clinical, counseling, social, or experimental psychology have specialized tracks or preceptorships in health psychology. A number of programs now exist in the United States and other countries specifically for doctoral training in health psychology. These programs are quite diverse: some specialize in training students either for research careers or for direct clinical service to patients. Division 38 has a directory of doctoral programs offering training in health psychology, available from the Division Services Office of the American Psychological Association.

Predoctoral Internships: Clinical and Counseling psychologists are required to complete a one-year predoctoral internship/residency before obtaining their doctorates. Many of these programs offer some training in health psychology. A number of internship programs provide specialized training in health psychology in which at least half of the trainee's time is spent in supervised health psychology activities. Division 38 distributes a directory of health psychology internships, which is linked to its web site.

Postdoctoral Fellowships: Many university medical centers, universities, health centers, and health psychology programs offer specialized research and/or clinical training in different areas of health psychology. Division 38 offers a directory of postdoctoral opportunities in health psychology, linked to its web site.

International Health Psychology Training Opportunities: A directory has been developed under the joint auspices of the Division of Health Psychology and the APA Office of International Affairs. This directory provides information about opportunities in health psychology outside the U.S. and Canada for students, faculty, and practicing professionals. The directory of international health psychology training opportunities is available through the Division Services Office of the American Psychological Association.

Training programs often vary with regard to specific educational emphases, formats and content of formal instruction, research opportunities, and opportunities to engage in supervised clinical training. After obtaining the appropriate directory of training opportunities, it is a good idea to contact specific programs to determine if programs match one's training needs.

By Sam A. Houston and Merritt McReynolds Marinelli

In the course of your practice you probably will learn of child abuse. As you know, failure to report such abuse may lead to civil liability or even criminal sanctions. You should probably keep a copy of the statute (Chapter 261 of the Family Code) in your office for quick reference. Still, there are many nuances in the statute and some pitfalls to avoid.

Chapter 261 mandates that a professional report suspected abuse or neglect (physical and mental) to the proper authorities. The report must be made within 48 hours after the professional first suspects that the child has been or may be abused or neglected. The law expressly prohibits a professional from delegating or relying on another person to make the report.

This duty to report applies without exception to an individual whose personal communications may otherwise be privileged - including any and all conversations with a mental health provider that would otherwise be privileged and confidential. Therefore, should you gain information in consultation that leads you to suspect a child has been or may become the victim of abuse or neglect, you must make a report of such concerns within 48 hours of when you first form this suspicion.

Reports of suspected abuse and neglect may be made to any of the following: local or state law enforcement agency; the Department of Protective and Regulatory Services, (if the alleged or suspected abuse involves a person responsible for the care, custody or welfare of the child) the state agency that operates, licenses, certifies, or registers the facility in which the alleged abuse or neglect occurred; or the agency designated by the court to be responsible for the protection of children. The report’s contents should include the name and address of the child, if known; the name and address of the person responsible for the care, custody or welfare of the child; and any other pertinent information concerning the alleged or suspected abuse or neglect.

The identity of anyone making a report under Chapter 261 is confidential and may be disclosed only upon court order or to a law enforcement officer for the purposes of conducting a criminal investigation of the report.

Abuse must be reported

The law requires any person who believes a child is being abused, neglected or exploited to report the circumstances to the Texas Department of Protective and Regulatory Services Abuse Hotline. A person making a report is immune from civil or criminal liability, and the name of the person making the report is kept confidential. Any person suspecting abuse and not reporting it can be held liable for a Class B misdemeanor.

Child Protective Services staff consider the following factors in determining whether the situation involves substantial risk of harm to a child:

  • Extent and severity of the injury;
  • Location of the injury on the child's bod;
  • The child's age;
  • The child's physical condition, psychological state and level of maturity and development;
  • Frequency and duration of the same behavior or similar incidents;
  • Previous history of abuse or neglect; and
  • How the injury occurred or was inflicted.

The Texas Abuse Hotline is staffed 24 hours a day, seven days a week. The toll-free number is (800) 252-5400.