Clinical Health Psychology

Question 1

What is clinical health psychology?

Answer 1

Rooted in scientific evidence base
Improve clinical outcomes
Provide psychologically informed care pathways

Question 2

What is the context for development of clinical health psychology?

Answer 2

Growing evidence over past 4 years that behaviours/ thoughts contribute to health
Shift to individual responsibility and prevention
Dissatisfaction with limits of biomedical approach

Question 3

What is the bio psychosocial model?

Answer 3

Biological, psychological and social all interact
Physical problems can adversely impact psychosocial wellbeing & social integration

Question 4

How can the biopsychosocial model create a cycle of comorbidity?

Answer 4

Psychosocial problems adversely impact physical health directly in psychneuroimmunological pathways or indirectly through poor adherence to treatment

Question 5

How is clinical health psychology delivered?

Answer 5

Offered in acute settings & primary care
Specialised services according to age/ condition
Rubric psychological principles/ theory utilised to help those with physical health problems

Question 6

What is the focus of delivery?

Answer 6

Significant difficulties with coping with ill health
Illness/ symptoms, treatment, recovery
Quality of life
Family/ carers
Healthcare utilisation

Question 7

What might affect the impact of a diagnosis?

Answer 7

Diagnosis (how, when, meaning)
Point in life
Adjustments
Treatments/ absence of
Side effects
Comorbidity
Palliative
End of life

Question 8

Who might a clinical health psychologist see?

Answer 8

Health anxiety
Unexplained physical symptoms
Diagnosed health problems
Staff
The system (primary/ secondary/ tertiary/ preventative)

Question 9

How can you work with ill adult clients?

Answer 9

Make sense of condition
Accommodate change
Losses and gains
Impact on caregiving, gender, beliefs etc
Maintain dignity & QoL

Question 10

What are the processes while addressing clients?

Answer 10

Respecting family authority
Addressing misunderstandings
Addressing communication issues with family
Identifying resources
Preparing for the future

Question 11

What are models of working?

Answer 11

All therapeutic models can be applied to working in clinical healthcare settings
Irrespective of theoretical orientation, psychoeducation is important
Specific health psychology models should be able to inform assessment, formulation & interventions

Question 12

What are illness perceptions?

Answer 12

Patients own implicit common-sense beliefs about illness
Influenced by information provided by professionals, prior experience, cultural beliefs & information gained form social context

Question 13

What is the self-regulatory model (Leventhal, 1980, 2007)?

Answer 13

Self-regulation is dynamic process in which individuals attempt to preserver sense of self and solve problem of what’s happening to their health
1 - interpretation, 2 - coping & 3 - appraisal

Question 14

What are illness representations?

Answer 14

Identity - label given
Consequence - perceptions of possible effects of illness
Timeline - length of illness
Control/ cure - treatment/ cure beliefs
Causes - perceived causes
Illness coherence - understanding of illness
Emotional representations - negative emotions from illness

Question 15

What is the importance of beliefs (Lewin, 1997)?

Answer 15

Can cause panic and people to do what they believe is right, but will not actually help

Question 16

How can we address illness perceptions?

Answer 16

Self-management
Rehabilitation
Behaviour change techwniues
CBT

Question 17

What is the crisis theory of coping with illness?

Answer 17

Relates to grief & mourning of change after crisis
Cognitive appraisal - adaptive task - coping skills

Question 18

What is the cognitive adaption theory of coping with illness?

Answer 18

Adjust to threatening events
Search for meaning - search for mastery - process of self-enhancement

Question 19

What is post-traumatic growth?

Answer 19

Based in positive psychology
Some negative consequences for QoL, people can consider life to have improved
Positivity improved by rehabilitation

Question 20

What makes adherence to treatment more likely?

Answer 20

Perceptions of treatment
Beleif of seriousness
Belief in treatment
Family & social input

Question 21

What is health?

Answer 21

State of complete physical, mental & social wellbeing - not merely absence of disease (WHO)
Cultural, psychosocial & economic determinants

Question 22

What are dementia interventions?

Answer 22

Adjustments
Managing stress, distress, anxiety & depression
Improving & maintaining cognitive functions
Maintaining QoL

Question 23

What is cardiovascular disease?

Answer 23

High BP & cholesterol, diets & obesity, physical
inactivity & smoking explain vast majority of CVD
Up to 80% deaths are preventable

Question 24

What are interventions for CVD?

Answer 24

Cardiac rehabilitation
Self management support interventions
MBSR
CBT
Belief & behaviours affect coping & illness representations as well as rehabilitation

Question 25

What are some cancer interventions?

Answer 25

HOPE programme (goal setting, fatigue management, stress management etc)
Self-management support programme
Psychosocial interventions
ACT interventions

Question 26

What are mediators of cancer?

Answer 26

Smoking - leading cause of preventable ill health
Physical activity - prevent & manage obesity
Alcohol - consumption negatively impacts almost every organ in body

Question 27

What are obstacles for clinical health psychology?

Answer 27

Legitimacy
Engagement
Physical difficulties
Therapist potentially overwhelmed
Expertise of individual

Question 28

What is the importance of establishing a rationale?

Answer 28

Acknowledge medical route of referral, consider role of psychologist
Establish nature, history & impact of health problems
Normalise referral
Explore links between health & psychological factors which are acceptable to patients