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Health Psychology Committee Report
Introduction
In the attempt to enhance patient health, measurable by shorter hospitalizations and improved adherence to medical regimens, the Health Psychology Committee has developed a psychiatry division comprised of five specialists responsible for implementing psychological methods which will enable the treatment of the patient on a more complete level. By implementing these psychological methods the patient can be treated from a “whole person” perspective which is essential to better overall patient health.
Research suggests one of the top human fears of both children and adults is the fear of hospitals (Child Development Institute, 2008). If this were the only reason to implement the use of psychological methods in the treatment of patients this would be reason enough alone. However, taking into consideration the undeniable presence of stress in any instance of illness and the fact that stress not only effects behavior responses but also impairs immune functioning by changes in the body’s physical systems the role of psychology becomes even more evident in providing patient care (Sarafino, 2006).
By incorporating psychology in to health care the patient can experience a reduction in stress which will ultimately enhance their overall health. This will result in shorter hospitalizations and increased patient compliance with treatment plans. Patients will be better equipped with the necessary skills to successfully adapt and cope with a variety of illnesses. Effective coping strategies can only be obtained through use of psychological methods.
Program Overview and Emphasis
Five psychologists will comprise the psychiatry division. These positions will include a substance abuse counselor, inpatient-only psychologist, child psychologist, adult psychologist and a pain management specialist. Each specialist will work closely with the patient and with other specialists in the division to ensure the patient needs are adequately addressed. In addition, the division will meet regularly as a whole to discuss patient management plans and assess patient progress.
Patient interactions and treatment plans will be developed using the positive psychology approach. The human strengths of self-control and hope will be a main focus. Because individuals who have well developed skills and ability to control their internal states are less likely to succumb to negative effects of stress the fostering of self-control is essential to patient health (Bolt, 2004). Patients will partake in treatment plans to strengthen self-control thus inducing increased positivity towards their illness or medical regimens. Trouble areas will be identified, realistic target behavior or thought patterns will be set, benefits of these desired goals will be identified, possible obstacles will be identified with a plan for overcoming such obstacles and patients will participate in monitoring their progress. The patients social support network will be assessed and utilized as well (Bolt, 2004).
“Hope is a good thing, maybe the best of things.” (Bolt, 2004, p.159). Hope is perhaps the most powerful of the human strengths. Hope encourages optimism and optimism has shown to have influential effect on patient health. Individuals with high levels of optimism have been proven to suffer less distress from major surgical procedures than those possessing pessimistic attitudes (Bolt, 2004). Optimism also aids in the patient’s behavior following surgery as optimistic patients tend to achieve milestones at a quicker pace than pessimistic patients by walking sooner or sitting up in bed which would lend merit to the idea that incorporating psychology in to patient treatment regimens would shorten hospitalization periods (Bolt, 2004).Individuals who have hope are generally optimistic people who have a sense of control over their lives and circumstances (Bolt, 2004). The patient who feels involved and has this sense of control will respond to illness and hospitalization more effectively than those who possess little hope. Therefore, the psychiatry division will place added emphasis on strengthening the feelings of self-control and hope with the patient.
Substance Abuse Counselor
The substance abuse counselor will be responsible for the coordination of the use of recovery programs for the substance abuse patient. In addition, the substance abuse counselor will work with a social worker to ensure after care plans are in place upon patient discharge.
Those suffering from addiction must receive intervention which addresses both their physical dependence as well as psychological dependence (Sarafino, 2006). Withdrawal must be approached carefully and on a case specific level to ensure the least amount of physical discomfort and psychological distress. The substance abuse counselor will develop a plan of initial detoxification for the client which is case appropriate implementing various methods of treatment including medical assistance when necessary. Client readiness for change will be assessed prior to beginning treatment. Thos individual’s identified to be in the contemplation or preparation stage will be considered for intensive treatment plans which will consist of a detoxification process followed by intensive individual and group therapy sessions which the counselor finds suitable to the specific case (Sarafino, 2006). These group sessions will enable to patient to identify with other individual’s also in the recovery process which can provide inspiration and hope to the patient.
Individual therapy will aid in the development of coping skills and reduce relapse potential by reducing stress levels and increasing patient confidence. The substance abuse counselor will develop a stress management plan involving relaxation exercises and cognitive restructuring to aid the patient in his or her ability to develop constructive and realistic thought patterns related to his or her recovery (Sarafino, 2006).
Treatment of the addict will shift from a focus on pathology, illness and disease symptoms to the pursuit of health and wellness through a variety of treatment options on a need specific basis appropriate to each individual patient (Recovery and Mental Health, 2008). As hope is critical to recovery from addiction this shall remain the main theme of approach to treatment (Recovery and Mental Health, 2008).
Inpatient-only Psychologist
The duties of the inpatient-only psychologist will include coordination of outpatient care for the recovering addict, working with the chronic, terminal or acute patient to facilitate effective coping skills and adjustment skills and providing patient preparation training prior to medical procedures.
Psychological preparation for surgery will include special attention to developing a sense of patient control over their experience. The psychologist will use age appropriate methods of educating the patient about their procedure to reduce anxiety levels (Sarafino, 2006). These methods may include audio, video recordings or books for children.
