The health Psychology Is a discipline that is born within a contextual framework where it begins to give importance to the role of behavioral and psychosocial variables in important health problems.
In addition, it has developed as a specialty focused on disease prevention and health promotion.
Definition of health psychology
The most complete definition of Health Psychology is that made by Matarazzo in 1980.
Health psychology is the sum of the specific professional, scientific and educational contributions of psychology as a discipline, for the promotion and maintenance of health, prevention and treatment of disease, identification of etiological correlates and diagnoses Of health, disease and associated dysfunction, as well as the improvement of the health system and the formulation of a health policy.
This definition includes the four fundamental lines in which the health psychologist is involved: promotion and maintenance of health; Prevention and treatment of the disease; Etiology (causes) and correlates of health, disease and dysfunctions and study of the health system and the formulation of a health policy.
As for the first line of action, it would include the entire scope of campaigns aimed at promoting healthy habits, such as a balanced diet.
The second line of action refers to the need to modify insane habits in order to prevent illness and to teach sick people to adapt more successfully to the new situation.
The third line of action, the etiology refers to the study of the causes that give rise to the disease, in this case, would mention the consumption of alcohol, tobacco, physical exercise or how to deal with stressful situations.
That is to say, from the health psychology what is interested is to intervene, endowing the individual with the resources that allow him to reach a certain level of sufficiency in the biological and, therefore, to maintain his state of health as long as possible.
Another definition provided by the Working Group on Health Psychology of the European Federation of Professional Psychological Associations (EFPPA) concludes"the mission of professional health psychology is to promote and maintain wellness through the application of Theory, methods and psychological research, taking into account the economic, political, social and cultural context. And, its main purpose is the use of knowledge, methods and psychological skills in the promotion and maintenance of well-being??.
General historical approach
Psychology was born linked to physiology and experimental laboratories, however, much earlier it was linked to the field of health through its participation in the diagnosis and treatment of mental illness.
This linking of psychology with the world of health, from the perspective of mental illness, defined the area of work of Clinical Psychology, and began close collaboration with psychiatry.
However, it was only a matter of time, in the middle of the twentieth century and next to the evolution of society, began to take interest a number of aspects, which combined gave rise to the origin of health psychology.
- The interest of infectious diseases, which are currently quite controlled by the use of antibiotics, has shifted to those of a chronic nature of multicausal origin, linked to lifestyle, such as cancer or cardiovascular problems. That is, the increase of these diseases is due to the interaction between alterations in the behaviors and health habits that act together, facilitating the appearance of the disease.
- These types of chronic diseases often lead to changes in the style and quality of life to which people have to adapt. For example, maintain a good adherence to treatments.
- Insufficiency of the medical model to treat chronic problems.
- The mind-body dualism.
Dualist and holistic vision
Context and culture influence the view of the relationship between body and mind. Thus stand out a dualistic or a holistic view.
The dualistic view is that of models such as the biomedical model, which see health as something given and in which less importance is given to the behaviors of individuals in their relation to their disease, for example in As for the treatments.
In the Middle Ages this vision was accommodated, people were thought to have an eternal spirit, within a finite body; The disease was a product of sin and the only possible cure was through faith.
While the holistic view is characteristic of the current biopsychosocial model, or cultures such as China or Ancient Greece. In them the disease was considered as a product of the rupture of the inner balance, by biological or other different causes, such as changes in behavior or the presence of an emotional event.
This view assumes that the human being is an inseparable whole, different from the sum of the elements. From this perspective, there is room for what the subject can do to maintain his or her health.
Health models
Biomedical model
This model is espoused by Engel (1977), and rests on two assumptions: the mind-body doctrine and reductionism. That is, the disease is due to a question of physical and chemical reactions, and only to that, ignoring other variables such as psychological, social aspects, which could influence treatment, recovery, relapses.
This model is replaced by the biopsychosocial model, due to the important shortcomings that it presented.
Biopsychosocial model
As its name suggests, from this model attention is paid to the set of biological, psychological and social factors. In the health-disease process there is an interaction between macroprocesses, such as, for example, social support, mental health disorders?? And microprocesses, such as biochemical alterations.
