Division 38, Society for Health Psychology, asked the candidates for APA President the questions below.
1. What do you see as the most significant challenges facing health psychology in the changing healthcare environment?
Thank you for posing this important question. I have worked in health psychology settings throughout my career. My maternal grandfather was a small-town family physician, and my maternal grandmother worked as his nurse. My paternal grandfather was a farmer, and his family was my maternal grandfather’s patients. I believe these family roots led me towards work in the healthcare field.
Health psychology has certainly “grown up,” so to speak, since I was on internship at the Indiana University School of Medicine. We were sort of the disregarded stepchild of psychiatry at that time. It seems to me we have made significant process integrating ourselves into medical settings. I remember Dr. Glenn Smith, my graduate school colleague at the University of Nebraska-Lincoln, talking to me about his vision of having a practice next door to the family doctor and sharing cases. This was the first time I considered a model of integrated care.
I have enjoyed having the opportunity to work as part of the Pediatric service, Psychiatry, OB/Gyn, Family Practice in medical center settings. Working in Pediatric Obesity was a new challenge for me, and I thoroughly enjoyed building the service that integrated behavioral health in that space. There are so many wonderful settings for psychologists to practice within and around health care delivery, such as in the areas of pain psychology, women’s health, cardiac care, oncology, rehabilitation just to name a few. Our discipline allows for general practice of health psychology and specialty training, which mirrors medicine and provides a myriad of opportunities for psychologists to enhance the delivery of medical care.
So much of our challenge has to do with money and payment for services rendered. We need to make the case for value added for the role of psychologists. This moment in our nation’s history, with the COVID pandemic throwing the world into crisis, has shone a spotlight on the importance of behavioral health. The question is, how can we pay for this in a sustainable way? We understand a payment model for services rendered, but it is hard to determine exactly how psychologists can be built in as essential in value-based transformation.
There are so many challenges to making the case for the importance of the work of psychologists. These threats come from other disciplines (e.g., social work, nursing, psychiatry), hospital systems with managers who do not understand (and do not care) what we do, services being provided by artificial intelligence and health coaches. Spotlighting our successes as individuals and in systems to external entities is one way we can make the case for the importance of payment for psychologists in healthcare. We need to convince federal and state government of the essential nature of services provided by psychologists, so that these are required by our hospital systems and medical clinics.
Rural healthcare has been historically neglected, in part because numbers of people are limited in these areas, and it has been financially difficult to provide high quality care for small numbers of people. As our population has become more urbanized, the lack of population in rural areas has led to lack of funding for rural hospitals and healthcare systems. Right now, there are hospitals and emergency medical services facing closure. We need to ensure that regulations and reimbursement issues do not derail the use of telehealth, which improved access to care for the underserved and for rural populations. I have utilized telehealth in various ways, including in pediatric obesity specialty practice, to reach rural patients who would not be able to reach me, due to barriers such as transportation and weather. I believe we need to continue to make the case for adequate funding to provide high quality services provided by psychologists in healthcare settings in rural areas.
2. As the staff, governance and advocacy structure of APA continues to change, how would you ensure that health psychology is prioritized in health care policy, research support, and training/clinical support?
Having served on the APA Board of Directors twice as first Member at Large and now as Recording Secretary, my experience leads me to believe it is important to continue to elect Presidents who are health psychologists and understand the central importance of this role literally for the survival and growth of our field. Having been a long-time member of Division 38 and central to APA governance facilitation of integrated care initiatives at APA, I believe active Division 38 membership in the larger APA system is vital. For example, I personally joined with other APA members to start a conversation about integrated care which resulted in a space for integrated care within Division 38. Although technically outside of the APA governance structure, the Health Care/Health Science Caucus, of which I am a member and served as Secretary, provides another vehicle to move Health Psychology priorities forward within APA.
As I consider your important question, it strikes me that some of the cross-directorate efforts advancing APA’s strategic plan would be essential in moving the needle forward regarding health care policy, research support, and training/clinical support. This would require working closely with our Advocacy Coordinating Committee (ACC) to make sure our advocacy priorities target these health psychology spaces. The ACC and our Chief Advocacy Officer and team will need to continue to work together with Science, Practice, Education, and Public Interest to assure health psychology is prioritized.
3. Please describe your vision for how Divisions will play an active role in APA governance, strategic initiatives, advocacy, and collaborations with outside organizations.
I believe APA needs to explore how to harness the brilliance of the leaders represented on the DIVTRIO listserv to be able to nimbly weigh in on initiatives being considered at APA. Division leadership and CODAPAR should also be able to suggest initiatives for APA staff and the Board of Directors and Council to consider. The Division Leadership Conference, modernized for post-COVID leadership, is a wonderful vehicle for connection and fostering initiatives. Division leadership is represented on our Council and therefore will continue to play an active role in APA governance and strategic initiatives in this regard.
Advocacy is critically important to our success, and the Divisions need to inform our advocacy priorities. In addition to our internal “locking arms,” we need to look externally for partners for health psychology advancement. This would include the professional organizations for other disciplines (e.g., medicine, social work, nursing) as well as health-related professional organizations (such as CFHA, SBM, NACHC, NRHA). Division 38 can play a central role in creating the future for the work of health psychologists, improving the health and wellness of people around our nation and the world.