Health Psychology: history, definition and application

There are a large number of disciplines within psychology. While some of them focus on research, the group setting 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.

What do we understand by "health"?

In the preamble to its Constitution, drawn up in 1948, the World Health Organization defined health as “a state of complete physical, mental and social well-being, and not the mere absence of disease 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 refer also to psychosocial variables influencing biology human, which gives a key role to Health Psychology.

Other definitions place health and disease on a continuum. Thus, at one of its extremes we would find total health, while at the other we would find premature death due to the lack of health.

Likewise, more and more importance is given to the understanding of health as a state and as resource that allows to achieve the 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 object of attention from 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 the 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 by then.

In the late nineteenth and early twentieth centuries, progress in medicine caused a change of course in this field and other related fields. Besides 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 attention of medicine to chronic, lifestyle-related diseases such as cardiovascular disorders and cancer.

The biopsychosocial model proposed by Engel it ended up replacing the biomedical model. In contrast to this, the biopsychosocial model highlights the relevance and interaction of psychological and social factors together with biological ones. This perspective raises the need for personalized and interdisciplinary treatments, since the intervention must address the three types of variables.

• Related article: "René Descartes' valuable contributions to Psychology”

Influences and antecedents

Johnson, Weinman and Chater (2011) point to several fundamental close antecedents in the emergence of Health Psychology as an independent discipline.

These include obtaining epidemiological data relating behavior to health, the emergence of Psychophysiology and Psychoneuroimmunology, and the addition of behavioral science and communication skills (to improve the relationship with patients) to training in medicine.

The development of disciplines such as Psychosomatic Medicine and Behavioral Medicine. Both one and the other focus on the treatment of physical illness through psychological intervention techniques, although Psychosomatics arose from approaches psychodynamic and Behavioral Medicine behaviorism.

Currently the term "Behavioral Medicine" is used to name an interdisciplinary field that includes 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 of Health Psychology. Joseph D. Matarazzo was named its president and Division 38 released its first manual (“Health Psychology. A handbook ”) and an official magazine.

Since then, Health Psychology has specialized in the treatment of physical and psychological illnesses, as the depression. However, the advancement 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 scarce government investment in psychology makes Health Psychology a relatively infrequent specialization.

Defining Health Psychology: what is it?

Although Health Psychology does not have an official definition, Matarazzo (1982) described it as a field that encompasses various contributions from psychology in relation to education, science and the profession, applied to health and disease.

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 et al. (2011) describe four sub-disciplines within Health Psychology: Clinical Health Psychology, Psychology of Public Health, 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 environment, it is easy to confuse these two branches of psychology, since they both fit with the idea of ​​intervention in patients with problems that make them suffer or that limit their autonomy. However, they do not deal with exactly the same.

Clinical Psychology aims to diagnose and offer psychotherapy to people who could have developed a psychological disorder, that is, it puts its target in mental health in the face of cognitive, emotional or behavioral alterations whose severity, at times, exceeds the clinical threshold and damages health mental. In contrast, Health Psychology does not focus its efforts on psychotherapy performed to reverse the symptoms of OCD, the bipolar disorder or other such complications, but rather attempts to encourage the patient's healthy habits in a sense broad, as well as ensuring that you are informed and know how to prevent and mitigate the discomfort caused by a certain physical disease or mental.

Of course, it must be borne in mind that this difference in categories depends on the regulations of each country, and 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 requiring a change in habits, such as cardiovascular disease or respiratory problems due to consumption from tobacco.

Psychology has a greater number of resources to improve adherence to treatment and relationship between the professional and the patient. Both variables have been fundamental in the efficacy of medical treatments.

2. Disease prevention and treatment

Both Medicine and Clinical psychology have historically focused on treating disease (physical and mental, respectively). However, both have neglected disease prevention, an inescapable aspect for achieving full health.

Health Psychology has been applied to a large number of physical illnesses. These include cardiovascular disorders, cancer, asthma, irritable bowel syndrome, diabetes and the chronic pain, such as those derived from fibromyalgia or headaches.

Likewise, Health Psychology is key in the prevention of problems derived from habits unhealthy, such as those caused by smoking or obesity.

3. Identification of etiological and diagnostic correlates

Health Psychology should not be devoted simply to applied tasks of disease prevention and treatment, but also to actively investigate what factors influence in its appearance and its course.

In this sense, Health Psychology would include contributions from epidemiology, from Psychology Basic 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 sanitary measures recommended by Health Psychology professionals should to be implemented through the public health system to reach a greater number of people.

However, as we have said previously, depending on the country in which we find ourselves, this objective is still somewhat utopian.

Prospects for this area

There are two main perspectives in relation to the direction that Health Psychology should take, which is still a very young field today.

One of them states that the discipline should specialize in contributing 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 leads to a regression to the conception dualist of the human being, with the separation of body and mind as independent entities.

The other point of view proposes rather 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.

• Related article: "The 12 branches (or fields) of Psychology”

Bibliographic references:

• Friend Vázquez, I., Fernández Rodríguez, C. & Pérez Álvarez, M. (2003). Psychological manual of health. Madrid: Pyramid.
• Johnson, M., Weinman, J. & Chater, A. (2011). A healthy Contribution. Health Psychology, 24 (12); 890-902.
• Matarazzo, J. D. (1982). Behavioral health's challenge to academic, scientific and professional psychology. American Psychologist, 37; 1–14.
• Thielke, S., Thompson, A. & Stuart, R. (2011). Health psychology in primary care: recent research and future directions. Psychology Research and Behavior Management, 4; 59-68.