Coping skills for the inpatient will be developed through working with the psychologists to identify strategies beneficial to the patient. These strategies may include the implementation of distraction techniques, strengthening relaxation techniques, imagery methods and biofeedback. The psychologists will use an operant approach to treatment when necessary (Sarafino, 2006).
The psychologist will also perform an initial pain assessment of each patient and develop a recommendation for patient pain management which will be forwarded to the pain management specialist for cases involving chronic pain or which may be complicated by aggravating circumstances such as a patient identified as a substance abuser or who is in recovery.
Child Psychologist
The psychiatry division child psychologist will have duties which include collaboration with local schools to encourage the implementation of various health education programs for school aged children. These programs would include nutritional education and exercise programs which would promote healthy behavior. In addition, the psychologist would work with the school to identify areas of special need for education. For example: If the school is located in a poverty stricken area with high crime rates and drug use the obvious need would be for program development that would create alternative outlets for children which promote positive behavior in the attempt to reduce the likelihood for deviant behavior.
The child psychologist will be responsible for working with the child to reduce stress and anxiety levels during patient hospitalization. Particular attention will be paid to avoid separation distress in the event of the parent or guardians absence (Sarafino, 2006). The child psychologist will work with the patient prior to hospitalization with the goal of educating the patient about their upcoming hospitalization and/or procedures in the attempt to reduce feelings of anxiousness. The psychologist will also tour the hospital with the patient to familiarize the patient with the surroundings (Sarafino, 2006).
The psychologist will also be responsible for coordinating group sessions in which children that are able to can interact with other children on a regular basis in a community room designed for children. During these group sessions the psychologist will be available to observe and assess any noticeable behavioral or physical difficulties which may need attention and will then consult with other members of the division to address these needs.
The child psychologist will visit with each child regularly and work closely with the family, physicians, surgeons and other division members to ensure minimal stress for the child during their illness or procedure.
Adult Psychologist
The adult psychologist will be responsible for psychological preparations for adults prior to medical procedures and surgery, diagnosis of stress disorders, implementing any necessary stress-relief interventions and working with the patient to enhance coping skills and promote successful patient adjustment to chronic or terminal illness. The psychologist will also work with any other divisions when necessary in the attempt to provide optimal pain management, stress reduction and emotional well-being of the patient. Should the patient require complex pain management methods for their illness the adult psychologist will make a recommendation to the pain management specialist. The psychologist will work closely with the patient on an individual level as well as providing services to family members who may need help in dealing with a terminally or chronically ill loved one. In cases involving terminal illness the psychologist will discuss hospice care, living will arrangements and other legal issues regarding the care of the patient and final stage preparations.
Pain Management Specialist
Our final division will utilize a psychologist trained in patient pain management. By effectively reducing or eliminating pain in the patient the patient will be more motivated to adhere to medical regimens, will maintain an optimistic attitude and maintain a greater sense of hope regarding their illness or recovery (The Health Psychology Network, 2008).
In cases involving patients who require extensive pain management for illness or procedures which result in pain not easily managed, chronic, or in the event the patient is a known substance abuser or recovering addict where careful attention needs to be paid to the plan of treating the patients pain this psychologist will be utilized to develop the most beneficial method of treatment for the individual. Acute pain will often be treated with pharmaceutical methods the psychologists finds appropriate for the case. In an effort to reduce the likelihood of dependence the psychologist will examine all possible methods of pain treatment for ongoing relief. Narcotic treatment plans will be closely monitored by the specialist and when appropriate the patient will be switched to non-narcotic methods involving the NSAID drugs or over-the-counter pain relievers. In addition, the specialist will recommend other pain relief and management methods including physical therapy, biofeedback, relaxation training, cognitive restructuring and massage therapy while also working on an individual level with the patient to enhance coping skills (The Health Psychology Network, 2008). In cases of chronic illness or terminal illness this specialist will be utilized to ensure the patient is kept as comfortable and pain free as possible with close monitoring of each patient.
Conclusion
While health care has been successful in treating patient’s physical illnesses without the added benefit of psychological intervention we must not lose sight of the fact that the patient is a unique individual. Each unique individual has thoughts and feelings related to their health status. To treat the whole patient we must not ignore the emotional health of these individuals. By incorporating psychology into total health care we are guaranteed better outcomes for those individuals in need of services. Hope, sometimes the only thing we have to bring us through darkness, is essential to patient attitude and behavior (Bolt, 2004). Hope is able to be fostered through psychology. Every patient should be afforded the opportunity to have access to one or more of the divisions of psychiatry which will soon be available within the hospital.
References
Bolt, M.(2004). Pursuing human strengths a positive psychology guide. New York: Worth
Publishers.
Child Development Institute(2008).Helping your child deal with fears & phobias. Retrieved
December3, 2008, from
The Health Psychology Network(2008).Pain management. Retrieved December4, 2008, from
Recovery and mental health(2008).Community Care, Issue 1737, 32-34.
RetrievedDecember4,2008,fromEBSCOhostdatabase.
Sarafino, E.P. (2006). Health psychology biopsychosocial interactions (5th ed.). Hoboken, N.J.:
John Wiley & Sons.