The Practice of Clinical Health Psychology Robin Perkins, Ph.D. Clinical Psychologist Archbold Integrative Medicine Center
Jan 15, 2016
The Practiceof
Clinical HealthPsychology
Robin Perkins, Ph.D.Clinical PsychologistArchbold Integrative
Medicine Center
Health Psychology:
Utilizes the contributions of the science of psychology to
promote and maintain health, prevent illness, and identify causes related to
health, illness, and wellbeing.
Titles:
Behavioral MedicineMedical Psychology
Psychosomatic MedicineHealth Psychology
Requirements:
Ph.D. in PsychologyPrefer Specific graduate training and graduate internship in
Clinical Health Psychology
State License in Psychology
Areas of Work:
Academic InstitutionsMedical Centers / HospitalsResearch InstitutionsPrivate PracticePrimary Care Practices
Top Three Professional Activities:
Clinical Practice 65%Research 55%Teaching / Supervision 50%
Clinical Focus:
Individual PsychotherapyGroup PsychotherapyPsychological Testing
Teaching Family Therapy
Specific Areas of Clinical Focus
CardiologyNeurologyPain ManagementSmoking CessationStress ManagementDiabetesCancerPulmonary Diseases
Cardiac Psychology
Prevalence:*** 4,000 People in the U.S.
suffer from myocardial Infarction (MI) eachday***
*** 1 out of 5 Americans have an MI before theage of 60***
Cardiac Risk Factors
Modifiable Non-ModifiableTotal Cholesterol Age
and LDL MaleDiabetes Family HistorySedentary Personal History
LifestyleSmokingObesityStressPsychosocial
Factors
Major Psychosocial Variables
***Type A Behavior***Anger and Hostility***Chronic Stress***Job Strain***Exhaustion***Social Isolation***Depression
Charlie
*Charlie is referred to you by his cardiologist.
*The referral reads: “Stress Management.”
*Charlie’s wife calls and makes the firstappointment.
*Charlie cancels the firstappointment but
attends the second with his
wife.
Charlie
*Assessment:Diagnostic Interview
PsychosocialMental StatusMedical historyPsych Hx / Sx
Psychological Testing?
Charlie
* 48 years old white male* Family history of heart
disease*Father died of a heart
attack at age 50 years*Older brother Fred is a
“cardiac cripple”.
Charlie
*Married (second time) for25 years.
*Oldest son (22 years) is in college.
*Has one daughter still living
at home (16 years).
Charlie
*Completed 4 years ofcollege
*Degree in Criminal Justice*Works as a prison guard in
a low security federalprison for men.
Charlie
*Smokes 1.5 to 2 packs of cigarettes per day.*Does not exercise and
really struggles to meetphysical demands of job.
*Drinks 1 to 2 beers per night, usually after work.
* Diet: SAD
Charlie
*Has no friends outside of afew co-workers that heoccasionally has a beerwith after work.
*Does not attend church with his wife anddaughter.
*Does not have much contact
with other family.
Charlie
*No significant past medicalhistory.
*No significant past mentalhealth history.
*No family history of mentalhealth issues.
Charlie
*Charlie presents as alert and oriented in all spheres.
*Walks with a cane, poorposture.
*Does not make good eyecontact.
*Speech is normal.
Charlie
*Mood seems depressed.*Affect is flattened.*Range is restricted.*He reports not knowing
why he is here anddenies any problems.
Charlie
*Talk with wife? *Important Issues to
address?*Build rapport?
Charlie
*Wife presents as verysupportive of Charlie.
*She reports that she is worried about him:
*He tends to work too hard.*Is not sleeping at night.*He is normally controlling
with a temper – nowworse.
Charlie
Issues to address?
Issues to address?*Personality factors*General stress*Work stress*Smoking*Alcohol?*Exercise*Diet
Issues to address? *Mood: depression?-
Anxiety?*Sleep*Social Isolation
Charlie
Rapport:*How can I help?*What does Charlie want?*Depression / Anxiety / Fear
/Denial?*Start with medical and
work to psychological
Other thoughts about Charlie?
Questions?
Thank You