Increasing numbers of psychotherapists have become interested in applying the science of psychology to problems of health and illness. Today, there are many psychologists, medical social workers, and psychiatrists who provide psychotherapy in a variety of primary-care and rehabilitation settings. Health psychology is an extraordinarily broad field. This issue of In Session focuses on the integration of health psychology into outpatient psychotherapy.
Physicians have long been accused of neglecting the psychological needs of medical patients. Many health-care professionals feel ill-prepared to recognize or assist their patients with psychological problems, despite the fact that up to 60% of all physician office visits are related to emotional distress (Pallak, Cummings, Dorken, & Henke, 1995). Mentalhealth professionals have been no less guilty of ignoring the health-risk behaviors and medical problems of their psychotherapy patients. Psychotherapists often do not view physical health problems as within their domain of expertise or practice. Thus, mindbody dualism-treating patients from either the head up or the neck down-has long been practiced by health-care and mental-health providers alike. New integrative forms of psychotherapy often aim to produce simultaneous improvement in physical and emotional health.
The chronic diseases of the heart, cancer, and stroke account for the three leading causes of death in the United States. Premature and preventable deaths largely are attributable to individual behaviors, such as cigarette smoking, poor diet, and sedentary lifestyle. Common clinical conditions such as anxiety, anger, depression, and relationship conflicts present significant obstacles to health-behavior change.
Pioneers in psychosomatics largely employed psychoanalytic psychotherapies. Pioneers in health psychology then primarily utilized cognitive-behavioral therapies to help clients alter health risks (Belar & Deardorff, 1995). However, the development of newer integrative models, such as the transtheoretical model, provide a new appreciation of the multidimensional and multidirectional ways in which emotions and health behaviors interact (Prochaska, DiClemente, & Norcross, 1992).