On the other hand, the model also maintains that the recommendations for the treatment must take into account these three types of variables, and the therapy must be adjusted to the particular needs of each person, considering their health status as a whole and making those treatment recommendations That serve to address the set of problems that the person has.
In addition, from this perspective, the therapeutic relationship that influences the improvement of the patient's adherence to the treatment, in the improvement of its effectiveness and in shortening the recovery time of the disease is of great importance.
Therefore, the biopsychosocial model considers that a person has health when he has covered his biological, psychological and social needs.
Other disciplines
There are other areas of knowledge and disciplines that have also dealt with the aforementioned aspects, however, there are similarities and differences between these and the psychology of health.
We speak of psychosomatic medicine, medical psychology, behavioral medicine and clinical psychology.
Psychosomatic medicine
Psychosomatic medicine was the first attempt to investigate, within the medical field, the relationships between psychosocial variables and psychophysiological alterations. This term was coined by Heinroth in 1918.
The main difference with the psychology of health is that psychosomatic medicine is more oriented to the treatment of the disease, because of its initial connection with psychoanalytic theory and the attention limited to a small group of physiological alterations.
Despite this, it had the value of highlighting the influence of the psychosocial, emotional, psychological, etc. variables.
Medical Psychology
Medical psychology, since its definition, would encompass practically everything, including psychosomatic medicine itself, and therefore does not present a particular theoretical orientation.
It focuses on the study of psychological factors related to health, disease and treatment, at individual, group and system level.
The differences with the health psychology are that the doctor focuses on the priority study of the disease, not putting health in the foreground as an intervention object, and also forgets the professional role of figures other than the doctor in the health care.
Thus, it subordinates the psychological field to the physician, confusing the object of study with professional competence.
Behavioral medicine
This discipline poses some difficulties in terms of its definition, since until the 1980s, behavioral medicine and health psychology were terms that were used interchangeably.
The term behavioral medicine was first used by Birk in 1973 and was used as a synonym and complement to the use of Biofeedback , Recognizing the importance of this technique in the birth of this discipline.
The term behavioral medicine is born as an extension of the behavioral theory tradition. That is why their main concerns were the health and illness behaviors and the contingencies that maintain them and changes that would have to be made in its modification. In clinical practice behavioral medicine employs the techniques of evaluation and treatment of behavior modification.
The differences with the psychology of health would be:
- Behavioral medicine emphasizes the interdisciplinary nature, while the psychology of health presents itself as a branch of medicine.
- Behavioral medicine focuses more on the treatment and rehabilitation of the disease, while health psychology is concerned with the promotion of health.
Clinical psychology
As for clinical psychology and its difference with the psychology of health, there are two opposing positions; On the one hand, those who argue that no other discipline is necessary, since clinical psychology can assume it, and on the other, the more than justified possibility of disconnecting one from the other.
With regard to the first position, the defenders argue that there are not enough elements that differentiate clinical psychology from health psychology; Which clinical psychology may contain at first, since the only element that would not cover clinical psychology would be prevention and, finally, to assume that they are two different entities, one dedicated to emotional disorders and another to the treatment of The physical illness, would be to resume the mind-body duality, which is what it is intended to overcome.
It is true that the second position, would require a comprehensive rethinking of the academic and professional world and the creation of a discipline, the so-called health sciences, around which others would turn.
CONCLUSIONS
In spite of all the conflicts that continue to exist around these concepts and, for example, in Spain at present, it is not possible to separate the professional practice of health psychology from that of clinical psychology. However, if there are specific fields of work in this area and every day more health psychologists are required by health services.
In the United States, it is in the medical centers where the greatest number of these have been requested in the areas of intervention and research in rehabilitation, cardiology, pediatrics, oncology, family medicine, dentistry??
In addition, in one study, it was found that the most demanded areas of work were:
- Stress management .
- Eating Disorders .
- Chronic pain .
References
- Amigo Vázquez, I., Fernández Rodríguez, C. and Pérez Álvarez, M. (2009). Psychological manual of health (3rd edition). Editions pyramid.
- Rodríguez Marín, J. (1998). Psychology of health and clinical psychology. Psychologist Papers , No. 69.
- Piña López, J.A. (2003). Clinical psychology and health psychology: in defense of the psychology of health. Psychological sum Vol. 10, nº1, 67-80.